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We investigated Bordetella holmesii and Bordetella pertussis in 935 suspected pertussis cases in northern India (2019-2023) using PCR and serology. B. holmesii showed increased prevalence in pertussis cases, particularly in older children, highlighting its emerging role and the need for ongoing surveillance and adjusted prevention strategies.

Sudden emergence and rapid spread of COVID-19 created an inevitable need for expansion of the COVID-19 laboratory testing network across the world. The strategy to test-track-treat was advocated for quick detection and containment of the disease. Being the second most populous country in the world, India was challenged to make COVID-19 testing available and accessible in all parts of the country. The molecular laboratory testing network was augmented expeditiously, and number of laboratories was increased from one in January 2020 to 2951 till mid-September, 2021. This rapid expansion warranted the need to have inbuilt systems of quality control/ quality assurance. In addition to the ongoing inter-laboratory quality control (ILQC), India implemented an External Quality Assurance Program (EQAP) with assistance from World Health Organization (WHO) and Royal College of Pathologists, Australasia. Out of the 953 open system rRTPCR laboratories in both public and private sector who participated in the first round of EQAP, 891(93.4%) laboratories obtained a passing score of > = 80%. The satisfactory performance of Indian COVID-19 testing laboratories has boosted the confidence of the public and policy makers in the quality of testing. ILQC and EQAP need to continue to ensure adherence of the testing laboratories to the desired quality standards.

The Government of India, in collaboration with the World Health Organization (WHO), established the National Polio Surveillance Project (NPSP) in 1997 and initiated acute flaccid paralysis (AFP) surveillance to achieve the goal of polio eradication. The WHO South-East Asia Region, comprising of 11 countries, including India, was certified as polio-free in March 2014. India was also validated to have eliminated maternal and neonatal tetanus in May 2015. Over the years, the surveillance of other vaccine-preventable diseases (VPDs) was integrated with AFP surveillance in the country. Outbreak-based measles–rubella (MR) surveillance was initiated in 2005 using AFP surveillance as a platform, case-based fever–rash (FR) surveillance started in 2021 as one of the strategies to achieve measles and rubella elimination in the country. The surveillance of diphtheria, pertussis, and neonatal tetanus was integrated with AFP surveillance in a phased manner during 2015–2022. The surveillance system for VPDs in India, supported by a laboratory network of 10 polio laboratories, 28 measles–rubella laboratories, and 20 diphtheria–pertussis laboratories, has enhanced the national health capacity and security. The setting up and expansion of the surveillance system in the country involved the important component of capacity building of personnel on various components of surveillance, including case identification, case investigation, sample collection and shipment, data analysis and public health response. These capacities have been used effectively during other emergencies, such as the recent COVID-19 pandemic, as well as during outbreaks of other diseases and natural calamities.

Metodos En colaboracion con la Organizacion Mundial de la Salud (OMS), el gobierno de la India desarrollo un programa de 10 pasos para ampliar de manera sistematica el numero de laboratorios que realizan pruebas serologicas y moleculares para detectar el sarampion y la rubeola. El Consejo Indio de Investigacion Medica y la OMS identificaron los laboratorios adecuados segun su ubicacion geografica, su disposicion, su preparacion, sus resultados anteriores y su adhesion a los mecanismos nacionales de control y garantia de calidad. El programa de 10 pasos se inicio con la formacion sobre las pruebas de diagnostico del sarampion y la rubeola, seguida de la realizacion de pruebas serologicas y moleculares para el sarampion y la rubeola en grupos desconocidos, la verificacion cruzada con los laboratorios de referencia y finalizo con la acreditacion in situ a cargo de la OMS.

To expand the measles and rubella laboratory network of India by integrating new laboratories. In collaboration with the World Health Organization (WHO), the Indian government developed a 10-step scheme to systematically expand the number of laboratories performing serological and molecular testing for measles and rubella. The Indian Council of Medical Research and WHO identified suitable laboratories based on their geographical location, willingness, preparedness, past performance and adherence to national quality control and quality assurance mechanisms. The 10-step scheme was initiated with training on measles and rubella diagnostic assays followed by testing of both measles and rubella serology and molecular unknown panels, cross-verification with reference laboratories and ended with WHO on-site accreditation. After extensive training, technical support, funding and monitoring, all six selected laboratories attained passing scores of 90.0% or more in serological and molecular proficiency testing of measles and rubella. Since 2018, the laboratories are a part of the measles and rubella network of India. Within 12 months of initiation of independent reporting, the six laboratories have tested 2287 serum samples and 701 throat or nasopharyngeal swabs or urine samples. The process led to strengthening and expansion of the network. This proficient laboratory network has helped India in scaling up serological and molecular testing of measles and rubella while ensuring high quality testing. The collaborative model developed by the Indian government with WHO can be implemented by other countries for expanding laboratory networks for surveillance of measles and rubella as well as other infectious diseases.

