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A history of diagnostic virology
Media Watch
Book A history of diagnostic virology To Catch a Virus is a historical account of the development of diagnostic virology intertwined with accounts of disease outbreaks that spurred advances in technology. The authors recount how “the diagnosis of rabies in the dog which bit Joseph Meister in 1885 was based on the findings of wood fragments in the dog’s stomach at necropsy” (at the time believed to be indicative of a rabid dog), and highlight how diagnostic virology has progressed in leaps and bounds since then. Leading us through each discovery and development with clarity and enthusiasm, the authors begin chapter one with a graphic description of the 1793 outbreak of yellow fever in Philadelphia. The chapter then provides an overview of the work of Louis Pasteur and Robert Koch in establishing the germ theory and Koch’s postulates, respectively. Returning to yellow fever, the authors describe the Yellow Fever Commission led by Dr Walter Reed, which was appointed in 1900 to find out how the disease was transmitted among the population and to identify the cause of disease. Human participants had a substantial role in the experimental studies although not without loss. Considering the risks involved, Dr Reed and his colleagues agreed to participate in the studies resulting in the death of Dr Lazear after contracting the virus. The Yellow Fever Commission achieved its aim and confirmed the route of transmission of disease and the filterable nature of the causative agent. Consequently it was established that outbreaks of disease could be eliminated by vector control. Ethical issues surrounding the use of human volunteers to study diseases and the requirement of living cells for replication of filterable agents prompted investigations to identify alternative models. In the second chapter, the authors explore the development and application of animal models for the study of rabies, polio, arthropodborne diseases, and influenza. In 1903, inclusion bodies were first described in the neurons of the central nervous system in animals and human beings infected with rabies. Although their importance was not recognised at the time, these inclusion bodies, later referred to as Negri bodies, are important histopathological markers for rapid diagnosis of rabies and a substantial improvement from diagnosis based on analysis of wood fragments during post mortem of an animal. In the absence of cell cultures, animal models served as the method of viral isolation and characterisation. The authors explore the role of smallpox in furthering knowledge of protective immunity and Edward Jenner’s contribution to vaccinology. Understanding host immune responses led to the development of classic serological assays to detect humoral immune responses to infection, including hemagglutination, complement www.thelancet.com/infection Vol 14 February 2014
fixation, and in-vitro neutralisation assays, and the subsequent establishment of serological tests in diagnostic laboratories. With an account of advances in microscopic techniques, chapter four describes visualisation of viruses and their direct effect on cells. Improvements in histopathological techniques have allowed descriptions of viral cytopathology and, finally, almost 50 years after identification of filterable agents as the cause of mammalian disease, the electron microscope allowed visualisation of these hitherto unseen filterable agents of disease. The establishment of diagnostic virology laboratories was a direct consequence of the development of simplified tissue culture techniques, which made it easier to isolate viruses. More advanced techniques, such as labelling of antibodies to allow visualisation, resulted in enhanced sensitivity of detection and refinement of serological assays. Classic serological assays have largely been replaced by enzyme immunoassays and immunofluorescent assays, which are more sensitive, and are now commonly used in diagnostic laboratories worldwide. The final chapter describes the molecular revolution, a historical overview dating from 1944 with Oswald Avery’s identification of DNA as the molecule of inheritance, to the discovery of the DNA double helix and the genetic code. The application of molecular techniques in the laboratory was in its infancy when HIV was identified as the cause of the AIDS epidemic. In 1981, the first reports were published in which cases of pneumonia, cytomegalovirus infections, and Karposi’s sarcoma were described in homosexual men with immune deficiencies. The AIDS epidemic was instrumental in driving the rapid development of molecular virology, which has an important role in diagnostic and research laboratories. Molecular diagnostics will continue to be important for increasing diagnostic capacity while the application of high-throughput sequencing platforms will substantially advance the discovery of new and emerging or re-emerging viruses. Booss and August conclude that “classical diagnostic virology has evolved remarkably since the concept of viruses as agents of disease became comprehensible”. To Catch a Virus should appeal not only to virologists but to anyone with an interest in the history of infectious diseases and immunology. Historical illustrations add additional life to the story, with historical recounts of the key contributors to our understanding of viruses and the diseases they cause providing an engaging and enthralling read.
