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In this study, we demonstrate the utility of a metagenomics-based strategy combining a rapid, broad-spectrum diagnostic assay (the Virochip microarray) with comprehensive deep sequencing to identify and characterize a novel outbreak pathogen, using pandemic 2009 H1N1 influenza as a case example.
We plan to share this system domestically as well as with the Asian epidemic network (The Program of Founding Research Centers for Emerging and Reemerging Infectious Diseases; http://www.crnid.riken.jp), in order to enable the earlier identification of unknown pathogens in a novel outbreak or bioterrorism.
Such estimation would be useful in the event of a novel outbreak where little was known about the pathogen.
Given this evidence, isolate L2625 does not represent a novel EC but should be considered a novel outbreak strain.
However, typical spatial scan approaches may fail to detect a novel outbreak if the resulting cases are not classified to any known prodrome.
This could improve the recognition of a novel outbreak without having to wait the extra time it takes to reach a definitive laboratory diagnosis through the use of follow-up tests.
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In 1994, a novel disease outbreak (mycoplasmal conjunctivitis) substantially reduced populations of the house finch (Haemorhous mexicanus) in the eastern United States, creating an opportunity to test whether bird feeding indirectly exacerbated or ameliorated the impacts of the disease.
EHRs not only help to identify a novel disease outbreak, but they do so with high geographic resolution [26].
The current year 2009 has been marked by a late season pandemic-scale emergence of a novel A/H1N1 outbreak strain, raising immediate concerns for public health as well as for pork and poultry production industries worldwide.
Our survey results have several implications for successful response to a novel influenza outbreak.
For example, if a diagnostic laboratory was seeing a disproportionate number of negative test results for a known disease could this information be an indication of a novel disease outbreak?
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