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Evaluation of ELISA and haemagglutination inhibition as screening tests in serosurveillance for H5/H7 avian influenza in commercial chicken flocks.

Identifieur interne : 000037 ( Main/Exploration ); précédent : 000036; suivant : 000038

Evaluation of ELISA and haemagglutination inhibition as screening tests in serosurveillance for H5/H7 avian influenza in commercial chicken flocks.

Auteurs : M E Arnold [Royaume-Uni] ; M J Slomka [Royaume-Uni] ; A C Breed [Royaume-Uni] ; C K Hjulsager [Danemark] ; S. Pritz-Verschuren [Pays-Bas] ; S. Venema-Kemper [Pays-Bas] ; R J Bouwstra [Pays-Bas] ; R. Trebbien [Danemark] ; S. Zohari [Suède] ; V. Ceeraz [Royaume-Uni] ; L E Larsen [Danemark] ; R J Manvell [Royaume-Uni] ; G. Koch [Pays-Bas] ; I H Brown [Royaume-Uni]

Source :

RBID : pubmed:29325601

Descripteurs français

English descriptors

Abstract

Avian influenza virus (AIV) subtypes H5 and H7 can infect poultry causing low pathogenicity (LP) AI, but these LPAIVs may mutate to highly pathogenic AIV in chickens or turkeys causing high mortality, hence H5/H7 subtypes demand statutory intervention. Serological surveillance in the European Union provides evidence of H5/H7 AIV exposure in apparently healthy poultry. To identify the most sensitive screening method as the first step in an algorithm to provide evidence of H5/H7 AIV infection, the standard approach of H5/H7 antibody testing by haemagglutination inhibition (HI) was compared with an ELISA, which detects antibodies to all subtypes. Sera (n = 1055) from 74 commercial chicken flocks were tested by both methods. A Bayesian approach served to estimate diagnostic test sensitivities and specificities, without assuming any 'gold standard'. Sensitivity and specificity of the ELISA was 97% and 99.8%, and for H5/H7 HI 43% and 99.8%, respectively, although H5/H7 HI sensitivity varied considerably between infected flocks. ELISA therefore provides superior sensitivity for the screening of chicken flocks as part of an algorithm, which subsequently utilises H5/H7 HI to identify infection by these two subtypes. With the calculated sensitivity and specificity, testing nine sera per flock is sufficient to detect a flock seroprevalence of 30% with 95% probability.

DOI: 10.1017/S0950268817002898
PubMed: 29325601


Affiliations:


