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Evaluation of oral swabs for surveillance and high throughput testing for FMDV.
R. J. Davis and P.D. Kirkland, Virology Laboratory,
Elizabeth Macarthur Agricultural Institute (EMAI)
www.dpi.nsw.gov.au
FMDV surveillance options
l  Clinical examinations of cattle and pigs are usually
considered adequate to provide a high level of sensitivity
for the detection of infection in unvaccinated animals.
www.dpi.nsw.gov.au
FMDV surveillance options
l  Sheep can often become infected but only
show mild or no clinical signs
l  Virus loads are lower than cattle or pigs
but can act as a reservoir to disseminate
virus (eg UK)
l  FMDV detection in sheep typically
depends on serology or virus isolation on
tissues or blood.
www.dpi.nsw.gov.au
FMDV transmission studies
l  Over the last decade Dutch
researchers have undertaken a
series of FMDV transmission
studies that have involved
sheep;
l  A wide range of samples had
been collected for virus isolation
and serology;
l  Some samples had been tested
by qRT-PCR using manual
extractions
www.dpi.nsw.gov.au
FMDV surveillance questions
l  Dutch studies had shown FMDV could be isolated from blood and oral swabs;
l  Virus could be isolated from oral swabs for longer than detection in blood;
l  Could oral swabs be used for FMDV surveillance in sheep by using qRT-PCR
in a high throughput format?
l  Is there potential to pool oral swab samples for qRT-PCR testing?
www.dpi.nsw.gov.au
FMDV research strategy
l  CVI Lelystad, The Netherlands retained
archival samples from all published studies;
l  All samples were offered for testing but
facilities at Lelystad not suitable for high
through-put testing;
l  Collaborating laboratory identified – FLI, Insel
Reims, Germany;
l  Consultation re suitable level of pooling - Will
vary depending on stage of infection;
l  Pooling questions – all samples on the same
day? A cross sectional mix? What should be
pooled – original samples? NA extracts?
www.dpi.nsw.gov.au
FMDV project planning logistics & challenges
l  Agreement on test methods (NA extraction,
qRT-PCR and reagents)
l  Use of internal control
l  “Pre-project” testing – comparison of all
reagents
l  Shipment of reagents to Germany
l  Sample transfer - >4000 samples across
FMDV free country;
l  Selection of samples for testing
l  Agreement on pooling options
www.dpi.nsw.gov.au
FMDV test methods
l  Overall aim was to simulate methods in routine use
at EMAI
l  Sample handling – sample into MagMax lysis buffer
l  NA extraction protocol – using MagMax-96 RNA kit
on KF96 platform
l  Assay & reagents – AgPath RT mastermix and OIE
3D assay;
l  Selection of internal control – available to all labs
l  Pooling – practical, rapid and takes stage of
infection into account
www.dpi.nsw.gov.au
The FLI Method Sample Inactivation
l  200 µl AL buffer into a deep well
transfer plate.
l  Heat sealed with adhesive foil.
l  Pre- heated at + 80ºC 20 mins.
l  100 µl of sample.
l  120 µl of PBS/Protease.
l  Heat sealed with foil again.
l  + 80ºC 2 x 10 mins (mixed by
inversion).
l  Transfer plate out of BSL3 Ag (3%
VENNO® VET solution) to BSL2.
www.dpi.nsw.gov.au
Extraction Volumes and Parameters.
			 EMAI			
MagMAX-96	
FLI		
Qiagen	+	MagMAX-96	
Sample	volume	 50	µl	 100	µl	
Lysis	buffer	 130	µl	 200	µl	–	AL	Buffer	
Heat	 No	 80	ᵒ	C	2	x	10	mins	
Protease	 No	 25	µl	+	100	µl	PBS	
Beads	 20	µl	 20	µl		
Lysis/sample/bead	mix	 5	minutes	 4	minutes	
Ethanol	wash	 150	µl	x	2	–	2	mins	 150	µl	x	2	–	75	sec	
Isopropanol	wash	 150	µl	x	2	–	2	mins	 150	µl	x	2	–	75	sec	
EluFon	buffer	 50	µl	 80	µl	
Mixing	speed	 Slow	 Fast	
Air	dry	 1	minute	 5	minutes	
EluFon	 4	minutes	 1	minute	40	seconds
www.dpi.nsw.gov.au
FLI Work Routine
l  Inactivations completed → BSL2 →
extractions → PCR.
l  3 days – 3 people = 1442 samples tested.
