Respiratory RNA Viruses

Abstract

Acute upper and lower respiratory infections are a major public health problem and a leading cause of morbidity and mortality worldwide. At greatest risk are young children, the elderly, the chronically ill, and those with suppressed or compromised immune systems. Viruses are the predominant cause of respiratory tract illnesses and include RNA viruses such as respiratory syncytial virus, influenza virus, parainfluenza virus, metapneumovirus, rhinovirus, and coronavirus. Laboratory testing is required for a reliable diagnosis of viral respiratory infections, as a clinical diagnosis can be difficult since signs and symptoms are often overlapping and not specific for any one virus. Recent advances in technology have resulted in the development of newer diagnostic assays that offer great promise for rapid and accurate detection of respiratory viral infections. This chapter emphasizes the fundamental characteristics and clinical importance of the various RNA viruses that cause upper and lower respiratory tract diseases in the immunocompromised host. It highlights the laboratory methods that can be used to make a rapid and definitive diagnosis for the greatest impact on the care and management of ill patients, and the prevention and control of hospital-acquired infections and community outbreaks.

Comparison of the performance of the Panther Fusion respiratory virus panel to R-Gene and laboratory developed tests for diagnostic and hygiene screening specimens from the upper and lower respiratory tract

“…Similar to our data on 310 LRT specimens, this study revealed a performance of PF assays for LRT specimens that was highly comparable to the performance in URT specimens [36]. Robust detection of viruses in LRT specimens is very important in particular for inpatient care to test individuals with suspected LRT infections, such as pneumonia [17,18].…”

“…While upper respiratory tract (URT) specimens are preferred for ARI routine diagnostics, analysing lower respiratory tract (LRT) specimens can be very helpful to confirm the viral aetiology of LRT infections such as bronchiolitis or pneumonia [17,18]. In addition, seasonal, PCR-based virus screening programmes ('hygiene screening') facilitate rapid infection control measures in patient cohorts at risk, in particular at haemato-oncological wards [19].…”

“…Although respiratory viruses can be identified using cell culture or antigen detection assays (direct fluorescent antibody tests or rapid immunoassays), molecular techniques such as PCR are nowadays the method of choice due to their greater sensitivity [17,20,21]. Besides the recently evolving rapid, sample-to-result automated molecular tests on downsized platforms with single-use cartridges (such as the Cepheid Xpert, GenMark ePlex or Alere I) [22][23][24], a broad variety of multiplex molecular assays based on different PCR machines, in real-time and conventional formats, have been developed in the last few decades, both as laboratory developed tests (LDTs) and as commercially available kits [17]. Multiplex assays, such as real-time PCR respiratory panels, allow rapid diagnosis of a selection of respiratory pathogens at once and can facilitate more comprehensive epidemiological surveys.…”

Comparison of the Panther Fusion and Allplex assays for the detection of respiratory viruses in clinical samples

“…Respiratory viral infections are a major global health problem today [21], and they require accurate diagnostic tools which must be thoroughly evaluated prior to their implementation in routine laboratory practice. In this study, we compared the performance of the Panther Fusion assays with Allplex respiratory panels (approved by Conformité Européenne-in vitro diagnostics [CE-IVD]), using R-GENE technology as a reference method.…”

Pathogenic viruses of the respiratory tract – A review

“…Viral infections of the respiratory tract can be self-limiting upper respiratory tract infections or more serious forms of lower respiratory tract infections. Rapid and accurate detection of pathogenic viruses of the respiratory tract can help the early diagnosis of pathogenic viral infection, decrease the duration of hospitalization and reduce management costs, as well as avoiding additional laboratory testing and unnecessary administration of antibiotics [19,20].…”