Cargando…

Feasibility and Validation of Viral Respiratory Disease Surveillance in a Combat Theater Using the Filmarray Respiratory Panel

BACKGROUND: Viral respiratory infections are a significant threat to deployed military units. Pathogen-based surveillance may be hampered by limitations in trained personnel in theater, difficulty with specimen shipment, and technical issues with equipment maintenance. In this project, we evaluated...

Descripción completa

Detalles Bibliográficos
Autores principales: Maves, Ryan, Larson, Derek, Dempsey, Michael, Connors, Benjamin, Baldwin, James, Thomas, Richard, Starr, Clarise
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5630894/
http://dx.doi.org/10.1093/ofid/ofx163.874
_version_ 1783269318780256256
author Maves, Ryan
Larson, Derek
Dempsey, Michael
Connors, Benjamin
Baldwin, James
Thomas, Richard
Starr, Clarise
author_facet Maves, Ryan
Larson, Derek
Dempsey, Michael
Connors, Benjamin
Baldwin, James
Thomas, Richard
Starr, Clarise
author_sort Maves, Ryan
collection PubMed
description BACKGROUND: Viral respiratory infections are a significant threat to deployed military units. Pathogen-based surveillance may be hampered by limitations in trained personnel in theater, difficulty with specimen shipment, and technical issues with equipment maintenance. In this project, we evaluated the performance of the FilmArray respiratory panel at military clinics in Afghanistan and compare results to testing performed in the United States. METHODS: Participants were recruited after presenting at military clinics at Bagram Airfield (BAF), Afghanistan, in 2013–2014 with fever (≥38° C) and respiratory symptoms (cough, dyspnea, chest pain, and/or sore throat). General medical laboratory staff at BAF were trained to operate the FilmArray; nasopharyngeal swabs were obtained and tested in-theater using the FilmArray respiratory panel (Biofire Diagnostics, Salt Lake City, UT). Samples were then shipped to the USAFSAM Applied Technology Center in 50% RNALater (Qiagen, Valencia, CA) without dry ice and then retested using the same panel. Selected influenza isolates then underwent sequencing to evaluate for potential novel circulating strains. RESULTS: 29 specimens underwent testing. A virus was identified on FilmArray in 22/29 specimens at BAF and 24/29 specimens at USAFSAM, of whom 17/29 had influenza A. Positive results between BAF and USAFSAM were concordant in all cases; 2 of the negative results at BAF were identified as having influenza A and rhinovirus, respectively. Among those with influenza A, all but one had undergone seasonal influenza vaccination. 5 influenza isolates then underwent sequencing; 2 were A(H1N1pdm09) consistent with the predominant 2012–2013 strain, while 3 were A(H3N2) viruses with HA mutations that differed from those in the 2013–2014 vaccine strain. No resistance-associated neuraminidase mutations were identified. CONCLUSION: Surveillance using the FilmArray system is effective and feasible in theater by general laboratory staff. H1N1 and H3N2 influenza A viruses predominated in this sample of acute respiratory infections in a deployed military setting despite high vaccination rates. The use of the RNALater preservative is an effective method for specimen transport without requiring a cold chain and may facilitate biosurveillance in remote settings. DISCLOSURES: All authors: No reported disclosures.
format Online
Article
Text
id pubmed-5630894
institution National Center for Biotechnology Information
language English
publishDate 2017
publisher Oxford University Press
record_format MEDLINE/PubMed
spelling pubmed-56308942017-11-07 Feasibility and Validation of Viral Respiratory Disease Surveillance in a Combat Theater Using the Filmarray Respiratory Panel Maves, Ryan Larson, Derek Dempsey, Michael Connors, Benjamin Baldwin, James Thomas, Richard Starr, Clarise Open Forum Infect Dis Abstracts BACKGROUND: Viral respiratory infections are a significant threat to deployed military units. Pathogen-based surveillance may be hampered by limitations in trained personnel in theater, difficulty with specimen shipment, and technical issues with equipment maintenance. In this project, we evaluated the performance of the FilmArray respiratory panel at military