The Joint FAO/IAEA Division will hold a consultant’s meeting on “Early Warning Devices and Tools to diagnose known and unknown emerging diseases” from the 13th to the 16th of October 2008, Vienna, Austria
It is a fact that the world demands more and healthier animals and animal products produced in an ‘environmentally safe, clean and ethical’ way. This imposes new challenges for animal scientists whose primary concern is improving livestock productivity. Increasing understanding and
transfer of technologies in animal nutrition, animal reproduction and breeding and animal health, is critically important on a global scale for food security, poverty alleviation and environment protection. It is well accepted that nuclear applications spearhead modern biotechnological research.
For example, the most used disease monitoring technology is the Enzyme Linked Immunosorbent Assay (ELISA) that was developed through serological research using radio active isotopes (Radioimmunoassay, Western Blot), and many still use gamma irradiated pathogens as safe antigens
(e.g. Rift Valley fever IgG and IgM ELISA’s). Similarly, molecular diagnosis and characterization techniques were founded using radio isotopic applications.
In fact, the most sensitive and cost effective pathogen detection and characterization applications
(1-100 protein or nucleic acid molecules) still demand the use of isotopes. In modern biotechnology, nuclear applications will continue to play a major role. The present day non-nuclear molecular biological applications will continue to build on the nuclear scientific research contribution.
We however, need to keep thread with the new developments in technologies and should be prepared to guide, advice and prompt the directions.
The IAEA is a global partner, together with FAO, OIE and AU/IBAR, in the success of the global rinderpest eradication campaign made possible through transfer of technologies, improvement in laboratory infrastructure and staff proficiency, and provision of methodology and operational
guidance.
The laboratory groundwork laid then forms is the basis of an increasingly successful animal health control programmes in countries, demonstrating the sustainability of the Animal Production and Health interventions of the IAEA. The technical support and guidance to countries e.g.,
which test to use, when’ for what purpose; equipment needs; staff training and proficiency and quality management; are demonstrated in its niche contribution to both the recent avian influenza (bird flu) and Rift Valley fever events. At the end of 2003, the Highly Pathogenic Avian Influenza type
A, subtype H5N1, virus (HPAI/H5N1) re-emerged in Asia, provoking an avian influenza epidemic. From Asia, it spread rapidly to Europe, the Middle-East and Africa. The rapid spread of this virus was due to the uncontrolled poultry trade and infected migratory wild birds carrying the
virus long distances. Because HPAI is a major zoonosis with a mortality of more than 60% in man, a possible global pandemic influenza constitutes a grave threat with severe implications for human and animal health; serious socioeconomic impacts and the complicated political repercussions.
The consequences of Avian Influenza Type A epidemics are already known namely, the Spanish Flu pandemic of 1918, where more than 40 million people died and the more recent epidemics of 1957 and 1968 where 2 and 1 million people died, respectively. It is also important to appreciate
that mortality in these pandemics was less than 5 percent compared with a mortality ten times greater with H5N1. Hence, in responding to the demands for help in the areas of detection; and control and surveillance; scientific and technological expertise will be seriously challenged. This is not
the only threat to animals and humans as can be seen from the Rift Valley fever outbreak in Kenya in 2005/6, where more than 150 people died and in Sudan 2007/8, where about 200 people died. As 75% of new human diseases in the last 25 years were of animal origin, i.e., classified
as zoonotic, a “one medicine” approach to address the pressing needs of the world should now be taken further and realized.
The Joint FAO/IAEA Division can be seen as the technical laboratory arm of the FAO. To this effect, the Animal Production and Health Subprogramme supports the Member States of the FAO and the IAEA through the transfer of technologies; training and laboratory infrastructure
and quality assurance management guidance. Fundamental questions are addressed such as which test equipment and consumables should be used and under what circumstances; what can be expected from this test; how are results interpretated and reported? The development, evaluation
and validation of ‘fitness for purpose’ diagnostic tools to support the rapid and early detection of emerging diseases; for example; foot-and-mouth disease, avian influenza, Rift Valley fever is essential and continuous. The developed tools have to be transferred directly to Member States
(both IAEA and FAO) to assist with their national disease control programmes and their Millennium Development Goals. This development should be coordinated by international organizations (IAEA, FAO. WHO and OIE) with participation from the private sector and scientific community.
