Advances in the diagnosis of respiratory virus infections

Abstract

The choice of diagnostic methods for respiratory virus infections depends on the type and location of the laboratory, the number of specimens tested, and the previous experience of the laboratory. Virus culture, whenever possible, should be the basic diagnostic method; the results, including identification of the virus, should be available no more than 24 h later than the results of rapid diagnostic tests. In small laboratories, especially in hospitals where specimen transportation is well organized, immunofluorescence may be the best choice for antigen detection with the provision that an experienced microscopist and a good UV microscope are available. If the laboratory receives a large number of specimens and has previous experience with EIAs, then biotin-EIAs or TR-FIAs may be the most practical techniques. Their advantages include the stability of the antigens in clinical samples since intact, exfoliated epithelial cells are not required, treatment of specimens is practical, testing of large numbers of specimens is possible, and reading the printed test result is less subjective than reading fluorescence microscopy. The larger role of PCR in the diagnosis of respiratory virus infections depends on future developments such as practical methods to extract DNA or RNA and to purify the extracts from nonspecific inhibitors, plus further improvements to minimize cross-contamination. Group-specific detection of enteroviruses and rhinoviruses is an example of the potential for PCR technology. In experienced laboratories. EIA IgG antibody tests should be available. Recombinant antigens may be a useful part of such assays.

Epidemiological Investigation of Nine Respiratory Pathogens in Hospitalized Children in Germany Using Multiplex Reverse-Transcriptase Polymerase Chain Reaction

“…The speed of culture in contrast to PCR is also slower, even when early detection systems such as centrifugationamplified cultures (shell vial or spin cultures) are used [5]. Most markedly, this applies to rhinovirus (not yet included in the 9-valent multiplex RT-PCR), which requires up to 28 days to appear in cell culture [6,7]. The multiplex RT-PCR requires 24-48 h of laboratory time, the same as that required for immunofluorescence tests, if performed on large sample numbers, but more than that required for rapid enzyme immunoassays (EIAs).…”

Molecular diagnosis of respiratory virus infections

“…RT-PCR and NASBA assays described for HRV detection are more sensitive than culture [193][194][195][196] . NATs targeting the 5′-UTR are the most sensitive for detection of HRV; however these assays also detect HEV and are not be able to distinguish between these two groups of viruses.…”

The value of virus serology in epidemiological studies of acute otitis media in children

“…The sensitivity level of the assays has earlier been determined to be between 0.1 and 1 ng/ml (Halonen et al, 1996). Positive standards containing cell-culture or egg-grown virus at the detection level of the assay were included in each test run.…”

“…Tests were available for RSV, influenza A and B, parainfluenza 1-3, and adenoviruses (Halonen et al, 1996). In each assay run, cell-culture or egg-grown virus and sample dilution buffer were included as positive and negative controls.…”