Patent Publication Number: US-11639532-B2

Title: Method for Influenza A virus and Influenza B virus detection

Description:
CROSS-REFERENCE TO RELATED APPLICATION 
     This application claims the benefit of Taiwan Patent Application No. 107138861, filed on Nov. 1, 2018, the contents of which is incorporated herein by reference. 
     FIELD OF THE INVENTION 
     This invention is rlated to a method for detecting Influenza A virus (Flu A) and Influenza B virus (Flu B) in a human tissue sample. In particular, for Flu A, the present invention provides primers, probes and other related reagents for detecting at least one of Influenza A subtype H1N1, H3N2, H5N1 and H7N9. For Flu B, the present invention provides primers, probes and other related reagents for detecting Influenza B virus. 
     BACKGROUND OF THE INVENTION 
     Influenza is commonly seen in local outbreaks or epidemics throughout the world. Epidemics may appear at any time but are usually concentrated in months of high humidity. They occur suddenly with little or no warning. The number of people affected can vary from a few hundred to hundreds of thousands. Epidemics may be short-lived, lasting days or weeks, but larger epidemics may last for months. Although influenza is a mild disease in most individuals, it is life threatening to elderly or debilitated individuals. Epidemics are responsible for large losses in productivity. The WHO commissioned an international network of communicating laboratories to monitor the antigenic changes in the infecting viruses and the spread of infection. 
     According to World Health Organization&#39;s research and data, Influenza A and B viruses accounted for the majority of influenza detections. Human Influenza A and B viruses cause seasonal epidemics of disease almost every winter in North America, East Asia, and South East Asia. Influenza type C infections generally cause a mild respiratory illness and are not thought to cause epidemics. Influenza D viruses only affect cattle and are not known to infect or cause illness in people. 
     Influenza A viruses are divided into subtypes based on two proteins on the surface of the virus: the hemagglutinin (H) and the neuraminidase (N). There are 18 different hemagglutinin subtypes and 11 different neuraminidase subtypes. Influenza A viruses can be further broken down into different strains. Influenza A virus belongs to the genus orthomyxovirus in the family of Orthomyxoviridae, which is a kind of ssRNA-enveloped virus with a helical symmetry. The genome of Influenza A virus is segmented, with 8 RNA fragments. There are four antigens present on Influenza A virus which are haemagglutinin (HA), neuraminidase (NA), nucleocapsid (NP) and the matrix (M) proteins. The NA is a type-specific antigen that occurs in 3 forms, A, B and C, which provides the basis for the classification of human influenza viruses. The matrix protein surrounds the nucleocapsid and makes up 35-45% of the particle mass. HA mediates the attachment of the virus to the cellular receptor. Neuraminidase molecules are present in lesser quantities in the envelope. 
     Influenza A virus is a major member of the human seasonal influenza, which can infect people of all ages and cause serious illnesses that can even lead to death. Seasonal influenza is an important global human respiratory disease caused by Influenza A virus, prevalent in tropical areas all year round, while in temperate regions occurs mainly in winter, with some seasonal epidemics features. Currently, there are two subtypes of Influenza A virus circulating in humans, which can lead to global pandemic infections, namely H1N1 and H3N2. Also, H5N1 and H7N9 are considered as important subtypes since infection with H5N1 and H7N9 in humans can cause severe disease and has a high mortality rate. 
     Influenza B virus is another genus in the virus family Orthomyxoviridae. The Influenza B virus genome is 14548 nucleotides long and consists of 8 segments of linear negative-sense, single-stranded RNA. The multipartite genome is encapsidated, each segment is in a separate nucleocapsid, and the nucleocapsids are surrounded by one envelope. Influenza B viruses are not divided into subtypes, but can be further broken down into lineages and strains. Currently there are two co-circulating lineages of the Influenza B virus based on the antigenic properties of the surface glycoprotein hemagglutinin. The lineages are termed B/Yamagata/16/88-like and B/Victoria/2/87-like viruses. The capsid of Influenza B virus is enveloped while its virion consists of an envelope, a matrix protein, a nucleoprotein complex, a nucleocapsid, and a polymerase complex. 
