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Volume 27, Number 7—July 2021
Research

Multiplex Real-Time Reverse Transcription PCR for Influenza A Virus, Influenza B Virus, and Severe Acute Respiratory Syndrome Coronavirus 2

Bo Shu1, Marie K. Kirby1, William G. Davis, Christine Warnes, Jimma Liddell, Ji Liu, Kai-Hui Wu, Norman Hassell, Alvaro J. Benitez, Malania M. Wilson, Matthew W. Keller, Benjamin L. Rambo-Martin, Yamundow Camara, Jörn Winter, Rebecca J. Kondor, Bin Zhou, Stacey Spies, Laura E. Rose, Jonas M. Winchell, Brandi M. Limbago, David E. Wentworth2, and John R. Barnes2Comments to Author 
Author affiliations: Centers for Disease Control and Prevention, Atlanta, Georgia, USA (B. Shu, M.K. Kirby, W.G. Davis, C. Warnes, J. Liddell, J. Liu, K.-H. Wu, N. Hassell, A.J. Benitez, M.M. Wilson, M.W. Keller, B.L. Rambo-Martin, Y. Camara, J. Winter, R.J. Kondor, B. Zhou, S. Spies, L.E. Rose, J.M. Winchell, B.M. Limbago, D.E. Wentworth, J.R. Barnes); Battelle Memorial Institute, Atlanta (W.G. Davis, J. Liddell); Leidos Inc, Atlanta (Y. Camara)

Main Article

Table 1

Primers and probes used in the Influenza SARS-CoV-2 Multiplex Assay*

Primer or probe
Oligonucleotide sequence, 5′→3′
Target gene or region
Nucleotide position†
Concentration, µM‡
InfA
Forward primer 1 CAA GAC CAA TCY TGT CAC CTC TGAC Matrix protein 143–167 3.33
Forward primer 2 CAA GAC CAA TYC TGT CAC CTY TGAC 143–167 3.33
Reverse primer 1 GCA TTY TGG ACA AAV CGT CTA CG 248–226 5
Reverse primer 2
GCA TTT TGG ATA AAG CGT CTA CG

248–226
1.67
InfB
Forward primer TCC TCA AYT CAC TCT TCG AGC G Nonstructural protein 746–767 6.67
Reverse primer
CGG TGC TCT TGA CCA AAT TGG

848–828
6.67
RP
Forward primer AGA TTT GGA CCT GCG AGC G Human RNase P 50–67 6.67
Reverse primer
GAG CGG CTG TCT CCA CAA GT

50–67
6.67
SARS-CoV-2
Forward primer CTG CAG ATT TGG ATG ATT TCT CC Nucleoprotein–3′ untranslated region 29463–29485 6.67
Reverse primer
CCT TGT GTG GTC TGC ATG AGT TTA G

29554–29530
6.67
InfA probe§
TGC AGT CCT /ZEN/ CGC TCA CTG GGC ACG
Matrix protein
224–201
1.67
InfB probe¶
CCA ATT CGA /ZEN/ GCA GCT GAA ACT GCG GTG
Nonstructural protein
790–817
1.67
RP probe#
TTC TGA CCT /TAO/ GAA GGC TCT GCG CG
Human RNase P
71–93
1.67
SARS-CoV-2 probe** ATT GCA ACA /TAO/ ATC CAT GAG CAG TGC TGA CTC Nucleoprotein–3′ untranslated region 29491–29520 1.67

*Multiplex real-time reverse transcription PCR for influenza A virus, influenza B virus, and SARS-CoV-2. InfA, influenza A; InfB, influenza B; RP, RNase P; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2. †Nucleotide positions are indicated as location in the coding domain sequences for the ribonuclease P/MRP subunit p30 (human; GenBank accession no. NM-004613), M gene (GISAID accession no. EPI 1312561) of A/Brisbane/02/2018-H1N1 (InfA), NS gene (GenBank accession no. CY232070) of B/Colorado/06/2017 (InfB), or Wuhan-Hu-1 (SARS-CoV-2; GenBank accession no. NC045512). ‡Multiplex assay is supplied with a tube of primers mixed in 1.5 mL aqueous solution and a tube of probes mixed in 1.5 mL aqueous solution. §Probe labeled with the reporter molecule 6-carboxyfluorescein at the 5′ end, a ZEN quencher between nt 9 and 10, and an Iowa Black FQ quencher at the 3′ end (Integrated DNA Technologies, Inc., https://www.idtdna.com). Probe and primer sequences are identical to InfA sequences used by the CDC Human Influenza Real-Time RT-PCR Diagnostic Panel [510(k) no. K200370] (9). ¶Probe labeled with Yakima Yellow reporter at the 5′ end, a ZEN quencher between nt 9 and 10, and an Iowa Black FQ quencher at the 3′ end (Integrated DNA Technologies, Inc.). Probe and primer sequences identical to InfB sequences used by the CDC Human Influenza Virus Real-Time RT-PCR Detection and Characterization Panel [510(k) no. K200370] (9). #Probe labeled with the CY5 reporter at the 5′ end, a TAO quencher between nt 9 and 10, and an Iowa Black RQ quencher at the 3′ end (Integrated DNA Technologies, Inc.). Probe and primer sequences identical to RP sequences in the CDC Human Influenza Virus Real-Time RT-PCR Detection and Characterization Panel [510(k) no. K200370]. **Probe labeled with the Texas Red-XN reporter at the 5′ end, a TAO quencher between nt 9 and 10, and an Iowa Black RQ quencher at the 3′ end (Integrated DNA Technologies, Inc.)

