Role of real-time RT-PCR platform technology in the diagnosis and management of notifiable avian influenza outbreaks: experiences in Great Britain.

Diagnosis and management of avian influenza outbreaks now include the use of validated real-time reverse transcription PCR (RRT-PCR) methods in many countries, including all member states of the European Union. Two outbreaks in poultry of notifiable avian influenza (H5 and H7 subtypes) that occurred in Great Britain during 2007 will serve as examples in which RRT-PCR demonstrated its value in 1) rapid diagnosis and confirmation of disease by sensitive and specific laboratory testing of samples derived from the index cases and 2) high-volume, rapid testing of surveillance samples. The two poultry outbreaks followed the incursion of a H7N2 low-pathogenicity notifiable avian influenza (LPNAI) virus (May-June 2007) and a Eurasian lineage H5N1 highly pathogenic notifiable avian influenza (HPNAI) virus (November 2007). Coupled with the use of high-throughput, robotic RNA extraction methods, a total of approximately 9300 and 20,300 field samples were tested by appropriate, validated RRT-PCR assays during the 4- and 5-wk duration of the H7N2 LPNAI and H5N1 HPNAI outbreaks, respectively. Fundamental features of the validated RRT-PCR assays used included their high degree of sensitivity, specificity, and rapidity, attributes that were invaluable in providing timely and accurate information for notifiable AI outbreak management.