     Influenza A and B virus infections are spread via respiratory droplets. The virus particles bind to cells of the respiratory epithelium, which are rich in viral receptors. Neuraminidases present on the virus particles aid the infectious process by releasing virus particles which have been bound by the mucous present on the surface of epithelial cells. The typical symptoms of influenza appear after the infection and include marked fever, headache, photophobia, shivering, a dry cough, malaise, myalgia, and a dry tickling throat. The fever is continuous and lasts around 3 days. Though the symptoms and the treatments of Influenza B virus are similar to those of Influenza A virus, the chance of developing severe complications from Influenza B virus is lower than from Influenza A virus. 
     Influenza A subtypes H1N1, H3N2, H5N1, and H7N9 are all highly contagious and can cause severe complications. One of the Influenza A subtypes, H5N1, which is of particular concern because it mutates much more quickly than other Influenza A subtypes and Influenza B virus, has been proven to be highly pathogenic and can cause severe disease in men. Therefore, in order to monitor the mutation in real-time, it is important to make a distinction between Influenza A subtypes H1N1, H3N2, H5N1, and H7N9 versus Influenza B virus. 
     Nowadays, there are available RT-PCR assays for the detection of RNA of Influenza A and B viruses that provide the greatest sensitivity and specificity. Moreover, the PCR product can be sequenced for strain identification. The most sensitive and appreciated specimens are nasopharyngeal swabs. However, throat and nasal swabs are more commonly used given the difficulties involved in taking nasopharyngeal swabs. 
     In light of the above, it is necessary to develop an assay with high accuracy and stability for detecting at least one of Influenza A subtypes H1N1, H3N2, H5N1, and H7N9, and Influenza B virus in a suspected sample simultaneously. 
     SUMMARY OF THE INVENTION 
     The object of this present invention is to provide a detection method for detecting the presence of a matrix gene (hereinafter “M gene”) of Influenza A subtypes H1N1, H3N2, H5N1, or H7N9 in a suspected sample, as well as for detecting the presence of a non-structural gene (hereinafter “NS gene”) of Influenza B virus in the suspected sample simultaneously. To be more precise, if a suspected sample contains at least one of Influenza A subtype H1N1, H3N2, H5N1, or H7N9, then it would be detected by the present invention. If a suspected sample contains at least one strain of Influenza B virus, it would be detected by the present invention. Also, if a suspected sample contains at least one of Influenza A subtype H1N1, H3N2, H5N1, and Influenza B virus, then it would be detected separately by the present invention. 
     The object of the present invention, in particular, is to provide designated primers and probes for detecting the presence of Influenza A subtypes H1N1, H3N2, H5N1, and H7N9, and Influenza B virus in a suspected sample, respectively. The designated probes and primers are specific to Influenza A subtypes H1N1, H3N2, H5N1, and H7N9, and Influenza B virus. A template-dependent polymerase with ability of exonuclease hydrolysis is also included in this process. This object is achieved according to the present invention by a method for the detection of the presence of at least one of Influenza A subtype H1N1, H3N2, H5N1, and H7N9, and/or Influenza B virus in a suspected sample comprising the following steps:
         (a) Provide a sample suspected to contain the M gene of Influenza A subtype H1N1, H3N2, H5N1, or H7N9, and/or the NS gene of Influenza B virus;   (b) provide a pair of primers comprising a forward and a reverse primer specific to the M gene of Influenza A subtype H1N1, H3N2, H5N1, and H7N9, wherein the forward primer is selected from a group of SEQ ID NO:2, SEQ ID NO:3, SEQ ID NO:4, SEQ ID NO:5, SEQ ID NO:6, SEQ ID NO:7, and SEQ ID NO:8; and the reverse primer is selected from a group of SEQ ID NO:11, SEQ ID NO:12, SEQ ID NO:13, SEQ ID NO:14, SEQ ID NO:15, SEQ ID NO:16, SEQ ID:17 NO, and SEQ ID NO:18;   (c) provide a pair of primers comprising a forward and a reverse primer specific to the NB gene of Influenza B virus, wherein the forward primer is selected from a group of SEQ ID NO:20, SEQ ID NO:21, SEQ ID NO:22, SEQ ID NO:23, SEQ ID NO:24, and SEQ ID NO:25; and the reverse primer is selected from a group of SEQ ID NO:29, SEQ ID NO:30, SEQ ID NO:31, SEQ ID NO:32, SEQ ID NO:33, SEQ ID NO:34, SEQ ID NO:35, and SEQ ID NO:36;   (d) amplify the nucleic acids contained in the suspected sample with a reverse transcriptase and a template-dependent polymerase;   (e) anneal two different probes to the nucleic acids contained in the suspected sample to form a hybridized product during step (d), wherein the first probe specific to the Influenza A subtypes H1N1, H3N2, H5N1, and H7N9 is selected from a group of SEQ ID NO:9 and SEQ ID NO:10; and the second probe specific to the Influenza B virus is selected from a group of SEQ ID NO:27 and SEQ ID NO:28; and   (f) detect two distinct signals generated from the RT-PCR products as an indicator of the presence of the target nucleic acid of the Influenza A subtypes H1N1, H3N2, H5N1, and H7N9 and/or Influenza B virus, respectively.       

