Working Group 1 Epidemiology:

The main activities of the Epidemiology Working Group involve the development of seven generic yet comprehensive epidemiological, virological and seroepidemiological investigation protocols outlined in the table below.

Consise Protocols Under Development:

Epidemic/Pandemic    
Protocol Primary Objectives Protocol Led by

1. Prospective longitudinal cohort study of influenza infection during epidemic periods

NEW: Version 1 of Protocol available here

Determine age specific cumulative incidence of infection during an influenza epidemic Seven Riley (Imperial College London)
2. Cross sectional seroprevalence study of influenza prior and post epidemic periods

Determine age specific cumulative incidence of infection with a novel influenza virus in the population

Measure prevalence of cross-reactive antibodies to the novel virus

 Anthony Mounts (USCDC)/Maria Van Kerkhove (Institut Pasteur)

3. Household transmission studies for pandemic influenza 

NEW: Version 1 of Protocol available here

Estimate household secondary infection risk, and factors associated with variation in the secondary infection risk

Characterize secondary cases including clinical presentation and asymptomatic fraction

Investigate serological response following confirmed influenza infection

Ben Cowling (UHK)/Richard Pebody (PHE)
4. Closed setting outbreak investigation protocol for pandemic influenza

Describe the clinical spectrum of infection including the asymptomatic fraction

Estimate overall clinical attack rates (by subgroup and clinical risk group)

Describe correlation between infection, disease and serology

Peter White (Imperial College London)/Vernon Lee (Singapore)
5. Assessment of health care personnel Detect the presence of human-to-human transmission of a novel virus within a health care setting  Anthony Mounts (USCDC)/ Maria Van Kerkhove (Institut Pasteur)
 Seasonal Influenzas    
Protocol

Primary Objectives

Protocol Led by
6. Seroepidemiology of human influenza infection using residual sera/convenience samples for establishing baselines and/or monitoring trends over time 

Estimate population immune status/susceptibility to relevant influenza viruses

Estimate incidence in previous-seasons for the different relevant influenza viruses

Angus Nicoll (ECDC)/Olav Hungnes (Norwegian Institute of Public Health, Norway)
Zoonotic Influenzas    
Protocol Primary Objectives Protocol Led by

7. Close Contact Serologic Investigation for Zoonotic influenza

 

NEW:  Version 1 of Protocol available here

 

Measure age-specific infection in relation to zoonotic exposure

Identify (modifiable) risk factors for human infection

Maria Van Kerkhove (Institut Pasteur)/Marianne van der Sande (National Institute for Public Health and the Environment [RIVM], the Netherlands)

 

 

 

Working Group 2 Laboratory:

The Laboratory Group has been working on a number of projects within the three themes identified at the Stockholm meeting: serologic assay standardization; quality assurance and assessment; and cooperation (see table below).

CONSISE Laboratory Work – to September 2013:

Standardization    
Topic Primary Objectives Development Based On*
1. Haemagglutination inhibition assay† Based on current knowledge and current best practice, continue to use HI as the primary serology test. [1]
2. Microneutralization assay Agreement on a standard protocol for microneutralization assay protocols (2-day ELISA endpoint assay (GISRS protocol [10]) and 3-day HA endpoint assay) [2] and individual laboratory protocols
3.Neuraminidase inhibition assay Establish standard neuraminidase inhibition assay in some of the consortium laboratories Protocols of Maryna Eichelberger (CBER/FDA) [3, 4]
4. International serology standards  To discuss the need for development of further influenza international standards for HI assay and to encourage the wider use of the existing standards. [1]
 Quality    
 5. Exploration of possibilities for external quality assessment for laboratories performing serological assays for influenza To explore possibilities for an external quality assessment scheme for serological assays NA    
Cooperation    
6. Laboratory network To form a laboratory network to actively participate in the standardization work NA
7. Cooperation with those undertaking influenza serology work for regulatory purposes and for evaluation of the response to vaccines To collaborate with and inform the international actors involved in the regulatory and development work of influenza vaccines about the recommendations of this laboratory working group NA
* See references below
NA – not applicable
†It was concluded at the Stockholm meeting to keep the widely used haemagglutination inhibition assay as the primary serology test in the laboratories

 

Selected References:

  1. Wood JM, Major D, Heath A, Newman RW, Höschler K, et al. (2012) Reproducibility of serology assays for pandemic influenza H1N1: Collaborative study to evaluate a candidate WHO International Standard. Vaccine 30: 210-217.
  2. WHO (2011) Global Influenza Surveillance Network Manual for the laboratory diagnosis and virological surveillance of influenza. Found at: http://whqlibdoc.who.int/publications/2011/9789241548090_eng.pdf
  3. Sandbulte MR, Gao J, Straight TM, Eichelberger MC (2009) A miniaturized assay for influenza neuraminidase-inhibiting antibodies utilizing reverse genetics-derived antigens. Influenza Other Respi Viruses 3: 233-240.
  4. Lambre CR, Terzidis H, Greffard A, Webster RG (1990) Measurement of anti-influenza neuraminidase antibody using a peroxidase-linked lectin and microtitre plates coated with natural substrates. J Immunol Methods 135: 49-57.