Laboratory Diagnosis of Avian Influenza and Newcastle Disease

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Laboratory Diagnosis of Avian Influenza and Newcastle Disease Dennis A. Senne dennis.a.senne@aphis.usda.gov (515) 239-7551 U. S. Department of Agriculture, Animal and Plant Health Inspection Service, Veterinary Services, National Veterinary Services Laboratories, Ames, Iowa 50010

Objectives: Laboratory Diagnosis of AI/ND Serologic Diagnosis AI AGID, ELISA, HI, NI ND HI, ELISA Virus isolation Antigen capture pen-side diagnostic tests (AI) Molecular diagnostics (rrt-pcr) (AI/ND) Types of samples needed for above tests Advantages and disadvantages of above tests

Diagnosis of AI/ND Presumptive diagnosis Serologic diagnosis Clinical signs/lesions (HPAI, VVND only) Antigen capture tests (AI) Definitive diagnosis Isolation and characterization of the virus Molecular detection with subtyping/pathotyping

Diagnosis of AI/ND Source of Samples Passive surveillance Investigations of clinical cases Active surveillance (random, organized and targeted) Live bird markets Processing plants slaughter, eggs Export testing Pre slaughter/movement Backyard poultry

Diagnosis of AI/ND Source of Samples Newcastle Disease vaccinated commercial flocks Monitor feed and water consumption, daily mortalities, egg production Collect swabs from daily mortality (dead birds) for virus isolation/detection

Diagnosis of AIV Serologic Tests: Type-Specific Tests (type A, B, C): Agar gel immunodiffusion (AGID) test IgM, (some IgG) Enzyme-linked immunosorbent assay (ELISA) IgG Detects all subtypes (H1-H16) Subtype-Specific Tests (H or N subtype): Hemaggltination-inhibition test Neuraminidase-inhibition test Detects only homologous subtype

Diagnosis of NDV Serologic Tests: Limited value because of routine use of vaccine Hemagglutination-inhibition test (HI) Enzyme-linked immunosorbent assay (ELISA)

AIV (Antibody Detection) Samples Versus Tests: Test Sample AGID ELISA HI/NI Serum Yes Yes Yes Plasma Yes Yes Yes Egg Yolk Yes Yes Yes Serum/ Plasma Egg Yolk

Type-Specific Tests for AIV: AGID Test Advantages: Gold Standard (screening) AS Detects Antibody to all influenza A virus Easy, inexpensive, requires few reagents/equipment Disadvantages: Semi quantitative Moderate sensitivity Subjective interpretation Requires 24 hous Further testing of positives Antibodies not detectable for several days + AS AG - + AS

AGID Test (AI) 1 2 Pour Agar Cut Agar 3 Remove Agar Plugs 4 Fill Wells

CAUTION! The AGID and ELISA tests should be used to determine the immune status of a flock, not an individual bird

Enzyme-Linked Immunosorbent Assay (ELISA)

Type-Specific Tests for AIV: ELISA Advantages Commercial kits available Rapid (same day) Can be semi-automated Disadvantages Requires expensive equipment False positive reactions Positives require confirmation

AIV ELISA Source of Diagnostic Kits: IDEXX Laboratories, Inc., Westbrook, Maine FlockChek Synbiotics International, San Diego, CA ProFLOK

Subtype-Specific Tests for AIV HI/NI (antibodies) Advantages Gold standard Quantitative (titer) Rapid (same day) Disadvantages Requires many reagents (antigens/antiserums) Non-specific (steric) inhibition Requires pre-treatment of serum to remove normal serum agglutinins (false negatives)

HI Test AIV Interpretation of Results: Serum HI titers of 1:8 are suggestive of previous exposure to AIV/NDV, provided the antigen used in the HI test was devoid of homologous neuraminidase For example: a serum with H9N2 antibodies could give a positive HI titer against the H5N2 antigen because of steric inhibition with the N2

AIV Neuraminidase-Inhibition Test 1 N1 N2 N3 N4 N5 N6 N7 N8 N9 Neg 2 3 4 5 6 +C -C

Neuraminidase-Inhibition Test NANA Virus + Antibody Fetuin Homologus Ab + Virus Heterologus Ab + Virus Bound NANA Unbound NANA Periodate Reagent Formation of a chromophore (Pink color) Heat (56C) Thiobarbituric Acid Sodium Arsenite β-formal Pyruvic Acid

Diagnosis of AIV: Virus Detection Methods Virus Isolation Required for virus characterization Rapid Diagnostics Antigen Capture (AI) Make quick decisions in the field Real Time Reverse Transcription- Polymerase Chain Reaction (rrt-pcr)

Virus Isolation Samples any (tissue, swabs) Advantages Gold standard Sensitive all subtypes Disadvantages Expensive and labor intensive False negatives (sample mishandling) Special facilities needed

Flow Chart for AI/ND Testing Specimens Received Prepare Worksheet Process Specimen Inoculate Embryos Candle Eggs Daily Review Case Run HI If HA+ Run HA Test Check for Bacteria Harvest AAF Yes Dead Embryos? Harvest AAF No Day 4 Dead Embryos? No Harvest AAF Yes HA Positive Yes No Repassed Before? Yes No Inoculate Additional Embryos HA+? Yes Notify Field Inoculate Chickens Dead Chickens? No Final Report No Yes Report Negative Sequence if H5 or H7 Necropsy Chickens