     According to the present invention, the signals generated from the hybridized products can be detected by a fluorescent detection system. One of the two distinct signals specific to the first probe is the indication of the presence of Influenza A subtypes H1N1, N3N2, H5N1, and/or H7N9, and the other specific to the second probe is the indication of the presence of the Influenza B virus. 
     This SUMMARY is provided to briefly identify some aspects of the present invention that are further described below in the DETAILED DESCRIPTION. This SUMMARY is not intended to identify key or essential features of the present disclosure nor is it intended to limit the scope of any claims. The term “aspects” is to be read as “at least one aspect.” The aspects described above and other aspects of the present disclosure described herein are illustrated by way of example(s) and not limited in the accompanying drawing. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         FIG.  1    illustrates the M gene primer sequence region of 4 Influenza A subtypes. 
         FIG.  2    illustrates the kinetic PCR growth curves of embodiment 1. 
         FIG.  3    illustrates the kinetic PCR growth curves of embodiment 2. 
         FIG.  4    illustrates the kinetic PCR growth curves of embodiment 3. 
         FIG.  5    illustrates the specificity test result of embodiment 4. 
     
    
    
     DETAILED DESCRIPTION OF THE INVENTION 
     The following merely illustrates the principles of the invention. It will thus be appreciated that those skilled in the art will be able to devise various arrangements which, although not explicitly described or shown herein, embody the principles of the invention and are included within its spirit and scope. 
     Furthermore, all examples and conditional language recited herein are principally intended expressly to be only for pedagogical purposes to aid the reader in understanding the principles of the disclosure and the concepts contributed by the inventor(s) to furthering the art, and are to be construed as being without limitation to such specifically recited examples and conditions. 
     Moreover, all statements herein reciting principles, aspects, and embodiments of the disclosure, as well as specific examples thereof, are intended to encompass both structural and functional equivalents thereof. Additionally, it is intended that such equivalents include both currently known equivalents as well as equivalents developed in the future, i.e., any elements later developed that perform the same function, regardless of structure. 
     Unless otherwise explicitly specified herein, the drawings are not drawn to scale. 
     To make sure the method can be processed successfully, the present invention provides a PCR or real-time PCR assay for rapid identification using TaqMan probes with conjugated minor groove binder (MGB) ligands. 
     In such assays, labeling the type-specific probes with different fluorescent reporters has ensured the detection of type-specific fluorescence. The Taq polymerase applied in this assay is a DNA-dependent polymerase with exonuclease hydrolysis function. The fluorescent signals are detected by the quantity of the fragments of the fluorescent reporter, which are cleaved from the probe hybridized to the target nucleic acid by an exonuclease hydrolysis of the DNA-dependent polymerase. The primer and/or probe comprise(s) a modified nucleotide or a non-nucleotide compound. 
     Currently, H1N1 and H3N2 are two commonly seen Influenza A subtypes leading to global pandemic infections circulating in humans. On the other hand, though H5N1 and H7N9 are uncommon Influenza A subtypes, they are very likely to cause severe disease and lead to high mortality rates in humans. Therefore, it is important to detect these four Influenza A subtypes as early as possible so that treatment can be initiated early. Also, since these four subtypes are all important, there is no need to discriminate any one of them from the others in the suspected samples. The present invention discloses a method for detecting a specific sequence shared and present in all four Influenza A subtypes H1N1, H3N2, H5N1 and H7N9. If the detection result of the present invention is positive for a suspected sample, that means at least one subtype is present. Then early treatment can begin. 
     The M gene (SEQ ID NO: 1) exists in Influenza A subtypes H1N1, H3N2, H5N1 and H7N9, and translates into the matrix protein (hereinafter “M protein”) that lies beneath the viral envelope in the form of dimers and interacts with viral ribonucleoprotein (vRNP) complex, forming a bridge between the inner core components and the membrane proteins. vRNPs harbor the determinants for host range. The M protein contacts with both viral RNA and vRNP, promoting the formation of RNP complexes and causing the dissociation of RNP from the nuclear matrix. The M gene plays a vital role in assembly by recruiting the viral components to the site of assembly and essential role in the budding process including formation of viral particles. Novel vaccines targeting M proteins to confer cross-subtype protection have been shown to be promising. 
     Therefore, given that the M gene exists in Influenza A subtypes H1N1 (SEQ ID NO:47), H3N2 (SEQ ID NO:48), H5N1 (SEQ ID NO:49) and H7N9 (SEQ ID NO:50), all primers and probes disclosed in the present invention are selected from and specific to the M gene of all four subtypes as shown in  FIG.  1   . To be more precise, the forward primer for detection of Influenza A subtypes H1N1, H3N2, H5N1 and H7N9 is selected from the group of SEQ ID NO:2, SEQ ID NO:3, SEQ ID NO:4, SEQ ID NO:5, SEQ ID NO:6, SEQ ID NO:7, and SEQ ID NO:8; and the reverse primer is selected from the group of SEQ ID NO:11, SEQ ID NO:12, SEQ ID NO:13, SEQ ID NO:14, SEQ ID NO:15, SEQ ID NO:16, SEQ ID NO:17, and SEQ ID NO:18. The probe, which is one of the group of SEQ ID NO: 9 and SEQ ID NO:10, is also specific to the M gene. The presence of the fluorescence signal is indicative of Influenza A subtypes H1N1, H3N2, H5N1 or H7N9 in a sample. 
     The NS gene exists in both Influenza A virus and Influenza B virus which express the NS protein during the replication stage. However, unique biological activities of the NS gene of Influenza B virus are indicated by its deficiency to inhibit pre-mRNA processing and by &lt;20% sequence identity to the NS gene of Influenza A virus. The NS protein is a homo-dimeric RNA-binding protein found in Influenza B virus, which is a necessary factor for viral replication. During the replication stage, the NS protein binds poly-A tails of mRNA for keeping them in the nucleus. Given that the NS gene of Influenza B virus (SEQ ID NO: 19) is highly conserved in both Influenza B/Yamagata/16/88-like and B/Victoria/2/87-like viruses, the primer and probe sequences specific to Influenza B virus disclosed in the present invention are selected from NS gene. 
     The internal control used in the present invention includes, but is not limited to, RNA oligonucleotide (e.g. Alere™ i Influenza A &amp; B 2 Test, Abbott, Abbott Park, Ill. 60064, U.S.A.), encapsulated (armored) RNA pseudovirus (e.g. Xpert® Flu/RSV XC Assay, Cepheid, Sunnyvale, Calif. 94089, U.S.A.), encapsulated RNA (e.g. cobas® Liat® Influenza A/B &amp; RSV, Roche, Basel, Switerland), in vitro transcribed RNA (e.g. ProFlu+™ Assay Test), armored RNA (e.g. Simplexa™ Influenza A H1N1 (2009) Kit, Focus Diagnostics), encapsulated RNA (e.g. Simplexa™ Flu A/B &amp; RSV Direct Kit, Focus Diagnostics), mengovirus (e.g. encephalomyocarditis virus (EMCV) RT-PCR kit), bacteriophage (e.g. Adenovirus R-GENE®, adenovirus species (A, B, C, D, E, F and G)), noninfectious armored RNA (e.g. in vitro PCR based assay for HCV RNA detection), bacteriophage MS2 (e.g. RIDA® GENE Norovirus GI/GII, Clinical Diagnostics), tobacco mosaic virus (TMV), phocine distemper virus, brome mosaic virus (BMV), and so on. Ms2, an ssRNA bacteriophage, is commonly used as an internal control in biological experiments and virus/pathogen detections after a preliminary reverse transcription process. The application of internal control is included for monitoring the adequate processing of the target viruses and the presence of inhibition factors in the RT-PCR reactions to prevent false-negative results due to inhibition or human error. Therefore, in the following embodiments, ms2 is added as an internal control into the detection tube containing the Influenza A subtypes H1N1, H3N2, H5N1, H7N9, and/or Influenza B virus to be detected. The full length complementary DNA of ms2 generated from reverse transcription is as represented by SEQ ID NO:37. 
     The present invention using TaqMan probes is more sensitive than a traditional method, where the limit of detection (hereinafter LOD) of the present invention can reach 10 1  copies on Influenza A subtypes H1N1, H3N2, H5N1 or H7N9, as well as on Influenza B virus. Therefore, the present invention is suitable for rapid and unambiguous detection of Influenza A subtypes H1N1, H3N2, H5N1, and H7N9 and Influenza B virus. 
     In one embodiment of the present invention, a serial step(s) are provided for testing the LOD of Influenza A subtypes H1N1, H3N2, H5N1, and H7N9 and Influenza B virus in a known-concentration (virus particle copy number) sample comprising the following steps: 
     (a) Prepare two serial single dilutions of at least one subtype of Influenza A subtype H1N1, H3N2, H5N1, or H7N9 from 10 3  virus copy number to 10 2  and 10 1 , wherein these three serial dilutions contain the M gene of Influenza A subtypes H1N1, H3N2, H5N1, or H7N9;
 
