Evidence map›Paper›PMID 41117594›Full record

ArticleJournal of clinical microbiology2025

Validation of H5 influenza virus subtyping RT-qPCR assay and low prevalence of H5 detection in 2024-2025 influenza virus season.

David J Bacsik, Margaret G Mills, Luke D Monroe, Cassey Spring, Ailyn C Perez-Osorio, Jonathan C Reed, Ferric C Fang, Lori Bourassa, Pavitra Roychoudhury, Katharine H D Crawford and 2 more

Abstract readValidation Study
In one paragraph

Article in Journal of clinical microbiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Article
  2. Review
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  5. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

David J BacsikDepartment of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, USA.ORCID 0000-0003-4912-0209
Margaret G MillsDepartment of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, USA.
Luke D MonroeDepartment of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, USA.
Cassey SpringDepartment of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, USA.
Ailyn C Perez-OsorioDepartment of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, USA.
Jonathan C ReedDepartment of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, USA.
Ferric C FangDepartment of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, USA.ORCID 0000-0002-3243-110X
Lori BourassaDepartment of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, USA.ORCID 0000-0001-8903-5274
Pavitra RoychoudhuryDepartment of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, USA.ORCID 0000-0002-4567-8232
Katharine H D CrawfordDepartment of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, USA.
Kevin SnekvikWashington Animal Disease Diagnostic Laboratory, College of Veterinary Medicine, Washington State University, Pullman, Washington, USA.
Alexander L GreningerDepartment of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, USA.ORCID 0000-0002-7443-0527

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

A sustained outbreak of H5N1 influenza virus among wild fowl and domestic livestock has caused more than 70 zoonotic infections in humans in North America, including two deaths. The United States Centers for Disease Control and Prevention has recommended rapid H5 subtyping for all hospitalized cases with influenza A virus infection to enable prompt initiation of antiviral treatment, as well as infection prevention and implementation of public health measures to control spread. To address these needs, we developed a qualitative multiplex RT-qPCR assay to subtype H5 influenza virus in nasal, nasopharyngeal, and conjunctival specimens with a limit of detection of 250 copies/mL. No cross-reactivity was observed with other common respiratory viruses, including seasonal H3N2 and H1N1 influenza A viruses. We retrospectively subtyped 590 influenza A virus-positive clinical specimens with Ct values less than 31 processed by University of Washington labs between March 2024 and February 2025, including 512 specimens collected during the 2024-2025 influenza season, and detected no H5 positives. After clinical implementation, we performed 150 clinically ordered H5 subtyping tests between February and April 2025 and again detected no positives. This work enhances clinical pandemic preparedness activities and highlights the exceedingly low prevalence of H5N1 influenza virus during the 2024-2025 respiratory season.IMPORTANCEThe spread of H5N1 influenza virus in the United States has led to the culling of almost 200 million birds, infected cow herds across 17 states, and resulted in 70 human infections as of July 2025. Rapid PCR subtyping of H5 influenza virus is critical to inform hospital infection prevention and public health to enable containment of viral transmission. Here, we report the design, validation, and clinical implementation of a qualitative multiplex H5-subtyping RT-qPCR assay for nasopharyngeal, nasal, and conjunctival swab specimens. Additionally, we offer the largest reported study of H5 subtyping of influenza A virus-positive specimens in the United States to date. No H5 infections were detected in 740 samples collected between March 2024 and April 2025 from patients with confirmed influenza A virus infection in a large academic medical system in Seattle, WA.

Indexed as

Influenza A virusInfluenza A Virus, H5N1 SubtypeInfluenza, HumanReal-Time Polymerase Chain ReactionAnimalsHumansMultiplex Polymerase Chain ReactionNasopharynxPrevalenceRetrospective StudiesSeasonsSensitivity and SpecificityUnited StatesH5N1influenzaNAATPCRsubtypingsurveillance

Identifiers

PMID41117594
PMCPMC12607698

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.