New Influenza “Variants” :coming to Alberta

TARRANT Symposium 2014

Kevin Fonseca

Clinical Virologist

ProvLab

Kevin.fonseca@albertahealthservices.ca

Themes

Biology & Transmission Lab Testing Disease Spectrum (Surveillance)

Subtypes of Influenza A

N1 - humanN2 - humanN3 - avianN4 - avianN5 - avianN6 - avianN7 - equineN8 - equineN9 - avian

H1 - swine, human

H2 - human

H3 - human

H4 - avian

H5* - avian, (human)

H6 - avian

H7* - equine,avian,human

H8 - avian

H9 - avian, (human)

H10 – H16 – avian

H5N1 H7N9 H10N8 H6N1

First Appearance

(humans)

1997 March 2013 Dec 2013 May 2013

Nos of Cases 650 354 3 1

Acquisition Infected Poultry

Infected poultry & (humans)

Infected poultry

Infected poultry

Person-to-person Rare Less rare Unknown Unknown

Age Young & old Older Old Old

Disease Generally severe

Generally severe

(asymptomatic)

(Severe) (mild)

Case Fatality 59% 32% 67% <

Geographical Distribution

Asia, Africa China China Taiwan

Pathogenicity classification

High Low Low Low

Key Virulence Elements Attachment of virus to host receptor

Mediated by hemagglutinin (HA) Fusion and uncoating

Mediated by hemagglutinin Replication of viral RNA

Role of polymerase Assembly Release/Transmission

Role of neuraminidase (NA)

Eurosurveillance pic

Laboratory Detection of Influenza

Test for Influenza A & B

Positive for Influenza A

Positive for Influenza B

Negative for both

Determine Lineage

Perform Subtyping

Positive for: A(H1N1)pdm09 ORH3 seasonal

Unresolved/not subtyped:Low viral load OR novel subtype

Could This Be ?

Recent travel, or in contact with travelers

Contact with poultry (abroad) Out of season cases Clinical symptoms not “typical” Discuss with local MOH Don’t be afraid to swab !

Questions ?