Field Evaluation of a Safe, Easy, and Low-Cost Protocol for Shipment of Samples from Suspected Cases of Foot-and-Mouth Disease to Diagnostic Laboratories

Identification and characterization of the foot-and-mouth disease virus (FMDV) strains circulating in endemic countries and their dynamics are essential elements of the global FMD control strategy. Characterization of FMDV is usually performed in reference laboratories (RL). However, shipping of FMD samples to RL is a challenge due to the cost and biosafety requirements of transportation, resulting in a lack of knowledge about the strains circulating in some endemic areas. In order to simplify this step and to encourage sample submission to RL, we have previously developed a low-cost protocol for the shipment of FMD samples based on the use of lateral flow devices (LFDs) combined with a simple virus inactivation step using 0.2% citric acid. The present study aimed to evaluate this inactivation protocol in the field. For this purpose, 60 suspected FMD clinical samples were collected in Nigeria, Pakistan, and Turkey, three countries where FMD is endemic. Sample treatment, testing on LFDs, and virus inactivation steps were performed in the field when possible. The effectiveness of the virus inactivation was confirmed at the RL. After RNA extraction from the 60 inactivated LFDs, all were confirmed as FMDV positive by real-time reverse transcription polymerase chain reaction (RT-PCR). The serotype was identified by conventional RT-PCR for 86% of the samples. The topotype and/or lineage was successfully determined for 60% of the samples by Sanger sequencing and sequence analyses. After chemical transfection of RNA extracted from inactivated LFDs, into permissive cells, infectious virus was rescued from 15% of the samples. Implementation of this user-friendly protocol can substantially reduce shipping costs, which should increase the submission of field samples and therefore improve knowledge of the circulating FMDV strains.