To Catch a Virus John Booss, Marilyn J August, ASM Press, 2013. Pp 392. US$39·95. ISBN 978-1555815073
Felicity Burt 107
Book A history of diagnostic virology To Catch a Virus is a historical account of the development of diagnostic virology intertwined with accounts of disease outbreaks that spurred advances in technology. The authors recount how “the diagnosis of rabies in the dog which bit Joseph Meister in 1885 was based on the findings of wood fragments in the dog’s stomach at necropsy” (at the time believed to be indicative of a rabid dog), and highlight how diagnostic virology has progressed in leaps and bounds since then. Leading us through each discovery and development with clarity and enthusiasm, the authors begin chapter one with a graphic description of the 1793 outbreak of yellow fever in Philadelphia. The chapter then provides an overview of the work of Louis Pasteur and Robert Koch in establishing the germ theory and Koch’s postulates, respectively. Returning to yellow fever, the authors describe the Yellow Fever Commission led by Dr Walter Reed, which was appointed in 1900 to find out how the disease was transmitted among the population and to identify the cause of disease. Human participants had a substantial role in the experimental studies although not without loss. Considering the risks involved, Dr Reed and his colleagues agreed to participate in the studies resulting in the death of Dr Lazear after contracting the virus. The Yellow Fever Commission achieved its aim and confirmed the route of transmission of disease and the filterable nature of the causative agent. Consequently it was established that outbreaks of disease could be eliminated by vector control. Ethical issues surrounding the use of human volunteers to study diseases and the requirement of living cells for replication of filterable agents prompted investigations to identify alternative models. In the second chapter, the authors explore the development and application of animal models for the study of rabies, polio, arthropodborne diseases, and influenza. In 1903, inclusion bodies were first described in the neurons of the central nervous system in animals and human beings infected with rabies. Although their importance was not recognised at the time, these inclusion bodies, later referred to as Negri bodies, are important histopathological markers for rapid diagnosis of rabies and a substantial improvement from diagnosis based on analysis of wood fragments during post mortem of an animal. In the absence of cell cultures, animal models served as the method of viral isolation and characterisation. The authors explore the role of smallpox in furthering knowledge of protective immunity and Edward Jenner’s contribution to vaccinology. Understanding host immune responses led to the development of classic serological assays to detect humoral immune responses to infection, including hemagglutination, complement www.thelancet.com/infection Vol 14 February 2014
fixation, and in-vitro neutralisation assays, and the subsequent establishment of serological tests in diagnostic laboratories. With an account of advances in microscopic techniques, chapter four describes visualisation of viruses and their direct effect on cells. Improvements in histopathological techniques have allowed descriptions of viral cytopathology and, finally, almost 50 years after identification of filterable agents as the cause of mammalian disease, the electron microscope allowed visualisation of these hitherto unseen filterable agents of disease. The establishment of diagnostic virology laboratories was a direct consequence of the development of simplified tissue culture techniques, which made it easier to isolate viruses. More advanced techniques, such as labelling of antibodies to allow visualisation, resulted in enhanced sensitivity of detection and refinement of serological assays. Classic serological assays have largely been replaced by enzyme immunoassays and immunofluorescent assays, which are more sensitive, and are now commonly used in diagnostic laboratories worldwide. The final chapter describes the molecular revolution, a historical overview dating from 1944 with Oswald Avery’s identification of DNA as the molecule of inheritance, to the discovery of the DNA double helix and the genetic code. The application of molecular techniques in the laboratory was in its infancy when HIV was identified as the cause of the AIDS epidemic. In 1981, the first reports were published in which cases of pneumonia, cytomegalovirus infections, and Karposi’s sarcoma were described in homosexual men with immune deficiencies. The AIDS epidemic was instrumental in driving the rapid development of molecular virology, which has an important role in diagnostic and research laboratories. Molecular diagnostics will continue to be important for increasing diagnostic capacity while the application of high-throughput sequencing platforms will substantially advance the discovery of new and emerging or re-emerging viruses. Booss and August conclude that “classical diagnostic virology has evolved remarkably since the concept of viruses as agents of disease became comprehensible”. To Catch a Virus should appeal not only to virologists but to anyone with an interest in the history of infectious diseases and immunology. Historical illustrations add additional life to the story, with historical recounts of the key contributors to our understanding of viruses and the diseases they cause providing an engaging and enthralling read.
To Catch a Virus John Booss, Marilyn J August, ASM Press, 2013. Pp 392. US$39·95. ISBN 978-1555815073
Felicity Burt 107