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Le document en format XML

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<name sortKey="Venema Kemper, S" sort="Venema Kemper, S" uniqKey="Venema Kemper S" first="S" last="Venema-Kemper">S. Venema-Kemper</name>
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<nlm:affiliation>Wageningen Bioveterinary Research,Houtribweg 39, 8221 RA Lelystad,The Netherlands.</nlm:affiliation>
<country xml:lang="fr">Pays-Bas</country>
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<name sortKey="Bouwstra, R J" sort="Bouwstra, R J" uniqKey="Bouwstra R" first="R J" last="Bouwstra">R J Bouwstra</name>
<affiliation wicri:level="1">
<nlm:affiliation>Wageningen Bioveterinary Research,Houtribweg 39, 8221 RA Lelystad,The Netherlands.</nlm:affiliation>
<country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea>Wageningen Bioveterinary Research,Houtribweg 39, 8221 RA Lelystad</wicri:regionArea>
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<name sortKey="Trebbien, R" sort="Trebbien, R" uniqKey="Trebbien R" first="R" last="Trebbien">R. Trebbien</name>
<affiliation wicri:level="1">
<nlm:affiliation>National Veterinary Institute,Technical University of Denmark (DTU),Kemitorvet, Building 204, 2800 Lyngby,Denmark.</nlm:affiliation>
<country xml:lang="fr">Danemark</country>
<wicri:regionArea>National Veterinary Institute,Technical University of Denmark (DTU),Kemitorvet, Building 204, 2800 Lyngby</wicri:regionArea>
<wicri:noRegion>2800 Lyngby</wicri:noRegion>
</affiliation>
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<name sortKey="Zohari, S" sort="Zohari, S" uniqKey="Zohari S" first="S" last="Zohari">S. Zohari</name>
<affiliation wicri:level="1">
<nlm:affiliation>National Veterinary Institute (SVA),Ulls väg 2B, Uppsala,Sweden.</nlm:affiliation>
<country xml:lang="fr">Suède</country>
<wicri:regionArea>National Veterinary Institute (SVA),Ulls väg 2B, Uppsala</wicri:regionArea>
<wicri:noRegion>Uppsala</wicri:noRegion>
</affiliation>
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<author>
<name sortKey="Ceeraz, V" sort="Ceeraz, V" uniqKey="Ceeraz V" first="V" last="Ceeraz">V. Ceeraz</name>
<affiliation wicri:level="1">
<nlm:affiliation>European Union Reference Laboratory for Avian Influenza and Newcastle Disease,APHA-Weybridge,Woodham Lane,Addlestone KT15 3NB,UK.</nlm:affiliation>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>European Union Reference Laboratory for Avian Influenza and Newcastle Disease,APHA-Weybridge,Woodham Lane,Addlestone KT15 3NB</wicri:regionArea>
<wicri:noRegion>Addlestone KT15 3NB</wicri:noRegion>
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<name sortKey="Larsen, L E" sort="Larsen, L E" uniqKey="Larsen L" first="L E" last="Larsen">L E Larsen</name>
<affiliation wicri:level="1">
<nlm:affiliation>National Veterinary Institute,Technical University of Denmark (DTU),Kemitorvet, Building 204, 2800 Lyngby,Denmark.</nlm:affiliation>
<country xml:lang="fr">Danemark</country>
<wicri:regionArea>National Veterinary Institute,Technical University of Denmark (DTU),Kemitorvet, Building 204, 2800 Lyngby</wicri:regionArea>
<wicri:noRegion>2800 Lyngby</wicri:noRegion>
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<name sortKey="Manvell, R J" sort="Manvell, R J" uniqKey="Manvell R" first="R J" last="Manvell">R J Manvell</name>
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<nlm:affiliation>European Union Reference Laboratory for Avian Influenza and Newcastle Disease,APHA-Weybridge,Woodham Lane,Addlestone KT15 3NB,UK.</nlm:affiliation>
<country xml:lang="fr">Royaume-Uni</country>
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<name sortKey="Koch, G" sort="Koch, G" uniqKey="Koch G" first="G" last="Koch">G. Koch</name>
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<nlm:affiliation>Wageningen Bioveterinary Research,Houtribweg 39, 8221 RA Lelystad,The Netherlands.</nlm:affiliation>
<country xml:lang="fr">Pays-Bas</country>
