The explosion in clinical testing has been especially rapid in virology, where emerging viruses and growing numbers of viral infections are driving advances. The Guide to Clinical and Diagnostic Virology offers a digestible view of the breadth and depth of information related to clinical virology, providing a practical, working knowledge of the wide array of viruses that cause human disease.

Introductory chapters cover the basics of clinical virology and laboratory diagnosis of infections, including virus structure, life cycle, transmission, taxonomy, specimen types and handling, and a comparison of assays used for detection. Detailed sections on important topics include

• Viral pathogens and their clinical presentations
• Diagnostic assays and techniques, including culture-based, immunological, and molecular
• Prevention and management of viral infections, with guidance on biosafety, vaccines, and antiviral therapies
• The regulatory environment for laboratory testing, including regulatory requirements and assay performance and interpretation

Critical concepts are carefully curated and concisely summarized and presented with detailed illustrations that aid comprehension, along with important highlights and helpful hints. These features, plus question sections that reinforce significant ideas and key concepts, make this an invaluable text for anyone looking for an accessible route through clinical and diagnostic virology. Laboratory technologists, medical students, infectious disease and microbiology fellows, pathology residents, researchers, and everyone involved with viruses in the clinical setting will find the Guide to Clinical and Diagnostic Virology an excellent text as well as companion to clinical virology references.

Reeti Khare, PhD, D(ABMM), is the Director of Microbiology at Northwell Health Laboratories in New York. She received her PhD in Virology and Gene Therapy at Mayo Clinic and did a postdoctoral fellowship at the University of Washington. Her research involved reengineering viral vectors, developing adenoviruses for liver gene therapy, and creating viral vector vaccines against MRSA. She returned to Mayo Clinic for her clinical microbiology fellowship and is a diplomate of the American Board of Medical Microbiology. Reeti enjoys teaching and learning about microbiology and has authored numerous publications, chapters, and reviews. At Northwell Health Labs she continues to pursue clinical research and provide student education, and is responsible for laboratory oversight, improving efficiency, designing workflows, and diagnostic microbiology testing.

Preface

Acknowledgments

Abbreviations

About the Author

Section I: Foundations of Clinical Virology

1 Introduction to Viruses
Virus structure, life cycle, Baltimore classification, figures of DNA and RNA virus classification, transmission, nomenclature

2 Laboratory Diagnosis of Viral Infections
Differential diagnosis for viral syndromes, specimen collection, comparison of diagnostic techniques

Section II: Viral Pathogens and Clinical Presentation

3 Respiratory Viruses
Influenza virus, respiratory syncytial virus, human metapneumonvirus, rhinovirus, coronavirus, mumps virus, diagram of seasonality

4 Viruses with Dermatologic Manifestations
Herpes simplex virus, varicella-zoster virus, measles virus, rubella virus, human herpesviruses 6 and 7, molluscum contagiosum, smallpox virus, figure of viral rashes, description and comparison of herpesviruses 1 to -8 

5 Gastrointestinal and Fecal-Oral Hepatitis Viruses
Rotavirus, norovirus, astrovirus, sapovirus, HAV, HEV, diagram of seasonality

6 Viruses That Can Cause Multiple Syndromes
Enterovirus and parechovirus, adenovirus, parvovirus B19, human bocavirus

7 Opportunistic, Transplant-Associated Viruses
Cytomegalovirus, BK virus, JC virus

8 Blood-Borne Hepatitis Viruses
Hepatitis B, C, and D viruses, and comparison of hepatitis viruses A through E

9 Human Retroviruses
HIV, HTLV-1/-2

10 Oncogenic Viruses
HPV, EBV, HHV-8

11 Zoonotic Viruses
Rabies virus, Ebola virus, Marburg virus, Lassa virus, Crimean Congo hemorrhagic virus, hantavirus, lymphochoriomeningitis virus, monkeypox virus, herpes B virus, Hendra virus, Nipah virus, comparison of zoonotic viruses

12 Arboviruses
Mosquitoes, ticks, dengue virus, yellow fever virus, chikungunya virus, West Nile virus, eastern, western and Venezuelan equine encephalitis viruses, Japanese encephalitis virus, Powassan virus, comparison of arboviruses 

Section III: Diagnostic Assays and Techniques

13 Culture- and Tissue-Based Diagnostic Techniques
Conventional viral culture and cell lines, viral growth rates, hemagglutination, quantification of plaques, histology/cytology, histologic and cytologic images of virally infected cells

14 Diagnostic Techniques Based on Immunological Interactions
Kinetics of immune responses, interpreting serologic results, antigen and antibody detection, ELISA and chemiluminescent immunoassay, immunohistochemistry, immunoblots, immunofluorescence, lateral-flow assay, comparison of immunologic assays

15 Molecular Techniques: Nucleic Acid Amplification
Basics of nucleic acids, nucleic acid amplification, PCR, RT-PCR, real-time PCR, quantitative PCR, melt curve analysis, viral loads, droplet digital PCR, nested PCR, multiplex PCR, transcription-mediated amplification, controls, contamination

16 Molecular Techniques: Sequencing
Sequencing terminology, applications, procedures, platforms (Sanger, NGS, Illumina, SMRT, Ion Torrent), data analysis, comparison of platforms 

Section IV:  Prevention and Management of Viral Infections

17 Biosafety
Biosafety levels, select agents, reportable diseases, PPE, techniques, biosafety cabinets, isolation precautions

18 Vaccines
Active and passive immunity, intravenous immunoglobulin, types of vaccines, delivery, complications, antibody dependent enhancement, table of available viral and other vaccines, diagram of routine vaccination schedule

19 Antivirals
Antivirals against herpesviruses, influenza virus, RSV, hepatitis C, other compounds, antiretrovirals and antivirals with broad coverage, mechanisms of action

Section V: The Regulatory Environment for Laboratory Testing

20 Regulatory Requirements
Classification of assays by the FDA, test complexity, regulatory agencies, CLIA, inspections, proficiency testing, billing and coding

21 Assay Performance and Interpretation
Validation/verification, performance characteristics (precision, accuracy, reportable range, reference range), diagnostic, clinical and analytic sensitivity and specificity, prevalence, predictive value, ROC curves

References

Answers

Index