Rapid Diagnosis of Pandemic (H1N1) 2009 in Cuba

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To the Editor: During 2005-2008, the Cuban National Infl uenza Center (NIC) at the Pedro Kourí Institute in Havana, Cuba, implemented a protocol for infl uenza surveillance proposed by the Pan American Health Organization and the US Centers for Disease Control and Prevention (1).One of the most essential features of this protocol was strengthening laboratory capacity for surveillance of seasonal infl uenza and timely detection of a new infl uenza virus with pandemic potential.On April 26, 2009, in response to an outbreak of pandemic (H1N1) 2009 in Mexico, NIC proposed an algorithm with 2 phases for processing specimens.The purpose of the algorithm was to identify the novel virus, effectively monitor its circulation in Cuba, and make these data available to the national health authorities and the World Health Organization (WHO) (2).The fi rst phase of the algorithm was used during April-September 2009.Following the recommendations of WHO (3), this phase included fl uorescent antigen tests, nucleic acid extraction by using QIAamp Viral RNA and QIAamp Viral DNA Kits (QIAGEN, Hilden, Germany), and 3 reverse transcription PCR (RT-PCR) assays for typing and subtyping of infl uenza A viruses.RT-PCRs were used for differential diagnoses, which included 15 other respiratory viruses (4-7).At the same time, on the basis of pandemic (H1N1) 2009 virus sequences published on the Global Initiative on Sharing Avian Infl uenza Data website (http://platform.gisaid.org/dante-cms/struktur.jdante?aid=1131), we designed a primer set specifi c for the hemagglutinin gene and we developed an in-house, conventional RT-PCR Belsy

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