Division of Epidemiology & Communicable Diseases, Indian Council of Medical Research, New Delhi, India.
Influenza Group, ICMR-National Institute of Virology, Pune, India.
Indian J Med Res. 2020;151(2 & 3):216-225. doi: 10.4103/ijmr.IJMR_594_20.
BACKGROUND & OBJECTIVES: An outbreak of respiratory illness of unknown aetiology was reported from Hubei province of Wuhan, People's Republic of China, in December 2019. The outbreak was attributed to a novel coronavirus (CoV), named as severe acute respiratory syndrome (SARS)-CoV-2 and the disease as COVID-19. Within one month, cases were reported from 25 countries. In view of the novel viral strain with reported high morbidity, establishing early countrywide diagnosis to detect imported cases became critical. Here we describe the role of a countrywide network of VRDLs in early diagnosis of COVID-19.
The Indian Council of Medical Research (ICMR)-National Institute of Virology (NIV), Pune, established screening as well as confirmatory assays for SARS-CoV-2. A total of 13 VRDLs were provided with the E gene screening real-time reverse transcription-polymerase chain reaction (rRT-PCR) assay. VRDLs were selected on the basis of their presence near an international airport/seaport and their past performance. The case definition for testing included all individuals with travel history to Wuhan and symptomatic individuals with travel history to other parts of China. This was later expanded to include symptomatic individuals returning from Singapore, Japan, Hong Kong, Thailand and South Korea.
Within a week of standardization of the test at NIV, all VRDLs could initiate testing for SARS-CoV-2. Till February 29, 2020, a total of 2,913 samples were tested. This included both 654 individuals quarantined in the two camps and others fitting within the case definition. The quarantined individuals were tested twice - at days 0 and 14. All tested negative on both occasions. Only three individuals belonging to different districts in Kerala were found to be positive.
INTERPRETATION & CONCLUSIONS: Sudden emergence of SARS-CoV-2 and its potential to cause a pandemic posed an unsurmountable challenge to the public health system of India. However, concerted efforts of various arms of the Government of India resulted in a well-coordinated action at each level. India has successfully demonstrated its ability to establish quick diagnosis of SARS-CoV-2 at NIV, Pune, and the testing VRDLs.
2019 年 12 月，中国湖北省武汉市报告了一起不明病因的呼吸道疾病疫情。该疫情归因于一种新型冠状病毒（CoV），称为严重急性呼吸综合征（SARS）-CoV-2，该疾病称为 COVID-19。在一个月内，已有 25 个国家报告了病例。鉴于这种新型病毒株发病率高，建立全国范围内的早期诊断以检测输入性病例至关重要。在这里，我们描述了一个全国范围内的病毒学参考实验室网络在 COVID-19 的早期诊断中的作用。
印度医学研究理事会（ICMR）-浦那国家病毒学研究所（NIV）建立了用于 SARS-CoV-2 的筛查和确认检测。为 13 个 VRDL 提供了 E 基因筛查实时逆转录聚合酶链反应（rRT-PCR）检测。根据它们靠近国际机场/海港的位置及其以往的表现选择 VRDL。检测的病例定义包括所有有武汉旅行史的人和有症状的去过中国其他地区的人。后来，该范围扩大到包括从新加坡、日本、香港、泰国和韩国返回的有症状的人。
在 NIV 标准化检测后的一周内，所有 VRDL 都可以开始对 SARS-CoV-2 进行检测。截至 2020 年 2 月 29 日，共检测了 2913 个样本。这包括在两个营地中隔离的 654 个人和符合病例定义的其他人。隔离的个人在第 0 天和第 14 天进行了两次检测。两次检测均为阴性。仅在喀拉拉邦的三个不同地区发现了三个阳性个体。
SARS-CoV-2 的突然出现及其引发大流行的潜力对印度的公共卫生系统构成了无法克服的挑战。然而，印度政府各部门的协调努力在各个层面上都取得了协调一致的行动。印度成功地证明了其在浦那的 NIV 快速诊断 SARS-CoV-2 的能力，以及对 VRDL 的检测能力。