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<name sortKey="Brown, I H" sort="Brown, I H" uniqKey="Brown I" first="I H" last="Brown">I H Brown</name>
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<nlm:affiliation>European Union Reference Laboratory for Avian Influenza and Newcastle Disease,APHA-Weybridge,Woodham Lane,Addlestone KT15 3NB,UK.</nlm:affiliation>
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<title level="j">Epidemiology and infection</title>
<idno type="eISSN">1469-4409</idno>
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<date when="2018" type="published">2018</date>
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<keywords scheme="KwdEn" xml:lang="en">
<term>Animals (MeSH)</term>
<term>Antibodies, Viral (blood)</term>
<term>Chickens (MeSH)</term>
<term>Denmark (epidemiology)</term>
<term>Enzyme-Linked Immunosorbent Assay (methods)</term>
<term>Enzyme-Linked Immunosorbent Assay (veterinary)</term>
<term>Europe (epidemiology)</term>
<term>Hemagglutination Inhibition Tests (methods)</term>
<term>Hemagglutination Inhibition Tests (veterinary)</term>
<term>Influenza in Birds (epidemiology)</term>
<term>Influenza in Birds (virology)</term>
<term>Netherlands (epidemiology)</term>
<term>Poultry Diseases (epidemiology)</term>
<term>Poultry Diseases (virology)</term>
<term>Prevalence (MeSH)</term>
<term>Sensitivity and Specificity (MeSH)</term>
<term>Seroepidemiologic Studies (MeSH)</term>
<term>Serogroup (MeSH)</term>
<term>Sweden (epidemiology)</term>
<term>United Kingdom (epidemiology)</term>
</keywords>
<keywords scheme="KwdFr" xml:lang="fr">
<term>Animaux (MeSH)</term>
<term>Anticorps antiviraux (sang)</term>
<term>Danemark (épidémiologie)</term>
<term>Europe (épidémiologie)</term>
<term>Grippe chez les oiseaux (virologie)</term>
<term>Grippe chez les oiseaux (épidémiologie)</term>
<term>Maladies de la volaille (virologie)</term>
<term>Maladies de la volaille (épidémiologie)</term>
<term>Pays-Bas (épidémiologie)</term>
<term>Poulets (MeSH)</term>
<term>Prévalence (MeSH)</term>
<term>Royaume-Uni (épidémiologie)</term>
<term>Sensibilité et spécificité (MeSH)</term>
<term>Suède (épidémiologie)</term>
<term>Sérogroupe (MeSH)</term>
<term>Test ELISA (médecine vétérinaire)</term>
<term>Test ELISA (méthodes)</term>
<term>Tests d'inhibition de l'hémagglutination (médecine vétérinaire)</term>
<term>Tests d'inhibition de l'hémagglutination (méthodes)</term>
<term>Études séroépidémiologiques (MeSH)</term>
</keywords>
<keywords scheme="MESH" type="chemical" qualifier="blood" xml:lang="en">
<term>Antibodies, Viral</term>
</keywords>
<keywords scheme="MESH" qualifier="epidemiology" xml:lang="en">
<term>Denmark</term>
<term>Europe</term>
<term>Influenza in Birds</term>
<term>Netherlands</term>
<term>Poultry Diseases</term>
<term>Sweden</term>
<term>United Kingdom</term>
</keywords>
<keywords scheme="MESH" qualifier="methods" xml:lang="en">
<term>Enzyme-Linked Immunosorbent Assay</term>
<term>Hemagglutination Inhibition Tests</term>
</keywords>
<keywords scheme="MESH" qualifier="médecine vétérinaire" xml:lang="fr">
<term>Test ELISA</term>
<term>Tests d'inhibition de l'hémagglutination</term>
</keywords>
<keywords scheme="MESH" qualifier="méthodes" xml:lang="fr">
<term>Test ELISA</term>
<term>Tests d'inhibition de l'hémagglutination</term>
</keywords>
<keywords scheme="MESH" qualifier="sang" xml:lang="fr">
<term>Anticorps antiviraux</term>
</keywords>
<keywords scheme="MESH" qualifier="veterinary" xml:lang="en">
<term>Enzyme-Linked Immunosorbent Assay</term>
<term>Hemagglutination Inhibition Tests</term>
</keywords>
<keywords scheme="MESH" qualifier="virologie" xml:lang="fr">
<term>Grippe chez les oiseaux</term>
<term>Maladies de la volaille</term>
</keywords>
<keywords scheme="MESH" qualifier="virology" xml:lang="en">
<term>Influenza in Birds</term>
<term>Poultry Diseases</term>
</keywords>
<keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr">
<term>Danemark</term>