(b) prepare two serial single dilutions of at least one subtype of Influenza B virus from 10 3  virus copy number to 10 2  and 10 1 , wherein these three serial dilutions contain the NS gene of Influenza B virus;
 
(c) provide a pair of primers comprising a forward and a reverse primer specific to the M gene of Influenza A subtype H1N1, H3N2, H5N1, and H7N9, wherein the forward primer is selected from a group of SEQ ID NO:2, SEQ ID NO:3, SEQ ID NO:4, SEQ ID NO:5, SEQ ID NO:6, SEQ ID NO:7, and SEQ ID NO:8; and the reverse primer is selected from a group of SEQ ID NO:11, SEQ ID NO:12, SEQ ID NO:13, SEQ ID NO:14, SEQ ID NO:15, SEQ ID NO:16, SEQ ID NO:17, and SEQ ID NO:18;
 
(d) provide a pair of primers comprising a forward and a reverse primer specific to the NS gene of Influenza B virus, wherein the forward primer is selected from a group of SEQ ID NO:20, SEQ ID NO:21, SEQ ID NO:22, SEQ ID NO:23, SEQ ID NO:24, and SEQ ID NO:25; and the reverse primer is selected from a group of SEQ ID NO:29, SEQ ID NO:30, SEQ ID NO:31, SEQ ID NO:32, SEQ ID NO:33, SEQ ID NO:34, SEQ ID NO:35, and SEQ ID NO:36;
 
(e) add the ms2 into all serial dilutions of Influenza A virus and Influenza B virus, and then add a pair of primers comprising a forward and a reverse primer of the ms2 as an internal control into all serial dilutions, wherein the forward primer is selected from a group of SEQ ID NO:38, SEQ ID NO:39, SEQ ID NO:40, and SEQ ID NO:41; and the reverse primer is selected from a group of SEQ ID NO:43, SEQ ID NO:44, SEQ ID NO:45, and SEQ ID NO:46;
 
(f) amplify the nucleic acids contained in the known-concentration samples of Influenza A virus, Influenza B virus and the internal control with a reverse transcriptase and a template-dependent polymerase;
 
(g) anneal two different probes to the nucleic acids contained in the known-concentration samples to form a hybridized product during step (f), wherein the first probe specific to the Influenza A subtypes H1N1, H3N2, H5N1, and H7N9 is selected from a group of SEQ ID NO:9 and SEQ ID NO:10; and the second probe specific to the Influenza B virus is selected from a group of SEQ ID NO:27 and SEQ ID NO:28;
 
(h) anneal the probe specific to the ms2 to form a hybridized product during step (f), wherein the probe sequence is as SEQ ID NO:42; and
 
(i) To detect three distinct signals generated from the hybridized products as an indicator of the presence of the target nucleic acid of the Influenza A subtypes H1N1, H3N2, H5N1, and H7N9 and/or Influenza B virus and the internal control, respectively.
 
