A CC perspective on the three Cs: Collaboration, Communication and Capacity building Anne Kelso Director WHO Collaborating Centre for Reference and Research.

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Presentation transcript:

A CC perspective on the three Cs: Collaboration, Communication and Capacity building Anne Kelso Director WHO Collaborating Centre for Reference and Research on Influenza 5 th WHO National Influenza Centres Meeting, Vientiane, June 2011

The three Cs Collaboration Communication Capacity building (Patrick Reading) virological surveillance and isolation of vaccine viruses research

Collaboration in virological surveillance and isolation of vaccine viruses

Countries that submitted samples to WHO CCs in 2010 US CDC (Atlanta) NIMR (London) VIDRL (Melbourne) NIID (Tokyo) CCDC (Beijing)

Collaboration in virological surveillance and isolation of vaccine viruses (1) What CCs need from NICs: What NICs need from CCs:

Collaboration in virological surveillance and isolation of vaccine viruses (1) What CCs need from NICs: What NICs need from CCs: Urgent submission of any novel or unsubtypable viruses Submission of representative recent circulating viruses to provide a global picture and contribute to vaccine strain selection by WHO Any relevant clinical or epidemiological information Submission of some clinical specimens for isolation of vaccine candidates

Collaboration in virological surveillance and isolation of vaccine viruses (1) What CCs need from NICs: What NICs need from CCs: Urgent submission of any novel or unsubtypable viruses Submission of representative recent circulating viruses to provide a global picture and contribute to vaccine strain selection by WHO Any relevant clinical or epidemiological information Submission of some clinical specimens for isolation of vaccine candidates Urgent identification of novel or unsubtypable viruses Rapid reporting of results for circulating viruses (eg, strains, antiviral drug resistance) Availability of vaccines matched to circulating viruses in your country Anything else?

Collaboration in virological surveillance and isolation of vaccine viruses (2) Novel and unsubtypable viruses: Contact us first: - , telephone, fax, smoke signals… (not facebook or twitter!) We can discuss technical issues, compare primer sequences, etc We can prepare to receive the viruses Send us the viruses as soon as possible Urgent samples go to the front of the queue! We will contact you about the results as soon as we have them.

Timing of virus submission to CCs: strain selection WHO Consultation for Southern Hemisphere WHO Consultation for Northern Hemisphere

Collaboration in virological surveillance and isolation of vaccine viruses (3) Representative recent circulating viruses: Send some viruses as often as you can They are most useful if they are recent Send some early in your season as well as later, so we have results in time for WHO Consultation Inter-season viruses are also useful Send us clinical or epidemiological information if you have it. We are testing a new electronic submission form – easier for NICs?

Collaboration in virological surveillance and isolation of vaccine viruses (4) Representative recent circulating viruses: We will report HI and antiviral resistance results as soon as we have them Reporting time depends on…. shipping time delays in customs if we don’t know samples are coming whether virus needs to be isolated how easily it grows in MDCK cells how many other viruses arrive at same time how urgent Please tell us if you need more information or explanation of results in reports.

* Samples received in the year following sample date Samples submitted to WHO CC at VIDRL, 2007 – samples 47 laboratories 20 countries

Analysis of submitted viruses at WHO CC Clinical specimen Antigenic analysis (HI, MN) HA and NA sequence Antiviral drug sensitivity (phenotypic, genotypic assays) Other testing (eg, human serology) Confirm HI & sequence Raise ferret antiserum Egg isolate Vaccine candidates Isolate MDCK isolate MDCK cells Eggs PCR Sequence

What else do we do with submitted viruses? Supply HI data to Cambridge University for antigenic cartography Raise post-infection ferret antisera against interesting viruses Full genome sequencing; test for reassortment (pyrosequencing) Follow up viruses showing unusual neuraminidase inhibitor resistance Analyse reactivity of serum panels from vaccine trials (Australia, Japan, Europe, US) with recent reference strains Prepare reagent kits for provision to requesting laboratories Study pathogenicity, transmission and immunological responses in ferrets

The importance of egg-isolated viruses Regulators require that influenza vaccine viruses are isolated and passaged exclusively in hen’s eggs (or primary egg-derived cells). WHO Collaborating Centres obtain egg isolates as candidate vaccine strains for provision to vaccine manufacturers (after reasssortment of type A viruses). Viruses are adapted growth in eggs by amniotic passage then growth in the allantoic cavity.

Timing of virus submission to CCs: vaccine candidates WHO Consultation for Southern Hemisphere WHO Consultation for Northern Hemisphere

