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PCR testing lab:

Thank you for your sample. What would you like us to find in it?

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If 'they' are "PCRing anything on two legs", I wonder if they're including actual chickens in this PCRing festival. After all, chickens have two legs ... and scratch ...

I await the UKHSA answer with bated breath. After all, we prospective H1N5 victims need to prepare - for lockdowns, masks, PCR tests and vaccines, repeating all we've 'learned' to do five years ago.

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Laboratory Investigations for

suspected Avian Influenza A(H7) and

A(H5) Human Infections in England

Testing and results

Respiratory virus screen2 and generic influenza A tests and seasonal (H1/H3) and either

A(H5) or A(H7) or both A(H5) and A(H7) testing performed at UKHSA testing laboratory3

Presumptive positive influenza A(H7) or A(H5) result

(virus detected by screening but confirmatory testing by

RVU is pending)

Reporting presumptive positive results

UKHSA Laboratory Duty microbiologist/virologist

communicates result to local HPT, referring laboratory and

RVU. All presumptive results should be telephoned and

confirmed in writing.

Local HPT informs Colindale Duty Doctor at any time.

UKHSA Laboratory sends residual material URGENTLY to

RVU by Category B Transport, for confirmatory testing.

Avian influenza virus detection confirmed

by RVU (confirmed case)5

Reporting confirmatory results

RVU informs the referring clinical laboratory, the UKHSA

Laboratory microbiologist/virologist, the HPT, the UKHSA

testing laboratory, and the avian flu epidemiology team,

by telephone and in writing.

Influenza A detected but seasonal H1/H3 and avian

H5 and H7 subtypes not detected (influenza A

unsubtypable) in a person with exposure to confirmed

AI and/or geographical risk.

Contact Colindale Duty Doctor

Influenza A Negative, or

Influenza A Positive Subtypes as Seasonal H3N2

(H1N1)pdm09, or

Influenza B Positive4

Reporting negative results

UKHSA Laboratory Duty microbiologist/virologist informs

the local HPT, the referring laboratory, and RVU. All

results should be telephoned and confirmed in writing.

Local HPT informs avian flu team by email (see PDU

sharepoint)

Sample transfer to the public health laboratory

1. Once the decision to test has been agreed, the UKHSA Laboratory Duty microbiologist/virologist will liaise with the referring

hospital/laboratory to arrange the transportation of the sample(s) to the assigned UKHSA avian influenza testing laboratory.

2. The UKHSA Laboratory microbiologist/virologist will inform the National Reference Laboratory, Respiratory Virus Unit

(RVU) UKHSA Colindale, that testing is going to be performed (respiratory@ukhsa.gov.uk or telephone 020 8327 6017).

3. The HPT will complete the case report form (via Programmed Delivery Unit (PDU) sharepoint) and notify the Colindale Duty

Doctor if hospitalised.

4. Samples should be sent by Category B transport. The referring laboratory must provide contact details for telephone and

hard copy reporting.

Deciding whether testing is indicated and obtaining samples

1. For possible A(H7) and A(H5) infections, the local clinician/microbiologist should follow the respective UKHSA investigation and

management algorithms, which reflect advice and definitions issued by the World Health Organization.

2. If the patient is considered to be a possible case, the local clinician/microbiologist should contact the Duty microbiologist/

virologist at the nearest regional UKHSA Laboratory. If the UKHSA Laboratory Duty microbiologist/virologist agrees that testing is

indicated, the local clinician/microbiologist must also notify the local UKHSA Health Protection Team (HPT).

Individuals at risk of infection with one subtype of avian influenza (AI) are potentially at risk of infection with other avian influenza

viruses1; the tests required will be informed primarily by a known or suspected exposure (for example, confirmed AI incident in UK)

and/or geographical risk.

Minimum diagnostic sample set

The following 2 samples should be taken.

1. An upper respiratory tract sample (combined nose and throat viral swabs, or nasopharyngeal aspirate).

2. If obtainable, a lower respiratory tract sample (sputum, or an endotracheal tube aspirate if intubated).

Appropriate personal protective equipment and infection prevention and control measures should be used when obtaining

diagnostic samples (see UKHSA guidance). All samples for influenza testing must be handled at containment level 3 in the

local laboratory. Ensure samples prior to sample transfer to a UKHSA avian influenza testing laboratory are not collected

into a medium containing an inactivating agent.