     In another embodiment of the present invention, a method is provided for the detection of the presence of at least one of Influenza A subtype H1N1, H3N2, H5N1, and H7N9, and/or Influenza B virus in one suspected sample comprising the following steps: 
     (a) Provide a sample suspected to contain the M gene of Influenza A subtypes H1N1, H3N2, H5N1, and H7N9, and/or the NS gene of Influenza B virus; 
     (b) provide a pair of primers comprising a forward and a reverse primer specific to the M gene of Influenza A subtypes H1N1, H3N2, H5N1, and H7N9, wherein the forward primer is selected from a group of SEQ ID NO:2, SEQ ID NO:3, SEQ ID NO:4, SEQ ID NO:5, SEQ ID NO:6, SEQ ID NO:7, and SEQ ID NO:8; and the reverse primer is selected from a group of SEQ ID NO:11, SEQ ID NO:12, SEQ ID NO:13, SEQ ID NO:14, SEQ ID NO:15, SEQ ID NO:16, SEQ ID NO:17, and SEQ ID NO:18;
 
(c) provide a pair of primers comprising a forward and a reverse primer specific to the NS gene of Influenza B virus, wherein the forward primer is selected from a group of SEQ ID NO:20, SEQ ID NO:21, SEQ ID NO:22, SEQ ID NO:23, SEQ ID NO:24, and SEQ ID NO:25; and the reverse primer is selected from a group of SEQ ID NO:29, SEQ ID NO:30, SEQ ID NO:31, SEQ ID NO:32, SEQ ID NO:33, SEQ ID NO:34, SEQ ID NO:35, and SEQ ID NO:36;
 
(d) provide the ms2 and a pair of primers comprising a forward and a reverse primer of the ms2 as an internal control, wherein the forward primer is selected from a group of SEQ ID NO:38, SEQ ID NO:39, SEQ ID NO:40, and SEQ ID NO:41; and the reverse primer is selected from a group of SEQ ID NO:43, SEQ ID NO:44, SEQ ID NO:45, and SEQ ID NO:46;
 
(e) amplify the nucleic acids contained in the suspected sample and the internal control with a reverse transcriptase and a template-dependent polymerase;
 
(f) anneal two different probes to the nucleic acids contained in the suspected sample to form a hybridized product during step (e), wherein the first probe specific to the Influenza A subtypes H1N1, H3N2, H5N1, and H7N9 is selected from a group of SEQ ID NO:9 and SEQ ID NO:10; and the second probe specific to the Influenza B virus is selected from a group of SEQ ID NO:27 and SEQ ID NO:28;
 
(g) anneal the probe specific to the ms2 to form a hybridized product during step (e), wherein the probe sequence is as SEQ ID NO:42; and
 
(h) detect three distinct signals generating from the hybridized products as an indicator of the presence of the target nucleic acid of the Influenza A subtypes H1N1, H3N2, H5N1, and H7N9 and/or Influenza B virus and the internal control, respectively.
 
     Embodiment 1 LOD of Influenza A Subtypes H1N1, H3N2, H5N1, and H7N9 
     H3N2 particles of known-concentration were used in this embodiment as the representative of Influenza A subtypes H1N1, H3N2, H5N1, and H7N9. Two serial dilutions were prepared from 10 3  copy number to 10 2  and 10 1  copy number. Primers having SEQ ID NO:5 (F) and SEQ ID NO:18 (R) are used to amplify the M gene of Influenza A subtypes H1N1, H3N2, H5N1, or H7N9. A probe having SEQ ID NO: 9 is also used in this embodiment. The probe can also be replaced with SEQ ID NO: 10. For internal control, primers having SEQ ID NO: 39 (F) and SEQ ID NO:45 (R) are used to amplify the ms2. A probe having SEQ ID NO: 42 is also used in this embodiment. The primer and probe sequences are shown in Table 1. 
     
       
         
           
               
             
               
                 TABLE 1 
               
             
            
               
                   
               
               
                 Primer Sequence 
               
               
                 Primers used in the examples 
               
            
           
           
               
               
               
            
               
                 Sequence ID 
                 Function 
                 Sequence 5′-3′ 
               
               
                   
               
            
           
           
               
            
               
                 M gene 
               
            
           
           
               
               
               
            
               
                 SEQ ID NO: 5 
                 Forward 
                 TCAGGCCCCCTCAAAGCCGA 
               
               
                   
                 primer 
                   
               
               
                   
               
               
                 SEQ ID NO: 18 
                 Reverse 
                 CTACGCTGCAGTCCTCGCTCA 
               
               
                   
                 primer 
                   
               
               
                   
               
               
                 SEQ ID NO: 9 
                 probe 
                 TTCACGCTCACCGTGCC 
               
               
                   
               
            
           
           
               
            
               
                 ms2 
               
            
           
           
               
               
               
            
               
                 SEQ ID NO: 39 
                 Forward 
                 CTGGCGCGTACGTAAAGTCTCC 
               
               
                   
                 primer 
                   
               
               
                   
               
               
                 SEQ ID NO: 45 
                 Reverse 
                 GACCCCGTTAGCGAAGTTGC 
               
               
                   
                 primer 
                   
               
               
                   
               
               
                 SEQ ID NO: 42 
                 probe 
                 CCCTCAACCGGAGTTTGAAGCATG 
               
               
                   
               
            
           
         
       
     
     The amplification was carried out and was measured and monitored in real-time on a Roche Light Cycler 96 Real-time System (Roche Molecular Systems, Inc.). Each reaction mixture volume was 20 μl, and was amplified under the following conditions: 
     
       
         
           
               
             
               
                 TABLE 2 
               
             
            
               
                   
               
               
                 Conditions of the Amplification of the reference samples 
               
            
           
           
               
               
               
            
               
                   
                 H3N2 particles 
                 Negative  
               
            
           
           
               
               
               
