Chapter 1 : Introduction

Abstract:

Clinical virology incorporates a spectrum of disciplines and information ranging from the x-ray crystallographic structure of viral proteins to the global socioeconomic impact of disease. Clinical virology is the domain of molecular biologists, geneticists, pharmacologists, microbiologists, vaccinologists, immunologists, practitioners of public health, epidemiologists, and clinicians, including both pediatric and adult health care providers. It encompasses events impacting history that range from pandemics and Jennerian vaccination to the identification of new pathogens, mechanisms of disease, and modern countermeasures like antiretrovirals. For example, since the previous edition of this text, sequencing techniques from human specimens have led to the identification of numerous new members of several virus families, including polyomaviruses, orthomyxoviruses, and bunyaviruses (1–3). New viral pathogens have emerged or been recognized, including a camel-associated coronavirus causing the SARS-like Middle East respiratory syndrome, the tick-borne zoonotic orthomyxovirus (Bourbon virus) (2), the bunyaviruses (severe fever with thrombocytopenia virus) (3) and Heartland virus (4, 5), and newly emerged avian and swine influenza viruses causing zoonotic infections (H7N9, H5N6, H6N1, H10N8, H3N2v) (6–10). A bornavirus, belonging to a virus family known to cause disease in animals but with an unproven role in human disease, has been isolated in a cluster of encephalitis cases (11). Well-recognized pathogens like Chikungunya and Zika viruses have spread geographically to cause major outbreaks in the Western Hemisphere (12, 13). The political and social consequences of vaccine denialism have delayed the eradication of polio and measles globally and resulted in re-emerging outbreaks of measles in Europe and North America. Most dramatically, the pattern of relatively limited, albeit lethal, outbreaks of Ebola virus in central Africa over the past 40 years changed in 2014 with the West African outbreak that caused over 28,000 infections leading to over 11,000 fatalities, including more than 500 health care workers, before coming under apparent control in 2016 (http://www.who.int/csr/disease/ebola/en/).