l  Results loaded into LIMS, scrutinized daily,
www.dpi.nsw.gov.au
VI & qRT-PCR – plasma (Asia 1)
Because virus could be detected in plasma for a limited period (based on virus
isolation results), qRT-PCR was only attempted on one sample set
0
10
20
30
40
50
60
70
80
90
1 2 3 4 5 6 7 8 9 10 11 12 Total
Number	
positive
Day	post	infection
VI	and	qRT-PCR	on	plasma	- sheep		infected	with	Asia	1
VI	+ve
PCR	+ve
www.dpi.nsw.gov.au
qRT-PCR testing of oral swabs
qRT-PCR detected FMDV RNA in oral swabs from a high
proportion of sheep throughout the 31 day study period
0
2
4
6
8
10
12
14
16
18
20
1 2 3 4 5 6 7 8 9 10111213141516171819202122232425262728293031
Number	
positive
Days	post	infection
VI	&	qRT-PCR	on	oral	swabs	- Sheep	Asia	1
VI +ve
PCR +ve
www.dpi.nsw.gov.au
qRT-PCR testing of oral swabs
After day 10 little change in Ct values detected in the
FMDV qRT-PCR over the 31 day study period
0
5
10
15
20
25
30
35
40
45
1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31
Ct
Day	post	infection
Ct	values	in	oral	swabs
Mean	Ct	+ves
No	+ve
Range	-	high
Range	-	low
www.dpi.nsw.gov.au
qRT-PCR – pooled oral swabs
l  Pooling simulated by diluting individual
positive samples in pooled RNA extract of
oral swabs from Day 0
l  Samples diluted for first day infection
detected
l  Pooling limited to 10 samples for practical
reasons (little advantage from larger pools)
l  All positive samples detected in pool of 10
l  Ct values from pool of 10 samples not
proportional to predicted results for highly
efficient assay (1/10 result frequently <3.3
Ct higher than undiluted sample
l  No opportunity to investigate aberrant
results
Sheep Undiluted 1/3 1/5 1/10
1 24.49 25.77 26.56 27.17
2 30.59 31.78 32.43 33.15
3 35.44 37.23 38.42 38.01
4 28.04 30.38 30.35 31.29
5 34.66 35.66 35.73 36.01
6 26.14 27.67 28.23 29.04
7 30.54 31.97 32.52 33.54
8 26.13 27.20 27.97 28.66
9 40.27 Neg Neg Neg
10 36.48 37.81 37.60 40.01
11 34.42 35.37 35.76 36.62
12 32.49 34.00 34.27 34.47
13 34.03 34.86 35.54 37.00
14 34.84 35.34 36.52 37.46
15 33.57 33.08 34.86 35.99
16 28.91 30.33 30.07 31.23
17 32.14 32.03 34.08 34.92
18 31.03 Neg 32.46 Neg
19 36.62 38.08 38.14 39.03
20 26.24 27.26 28.04 28.70
Day	2	post	infection
www.dpi.nsw.gov.au
qRT-PCR – pooled oral swabs
Sheep Undiluted 1/3 1/5
1 36.00 37.34 37.72
2 Neg NT NT
3 37.32 38.64 38.66
4 36.16 37.71 37.39
5 38.99 39.07 39.8
6 40.01 NT NT
7 37.01 38.02 39.24
8 34.86 36.58 37.27
9 30.84 32.35 32.89
10 35.24 36.87 37.1
11 39.06 39.37 38.6
12 34.79 33.1 36.73
13 30.50 37.26 33.64
14 36.27 NT NT
15 41.01 Neg Neg
16 34.03 36.02 35.95
17 30.62 32.17 32.85
18 36.00 36.79 37.12
19 Neg NT NT
20 36.61 39.38 38.43
Day	28
l  Samples diluted to 1/5 for samples near end
of sampling period;
l  Day 28 chosen to give maximum number of
positive samples (little day to day change)
l  Pooling limited to 5 samples - larger pools
less likely to detect infection??
l  All samples detected in pool of 5 samples
l  Samples giving very high Ct values
remarkably consistent after dilution – is
maximum quantity of RNA being detected??
l  XIPC remarkably stable
l  No opportunity to investigate further
www.dpi.nsw.gov.au
qRT-PCR – Internal control
l  Due to local logistics, the exogenous internal
positive control was not used in the standard
format.