               
               
            
               
                   
                 10 3   
                 10 2   
                 10 1   
                 control 
               
               
                   
               
            
           
           
               
               
               
            
               
                 Sample RNA template 
                 1 μl 
                 0 
               
            
           
           
               
               
               
            
               
                 Flu A Primer (F) 
                 0.3  
                 μM 
               
               
                 Flu A Primer (R) 
                 0.3  
                 μM 
               
               
                 Flu A Probe 
                 0.15  
                 μM 
               
               
                 ms2 
                 10 2    
                 copies 
               
               
                 ms2 primer (F) 
                 0.3  
                 μM 
               
               
                 ms2 primer (R) 
                 0.3  
                 μM 
               
               
                 ms2 probe 
                 0.15  
                 μM 
               
               
                 dNTP 
                 0.5  
                 mM 
               
               
                 DNA Polymerase 
                 5  
                 units 
               
               
                 RNA dependent DNA polymerase 
                 20  
                 units 
               
               
                 RNase inhibitor 
                 10  
                 units 
               
               
                 Total Volume  
                 20  
                 μl 
               
               
                   
               
            
           
         
       
     
     The reaction mixtures were firstly subjected to reverse transcription for 2 minutes at 50° C. The actual amplification reaction was first incubated at 95° C. for 2 min, and then carried out for 50 cycles according to the following scheme:
 
95° C. 1 sec.→60° C. 1 sec.
 
       FIG.  2    shows the kinetic PCR growth curve for the given pair of primers, probes, and internal control. When the growth curves of the 10 3 , 10 2 , and 10 1  of H3N2 particles exceed the threshold, an unambiguous and specific signal is initially detectable. The detection limit could reach to 10 1  copy number under such condition and primer sequences. 
     In other words, if a suspected sample was infected by Influenza A subtypes H1N1, H3N2, H5N1, or H7N9, all of which contain the M gene sequence, a climbing curve will show in the kinetic PCR growth curve. In the meantime, the ms2 signal is also detectable as a representative of adequate process. 
     Embodiment 2 LOD of Influenza B Virus 
     The Malaysia 2506/2004 strain, which is a strain of Influenza B/Victoria/2/87-like virus, was used in this embodiment as the representative of two lineages of Influenza B virus. Two serial dilutions were prepared from 10 3  virus copy number to 10 2  and 10 1  copy number. Primers having SEQ ID NO:22 (F) and SEQ ID NO:33 (R) are used to amplify a suspected NS gene of Influenza B virus. A probe having SEQ ID NO: 28 is also used in this embodiment. The probe can also be replaced to SEQ ID No: 27. For internal control, primers having SEQ ID NO: 39 (F) and SEQ ID NO:45 (R) are used to amplify the ms2. A probe having SEQ ID NO: 42 is also used in this embodiment. The primer and probe sequences are shown in Table 3. 
     
       
         
           
               
             
               
                 TABLE 3 
               
             
            
               
                   
               
               
                 Primer Sequence 
               
               
                 Primers used in the examples 
               
            
           
           
               
               
               
            
               
                 Sequence ID 
                 Function 
                 Sequence 5′-3′ 
               
               
                   
               
            
           
           
               
            
               
                 NS gene 
               
            
           
           
               
               
               
            
               
                 SEQ ID NO: 22 
                 Forward 
                 AAGATGGCCATCGGATCCTC 
               
               
                   
                 primer 
                   
               
               
                   
               
               
                 SEQ ID NO: 33 
                 Reverse 
                 GGTGATAATCGGTGCTCTTGACC 
               
               
                   
                 primer 
                   
               
               
                   
               
               
                 SEQ ID NO: 28 
                 probe 
                 CCAATTCGAGCAGCTGAAACTGCG 
               
               
                   
               
            
           
           
               
            
               
                 ms2 
               
            
           
           
               
               
               
            
               
                 SEQ ID NO: 39 
                 Forward 
                 CTGGCGCGTACGTAAAGTCTCC 
               
               
                   
                 primer 
                   
               
               
                   
               
               
                 SEQ ID NO: 45 
                 Reverse 
                 GACCCCGTTAGCGAAGTTGC 
               
               
                   
                 primer 
                   
               
               
                   
               
               
                 SEQ ID NO: 42 
                 probe 
                 CCCTCAACCGGAGTTTGAAGCATG 
               
               
                   
               
            
           
         
       
     
     The amplification was carried out and was measured and monitored in real-time on a Roche Light Cycler 96 Real-time System (Roche Molecular Systems, Inc.). Each reaction mixture volume was 20 μl, and was amplified under the following conditions: 
     
       
         
           
               
             
               
                 TABLE 4 
               
             
            
               
                   
               
               
                 Conditions of the Amplification of the reference samples 
               
            
           
           
               
               
               
            
               
                   
                 Influenza B virus particles 
                 Negative  
               
            
           
           
               
               
               
               
               
            
               
                   
                 10 3   
                 10 2   
                 10 1   
                 control 
               
               
                   
               
            
           
           
               
               
               
            
               
                 Sample RNA template 
                 1 μl 
                 0 
               
            
           
           
               
               
               
            
               