Main Article

References
  1. World Health Organization. Pneumonia of unknown cause—China. 2020 [cited 2020 Jul 8]. https://www.who.int/csr/don/05-january-2020-pneumonia-of-unkown-cause-china/en/
  2. Zhu  N, Zhang  D, Wang  W, Li  X, Yang  B, Song  J, et al.; China Novel Coronavirus Investigating and Research Team. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med. 2020;382:72733. DOIPubMedGoogle Scholar
  3. Cucinotta  D, Vanelli  M. WHO declares COVID-19 a pandemic. Acta Biomed. 2020;91:15760.PubMedGoogle Scholar
  4. Dong  E, Du  H, Gardner  L. An interactive web-based dashboard to track COVID-19 in real time. Lancet Infect Dis. 2020;20:5334. DOIPubMedGoogle Scholar
  5. Slabodkin  G. FDA chief warns of supply pressure on reagents for coronavirus tests. MedTech Dive. 2020 [cited 2020 Sep 15]. https://www.medtechdive.com/news/fda-chief-warns-of-supply-pressure-on-reagents-for-coronavirus-tests/573999/
  6. Wu  KJ. It’s like Groundhog Day: coronavirus testing labs again lack key supplies. The New York Times. 2020 Jul 23 [cited 2020 Sep 15]. https://www.nytimes.com/2020/07/23/health/coronavirus-testing-supply-shortage.html
  7. Lu  X, Wang  L, Sakthivel  SK, Whitaker  B, Murray  J, Kamili  S, et al. US CDC real-time reverse transcription PCR panel for detection of severe acute respiratory syndrome coronavirus 2. Emerg Infect Dis. 2020;26:165465. DOIPubMedGoogle Scholar
  8. Houser  K, Subbarao  K. Influenza vaccines: challenges and solutions. Cell Host Microbe. 2015;17:295300. DOIPubMedGoogle Scholar
  9. US Food and Drug Administration. 510 (k): CDC Human Influenza Virus Real-Time RT-PCR Diagnostic Panel. 2020 [2020 Mar 10]. https://www.accessdata.fda.gov/cdrh_docs/pdf20/K200370.pdf
  10. US Food and Drug Administration. Human Influenza Virus Real-Time RT-PCR Detection and Characterization Panel: 510(k) 080570. 2008 [2008 Sep 26]. https://www.accessdata.fda.gov/cdrh_docs/pdf8/k080570.pdf
  11. World Health Organization. CDC protocol of realtime RT-PCR for influenza H1N1. 2009 [2009 Apr 30]. https://www.who.int/csr/resources/publications/swineflu/realtimeptpcr/en/index.html
  12. World Health Organization. Real-time RT-PCR protocol for the detection of avian influenza A(H7N9) virus. 2013 [2013 Apr 15]. https://www.who.int/influenza/gisrs_laboratory/cnic_realtime_rt_pcr_protocol_a_h7n9.pdf
  13. US Food and Drug Administration. New traditional 510(k): CDC Human Influenza Virus Real-Time RT-PCR Diagnostic Panel. 2019 [2019 Mar 27]. https://www.accessdata.fda.gov/cdrh_docs/pdf19/K190302.pdf
  14. Shu  B, Kirby  MK, Warnes  C, Sessions  WM, Davis  WG, Liu  J, et al. Detection and discrimination of influenza B Victoria lineage deletion variant viruses by real-time RT-PCR [Erratum in: Euro Surveill. 2020;25:201022e]. Euro Surveill. 2020;25:1900652. DOIGoogle Scholar
  15. US Food and Drug Administration. Coronavirus (COVID-19) update: FDA authorizes additional COVID-19 combination diagnostic test ahead of flu season. 2020 [cited 2020 Jul 8]. https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-authorizes-additional-covid-19-combination-diagnostic-test-ahead-flu
  16. Szretter  KJ, Balish  AL, Katz  JM. Influenza: propagation, quantification, and storage. Curr Protoc Microbiol. 2006;3:15G.1.115G.1.22. DOIGoogle Scholar
  17. Shu  B, Wu  KH, Emery  S, Villanueva  J, Johnson  R, Guthrie  E, et al. Design and performance of the CDC real-time reverse transcriptase PCR swine flu panel for detection of 2009 A (H1N1) pandemic influenza virus. J Clin Microbiol. 2011;49:26149. DOIPubMedGoogle Scholar
  18. Garten  RJ, Davis  CT, Russell  CA, Shu  B, Lindstrom  S, Balish  A, et al. Antigenic and genetic characteristics of swine-origin 2009 A(H1N1) influenza viruses circulating in humans. Science. 2009;325:197201. DOIPubMedGoogle Scholar
