- The role of laboratory diagnostics in emerging viral infections: the example of the Middle East respiratory syndrome epidemic
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Jasper F. W. Chan , Siddharth Sridhar , Cyril C. Y. Yip , Susanna K. P. Lau , Patrick C. Y. Woo
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J. Microbiol. 2017;55(3):172-182. Published online February 28, 2017
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DOI: https://doi.org/10.1007/s12275-017-7026-y
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Rapidly emerging infectious disease outbreaks place a great
strain on laboratories to develop and implement sensitive
and specific diagnostic tests for patient management and
infection control in a timely manner. Furthermore, laboratories
also play a role in real-time zoonotic, environmental,
and epidemiological investigations to identify the ultimate
source of the epidemic, facilitating measures to eventually
control the outbreak. Each assay modality has unique pros
and cons; therefore, incorporation of a battery of tests using
traditional culture-based, molecular and serological diagnostics
into diagnostic algorithms is often required. As such,
laboratories face challenges in assay development, test evaluation,
and subsequent quality assurance. In this review, we
describe the different testing modalities available for the ongoing
Middle East respiratory syndrome (MERS) epidemic
including cell culture, nucleic acid amplification, antigen detection,
and antibody detection assays. Applications of such
tests in both acute clinical and epidemiological investigation
settings are highlighted. Using the MERS epidemic as an example,
we illustrate the various challenges faced by laboratories
in test development and implementation in the setting
of a rapidly emerging infectious disease. Future directions in
the diagnosis of MERS and other emerging infectious disease
investigations are also highlighted.
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