                 Flu B Primer (F) 
                 0.3  
                 μM 
               
               
                 Flu B Primer (R) 
                 0.3  
                 μM 
               
               
                 Flu B Probe 
                 0.15  
                 μM 
               
               
                 ms2 
                 10 2    
                 copies 
               
               
                 ms2 primer (F) 
                 0.3  
                 μM 
               
               
                 ms2 primer (R) 
                 0.3  
                 μM 
               
               
                 ms2 probe 
                 0.15  
                 μM 
               
               
                 dNTP 
                 0.5  
                 mM 
               
               
                 DNA Polymerase 
                 5  
                 unit 
               
               
                 RNA dependent DNA polymerase 
                 20  
                 unit 
               
               
                 RNase inhibitor 
                 10  
                 unit 
               
               
                 Total Volume  
                 20  
                 μl 
               
               
                   
               
            
           
         
       
     
     The reaction mixtures were firstly subjected to reverse transcription for 2 minutes at 50° C. The actual amplification reaction was first incubated at 95° C. for 2 min, and then carried out for 50 cycles according to the following scheme:
 
95° C. 1 sec.→60° C. 1 sec.
 
       FIG.  3    shows the kinetic PCR growth curve for the given pair of primers, probes, and internal control. When the growth curves of the 10 3 , 10 2 , and 10 1  of Malaysia 2506/2004 particles exceed the threshold, an unambiguous and specific signal is initially detectable. The detection limit could reach to 10 1  copy number in this condition. 
     In other words, if a suspected sample was infected by Influenza B virus, which contains the NS gene sequence, a climbing curve will show in the kinetic PCR growth curve. In the meantime, the ms2 signal is also detectable as a representative of adequate process. 
     Embodiment 3 Influenza A Subtypes H1N1, H3N2, H5N1, and H7N9 and Influenza B Virus Detection 
     The present invention discloses a method to detect the presence of at least one of the four Influenza A subtypes H1N1, H3N2, H5N1, and H7N9, and/or Influenza B virus, respectively. Preferably, the present invention does not comprise the step of sample preparation. After purification or isolation of the nucleic acids from a suspected sample, which might be throat/nasal swabs or nasopharyngeal swabs, the nucleic acids are contained in the sample collection buffer. 
     This embodiment is to provide a detection method for detecting the presence of the M gene of Influenza A subtypes H1N1, H3N2, H5N1, or H7N9 in a suspected sample of an unknown patient with flu-like symptoms, wherein the nucleic acid of the suspected samples is contained in the sample collection buffer as mentioned above. The presence of the NS gene of Influenza B virus is also detected simultaneously. To be more precise, if a suspected sample contains at least one of Influenza A subtype H1N1, H3N2, H5N1, or H7N9, the detection result would reflect such outcome that at least one subtype of Influenza A virus is present in this suspected sample regardless of which one of these four subtypes is present. Also, if a suspected sample contains at least one strain of Influenza B virus, it would also be detected by this invention simultaneously. And also, if a suspected sample contains at least one of Influenza A subtype H1N1, H3N2, H5N1 and H7N9 and/or Influenza B virus, then it would be detected separately. 
     For detecting at least one of Influenza A subtypes H1N1, H3N2, H5N1, or H7N9, primers having SEQ ID NO:5 (F) and SEQ ID NO:18 (R) are used to amplify the M gene of Influenza A subtypes H1N1, H3N2, H5N1, or H7N9. A probe having SEQ ID NO: 9 is also used in this embodiment. For internal control, primers having SEQ ID NO: 39 (F) and SEQ ID NO:45 (R) are used to amplify the ms2. A probe having SEQ ID NO: 42 is also used in this embodiment. The primer and probe sequences are shown in Table 1. 
     For detecting Influenza B virus, primers having SEQ ID NO:22 (F) and SEQ ID NO:33 (R) are used to amplify a suspected NS gene of Influenza B virus. A probe having SEQ ID NO: 28 is also used in this embodiment. For internal control, primers having SEQ ID NO: 39 (F) and SEQ ID NO:45 (R) are used to amplify the ms2. A probe having SEQ ID NO: 42 is also used in this embodiment. The primer and probe sequences are shown in Table 3. 
     The amplification was carried out and was measured and monitored in real-time on a Roche Light Cycler 96 Real-time System (Roche Molecular Systems, Inc.). Each reaction mixture volume was 20 μl, and was amplified under the following conditions: 
     
       
         
           
               
             
               
                 TABLE 5 
               
             
            
               
                   
               
               
                 Conditions of the Amplification of the reference samples 
               
            
           
           
               
               
               
               
            
               
                   
                   
                 Samples 
                 Negative  
               
               
                   
                   
                 to-be detected 
                 control 
               
               
                   
                   
               
               
                   
                 Sample RNA template 
                 1 μl 
                 0 
               
               
                   
                 Flu A Primer (F) 
                 0.3  
                 μM 
               
               
                   
                 Flu A Primer (R) 
                 0.3  
                 μM 
               
               
                   
                 Flu B Primer (F) 
                 0.3  
                 μM 
               
               
                   
                 Flu B Primer (R) 
                 0.3  
                 μM 
               
               
                   
                 Flu A Probe 
                 0.15  
                 μM 
               
               
                   
                 Flu B Probe 
                 0.15  
                 μM 
               
               
                   
                 ms2 
                 10 2    
                 copies 
               
               
                   
                 ms2 primer (F) 
                 0.3  
                 μM 
               
               
                   
                 ms2 primer (R) 
                 0.3  
                 μM 
               
               
                   
                 ms2 probe 
                 0.15  
                 μM 
               
               
                   
                 dNTP 
                 0.5  
                 mM 
               
               
                   
                 DNA Polymerase 
                 5  
                 units 
               
               
                   
                 RNA dependent DNA polymerase 
                 20  
                 units 
               
               
                   
                 RNase inhibitor 
                 10  
                 units 
               
               
                   
                 Total Volume  
                 20  
                 μl 
               
               
                   
                   
               
            
           
         
       
     
     The reaction mixtures were firstly subjected to reverse transcription for 2 minutes at 50° C. The actual amplification reaction was first incubated at 95° C. for 2 min, and then carried out for 50 cycles according to the following scheme:
 
95° C. 1 sec.→60° C. 1 sec.
 