clinics in Afghanistan and compare results to testing performed in the United States. METHODS: Participants were recruited after presenting at military clinics at Bagram Airfield (BAF), Afghanistan, in 2013–2014 with fever (≥38° C) and respiratory symptoms (cough, dyspnea, chest pain, and/or sore throat). General medical laboratory staff at BAF were trained to operate the FilmArray; nasopharyngeal swabs were obtained and tested in-theater using the FilmArray respiratory panel (Biofire Diagnostics, Salt Lake City, UT). Samples were then shipped to the USAFSAM Applied Technology Center in 50% RNALater (Qiagen, Valencia, CA) without dry ice and then retested using the same panel. Selected influenza isolates then underwent sequencing to evaluate for potential novel circulating strains. RESULTS: 29 specimens underwent testing. A virus was identified on FilmArray in 22/29 specimens at BAF and 24/29 specimens at USAFSAM, of whom 17/29 had influenza A. Positive results between BAF and USAFSAM were concordant in all cases; 2 of the negative results at BAF were identified as having influenza A and rhinovirus, respectively. Among those with influenza A, all but one had undergone seasonal influenza vaccination. 5 influenza isolates then underwent sequencing; 2 were A(H1N1pdm09) consistent with the predominant 2012–2013 strain, while 3 were A(H3N2) viruses with HA mutations that differed from those in the 2013–2014 vaccine strain. No resistance-associated neuraminidase mutations were identified. CONCLUSION: Surveillance using the FilmArray system is effective and feasible in theater by general laboratory staff. H1N1 and H3N2 influenza A viruses predominated in this sample of acute respiratory infections in a deployed military setting despite high vaccination rates. The use of the RNALater preservative is an effective method for specimen transport without requiring a cold chain and may facilitate biosurveillance in remote settings. DISCLOSURES: All authors: No reported disclosures. Oxford University Press 2017-10-04 /pmc/articles/PMC5630894/ http://dx.doi.org/10.1093/ofid/ofx163.874 Text en © The Author 2017. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Abstracts
Maves, Ryan
Larson, Derek
Dempsey, Michael
Connors, Benjamin
Baldwin, James
Thomas, Richard
Starr, Clarise
Feasibility and Validation of Viral Respiratory Disease Surveillance in a Combat Theater Using the Filmarray Respiratory Panel
title Feasibility and Validation of Viral Respiratory Disease Surveillance in a Combat Theater Using the Filmarray Respiratory Panel
title_full Feasibility and Validation of Viral Respiratory Disease Surveillance in a Combat Theater Using the Filmarray Respiratory Panel
title_fullStr Feasibility and Validation of Viral Respiratory Disease Surveillance in a Combat Theater Using the Filmarray Respiratory Panel
title_full_unstemmed Feasibility and Validation of Viral Respiratory Disease Surveillance in a Combat Theater Using the Filmarray Respiratory Panel
title_short Feasibility and Validation of Viral Respiratory Disease Surveillance in a Combat Theater Using the Filmarray Respiratory Panel
title_sort feasibility and validation of viral respiratory disease surveillance in a combat theater using the filmarray respiratory panel
topic Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5630894/
http://dx.doi.org/10.1093/ofid/ofx163.874
work_keys_str_mv AT mavesryan feasibilityandvalidationofviralrespiratorydiseasesurveillanceinacombattheaterusingthefilmarrayrespiratorypanel
AT larsonderek feasibilityandvalidationofviralrespiratorydiseasesurveillanceinacombattheaterusingthefilmarrayrespiratorypanel
AT dempseymichael feasibilityandvalidationofviralrespiratorydiseasesurveillanceinacombattheaterusingthefilmarrayrespiratorypanel
AT connorsbenjamin feasibilityandvalidationofviralrespiratorydiseasesurveillanceinacombattheaterusingthefilmarrayrespiratorypanel
AT baldwinjames feasibilityandvalidationofviralrespiratorydiseasesurveillanceinacombattheaterusingthefilmarrayrespiratorypanel
AT thomasrichard feasibilityandvalidationofviralrespiratorydiseasesurveillanceinacombattheaterusingthefilmarrayrespiratorypanel
AT starrclarise feasibilityandvalidationofviralrespiratorydiseasesurveillanceinacombattheaterusingthefilmarrayrespiratorypanel