a b s t r a c tHuman respiratory syncytial virus (RSV) is a major health problem and the main cause of hospitalization due to bronchiolitis. RSV is divided into two antigenic subgroups, RSV-A and -B that co-circulate worldwide. Rapid and sensitive detection is desirable for proper patient handling while assessment of viral load may help to evaluate disease severity and progression. Finally RSV subtyping is needed to determine the prevalence and pathogenicity of each RSV subgroup, as well as their sensitivity to treatment. In this study, we took into account the most recent circulating RSV variants and designed two quantitative TaqMan one-step RT-PCR assays to detect and quantify both RSV subgroups separately. Standard dilutions of transcripts of positive and negative polarities were included in the assay validation to assess potential differences in sensitivity on negative-sense genomes and positive-sense RNAs. In addition, RSV detection in respiratory specimens of different types and sampled in different populations was compared to commercially available RSV diagnostic tools. Altogether, the RSV-A and -B assays revealed sensitive and quantitative over a wide range of viral loads, with a slight improved sensitivity of the RSV-B assay on positive sense transcripts, and allowed accurate RSV subtyping. We thus provide a useful tool for both RSV diagnostics and research.

BACKGROUND Carbon monoxide poisoning is an important cause of morbidity and mortality worldwide. Symptoms are mostly aspecific, making it harder to identify, and its diagnosis is usually made through blood gas analysis. However, the bulkiness of gas analyzers prevents them from being used at the scene of the incident, thereby leading to the unnecessary transport and admission of several patients. While multiple wavelengths pulse oximeters have been developed to discriminate carboxyhemoglobin from oxyhemoglobin, their reliability is debatable, particularly in the hostile prehospital environment. OBJECTIVE The main objective of this pilot study was to assess whether the Avoximeter 4000, a transportable blood gas analyzer, could be considered for prehospital triage. METHODS Blood samples from an emergency department cohort of 68 patients and 12 forensic specimens were tested using the Avoximeter 4000. A standard intra-hospital blood gas analyzer (ABL827 FLEX) was used as gold standard. RESULTS The Avoximeter overestimated carboxyhemoglobin levels by a mean difference of 1.8% (95% CI 1.5-2.1) and yielded a diagnostic specificity of 95.6% (95%CI 87.0-98.6) according to commonly accepted diagnostic thresholds. CONCLUSIONS The limited difference, which erred on the side of safety, and the relatively low overtriage rate warrant further exploration of this device as a prehospital triage tool.