l  The XIPC was still added to samples prior to
extraction
l  Very high degree of reproducibility for the XIPC
with individual samples:
99.2% of samples within range (12/1442 failed)
(no opportunity to investigate)
l  For pooled samples, all samples within range:
Range 34.03-36.35; Mean 35.05, SD 0.43
www.dpi.nsw.gov.au
Impact of buffer combinations
l  Pre-project evaluation of the Official protocol indicated a lack of compatibility
between buffers from different kits (cf RLT buffer).
l  Results suggest suboptimal extraction and presence of inhibitors (eg blood)
l  Possible solutions: standard sample volumes, wash times & elution conditions,
A	(PBS) B	(blood) A	(PBS) B	(blood) A	(PBS) B	(blood) A	(PBS) B	(blood)
PEV	dilution
10^-1 35.44 37.58 no	Cq 38.86 34.07 39.01 34.91 39.03
10^-2 40.94 no	Cq no	Cq no	Cq 36.03 no	Cq 38.03 35.84
10^-3 37.26 no	Cq no	Cq no	Cq 33.45 no	Cq 35.94 no	Cq
10^-4 36.33 39.00 no	Cq no	Cq 33.92 no	Cq 34.76 38.93
10^-5 no	Cq no	Cq no	Cq no	Cq 35.32 no	Cq 34.13 no	Cq
10^-6 36.10 no	Cq no	Cq no	Cq 35.73 no	Cq 37.53 38.95
10^-7 37.73 no	Cq no	Cq no	Cq 39.20 no	Cq 35.00 38.13
10^-8 39.13 no	Cq no	Cq no	Cq 37.47 no	Cq 37.23 38.17
AL	Buffer-FLI	extraction AL	Buffer	into	MMX Modified	+	50uL	elution Modified	+	80uL	elution
www.dpi.nsw.gov.au
FMDV project challenges & next steps
l  Results on pooled samples suggest suboptimal
amplification of RNA
l  Need to evaluate effects of heating and compare
alternative time/temperatures
l  Compare standard EMAI extraction protocol with
modified FLI-EMAI protocol
l  Need to re-evaluate FMDV inactivation with
standard lysis buffers with/without heating at lower
temperatures
www.dpi.nsw.gov.au
The FMD Research Team
- CVI Lelystad, The Netherlands
Aldo Dekker, Phaedre Eble
- Institute of Diagnostic Virology,
Friederich Loeffler Institute, Insel Reims, Germany
Holger Scholten, Anja Schultz, Kerstin Wernike, Martin Beer, Bernd Haas
- Virology Laboratory, EMAI
Rodney Davis & Peter Kirkland.
Funding: NSW DPI, McGarvie Smith Animal Health Trust, MLA Donor Company
www.dpi.nsw.gov.au
Thank you for your attention

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  • 1. Evaluation of oral swabs for surveillance and high throughput testing for FMDV. R. J. Davis and P.D. Kirkland, Virology Laboratory, Elizabeth Macarthur Agricultural Institute (EMAI)
  • 2. www.dpi.nsw.gov.au FMDV surveillance options l  Clinical examinations of cattle and pigs are usually considered adequate to provide a high level of sensitivity for the detection of infection in unvaccinated animals.
  • 3. www.dpi.nsw.gov.au FMDV surveillance options l  Sheep can often become infected but only show mild or no clinical signs l  Virus loads are lower than cattle or pigs but can act as a reservoir to disseminate virus (eg UK) l  FMDV detection in sheep typically depends on serology or virus isolation on tissues or blood.
  • 4. www.dpi.nsw.gov.au FMDV transmission studies l  Over the last decade Dutch researchers have undertaken a series of FMDV transmission studies that have involved sheep; l  A wide range of samples had been collected for virus isolation and serology; l  Some samples had been tested by qRT-PCR using manual extractions
  • 5. www.dpi.nsw.gov.au FMDV surveillance questions l  Dutch studies had shown FMDV could be isolated from blood and oral swabs; l  Virus could be isolated from oral swabs for longer than detection in blood; l  Could oral swabs be used for FMDV surveillance in sheep by using qRT-PCR in a high throughput format? l  Is there potential to pool oral swab samples for qRT-PCR testing?
  • 6. www.dpi.nsw.gov.au FMDV research strategy l  CVI Lelystad, The Netherlands retained archival samples from all published studies; l  All samples were offered for testing but facilities at Lelystad not suitable for high through-put testing; l  Collaborating laboratory identified – FLI, Insel Reims, Germany; l  Consultation re suitable level of pooling - Will vary depending on stage of infection; l  Pooling questions – all samples on the same day? A cross sectional mix? What should be pooled – original samples? NA extracts?