Which technologies are we talking about?
The detection and characterization of specific nucleic acids and proteins of medico- veterinary pathogens have proven invaluable for diagnostic purposes. Apart from hybridization and sequencing techniques, ELISA and PCR and numerous other methods have contributed significantly to this
process. The integration of amplification and signal detection systems including on-line real-time devices, has increased speed and sensitivity and greatly facilitated the quantification of target proteins and nucleic acids. Rugged portable real-time instruments for field use and robotic devices
for processing samples are already available commercially.
Nucleic acid based-technologies are making considerable contributions to the field of diagnostics. PCR-based assays are being utilised routinely by many laboratories and developments are refining as well as expanding their capabilities. The use of real-time PCR and automated sample
processing devices has already made significant contributions in reducing contamination, whilst improving test consistency, rapidity, sensitivity and throughput. Improving the sensitivity of detection would also obviate the need to perform amplification reactions and any requirement to have
suitable primers to amplify the target sequence. Several alternative target, probe and signal amplification systems have been described (LCR, SDA, RCA, bDNA, invasive cleavase). In addition, technologies to enhance separation and detection of nucleic acids have been developed
(capillary electrophoresis, mass spectrometry). Labelling and detection methods other than radioactivity are also making important contributions (enzymatic, fluorescence, chemiluminescence, and nanoparticle labelling). Nevertheless, conventional microbiological assays should
be maintained to validate and guide further developments with the newer diagnostic approaches. Commercial kits for the molecular detection of the most important pathogens are increasingly becoming available. There is also a need to standardise nucleic acid assays through ring
tests and the establishment of suitable guidelines and quality control programmes. The availability of lyophilised standards will assist in this process.
The need for suitably trained staff to perform and evaluate nucleic acid- and protein-based assays, as well as the costs associated with
many modern technological platforms, is an important consideration and can be a large obstacle for their wider dissemination and application. There is a need now for centralised facilities to perform such tests, but in the medium term, developments in integrated systems are likely to
allow point-of-care testing. Rapid progress in in biosensors development is producing more effective biological recognition molecules, as well as transducers. Many of these have the potential of generating signals following the detection of single molecules. Microarray technologies
have the potential of parallel testing large numbers of pathogens simultaneously, and this can have significant contributions to the diagnostic capabilities of laboratories. Developments on the integration of sample processing; amplification and analysis and the eventual production of
effective commercial testing devices would herald an important achievement in allowing for point-of-care testing. Advances in nanotechnology have potentially important contributions to make in this process, with the likelihood that test results could be obtained within minutes.
Suitable wireless communication systems with centralised data banks and access to decision making tools, will allow for speedy management of therapeutic and prophylactic decision making, a desirable achievement in any effective diagnostics programme.
The IAEA, in collaboration with the FAO, OIE and WHO are aware of the dynamic changes in technologies and equipment and therefore organized this technical consultant's meeting regarding "Early warning devices and tools to diagnose known and unknown emerging diseases".
The topics for discussion will include:
Early Warning Devices and Systems - the technology; Amplification systems ("back-pack" lightcycler, self sustainable devices, on-line real-time PCR devices, hand held devises, "lab on a chip”, “on-the-spot diagnosis"); On-site types (dipsticks, non amplification systems); biosensors, remote
sensing (eg. infra red detection); nano-equipment; communications technologies (GPRS/mobile phone-IR-laptop-satellite-information centre etc, bioinformatics, electronics etc), administrative, logistical set-ups, networks, partnerships etc) and other items.
The big question for discussion is: “Where is the technology now, how can we use it maximally and what does the future promise?”.
