Frontline medical advances

Virology is now a key discipline

Virology is fast emerging as a key discipline within modern healthcare against a backdrop of a shifting global demographic and the impact of climate change.

Report: Mark Nicholls

An illustration of the Zika Virus, which symptoms include mild headaches, maculopapular rash, fever, malaise, conjunctivitis, and arthralgia.

shutterstock/AuntSpray

With the on-going development of new laboratory techniques, antiviral drugs, vaccines and emerging pathogens, the speciality is always evolving, making it both intellectually challenging and exciting.

Dr. Mark Zuckerman

The study, diagnosis and treatment viral infections has grown in importance at a when a panel of scientists and public health experts, convened by the World Health Organisation, listed seven viruses in the top 10 emerging pathogens likely to cause severe outbreaks.

European hospitals and health professionals also face ever-more challenging viral infections as the world population becomes more mobile. Along with HIV, Ebola and Zika – often in the headlines – hantavirus and hepatitis E virus infections are more prevalent and being seen more by European health services.

With medical virology at the forefront of diagnostic advances, UK clinical virologist Dr Mark Zuckerman explained that the perception is that some of these viruses are new, yet in reality have been around for many years but have only more recently gained a higher profile.

Following its outbreak in Brazil, with its huge population, Zika’s impact, for example, has magnified with its presence now seen in the Americas and reported in Europe. Earlier, however, it had emerged in smaller populations in the South Pacific islands.

Zuckerman, who heads Virology at King’s College Hospital, London, said some of the ‘time-honoured’ viruses are now turning up in unusual situations, but more significantly some of the rarer viruses are now appearing in unexpected locations.

Greater global mobility and travel, as well as climate change, are factors within this, he added.

As the challenge of tackling viruses grows, health systems need to adapt to meet those challenges, he pointed out, becoming proactive as well as reactive and embracing new techniques and advances in molecular diagnostic testing and point-of-care testing.

‘Medical virology continues to be at the forefront of technological advances. With the on-going development of new laboratory techniques, antiviral drugs, vaccines and emerging pathogens, the speciality is always evolving, making it both intellectually challenging and exciting.’

In healthcare terms, clinical virology is a relatively new specialty drawing together clinical work, laboratory liaison, research, development and teaching.

Virologists have a role in infection control of norovirus, viral gastroenteritis and flu virus infections, working with microbiology colleagues and infection control nursing teams.

Dr. Mark Zuckerman

Clinical virologists concentrate on the diagnosis and management of patients with viral infections, with rapid diagnosis using molecular based tests, monitoring resistance to antiviral drugs and research and development key parts of the specialty.

‘Patients are generally in hospital or the community with acute or chronic viral infections,’ Zuckerman said. ‘They may have travelled to areas where specific virus infections are endemic; may need screening for viral infections that cause complications in pregnancy and after organ transplantation; and may be immune-compromised and need monitoring as they are at risk of complications of a variety of viral infections, some of which are latent and may reactivate.’
As well as the diagnosis and management of acute infections, there is a high level of involvement in the management of chronic infections, which include HIV and chronic hepatitis B and C, herpes virus infections in immune-compromised hosts as well as with emerging infections including Zika, Ebola, hepatitis E, avian flu and pandemic influenza.

Clinical virologists also work closely with laboratory scientists in day-to-day diagnostics involving serological assays and molecular tests, including polymerase chain reaction (PCR) and sequencing and also ensure antiviral drugs are prescribed and used appropriately.

‘Virologists have a role in infection control of norovirus, viral gastroenteritis and flu virus infections, working with microbiology colleagues and infection control nursing teams.

‘The multidisciplinary nature of the job involves daily contact with a variety of healthcare professionals including hospital doctors, general practitioners, microbiologists, trainees, infection control nurses, healthcare and clinical scientists and public health doctors,’ said Zuckerman, who also chairs the Clinical Virology Network (CVN), a co-ordinated group of laboratories in major centres in the UK and Ireland, which promotes the interests of clinical virology, providing evidence-based and practical virology advice on viral infections and helps to establish and maintain the standards of practice amongst its membership and promotes a uniform approach to surveillance.

06.11.2016

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