Respiratory virus surveillance and outbreak investigation.
Respiratory virus surveillance and outbreak investigation.
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DOI：
10.1016/s1386-6532(07)70006-9
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发表时间：
2007-11
期刊：
影响因子：
--
通讯作者：
Fox JD
中科院分区：
文献类型：
--
作者：
Fox JD
对呼吸道病毒的敏感、快速检测是监测和调查流行病学相关病例所必需的。基于抗原的快速方法用于检测常见呼吸道病毒和确认暴发原因的实用性已得到充分确立。然而，核酸扩增检测（NAT）提供了一些优于抗原或基于培养的程序的好处，主要优点是可检测病原体的灵敏度和范围。重要的是要了解我们的检测方法的变化如何改变呼吸道病毒检测和流行病学研究的信息。对于甲型流感、B流感和呼吸道合胞病毒等病毒，NAT的灵敏度高于抗原检测，但仍能识别对预测疾病和管理时间敏感的预防措施至关重要的季节性高峰。对于其他病毒，如鼻病毒、冠状病毒、人博卡病毒和副流感病毒4型，培养和基于抗原的程序不可用和/或缺乏敏感性。因此，如果NAT不包括在监测和疫情调查的测试中，这些目标将被错过。随着越来越多的呼吸道病毒被发现，有必要扩大监测，并进一步评估现有诊断之外的新技术和自动化，以解决广泛的潜在病原体的检测问题。
Sensitive, rapid detection of respiratory viruses is needed for surveillance and for investigation of epidemiologically linked cases. The utility of rapid antigen-based methods for detection of common respiratory viruses and to confirm the cause of outbreaks is well established. However, nucleic acid amplification tests (NATs) offer some benefits above antigen or culture-based procedures, with the main advantages being sensitivity and range of pathogens detectable. It is important to understand how changes in our testing methodology alter respiratory virus detection and information for epidemiological studies. For viruses such as influenza A, influenza B and respiratory syncytial virus, NATs offer enhanced sensitivity above antigen assays but still identify the seasonal peaks important for predicting disease and managing time-sensitive prophylaxis. For other viruses, such as rhinoviruses, coronaviruses, human bocavirus and parainfluenza virus type 4, culture and antigen-based procedures are not available and/or lack sensitivity. Thus such targets would be missed if NATs were not included in testing for surveillance and outbreak investigation. As more respiratory viruses are identified there is a need to expand surveillance and further evaluate new technologies and automation beyond currently-available diagnostics to address detection of a broad range of potential pathogens.