  • 7. www.dpi.nsw.gov.au FMDV project planning logistics & challenges l  Agreement on test methods (NA extraction, qRT-PCR and reagents) l  Use of internal control l  “Pre-project” testing – comparison of all reagents l  Shipment of reagents to Germany l  Sample transfer - >4000 samples across FMDV free country; l  Selection of samples for testing l  Agreement on pooling options
  • 8. www.dpi.nsw.gov.au FMDV test methods l  Overall aim was to simulate methods in routine use at EMAI l  Sample handling – sample into MagMax lysis buffer l  NA extraction protocol – using MagMax-96 RNA kit on KF96 platform l  Assay & reagents – AgPath RT mastermix and OIE 3D assay; l  Selection of internal control – available to all labs l  Pooling – practical, rapid and takes stage of infection into account
  • 9. www.dpi.nsw.gov.au The FLI Method Sample Inactivation l  200 µl AL buffer into a deep well transfer plate. l  Heat sealed with adhesive foil. l  Pre- heated at + 80ºC 20 mins. l  100 µl of sample. l  120 µl of PBS/Protease. l  Heat sealed with foil again. l  + 80ºC 2 x 10 mins (mixed by inversion). l  Transfer plate out of BSL3 Ag (3% VENNO® VET solution) to BSL2.
  • 10. www.dpi.nsw.gov.au Extraction Volumes and Parameters. EMAI MagMAX-96 FLI Qiagen + MagMAX-96 Sample volume 50 µl 100 µl Lysis buffer 130 µl 200 µl – AL Buffer Heat No 80 ᵒ C 2 x 10 mins Protease No 25 µl + 100 µl PBS Beads 20 µl 20 µl Lysis/sample/bead mix 5 minutes 4 minutes Ethanol wash 150 µl x 2 – 2 mins 150 µl x 2 – 75 sec Isopropanol wash 150 µl x 2 – 2 mins 150 µl x 2 – 75 sec EluFon buffer 50 µl 80 µl Mixing speed Slow Fast Air dry 1 minute 5 minutes EluFon 4 minutes 1 minute 40 seconds
  • 11. www.dpi.nsw.gov.au FLI Work Routine l  Inactivations completed → BSL2 → extractions → PCR. l  3 days – 3 people = 1442 samples tested. l  Results loaded into LIMS, scrutinized daily,
  • 12. www.dpi.nsw.gov.au VI & qRT-PCR – plasma (Asia 1) Because virus could be detected in plasma for a limited period (based on virus isolation results), qRT-PCR was only attempted on one sample set 0 10 20 30 40 50 60 70 80 90 1 2 3 4 5 6 7 8 9 10 11 12 Total Number positive Day post infection VI and qRT-PCR on plasma - sheep infected with Asia 1 VI +ve PCR +ve
  • 13. www.dpi.nsw.gov.au qRT-PCR testing of oral swabs qRT-PCR detected FMDV RNA in oral swabs from a high proportion of sheep throughout the 31 day study period 0 2 4 6 8 10 12 14 16 18 20 1 2 3 4 5 6 7 8 9 10111213141516171819202122232425262728293031 Number positive Days post infection VI & qRT-PCR on oral swabs - Sheep Asia 1 VI +ve PCR +ve
  • 14. www.dpi.nsw.gov.au qRT-PCR testing of oral swabs After day 10 little change in Ct values detected in the FMDV qRT-PCR over the 31 day study period 0 5 10 15 20 25 30 35 40 45 1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 Ct Day post infection Ct values in oral swabs Mean Ct +ves No +ve Range - high Range - low
  • 15. www.dpi.nsw.gov.au qRT-PCR – pooled oral swabs l  Pooling simulated by diluting individual positive samples in pooled RNA extract of oral swabs from Day 0 l  Samples diluted for first day infection detected l  Pooling limited to 10 samples for practical reasons (little advantage from larger pools) l  All positive samples detected in pool of 10 l  Ct values from pool of 10 samples not proportional to predicted results for highly efficient assay (1/10 result frequently <3.3 Ct higher than undiluted sample l  No opportunity to investigate aberrant results Sheep Undiluted 1/3 1/5 1/10 1 24.49 25.77 26.56 27.17 2 30.59 31.78 32.43 33.15 3 35.44 37.23 38.42 38.01 4 28.04 30.38 30.35 31.29 5 34.66 35.66 35.73 36.01 6 26.14 27.67 28.23 29.04 7 30.54 31.97 32.52 33.54 8 26.13 27.20 27.97 28.66 9 40.27 Neg Neg Neg 10 36.48 37.81 37.60 40.01 11 34.42 35.37 35.76 36.62 12 32.49 34.00 34.27 34.47 13 34.03 34.86 35.54 37.00 14 34.84 35.34 36.52 37.46 15 33.57 33.08 34.86 35.99 16 28.91 30.33 30.07 31.23 17 32.14 32.03 34.08 34.92 18 31.03 Neg 32.46 Neg 19 36.62 38.08 38.14 39.03 20 26.24 27.26 28.04 28.70 Day 2 post infection
