A deadly form of "bird 'flu'", the H7N9 Avian Influenza A virus, was detected in four provinces of eastern China, where it has infected 135 people, and 44 of the infected individuals have died in the course of the past five months. These incidents are of particular importance, since it is the first time that this subtype of the Avian Influenza A virus has been verifiably transmitted from infected poultry to humans. The public health risk remains low at present. No cases of poultry or human infection from this novel H7N9 subtype have yet been reported outside China. The virus is classified as "low pathogenic", which means that the infected birds appear healthy although they carry the H7N9 virus and are thus a potential threat to human health.
"Bird Flu" is caused by a virus present among wild birds. Usually, wild birds, resistant to the disease, carry and secrete the virus, transmitting it to domesticated birds, such as chicken, duck, and turkey, which are susceptible to infection and can become sick and die. In the case of Avian Influenza H7N9, both nuclear and nuclear related technologies play a critical role in detecting and analysing the virus. Gerrit Viljoen, Head of the Animal Production and Health Section of the Joint FAO/IAEA Division of Nuclear Techniques in Food and Agriculture, explained that "he most sensitive and cost effective pathogen detection and characterization applications require radioisotopes. Nuclear and nuclear related applications, together with the irradiation of harmful pathogens, are essential tools in any diagnostic veterinary laboratory."
To help IAEA Member States respond effectively to the emergence of this new avian influenza virus, Adama Diallo, Head of the Joint FAO-IAEA Division's Animal Production and Health Laboratory said, "We develop, evaluate, validate and disseminate guidelines, procedures and SOPs to Member States and follow this with individual and group training. We are conducting two training courses on the serological and molecular detection of H7N9 in order to contribute to the early detection of this virus and early reaction capabilities in Member States."
These training courses are organized as part of the IAEA's regional technical cooperation projects in Europe and in the Asia-Pacific region (see detailed background below). Alessia Rodriguez y Baena, the Programme Management Officer for this project at the IAEA Technical Cooperation Department's Division for Europe, said, "To help Member States fight this emerging public health risk, the avian influenza A H7N9 virus, the IAEA provides technical cooperation support in applying these nuclear and nuclear related techniques that are particularly effective in identifying and characterizing this disease's spread. That is vital public health information to which every Member State should have ready access."
The first course hosted 22 participants from 14 countries of the European region (Albania, Armenia, Azerbaijan, Bosnia and Herzegovina, Bulgaria, Croatia, Georgia, Hungary, Latvia, Montenegro, Serbia, Tajikistan, The former Yugoslav Republic of Macedonia and Turkey) and was held from 19 to 30 August 2013. The second course, scheduled for 9 to 20 September 2013, will host 21 participants from 17 countries from the Asian region.
Speaking on behalf of the group, Kiril Dimitrov from Bulgaria and Slavcho Mrenoshki of the former Yugoslav Republic of Macedonia, both veterinarians, said, "the timely responsiveness of the TC Programme to the needs of Member States, and the theoretical and practical content and standard of the course are greatly appreciated and most valuable for our work."
With the assistance of international Avian Influenza experts from China, Germany, Italy, the United Kingdom, the FAO, and the World Organization for Animal Health (OIE), the course enhances technical, risk assessment and epidemiological knowledge of avian influenza H7N9. The course consists of sampling and submission procedures (including shipment of samples to the FAO/OIE reference laboratories), identification and differentiation of the virus sub-types involved, lectures on epidemiology, risk assessment, as well as control measures to be implemented in order to control the further dissemination and the animal-to-human transmission of the virus. Practical training is part of the course providing hands-on experience in current rapid techniques for disease diagnosis, in particular, the use of nuclear-based or related techniques for the identification and characterization of the pathogens. The course included genome sequencing, molecular epidemiological and computer based analysis of H7N9 viruses. Specifically, the on-site computer teaching facilities were used for the analysis of avian influenza genomes using web-based and freeware analysis software.
The avian influenza A virus is found in the saliva, nasal secretions, and feces of the birds. There are several subtypes of influenza A virus, based on differences in two proteins on the virus membrane: hemagglutinin (HA) and neuraminidase (NA). There are 17 known HA subtypes (H1 to H17) and 9 NA subtypes (N1 to N9) and therefore, there are many possible combinations of HA and NA. Some of the strains are of the "low pathogenic" form causing mild, if any, clinical signs in poultry and others are "highly pathogenic" causing high morbidity and mortality, e.g. the H5N1 that killed millions of birds and forced the culling of several hundreds of millions more birds in the early 2000s, especially in Asian regions.
Nuclear applications spearhead modern biotechnological research and development. For example, the most widely used disease monitoring technology is the Enzyme Linked Immunosorbent Assay (ELISA) which was developed through serological research using radioactive isotopes (Radioimmunoassay, Western Blot) in addition to using gamma irradiated pathogens as safe inactivated antigens. Similarly, molecular diagnostic and characterization techniques were developed using radio isotopic applications.
Under the Technical Cooperation programme, the IAEA assists countries in building technical and human resource capacities to strengthen their capabilities for detecting, monitoring and improving the control of the virus through expert missions, fellowships, scientific visits, and training courses. The IAEA also provides technical support, such as evaluating procedures, providing standard operating procedures, and offering practical laboratory hands-on guidance and support. The avian flu detection training courses are organized as part of the IAEA's regional technical cooperation projects RER/5/016: Supporting Coordinated Control of Transboundary Animal Diseases with Socioeconomic Impact and that Affect Human Health and RAS/5/060: Supporting Early Warning, Response and Control of Transboundary Animal Diseases.