Chapter 78 : Influenza Viruses

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Influenza viruses replicate predominantly in the ciliated columnar epithelium of the respiratory tract. Early in infection, large amounts of virus are shed into respiratory secretions which when expelled through sneezing and coughing can be transmitted to close contacts. This chapter focuses on diagnosis of influenza A and B viruses since these types are the major human pathogens. Vaccination is the primary means to reduce the impact of influenza viruses and the disease they cause. Identification of influenza viruses must be done by hemadsorption, hemagglutinin (HA) titration, or fluoescent antibody (FA) staining. Reverse transcriptase PCR (RT-PCR) can be used for the detection of influenza viruses in original respiratory samples from patients, or for the characterization of viruses grown in tissue culture or embryonated eggs. The gold standard for serodiagnosis of infection or response to vaccination with human influenza viruses is the hemagglutination inhibition (HAI) assay. The microneutralization test is an alternative method for the detection of strain-specific antibodies to influenza viruses and in some cases may be more sensitive than the HAI test. The microneutralization test is a highly sensitive assay applicable to the identification of virus-specific antibody in human sera. The neutralization test has several additional advantages for detecting antibody to influenza virus. However, specialized laboratories must continue to use more sophisticated techniques such as virus isolation, RT-PCR, and serological methods in order to monitor the antigenic and genetic characteristics of influenza viruses circulating worldwide.

Citation: Katz J, Klimov A, Lindstrom S, Cox N. 2006. Influenza Viruses, p 691-699. In Detrick B, Hamilton R, Folds J (ed), Manual of Molecular and Clinical Laboratory Immunology, 7th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815905.ch78

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Influenza A virus Subtype H3N2
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Rapid diagnostic tests for influenza

Citation: Katz J, Klimov A, Lindstrom S, Cox N. 2006. Influenza Viruses, p 691-699. In Detrick B, Hamilton R, Folds J (ed), Manual of Molecular and Clinical Laboratory Immunology, 7th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815905.ch78
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Sensitivity, specificity, and predictive values of tests

Citation: Katz J, Klimov A, Lindstrom S, Cox N. 2006. Influenza Viruses, p 691-699. In Detrick B, Hamilton R, Folds J (ed), Manual of Molecular and Clinical Laboratory Immunology, 7th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815905.ch78
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Antigenic drift of H3N2 viruses between 1968 and 2004 as demonstrated by their cross-reactivities in HAI tests using postinfection ferret sera

Citation: Katz J, Klimov A, Lindstrom S, Cox N. 2006. Influenza Viruses, p 691-699. In Detrick B, Hamilton R, Folds J (ed), Manual of Molecular and Clinical Laboratory Immunology, 7th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815905.ch78

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