© Crown copyright 2022

UKHSA Publications gateway number: GOV-11481

Notes

1Specific subtype testing for avian influenza viruses not available routinely and

should be discussed with the local UKHSA Laboratory microbiologist/virologist in

the first instance.

2 Non-influenza respiratory virus screens vary between different UKHSA

Laboratories. If a referring laboratory chooses to perform its own respiratory virus

panel (in addition to requesting avian influenza testing), a local risk assessment

should be performed and appropriate health and safety measures followed.

3 The UKHSA testing laboratory should divide each sample into 2 aliquots, with one

untreated aliquot reserved at containment level 3; lysis buffer should be added to

other aliquot(s). Following lysis, samples may be handled at containment level 2 for

further testing.

4 If appropriate samples were obtained and an alternative diagnosis is possible,

then A(H5) or A(H7) may be considered excluded. If clinical suspicion remains, the

local clinician/microbiologist should discuss repeat sampling and testing with the

local UKHSA Laboratory Duty microbiologist/virologist.

5 In the event of an indeterminate result, RVU will contact the local UKHSA

Laboratory Duty microbiologist/virologist to discuss further actions.

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Gawd…help us all.. ..the lunatics appear to be back in the asylum…….please see below as The UKHSA don’t beat about the bush. It was mentioned we should maybe prepare to get a flying start by identifying some possible super spreaders. Some sensitive birds with academic reputations to protect, mentioned they may be forced to adopt aliases due to possible career pigeon assassinations.

Top (incognito):Flyers include : As scarce as Hen’s Teeth, Beaky Blinders, Pecking Order, Feather your Nest, Sick as a Parrot, Spitting Feathers, The Bird Person of Alcatraz, An albatross around one’s neck, Tweetie pie, Orville, A Bird flew over the cuckoo nest, Bird Brain, Chicken Out, A Bird in the hand is worth 400 corpses buried with reports of positive PCR Tests, Dead Duck, Foul Play, Jail Bird, Wild Goose Chase, Nest Egg and of course The Oozlum Bird. …….

“The enhanced surveillance programme

To improve scientific understanding of the threat of avian influenza to humans, UKHSA runs a zoonotic influenza surveillance programme in humans.

This programme aims to detect possible animal-to-human infections in people who are exposed to infected birds - for example poultry workers and those involved in culling birds in infected commercial and domestic premises - so that we can better understand whether transmissions from birds to humans occur and if so, how often.

Individuals taking part in the programme are sampled through virological nose and throat swabs. Samples are then processed by UKHSA testing laboratories, with any positive samples being sent to the WHO designated National influenza reference laboratory in our Colindale premises for genomic analysis. Over 200 participants have been recruited, although some of these have participated more than once.

If a positive test is returned, individuals will be managed in line with UKHSA guidance. As part of the public health response to any positive detections, our Health Protection Teams follow up all individuals who have been in contact with a confirmed human case of avian influenza.

NHS surveillance

Alongside this zoonotic influenza surveillance programme we are working with the NHS to ensure patients admitted to intensive care with severe acute respiratory infections, or influenza-like-illnesses are tested for respiratory viruses, including influenza.UKHSA public health labs and the influenza reference laboratory undertake additional testing of samples that are positive for influenza A but where normal seasonal influenza is not found, to confirm that the detection is not due to avian influenza.Monitoring of these samples is an important mechanism for the early detection of avian influenza and novel influenza viruses. For example, in November 2023 a novel human case of influenza A(H1N2)v was identified in this way.

As people developing avian influenza infections may become severely ill, intensive care units are a good place to target disease surveillance; this work fits within wider surveillance programmes alongside the existing contact management process, where people who are exposed to birds with avian influenza are monitored by UKHSA Health Protection Teams.”

Vaccination

The standard seasonal flu vaccination is not expected to protect against avian influenza, although it remains important for those eligible to take up the seasonal flu vaccine to protect them from severe illness caused by the flu that circulates every winter in people.As part of long-standing preparedness plans, the government has recently purchased over 5 million human A(H5) influenza vaccines in case these are ever needed in a pandemic scenario.”

THREE CHEERS - HIP, HIP HURRAH, HIP,bHIP HURRAH, HIP, HIP HURRAH! For they are jolly good……..scratch that………

https://ukhsa.blog.gov.uk/2024/12/03/what-is-bird-flu-and-how-are-we-protecting-people-against-it-in-the-uk/

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