<term>Europe</term>
<term>Grippe chez les oiseaux</term>
<term>Maladies de la volaille</term>
<term>Pays-Bas</term>
<term>Royaume-Uni</term>
<term>Suède</term>
</keywords>
<keywords scheme="MESH" xml:lang="en">
<term>Animals</term>
<term>Chickens</term>
<term>Prevalence</term>
<term>Sensitivity and Specificity</term>
<term>Seroepidemiologic Studies</term>
<term>Serogroup</term>
</keywords>
<keywords scheme="MESH" xml:lang="fr">
<term>Animaux</term>
<term>Poulets</term>
<term>Prévalence</term>
<term>Sensibilité et spécificité</term>
<term>Sérogroupe</term>
<term>Études séroépidémiologiques</term>
</keywords>
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<front>
<div type="abstract" xml:lang="en">Avian influenza virus (AIV) subtypes H5 and H7 can infect poultry causing low pathogenicity (LP) AI, but these LPAIVs may mutate to highly pathogenic AIV in chickens or turkeys causing high mortality, hence H5/H7 subtypes demand statutory intervention. Serological surveillance in the European Union provides evidence of H5/H7 AIV exposure in apparently healthy poultry. To identify the most sensitive screening method as the first step in an algorithm to provide evidence of H5/H7 AIV infection, the standard approach of H5/H7 antibody testing by haemagglutination inhibition (HI) was compared with an ELISA, which detects antibodies to all subtypes. Sera (n = 1055) from 74 commercial chicken flocks were tested by both methods. A Bayesian approach served to estimate diagnostic test sensitivities and specificities, without assuming any 'gold standard'. Sensitivity and specificity of the ELISA was 97% and 99.8%, and for H5/H7 HI 43% and 99.8%, respectively, although H5/H7 HI sensitivity varied considerably between infected flocks. ELISA therefore provides superior sensitivity for the screening of chicken flocks as part of an algorithm, which subsequently utilises H5/H7 HI to identify infection by these two subtypes. With the calculated sensitivity and specificity, testing nine sera per flock is sufficient to detect a flock seroprevalence of 30% with 95% probability.</div>
</front>
</TEI>
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<DateCompleted>
<Year>2018</Year>
<Month>11</Month>
<Day>01</Day>
</DateCompleted>
<DateRevised>
<Year>2018</Year>
<Month>11</Month>
<Day>01</Day>
</DateRevised>
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<Journal>
<ISSN IssnType="Electronic">1469-4409</ISSN>
<JournalIssue CitedMedium="Internet">
<Volume>146</Volume>
<Issue>3</Issue>
<PubDate>
<Year>2018</Year>
<Month>02</Month>
</PubDate>
</JournalIssue>
<Title>Epidemiology and infection</Title>
<ISOAbbreviation>Epidemiol. Infect.</ISOAbbreviation>
</Journal>
<ArticleTitle>Evaluation of ELISA and haemagglutination inhibition as screening tests in serosurveillance for H5/H7 avian influenza in commercial chicken flocks.</ArticleTitle>
<Pagination>
<MedlinePgn>306-313</MedlinePgn>
</Pagination>
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<Abstract>
<AbstractText>Avian influenza virus (AIV) subtypes H5 and H7 can infect poultry causing low pathogenicity (LP) AI, but these LPAIVs may mutate to highly pathogenic AIV in chickens or turkeys causing high mortality, hence H5/H7 subtypes demand statutory intervention. Serological surveillance in the European Union provides evidence of H5/H7 AIV exposure in apparently healthy poultry. To identify the most sensitive screening method as the first step in an algorithm to provide evidence of H5/H7 AIV infection, the standard approach of H5/H7 antibody testing by haemagglutination inhibition (HI) was compared with an ELISA, which detects antibodies to all subtypes. Sera (n = 1055) from 74 commercial chicken flocks were tested by both methods. A Bayesian approach served to estimate diagnostic test sensitivities and specificities, without assuming any 'gold standard'. Sensitivity and specificity of the ELISA was 97% and 99.8%, and for H5/H7 HI 43% and 99.8%, respectively, although H5/H7 HI sensitivity varied considerably between infected flocks. ELISA therefore provides superior sensitivity for the screening of chicken flocks as part of an algorithm, which subsequently utilises H5/H7 HI to identify infection by these two subtypes. With the calculated sensitivity and specificity, testing nine sera per flock is sufficient to detect a flock seroprevalence of 30% with 95% probability.</AbstractText>
