Molecular diagnosis of respiratory virus infections

The appearance of eight new respiratory viruses, including the SARS coronavirus in 2003 and swine-origin influenza A/H1N1 in 2009, in the human population in the past nine years has tested the ability of virology laboratories to develop diagnostic tests to identify these viruses. Nucleic acid based amplification tests (NATs) for respiratory viruses were first introduced two decades ago and today are utilized for the detection of both conventional and emerging viruses. These tests are more sensitive than other diagnostic approaches, including virus isolation in cell culture, shell vial culture (SVC), antigen detection by direct fluorescent antibody (DFA) staining, and rapid enzyme immunoassay (EIA), and now form the backbone of clinical virology laboratory testing around the world. NATs not only provide fast, accurate and sensitive detection of respiratory viruses in clinical specimens but also have increased our understanding of the epidemiology of both new emerging viruses such as the pandemic H1N1 influenza virus of 2009, and conventional viruses such as the common cold viruses, including rhinovirus and coronavirus. Multiplex polymerase chain reaction (PCR) assays introduced in the last five years detect up to 19 different viruses in a single test. Several multiplex PCR tests are now commercially available and tests are working their way into clinical laboratories. The final chapter in the evolution of respiratory virus diagnostics has been the addition of allelic discrimination and detection of single nucleotide polymorphisms associated with antiviral resistance. These assays are now being multiplexed with primary detection and subtyping assays, especially in the case of influenza virus. These resistance assays, together with viral load assays, will enable clinical laboratories to provide physicians with new and important information for optimal treatment of respiratory virus infections.

A duplex real-time polymerase chain reaction assay for the simultaneous detection of long terminal repeat regions and envelope protein gene sequences of Reticuloendotheliosis virus in avian blood samples

The Reticuloendotheliosis virus (REV) group of retroviruses infects a wide range of avian species, including chickens, turkeys, ducks, geese, quail, and prairie chickens. The objective of the present study was to develop a highly sensitive and specific diagnostic test for the detection of REV in whole blood samples. In order to increase the diagnostic sensitivity, a duplex real-time polymerase chain reaction (PCR) that detects both the envelope protein gene ( env) and the long terminal repeat (LTR) region of REV was designed. This assay demonstrated greater analytical and diagnostic sensitivity than the gel-based PCR assay when using DNA extracted from whole blood by both phenol-chloroform and magnetic bead methods. In general, threshold cycle values in the duplex real-time PCR assay were lower from DNA extracted using the magnetic bead system compared to DNA extracted by the phenol-chloroform method. Data presented herein show the successful development of a rapid and accurate test procedure, with high-throughput capability, for the diagnosis of REV infection using avian blood samples.

Comparison of real-time reverse transcription-PCR and virus isolation for estimating prevalence of avian influenza virus in hunter-harvested wild birds at waterfowl wintering grounds along the Texas mid-Gulf Coast (2005-2006 through 2008-2009)

Historically, virus isolation has been the method of choice for conducting surveillance for avian influenza virus (AIV) in avian species. More recently, the primary screening method has become real-time reverse transcription-polymerase chain reaction (RRT-PCR). We wanted to determine how these two testing methods (virus isolation and RRT-PCR) affected AIV prevalence estimation, particularly in an understudied, low-prevalence region-the waterfowl wintering grounds along the Texas mid-Gulf Coast. Cloacal swabs were collected from hunter-harvested waterfowl and other wetland-associated game birds during four consecutive hunting seasons (2005-2006 through 2008-2009). Overall prevalence by RRT-PCR (5.9%, 6.5%, 11.2%, and 5.5%) was approximately an order of magnitude higher than prevalence by virus isolation (0.5%, 1.3%, 3.9%, and 0.7%) for the four hunting seasons, respectively. Apparent AIV prevalence by virus isolation conducted only on RRT-PCR-positive samples resulted in estimates nearly identical in magnitude to those derived from parallel testing (0.5% vs. 0.6%, 1.3% vs. 1.7%, and 3.9% vs. 4.0% for 2005-2006, 2006-2007, and 2007-2008, respectively). Unlike most reports of seasonal variation in AIV prevalence, we documented differences in prevalence estimates among months by RRT-PCR only during 2008-2009 and by virus isolation only during 2006-2007 and 2007-2008. Our data indicate that screening samples by RRT-PCR followed by virus isolation only on RRT-PCR-positive samples provides a reasonable means to generate prevalence estimates close to the true prevalence as determined by virus isolation. We also confirmed the low prevalence of AIV in waterfowl wintering grounds along the Texas mid-Gulf Coast and demonstrated little variation in prevalence among months during the four hunting seasons sampled.

Methods for molecular surveillance of influenza

Molecular-based techniques for detecting influenza viruses have become an integral component of human and animal surveillance programs in the last two decades. The recent pandemic of the swine-origin influenza A virus (H1N1) and the continuing circulation of highly pathogenic avian influenza A virus (H5N1) further stress the need for rapid and accurate identification and subtyping of influenza viruses for surveillance, outbreak management, diagnosis and treatment. There has been remarkable progress on the detection and molecular characterization of influenza virus infections in clinical, mammalian, domestic poultry and wild bird samples in recent years. The application of these techniques, including reverse transcriptase-PCR, real-time PCR, microarrays and other nucleic acid sequencing-based amplifications, have greatly enhanced the capability for surveillance and characterization of influenza viruses.