RAPID IMMUNOFLUORESCENCE DIAGNOSIS OF RESPIRATORY SYNCYTIAL VIRUS INFECTIONS AMONG CHILDREN IN EUROPEAN COUNTRIES

32

addition, the bleeding tendency, noted in this patient, may be hazardous. Safety of prostacyclin in pregnancy has not been established but the fetal outcome in this case is reassuring.

JACK FIDLER MICHAEL J. BENNETT MICHAEL DE SWIET CHERYL ELLIS PETER J. LEWIS

Institute of Obstetrics and Gynæcology, Queen Charlotte’s Maternity Hospital, London W6 0X

RAPID IMMUNOFLUORESCENCE DIAGNOSIS OF RESPIRATORY SYNCYTIAL VIRUS INFECTIONS AMONG CHILDREN IN EUROPEAN COUNTRIES

SIR,-On Nov. 1, 1978, there began

comparative study of European virus respiratory laboratories (Copenhagen, Newcastle, Oslo, Stockholm, Turku, Vienna). The study was organised by the European Group for Rapid Laboratory Virus Diagnosis.I Nasopharyngeal secretions in patients less than six years of age were tested by indirect fluorescent antibody technique (FAT).2 All reagents were standardised and their quality control checked by the Newcastle and Stockholm laboratories along the lines suggested by Gardner and McQuillin.3 Reagents (antiglobulin conjugates and virus immune sera) were supplied by Wellcome Reagents Ltd and by the Newcastle and Stockholm laboratories. All participants were experienced in the technique or had attended the course on immunofluorescence for rapid diagnosis in Oslo in March, 1978, arranged by the European group and sponsored by the World Health Organisation. The aims of the study were to promote the use of FAT as a rapid routine diagnostic method in more virus laboratories, to study the epidemiology of some virus infections in children by the standardised technique in different parts of Europe, and to introduce a technique which would be useful for handling specimens at a distance from the main virus laboratory. The preliminary study of respiratory syncytial virus (RSV) identification of the first seven months of the study and which is continuing, are shown in the table. RSV was identified in a

virus infections in children in six

305 of the 1710 specimens which were examined. A notable difference in the epidemiology of the virus infection was observed among the different centres; whereas most infections diagnosed in the Scandinavian laboratories and in Vienna were in January and February the main incidence of RSV infection in Newcastle was in May to June and appeared to be continuing. The observation was unexpected since RSV infections have previously been reported to be most frequent during winter and early spring. Influenza A and parainfluenza virus types 1 and 2 were also sought. All these viruses were found, though in smaller numbers than for RSV; details will be reported elsewhere. Rapid diagnosis by immunofluorescence can be of great clinical value; especially when the diagnosis is available within 2-3 h of admission. In experienced hands, and with standardised reagents which have been quality controlled, this technique is as sensitive as conventional cell culture and far superior to conventional serological methods in children.3 The FAT is also well suited for epidemiological surveillance of these virus infections on a large scale without the need for virus isolation facilities. We hope that the development of this collaborative study will bring further understanding to the epidemiology of respiratory virus infection in children. Ulleval

Sykehus,

Oslo, Norway

I. ØRSTAVIK

Department of Virology, National Bacteriological Laboratory, Stockholm, Sweden

M. GRANDIEN

Department of Virology, University of Tuku, Turku, Finland

P. HALONEN P. ARSTILA

Statens Seruminstitut,

Copenhagen, Denmark Institute of Medical Microbiology, University of Copenhagen Institute of Virology, University of Vienna,

C. H. MORDHORST A. HORNSLETH

Vienna, Austria

T. POPOW-KRAUPP

Department of Virology, Royal Victoria Infirmary, Newcastle upon Tyne

J. MCQUILLIN P. S. GARDNER*

*

Present address (and address for correspondence): Division of Microbiological Reagents and Quality Control, P.H.L.S., Colindale Avenue, London NW9 5HT.

1. Br Med J 1975,iii. 444. Organisation.

2. World Health

Manual for

VIR/77.8. 3. Gardner PS, McQuillin J. Rapid

virus

rapid laboratory

virus

diagnosis

Diagnosis. London: Butterworths,

1974.

PERINATAL LISTERIOSIS IDENTIFICATION OF RSV BY IMMUNOFLUORESCENCE IN SIX DIFFERENT EUROPEAN CENTRES: NOVEMBER

1978, TO MAY 1979

p. 911) advises treatment of and mothers fathers of children with perinatal culture-positive listeriosis. There is no good evidence that listeriosis is responsible for habitual abortion, and the repeated demonstrations that penicillin therapy fails to eradicate genital carriage of group-B streptococci strongly suggests the failure of prophylaxis versus listeria.

SIR,-Your editorial (April 26,

Clinical Laboratories, University of California

School of Medicine, Francisco, California 94143, U.S A.

San

STEPHEN N. COHEN

***There is some evidence that treatment of culture-positive mothers and fathers may reduce the risk of habitual abortion.I.2 The disappointing experience with group-B sd’eptococci may not be relevant to listeria-a rather different organism.-ED. L. Rabinovitz M, Toaff R, Krochik N. Genital listeriosis as a 1273-75. 2. Toaff R, Krochik N, Rabinovitz M. Genital listeriosis in the male. Lancet 1.

Rappaport F, cause

of repeated abortion. Lancet 1960; i:

1962, ii. 482-83.