WHO recommendations for seasonal vaccines YearMonthA(H1N1)A(H3N2)B 2000FebruaryA/New Caledonia/20/99A/Moscow/10/99B/Beijing/184/93 SeptemberA/New Caledonia/20/99A/Moscow/10/99B/Sichuan/379/ FebruaryA/New Caledonia/20/99A/Moscow/10/99B/Sichuan/379/99 SeptemberA/New Caledonia/20/99A/Moscow/10/99B/Sichuan/379/ FebruaryA/New Caledonia/20/99A/Moscow/10/99B/Hong Kong/330/2001 SeptemberA/New Caledonia/20/99A/Moscow/10/99B/Hong Kong/330/ FebruaryA/New Caledonia/20/99A/Moscow/10/99B/Hong Kong/330/2001 SeptemberA/New Caledonia/20/99A/Fujian/411/2002B/Hong Kong/330/ FebruaryA/New Caledonia/20/99A/Fujian/411/2002B/Shanghai/361/2002 SeptemberA/New Caledonia/20/99A/Wellington/1/2004B/Shanghai/361/ FebruaryA/New Caledonia/20/99A/California/7/2004B/Shanghai/361/2002 SeptemberA/New Caledonia/20/99A/California/7/2004B/Malaysia/2506/ FebruaryA/New Caledonia/20/99A/Wisconsin/67/2005B/Malaysia/2506/2004 SeptemberA/New Caledonia/20/99A/Wisconsin/67/2005B/Malaysia/2506/ FebruaryA/Solomon Islands/3/2006A/Wisconsin/67/2005B/Malaysia/2506/2004 SeptemberA/Solomon Islands/3/2006A/Brisbane/10/2007B/Florida/4/ FebruaryA/Brisbane/59/2007A/Brisbane/10/2007B/Florida/4/2006 SeptemberA/Brisbane/59/2007A/Brisbane/10/2007B/Florida/4/ FebruaryA/Brisbane/59/2007A/Brisbane/10/2007B/Brisbane/60/2008 SeptemberA/California/7/2009 (pdm)A/Perth/16/2009B/Brisbane/60/ FebruaryA/California/7/2009A/Perth/16/2009B/Brisbane/60/2008 SH 2010 NH SH 2011 NH SeptemberA/California/7/2009A/Perth/16/2009B/Brisbane/60/ FebruaryA/California/7/2009A/Perth/16/2009B/Brisbane/60/2008

WHO recommended vaccine viruses from WPR YearMonthA(H1N1)A(H3N2)B 2000FebruaryA/New Caledonia/20/99B/Beijing/184/93 SeptemberA/New Caledonia/20/99B/Sichuan/379/ FebruaryA/New Caledonia/20/99B/Sichuan/379/99 SeptemberA/New Caledonia/20/99B/Sichuan/379/ FebruaryA/New Caledonia/20/99B/Hong Kong/330/2001 SeptemberA/New Caledonia/20/99B/Hong Kong/330/ FebruaryA/New Caledonia/20/99B/Hong Kong/330/2001 SeptemberA/New Caledonia/20/99A/Fujian/411/2002B/Hong Kong/330/ FebruaryA/New Caledonia/20/99A/Fujian/411/2002B/Shanghai/361/2002 SeptemberA/New Caledonia/20/99A/Wellington/1/2004B/Shanghai/361/ FebruaryA/New Caledonia/20/99B/Shanghai/361/2002 SeptemberA/New Caledonia/20/99B/Malaysia/2506/ FebruaryA/New Caledonia/20/99B/Malaysia/2506/2004 SeptemberA/New Caledonia/20/99B/Malaysia/2506/ FebruaryA/Solomon Islands/3/2006B/Malaysia/2506/2004 SeptemberA/Solomon Islands/3/2006A/Brisbane/10/ FebruaryA/Brisbane/59/2007A/Brisbane/10/2007 SeptemberA/Brisbane/59/2007A/Brisbane/10/ FebruaryA/Brisbane/59/2007A/Brisbane/10/2007B/Brisbane/60/2008 SeptemberA/Perth/16/2009B/Brisbane/60/ FebruaryA/Perth/16/2009B/Brisbane/60/2008 SH 2010 NH SH 2011 NH SeptemberA/Perth/16/2009B/Brisbane/60/ FebruaryA/Perth/16/2009B/Brisbane/60/2008

Collaboration in research

Collaboration in research: the goal…. Collaboration on projects of mutual interest where each party brings specific expertise and/or resources (viruses, data, techniques etc) For example: with authors from Australia, South Africa, Cambodia, Thailand, Taiwan, New Caledonia, Macao, Singapore, Malaysia, Philippines and New Zealand If we can help with your research, please let us know. Emergence and spread of oseltamivir-resistant A(H1N1) influenza viruses in Oceania, South East Asia and South Africa Aeron C. Hurt, Joanne Ernest, Yi-Mo Deng, Pina Iannello, Terry G. Besselaar, Chris Birch, Philippe Buchy, Malinee Chittaganpitch, Shu-Chun Chiu, Dominic Dwyer, Aurélie Guigon, Bruce Harrower, Ip Peng Kei, Tuckweng Kok, Cui Lin, Ken McPhie, Apandi Mohd, Remigio Olveda, Tony Panayotou, William Rawlinson, Lesley Scott, David Smith, Holly D'Souza, Naomi Komadina, Robert Shaw, Anne Kelso and Ian G. Barr Antiviral Research 83(1): 90 – 93 (2009)

Communication

How can we help each other through communication? Good human relationships underpin all successful endeavours Share virological, technical and other information so we can help each other and do our own work more effectively Strengthen our collaborative networks. Meet Talk Report Browse

The three Cs Collaboration Communication Capacity building (Patrick Reading) virological surveillance and isolation of vaccine viruses research

Acknowledgements WHO National Influenza Centres and other submitting laboratories WHO Collaborating Centres and others in GISRS Staff of the Melbourne WHO Collaborating Centre: The Melbourne WHO Collaborating Centre for Reference and Research on Influenza is supported by the Australian Government Department of Health and Ageing. Chantal Baas, Ian Barr, Iwona Buettner, Natalie Caldwell, Louise Carolan, Michelle Chow, Yi-Mo Deng, Joelle Dharmakumara, Chris Durrant, Aeron Hurt, Pina Iannello, Naomi Komadina, Karen Laurie, Leah Leang, Tasoula Mastorakos, Katie O’Bryan, Heidi Peck, Patrick Reading, Rob Shaw, Helen Sjogren