Rapid diagnosis of respiratory virus infections in patients with acute respiratory disease

Viral respiratory infections represent a significant segment of the total respiratory disease spectrum; however, until recently the laboratory diagnosis of viral respiratory infections was relatively inefficient. Development of new and improved immunologic assay systems has paved the way for accurate and reliable rapid diagnostic tests that detect viral antigens in clinical specimens. We conducted a careful and elaborate study in which radioimmunoassay for antigen detection was compared with a battery of tissue culture systems for viral isolation and identification. Using a fine plastic catheter, a specimen of mucus was aspirated from the nasopharynx of patients with clinical signs and symptoms of acute viral upper respiratory tract infections. Each specimen was divided into two portions; one was used to inoculate a variety of tissue culture cell lines and the other was used for radioimmunoassay tests for influenza A and B, adenovirus, parainfluenza 1, 2, and 3, and respiratory syncytial virus. Radioimmunoassay results compared very favorably with the tissue culture data with only one exception—adenovirus. Essentially this degree of accuracy and reproducibility was obtained with an enzyme-linked immunosorbent assay test, which has replaced radioimmunoassay. Tissue cultures are still used for backup, but with a rapid antigen detection system in place, coupled with a modern computer program to facilitate the laboratory data to the clinician, considerable strides have been made, and will continue to be made, in the diagnosis and therapy of viral respiratory tract infections.