</Abstract>
<AuthorList CompleteYN="Y">
<Author ValidYN="Y">
<LastName>Arnold</LastName>
<ForeName>M E</ForeName>
<Initials>ME</Initials>
<AffiliationInfo>
<Affiliation>Department of Epidemiological Sciences (Biomathematics and Risk Research),Animal and Plant Health Agency (APHA),The Elms,College Road,Sutton Bonington,Loughborough LE12 5RB,UK.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Slomka</LastName>
<ForeName>M J</ForeName>
<Initials>MJ</Initials>
<Identifier Source="ORCID">0000-0002-4944-5073</Identifier>
<AffiliationInfo>
<Affiliation>European Union Reference Laboratory for Avian Influenza and Newcastle Disease,APHA-Weybridge,Woodham Lane,Addlestone KT15 3NB,UK.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Breed</LastName>
<ForeName>A C</ForeName>
<Initials>AC</Initials>
<Identifier Source="ORCID">0000-0002-3439-9510</Identifier>
<AffiliationInfo>
<Affiliation>European Union Reference Laboratory for Avian Influenza and Newcastle Disease,APHA-Weybridge,Woodham Lane,Addlestone KT15 3NB,UK.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Hjulsager</LastName>
<ForeName>C K</ForeName>
<Initials>CK</Initials>
<AffiliationInfo>
<Affiliation>National Veterinary Institute,Technical University of Denmark (DTU),Kemitorvet, Building 204, 2800 Lyngby,Denmark.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Pritz-Verschuren</LastName>
<ForeName>S</ForeName>
<Initials>S</Initials>
<AffiliationInfo>
<Affiliation>Wageningen Bioveterinary Research,Houtribweg 39, 8221 RA Lelystad,The Netherlands.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Venema-Kemper</LastName>
<ForeName>S</ForeName>
<Initials>S</Initials>
<AffiliationInfo>
<Affiliation>Wageningen Bioveterinary Research,Houtribweg 39, 8221 RA Lelystad,The Netherlands.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Bouwstra</LastName>
<ForeName>R J</ForeName>
<Initials>RJ</Initials>
<AffiliationInfo>
<Affiliation>Wageningen Bioveterinary Research,Houtribweg 39, 8221 RA Lelystad,The Netherlands.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Trebbien</LastName>
<ForeName>R</ForeName>
<Initials>R</Initials>
<AffiliationInfo>
<Affiliation>National Veterinary Institute,Technical University of Denmark (DTU),Kemitorvet, Building 204, 2800 Lyngby,Denmark.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Zohari</LastName>
<ForeName>S</ForeName>
<Initials>S</Initials>
<AffiliationInfo>
<Affiliation>National Veterinary Institute (SVA),Ulls väg 2B, Uppsala,Sweden.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Ceeraz</LastName>
<ForeName>V</ForeName>
<Initials>V</Initials>
<AffiliationInfo>
<Affiliation>European Union Reference Laboratory for Avian Influenza and Newcastle Disease,APHA-Weybridge,Woodham Lane,Addlestone KT15 3NB,UK.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Larsen</LastName>
<ForeName>L E</ForeName>
<Initials>LE</Initials>
<AffiliationInfo>
<Affiliation>National Veterinary Institute,Technical University of Denmark (DTU),Kemitorvet, Building 204, 2800 Lyngby,Denmark.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Manvell</LastName>
<ForeName>R J</ForeName>
<Initials>RJ</Initials>
<AffiliationInfo>
<Affiliation>European Union Reference Laboratory for Avian Influenza and Newcastle Disease,APHA-Weybridge,Woodham Lane,Addlestone KT15 3NB,UK.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Koch</LastName>
<ForeName>G</ForeName>
<Initials>G</Initials>
<AffiliationInfo>
<Affiliation>Wageningen Bioveterinary Research,Houtribweg 39, 8221 RA Lelystad,The Netherlands.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Brown</LastName>