  19. Jhung  MA, Epperson  S, Biggerstaff  M, Allen  D, Balish  A, Barnes  N, et al. Outbreak of variant influenza A(H3N2) virus in the United States. Clin Infect Dis. 2013;57:170312. DOIPubMedGoogle Scholar
  20. Nelson  MI, Gramer  MR, Vincent  AL, Holmes  EC. Global transmission of influenza viruses from humans to swine. J Gen Virol. 2012;93:2195203. DOIPubMedGoogle Scholar
  21. Rajao  DS, Vincent  AL, Perez  DR. Adaptation of human influenza viruses to swine. Front Vet Sci. 2019;5:347. DOIPubMedGoogle Scholar
  22. Schicker  RS, Rossow  J, Eckel  S, Fisher  N, Bidol  S, Tatham  L, et al. Outbreak of influenza A(H3N2) variant virus infections among persons attending agricultural fairs housing infected swine—Michigan and Ohio, July–August 2016. MMWR Morb Mortal Wkly Rep. 2016;65:115760. DOIPubMedGoogle Scholar
  23. Corman  VM, Landt  O, Kaiser  M, Molenkamp  R, Meijer  A, Chu  DK, et al. Detection of 2019 novel coronavirus (2019-nCoV) by real-time RT-PCR [Erratum in: Euro Surveill. 2020;25:20200409c; 2020;25:2007303; 2021;26:210204e]. Euro Surveill. 2020;25. DOIGoogle Scholar
  24. Züst  R, Miller  TB, Goebel  SJ, Thiel  V, Masters  PS. Genetic interactions between an essential 3′ cis-acting RNA pseudoknot, replicase gene products, and the extreme 3′ end of the mouse coronavirus genome. J Virol. 2008;82:121428. DOIPubMedGoogle Scholar
  25. Konala  VM, Adapa  S, Gayam  V, Naramala  S, Daggubati  SR, Kammari  CB, et al. Co-infection with influenza A and COVID-19. Eur J Case Rep Intern Med. 2020;7:001656. DOIPubMedGoogle Scholar
  26. Konala  VM, Adapa  S, Naramala  S, Chenna  A, Lamichhane  S, Garlapati  PR, et al. A case series of patients coinfected with influenza and COVID-19. J Investig Med High Impact Case Rep. 2020;8:2324709620934674. DOIPubMedGoogle Scholar
  27. US Food and Drug Administration. Coronavirus disease 2019 (COVID-19) emergency use authorizations for medical devices: in vitro diagnostics EUAs. 2019 [cited 2021 Jan 11]. https://www.fda.gov/medical-devices/coronavirus-disease-2019-covid-19-emergency-use-authorizations-medical-devices/vitro-diagnostics-euas
  28. Dominguez  SR, Shrivastava  S, Berglund  A, Qian  Z, Góes  LGB, Halpin  RA, et al. Isolation, propagation, genome analysis and epidemiology of HKU1 betacoronaviruses. J Gen Virol. 2014;95:83648. DOIPubMedGoogle Scholar
  29. Rangan  R, Zheludev  IN, Hagey  RJ, Pham  EA, Wayment-Steele  HK, Glenn  JS, et al. RNA genome conservation and secondary structure in SARS-CoV-2 and SARS-related viruses: a first look. RNA. 2020;26:93759. DOIPubMedGoogle Scholar
  30. BioSpectrum Asia. FDA sets up SARS-CoV-2 reference panel for diagnostic tests. 2020 [cited 2020 Sep 15]. https://www.biospectrumasia.com/news/30/16018/fda-sets-up-sars-cov-2-reference-panel-for-diagnostic-tests.html
  31. US Food and Drug Administration. Coronavirus (COVID-19) update: FDA provides new tool to aid development and evaluation of diagnostic tests that detect SARS-CoV-2 infection. 2020 [cited 2020 Sep 15]. https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-provides-new-tool-aid-development-and-evaluation-diagnostic-tests
  32. US Food and Drug Administration. SARS-CoV-2 reference panel comparative data. 2020 [cited 2010 Sep 16]. https://www.fda.gov/medical-devices/coronavirus-covid-19-and-medical-devices/sars-cov-2-reference-panel-comparative-data

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1These first authors contributed equally to this article.

2These senior authors contributed equally to this article.

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Page updated: June 16, 2021
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