  • 16. www.dpi.nsw.gov.au qRT-PCR – pooled oral swabs Sheep Undiluted 1/3 1/5 1 36.00 37.34 37.72 2 Neg NT NT 3 37.32 38.64 38.66 4 36.16 37.71 37.39 5 38.99 39.07 39.8 6 40.01 NT NT 7 37.01 38.02 39.24 8 34.86 36.58 37.27 9 30.84 32.35 32.89 10 35.24 36.87 37.1 11 39.06 39.37 38.6 12 34.79 33.1 36.73 13 30.50 37.26 33.64 14 36.27 NT NT 15 41.01 Neg Neg 16 34.03 36.02 35.95 17 30.62 32.17 32.85 18 36.00 36.79 37.12 19 Neg NT NT 20 36.61 39.38 38.43 Day 28 l  Samples diluted to 1/5 for samples near end of sampling period; l  Day 28 chosen to give maximum number of positive samples (little day to day change) l  Pooling limited to 5 samples - larger pools less likely to detect infection?? l  All samples detected in pool of 5 samples l  Samples giving very high Ct values remarkably consistent after dilution – is maximum quantity of RNA being detected?? l  XIPC remarkably stable l  No opportunity to investigate further
  • 17. www.dpi.nsw.gov.au qRT-PCR – Internal control l  Due to local logistics, the exogenous internal positive control was not used in the standard format. l  The XIPC was still added to samples prior to extraction l  Very high degree of reproducibility for the XIPC with individual samples: 99.2% of samples within range (12/1442 failed) (no opportunity to investigate) l  For pooled samples, all samples within range: Range 34.03-36.35; Mean 35.05, SD 0.43
  • 18. www.dpi.nsw.gov.au Impact of buffer combinations l  Pre-project evaluation of the Official protocol indicated a lack of compatibility between buffers from different kits (cf RLT buffer). l  Results suggest suboptimal extraction and presence of inhibitors (eg blood) l  Possible solutions: standard sample volumes, wash times & elution conditions, A (PBS) B (blood) A (PBS) B (blood) A (PBS) B (blood) A (PBS) B (blood) PEV dilution 10^-1 35.44 37.58 no Cq 38.86 34.07 39.01 34.91 39.03 10^-2 40.94 no Cq no Cq no Cq 36.03 no Cq 38.03 35.84 10^-3 37.26 no Cq no Cq no Cq 33.45 no Cq 35.94 no Cq 10^-4 36.33 39.00 no Cq no Cq 33.92 no Cq 34.76 38.93 10^-5 no Cq no Cq no Cq no Cq 35.32 no Cq 34.13 no Cq 10^-6 36.10 no Cq no Cq no Cq 35.73 no Cq 37.53 38.95 10^-7 37.73 no Cq no Cq no Cq 39.20 no Cq 35.00 38.13 10^-8 39.13 no Cq no Cq no Cq 37.47 no Cq 37.23 38.17 AL Buffer-FLI extraction AL Buffer into MMX Modified + 50uL elution Modified + 80uL elution
  • 19. www.dpi.nsw.gov.au FMDV project challenges & next steps l  Results on pooled samples suggest suboptimal amplification of RNA l  Need to evaluate effects of heating and compare alternative time/temperatures l  Compare standard EMAI extraction protocol with modified FLI-EMAI protocol l  Need to re-evaluate FMDV inactivation with standard lysis buffers with/without heating at lower temperatures
  • 20. www.dpi.nsw.gov.au The FMD Research Team - CVI Lelystad, The Netherlands Aldo Dekker, Phaedre Eble - Institute of Diagnostic Virology, Friederich Loeffler Institute, Insel Reims, Germany Holger Scholten, Anja Schultz, Kerstin Wernike, Martin Beer, Bernd Haas - Virology Laboratory, EMAI Rodney Davis & Peter Kirkland. Funding: NSW DPI, McGarvie Smith Animal Health Trust, MLA Donor Company