Isolation of AIV: Sample Collection Tissues (do not pool tissues from different birds) Lung Spleen Swabs (pool up to 5/tube in BHI) Tracheal or oropharyngeal Cloacal Note: Keep tissue and swabs cold (on ice)

Isolation of AIV: Embryonating Eggs Specific-pathogen-free (SPF) flocks Commercial flocks negative for AIV Inoculate between 9-11 days of incubation Chorioanllantoic sac (CAS) route Yolk-sac (YS) route

Characterization of H5 and H7 Subtypes of AIV Usually performed by reference laboratories Determine H and N subtype Intravenous inoculation of chickens: 8 chickens (4-8-weeks of age) Observe for 10 days Isolates killing 6 of 8 chickens (75%) = HPAI Sequence cleavage site of HA gene Presence of multiple basic amino acids = HPAI

Characterization of NDV Usually performed by reference laboratories Intracerebral Pathogenicity Index (ICPI) in day-old chicks 10 day-old chicks Observe for 8 days Isolates with ICPI 0.7 = virulent Sequence cleavage site of F gene Presence of multiple basic amino acids = virulent NDV

Alternate Methods to Dectect AIV Antigen Capture Directigen Flu A Test (Becton Dikinson) Flu DetectTM (Synbiotics) 15-20 minute tests, 70%-80% sensitivity Most useful for sick and dead birds (acute)

Antigen Capture: Directigen/Flu Detect Samples swabs only Advantages Rapid (15-20 minutes) Highly specific No special facilities required Disadvantages Cost ($8-$25/test) Moderate sensitivity (70-80% compared to VI) False positives (bacterial contamination) Interference by blood (alkaline phosphatase)

Molecular Diagnostics: AIV rrt-pcr Samples: tracheal/oropharyngeal swabs preferred, cloacal swabs, tissue (lung, spleen) Advantages Rapid (2.5 hours) Highly sensitive/specific Differentiates type A, H5, and H7 Disadvantages Expensive equipment Moderate per test cost ($8) Special facilities required False negatives genetic variation

Molecular Diagnostics: NDV RRT-PCR Samples: tracheal/oropharyngeal swabs preferred, cloacal swabs, tissue (lung, spleen) Advantages Rapid (2.5 hours) Highly sensitive/specific Can differentiate between birulent and avirulent strains Disadvantages Expensive equipment Moderate per test cost Special facilities required

Avian Influenza Diagnostic Tests (LPAI): Range of Detection in a Flock (Unvaccinated) AGID (IgM, may start to decrease after 30 days) ELISA (IgG) HI (IgG) Virus Level Antigen Capture rrt-pcr Virus Isolation 0 7 14 21 28 Days Post-Infection

Strategies for Virologic Surveillance Remarks: Virus isolation is the gold standard test Sequence is important to define or predict a change in pathogenicity Real-time PCR for the detection of AI and the differentiation of H5/H7 Pen-side antigen detection tests provide a quick screen of respiratory cases in 15 minutes with 70-80% sensitivity

Strategies for Serologic Surveillance If ELISA tests are used for screening, positive results should be confirmed with AGID, followed by HI for H5 or H7 For vaccinated populations, sentinel birds must be used and diagnostic tests must be able to differentiate between infected and vaccinated animals (DIVA) Source: OIE Terrestrial Animal Health Code, Fifteenth ed. 2006

Summary Serologic tests used for AI surveillance in absence of or following outbreaks AGID, ELISA, HI Positive AI AGID and ELISA serums should be submitted to reference laboratory for subtyping Virus isolation is needed to determine the pathogenicity of new field isolates of AIV/NDV Antigen detection kits are useful pen-side tests to quickly confirm AI infections Molecular diagnostics (rrt-pcr) are rapidly replacing conventional isolation procedures for AI/ND

Surveillance Tools for Influenza: Agent Detection Virus isolation (embryonating chicken eggs or cell culture) Gold standard Molecular detection assays Conventional RT-PCR assays Real-time RT-PCR Nucleic acid sequence based amplification (NASBA) Antigen capture immunoassays On-farm testing quick diagnosis

Antigen Capture Immunoassays - AI Samples best suited for testing sick or dead birds (need 3-5 logs of virus) Advantages Rapid (15-20 minutes) Highly specific No special facilities required Cost varies ($8-25/test) Disadvantages Moderate sensitivity (70-80% compared to VI) False positives (poor sample quality) Low sensitivity in vaccinated populations

Molecular Detection Assays - AI Advantages (PCR, NASBA) Rapid (2-6 hours) Sensitivity similar to VI (85-95%), high specificity Type or subtype specificity (H5 and H7) Can determine pathogenicity of H5 and H7 virus from clinical specimens (sequence the HA gene) Cost varies ($8-50/test) Potential for high throughput (96, 384) Live virus not required

Molecular Detection Assays - AI (cont d) Disadvantages High cost of equipment ($25,000-90,000) False positives (lab contamination) Does not differentiate live from inactivated virus (not good for environmental testing to show freedom from virus) False negatives (PCR inhibitors, extraction inefficiency, genetic diversity of isolates)

Avian Influenza Diagnostic Tests (HPAI): Range of Detection in a Flock (Vaccinated) Antibody levels (AGID, ELISA, HI) will remain high, but of little value unless DIVA testing is used Virus Level Antigen Capture (not likely to detect infection) Virus Isolation, rrt-pcr? 0 7 14 21 28 Days Post-Infection