Molecular Biology Laboratory (CIMBL)

Real-Time PCR is a molecular technique that is used to detect and measure a specific genetic target, i.e., DNA or RNA, in real-time.

The process involves the repetitive amplification of a target genetic sequence of interest, for unambiguous identification of the target’s presence. Detecting a genetic target can infer the presence of the organism associated with that target.

For a detailed breakdown, the United Kingdom Health Security Agency (UKHSA) explains the various PCR techniques and how they are applied to SARS-CoV-2 (COVID-19).

Click here for more information

WGS characterises the complete set of genetic material derived from an organism.

The information derived from WGS is important for:

1. Identifying and tracking infectious disease outbreaks (Pathogen Genomics) and predicting microbial response to antibiotics through Antimicrobial Resistance Genotyping (AMR).
2. Investigating inherited disorders (Clinical Genetics).
3. Characterising mutations that underpin the progression of cancers (Oncogenomics).
4. Prediction of response to drug dosage (Pharmacogenomics).

Pathogen sequencing is vital component of a modern Public Health response to infectious disease and is a key component of Genomic Epidemiology.

In leading jurisdictions, genomic epidemiology is already routinely integrated into many areas of clinical and public health, whether it is related to keeping the food chain safe from outbreaks, allowing tuberculosis patients to receive appropriate treatment and halt transmission, or to inform our choice of the most effective vaccines to deploy for seasonal influenza spread.

Built upon the capability established during the Cayman Islands response to the SARS-CoV-2 pandemic, CIMBL now performs WGS for SARS-CoV-2, Influenza A & B, Avian Influenza and bacterial pathogens.

This new capability provides the Cayman Islands Government with:

1. An early-warning system for emerging infectious diseases and precise determination of new variants of infectious agents.
2. An understanding of infectious diseases routinely circulating in the community and how those trends relate to global reports.
3. Being able to identify the relationships between local infectious disease outbreaks, how they are spreading and their potential risk to the population.
4. A national overview of the persistent and emerging trends in antimicrobial resistant infections, allowing for evidence-based policymaking on control measures.
5. Information on how to deploy vaccines to support the interruption of disease transmission and achieve disease elimination targets.

CIMBL is the sole provider of SARS-CoV-2 genome sequences for the Cayman Islands. This service was initiated as a part of the national Public Health response for the nCoV-19 Pandemic. By sequencing the entire genome of the SARS-CoV-2 virus, Public Health can assess, in real-time, the different lineages or variants that are being transmitted throughout the population.

As a part of this national response, CIMBL also shares its data with the global scientific community by uploading the viral genomic sequences generated to the database within the Global Initiative for Sharing All Influenza Data (GISAID). This database is monitored by the World Health Organization (WHO) to help update future versions of the SARS-CoV-2 vaccines. CIMBL’s real-time data output of genome sequencing results within GISAID are visualized below, via the interactive phylodynamic map.

Click here to view the Interactive Phylodynamic map

The New Variant Assessment Platform (NVAP) was a service lead by the UK Health Security Agency (UKHSA) which permitted the extension of UK capacity and expertise to assist other countries in the SARS-CoV-2 response effort. Specifically, the detection and assessment of new SARS-CoV-2 variants around the world. NVAP specialised in providing genomic sequencing support and virus assessment to calculate potential impact of viral characteristics and countermeasures. From 2022 to present day, NVAP has provided support to nine countries including the Cayman Islands (CIMBL), boosting our genomic sequencing capacities and expertise through structured training in bioinformatics and facilitating global scientific exchanges with partnering laboratories.

NVAP was committed to making its data globally available through GISAID, to inform UK risk assessment and for global pandemic control strategy measures. NVAP maximised its benefits by consulting with the WHO – contributing to their global surveillance 10-year plan and partnering with other donor organisations.

Read the Article: UKHSA expands support to help countries identify emerging variants

The Global Influenza Initiative includes the Global Influenza Programme (GIP) and the Global Influenza Surveillance and Response System (GISRS), which were established in 1947 via the WHO’s Interim Committee to offer a globally coordinated effort against Influenza. The GIP offers strategic guidance, technical assistance and coordination to enhance preparedness of the health systems of member states against various influenza threats – including seasonal occurrence, zoonotic, and pandemics.

The GIP was further expanded in 1997 with the establishment of FluNet. FluNet is a global, web-based tool used for influenza virological surveillance. It is used primarily to track the modulations and movements of globally circulating influenza viruses and is used to interpret epidemiological data.

PCR data from the Cayman Islands, through CIMBL, is collected and submitted on a weekly basis to GISRS. This data is made freely available to public health policy makers for informed decision making. CIMBL is actively engaging with the WHO to be officially recognised as a National Influenza Centre (NIC).