With the eradication of poliovirus, the focus has now shifted to environmental surveillance of poliovirus to determine the circulating polioviruses in an area. L20B and RD cell lines are used for isolation of polioviruses. It is imperative to study the efficacy of these cell line in isolating polioviruses from environmental samples. The present study was carried out to determine the sensitivity and specificity of L20B cell line for isolation of polioviruses from environmental samples. L20B and RD cell lines are used for isolation of polioviruses. Molecular characterization was done by using real time RT-PCR. A total of 432 sewage samples from Delhi and Punjab were processed for the isolation of polioviruses during Jan–Dec 2015. 96.76% of the samples were positive in either of the cell lines. Non-polio enteroviruses were obtained in 50 samples on primary isolation. On RT-PCR, 347 (94.29%) samples yielded polioviruses and the rest (21) non-polio enteroviruses or non-enteroviruses. A total of 703 isolates were obtained. 635 isolates were found polioviruses by PCR (90.33%), 20 isolates were found to be NPEV (2.84%) and 48 (6.83%) were found to be NEV. Out of the 20 NPEV isolates, 14 were from RLR (RD-L20B-RD) route and six isolates were from LR (L20B-RD) route. All 48 NEV isolates were from LR route. Thus L20B cell line is more sensitive as compared to RD cell line for isolation of polioviruses however it is not absolutely specific for polioviruses.

Environmental surveillance of polioviruses has been used as an important tool in monitoring circulation of wild polioviruses and/or Vaccine derived polioviruses in sewage samples. It is important to distinguish Sabin like isolates from non-Sabin like; ELISA & dual stage real time RT-PCR have been used for the same. Current study was carried out on sewage isolates to compare ELISA & RT-PCR with sequencing to distinguish Sabin like from non-Sabin like. Out of 468 sewage specimens, 91 (19.44%) were non-polio enteroviruses positive and 377 (80.56%) were polio positive by virus isolation method. A total of 488 polio virus isolates were detected by L20B and RD route which were further subjected to ELISA and RT-PCR. The results were compared with sequencing. On comparison, the specificity of ELISA was only 66.67% in spite of very low sensitivity (3.43%). The sensitivity of RT-PCR was 97.71% which makes it a good primary screening test for detection of non-Sabin like viruses. However, the specificity was only 33.33%. RT-PCR appears to be a sensitive tool for detecting non-Sabin like viruses however; the isolates which are non-Sabin like by RT-PCR may not necessarily be mutated viruses. ELISA cannot be used for differentiation of Sabin likes from non-Sabin likes due to low sensitivity.

Sudden emergence and rapid spread of COVID-19 created an inevitable need for expansion of the COVID-19 laboratory testing network across the world. The strategy to test-track-treat was advocated for quick detection and containment of the disease. Being the second most populous country in the world, India was challenged to make COVID-19 testing available and accessible in all parts of the country. The molecular laboratory testing network was augmented expeditiously, and number of laboratories was increased from one in January 2020 to 2951 till mid-September, 2021. This rapid expansion warranted the need to have inbuilt systems of quality control/ quality assurance. In addition to the ongoing inter-laboratory quality control (ILQC), India implemented an External Quality Assurance Program (EQAP) with assistance from World Health Organization (WHO) and Royal College of Pathologists, Australasia. Out of the 953 open system rRTPCR laboratories in both public and private sector who participated in the first round of EQAP, 891(93.4%) laboratories obtained a passing score of > = 80%. The satisfactory performance of Indian COVID-19 testing laboratories has boosted the confidence of the public and policy makers in the quality of testing. ILQC and EQAP need to continue to ensure adherence of the testing laboratories to the desired quality standards.

Objectif Étendre le réseau de laboratoires d'analyse de la rougeole et de la rubéole en Inde en y intégrant de nouveaux établissements. Méthodes En collaboration avec l'OrganisatIon mondiale de la Santé (OMS), le gouvernement Indien a mis au point un programme en 10 étapes destiné a accroître systématiquement le nombre de laboratoires effectuant des tests sérologiques et moléculaires de détection de la rougeole et de la rubéole. Le Conseil Indien de la recherche médicale et l'OMS ont Identifié une série de laboratoires éligibles en raison de leur situation géographique, de leur volonté d'y participer, de leur niveau de préparation, de leurs performances antérieures et de leur respect des mécanismes nationaux de contróle et d'assurance qualité. Ce programme en 10 étapes a commencé par une formation aux analyses diagnostiques pour la rougeole et la rubéole, suivie de la réalisation de tests sérologiques et moléculaires pour détecter la rougeole et la rubéole sur des échantillons Inconnus, une vérification croisée avec les laboratoires de référence et enfin, une accreditation OMS sur site. Résultats Apres avoir reçu une formation complete, un soutien technique, un financement et fait l'objet d'une surveillance, les six laboratoires sélectionnés ont tous réussi, obtenant une note égale ou supérieure a 90,0% dans les tests d'aptitude au dépistage sérologique et moléculaire de la rougeole et de la rubéole. Depuis 2018, ces laboratoires font partie du réseau d'analyse de la rougeole et de la rubéole en Inde. Douze mois apres l'établissement des premiers rapports Indépendants, les six laboratoires avaient testé 2287 échantillons de sérum et 701 écouvillons nasopharyngés, prélevements de gorge ou échantillons d'urine. Conclusion Le programme a permis de renforcer et d'étendre le réseau de laboratoires compétents. L'Inde a ainsi pu développer un systeme de tests sérologiques et moléculaires de haute qualité pour dépister la rougeole et la rubéole. Le modele collaboratif adopté par le gouvernement Indien avec l'OMS pourrait s'appliquer a d'autres pays qui souhaitent étendre leur réseau de laboratoires chargés de surveiller la rougeole et la rubéole, mais aussi d'autres maladies infectieuses.