       FIG.  4    shows the kinetic PCR growth curve for the given pair of primers, probes, and internal control. In  FIG.  4   , the detection results show that the suspected sample contained at least one of Influenza A subtype H1N1, H3N2, H5N2, and H7N9, and Influenza B virus. The suspected sample was then processed with a sequencing procedure, and the results showed that the suspected sample contained Influenza A H3N2 and Influenza B virus Malaysia 2506/2004. 
     Embodiment 4 Random Detection of Influenza A Subtypes H1N1, H3N2, H5N1, and H7N9 and Influenza B Virus 
     In this embodiment, a test for the detection specificity of the present invention is provided. The specificity of a clinical detection refers to the ability of the detection to correctly identify those samples without the disease/symptom. Therefore, a detection with 100% specificity correctly identifies all samples without the disease/symptom. A detection with 80% specificity correctly reports 80% of samples without the disease/symptom as detection negative (true negatives) but 20% samples without the disease/symptom are incorrectly identified as detection positive (false positives). In order to test the specificity of the present invention, 4 samples not belonging to the Orthomyxoviridae species as listed below are provided in this embodiment. The TCID50 of each species is higher than 1.43*10 5 /ml. 
     
       
         
           
               
             
               
                 TABLE 6 
               
               
                   
               
               
                 Sample list of the 4 samples 
               
               
                   
               
             
            
               
                   
               
            
           
           
               
               
               
            
               
                   
                 No. 1 
                 Parainfluenza virus type 1 
               
               
                   
                 No. 2 
                 Parainfluenza virus type 2 
               
               
                   
                 No. 3 
                 Parainfluenza virus type 3 
               
               
                   
                 No. 4 
                 Human coxsackievirus A16 
               
               
                   
                   
               
            
           
         
       
     
     The same preparation procedures and amplification conditions are used in these 4 samples, including the designated primers and probes which are specific to Influenza A H1N1, H3N2, H5N1, and H7N9 (Primers: SEQ ID NO:5 and SEQ ID NO:18; Probe: SEQ ID NO: 9), and Influenza B virus (Primers: SEQ ID NO:22 and SEQ ID NO:33; Probe: SEQ ID NO: 28), respectively. The ms2 particles, the primers, and the probe (Primers: SEQ ID NO: 39 and SEQ ID NO:45; Probe: SEQ ID NO: 42) are also used in this embodiment as an internal control. 
     The amplification is carried out and was measured and monitored in real-time on a Roche Light Cycler 96 Real-time System. (Roche Molecular Systems, Inc.) Each reaction mixture volume was 20 μl, and was amplified under the following conditions: 
     
       
         
           
               
             
               
                 TABLE 7 
               
             
            
               
                   
               
               
                 Conditions of the Amplification of the reference samples 
               
            
           
           
               
               
               
            
               
                   
                 Samples  
                 Negative  
               
               
                   
                 to-be detected 
                 control 
               
               
                   
               
               
                 Suspected Sample  
                 1 μl 
                 0 
               
               
                 Flu A Primer (F) 
                 0.3  
                 μM 
               
               
                 Flu A Primer (R) 
                 0.3  
                 μM 
               
               
                 Flu B Primer (F) 
                 0.3  
                 μM 
               
               
                 Flu B Primer (R) 
                 0.3  
                 μM 
               
               
                 Flu A Probe 
                 0.15  
                 μM 
               
               
                 Flu B Probe 
                 0.15  
                 μM 
               
               
                 ms2 
                 10 2    
                 copies 
               
               
                 ms2 primer (F) 
                 0.3  
                 μM 
               
               
                 ms2 primer (R) 
                 0.3  
                 μM 
               
               
                 ms2 probe 
                 0.15  
                 μM 
               
               
                 dNTP 
                 0.5  
                 mM 
               
               
                 DNA Polymerase 
                 5  
                 units 
               
               
                 RNA dependent DNA polymerase 
                 20  
                 units 
               
               
                 RNase inhibitor 
                 10  
                 units 
               
               
                 Total Volume  
                 20  
                 μl 
               
               
                   
               
            
           
         
       
     
     The reaction mixtures were firstly subjected to reverse transcription for 2 minutes at 50° C. The actual amplification reaction was first incubated at 95° C. for 2 min, and then carried out for 50 cycles according to the following scheme:
 
95° C. 1 sec.→60° C. 1 sec.
 
       FIG.  5    shows the kinetic PCR growth curve for the given pair of primers, probes, and internal control. In  FIG.  5   , the detection results of these four samples show that no samples were detected and recognized as Influenza A subtypes H1N1, H3N2, H5N1, and H7N9, nor as Influenza B virus while the internal controls of each species were normally detected. Therefore, the specificity of the present invention is able to reach a 100% specificity correction in identifying Influenza A subtypes H1N1, H3N2, H5N1, or H7N9, as well as to the Influenza B virus.