<ForeName>I H</ForeName>
<Initials>IH</Initials>
<AffiliationInfo>
<Affiliation>European Union Reference Laboratory for Avian Influenza and Newcastle Disease,APHA-Weybridge,Woodham Lane,Addlestone KT15 3NB,UK.</Affiliation>
</AffiliationInfo>
</Author>
</AuthorList>
<Language>eng</Language>
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<PublicationType UI="D003160">Comparative Study</PublicationType>
<PublicationType UI="D016428">Journal Article</PublicationType>
<PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType>
</PublicationTypeList>
<ArticleDate DateType="Electronic">
<Year>2018</Year>
<Month>01</Month>
<Day>12</Day>
</ArticleDate>
</Article>
<MedlineJournalInfo>
<Country>England</Country>
<MedlineTA>Epidemiol Infect</MedlineTA>
<NlmUniqueID>8703737</NlmUniqueID>
<ISSNLinking>0950-2688</ISSNLinking>
</MedlineJournalInfo>
<ChemicalList>
<Chemical>
<RegistryNumber>0</RegistryNumber>
<NameOfSubstance UI="D000914">Antibodies, Viral</NameOfSubstance>
</Chemical>
</ChemicalList>
<CitationSubset>IM</CitationSubset>
<MeshHeadingList>
<MeshHeading>
<DescriptorName UI="D000818" MajorTopicYN="N">Animals</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D000914" MajorTopicYN="N">Antibodies, Viral</DescriptorName>
<QualifierName UI="Q000097" MajorTopicYN="N">blood</QualifierName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D002645" MajorTopicYN="Y">Chickens</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D003718" MajorTopicYN="N">Denmark</DescriptorName>
<QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D004797" MajorTopicYN="N">Enzyme-Linked Immunosorbent Assay</DescriptorName>
<QualifierName UI="Q000379" MajorTopicYN="N">methods</QualifierName>
<QualifierName UI="Q000662" MajorTopicYN="Y">veterinary</QualifierName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D005060" MajorTopicYN="N">Europe</DescriptorName>
<QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName>
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<QualifierName UI="Q000662" MajorTopicYN="Y">veterinary</QualifierName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D005585" MajorTopicYN="N">Influenza in Birds</DescriptorName>
<QualifierName UI="Q000453" MajorTopicYN="Y">epidemiology</QualifierName>
<QualifierName UI="Q000821" MajorTopicYN="N">virology</QualifierName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D009426" MajorTopicYN="N">Netherlands</DescriptorName>
<QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D011201" MajorTopicYN="N">Poultry Diseases</DescriptorName>
<QualifierName UI="Q000453" MajorTopicYN="Y">epidemiology</QualifierName>
<QualifierName UI="Q000821" MajorTopicYN="N">virology</QualifierName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D015995" MajorTopicYN="N">Prevalence</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D012680" MajorTopicYN="N">Sensitivity and Specificity</DescriptorName>
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<MeshHeading>
<DescriptorName UI="D016036" MajorTopicYN="N">Seroepidemiologic Studies</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D065288" MajorTopicYN="N">Serogroup</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D013548" MajorTopicYN="N">Sweden</DescriptorName>
<QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName>
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<MeshHeading>
<DescriptorName UI="D006113" MajorTopicYN="N">United Kingdom</DescriptorName>
<QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName>
</MeshHeading>
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<Keyword MajorTopicYN="Y">AIV (avian influenza virus)</Keyword>
<Keyword MajorTopicYN="Y">Bayesian</Keyword>
<Keyword MajorTopicYN="Y">ELISA (enzyme-linked immunosorbent assay)</Keyword>
<Keyword MajorTopicYN="Y">H5/H7 AIV surveillance</Keyword>
<Keyword MajorTopicYN="Y">HI (haemagglutination inhibition)</Keyword>
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