Emerging technologies for the detection of rabies virus: challenges and hopes in the 21st century.
The diagnosis of rabies is routinely based on clinical and epidemiological information, especially when exposures are reported in rabies-endemic countries. Diagnostic tests using conventional assays that appear to be negative, even when undertaken late in the disease and despite the clinical diagnos...
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Public Library of Science (PLoS)
2009
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oai:doaj.org-article:18f34de54fe84732a6eca0ce7e4c93e22021-11-25T06:33:11ZEmerging technologies for the detection of rabies virus: challenges and hopes in the 21st century.1935-27271935-273510.1371/journal.pntd.0000530https://doaj.org/article/18f34de54fe84732a6eca0ce7e4c93e22009-09-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/19787037/?tool=EBIhttps://doaj.org/toc/1935-2727https://doaj.org/toc/1935-2735The diagnosis of rabies is routinely based on clinical and epidemiological information, especially when exposures are reported in rabies-endemic countries. Diagnostic tests using conventional assays that appear to be negative, even when undertaken late in the disease and despite the clinical diagnosis, have a tendency, at times, to be unreliable. These tests are rarely optimal and entirely dependent on the nature and quality of the sample supplied. In the course of the past three decades, the application of molecular biology has aided in the development of tests that result in a more rapid detection of rabies virus. These tests enable viral strain identification from clinical specimens. Currently, there are a number of molecular tests that can be used to complement conventional tests in rabies diagnosis. Indeed the challenges in the 21st century for the development of rabies diagnostics are not of a technical nature; these tests are available now. The challenges in the 21st century for diagnostic test developers are two-fold: firstly, to achieve internationally accepted validation of a test that will then lead to its acceptance by organisations globally. Secondly, the areas of the world where such tests are needed are mainly in developing regions where financial and logistical barriers prevent their implementation. Although developing countries with a poor healthcare infrastructure recognise that molecular-based diagnostic assays will be unaffordable for routine use, the cost/benefit ratio should still be measured. Adoption of rapid and affordable rabies diagnostic tests for use in developing countries highlights the importance of sharing and transferring technology through laboratory twinning between the developed and the developing countries. Importantly for developing countries, the benefit of molecular methods as tools is the capability for a differential diagnosis of human diseases that present with similar clinical symptoms. Antemortem testing for human rabies is now possible using molecular techniques. These barriers are not insurmountable and it is our expectation that if such tests are accepted and implemented where they are most needed, they will provide substantial improvements for rabies diagnosis and surveillance. The advent of molecular biology and new technological initiatives that combine advances in biology with other disciplines will support the development of techniques capable of high throughput testing with a low turnaround time for rabies diagnosis.Anthony R FooksNicholas JohnsonConrad M FreulingPhilip R WakeleyAshley C BanyardLorraine M McElhinneyDenise A MarstonAkbar DastjerdiEdward WrightRobin A WeissThomas MüllerPublic Library of Science (PLoS)articleArctic medicine. Tropical medicineRC955-962Public aspects of medicineRA1-1270ENPLoS Neglected Tropical Diseases, Vol 3, Iss 9, p e530 (2009) |
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DOAJ |
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| topic |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
| spellingShingle |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Anthony R Fooks Nicholas Johnson Conrad M Freuling Philip R Wakeley Ashley C Banyard Lorraine M McElhinney Denise A Marston Akbar Dastjerdi Edward Wright Robin A Weiss Thomas Müller Emerging technologies for the detection of rabies virus: challenges and hopes in the 21st century. |
| description |
The diagnosis of rabies is routinely based on clinical and epidemiological information, especially when exposures are reported in rabies-endemic countries. Diagnostic tests using conventional assays that appear to be negative, even when undertaken late in the disease and despite the clinical diagnosis, have a tendency, at times, to be unreliable. These tests are rarely optimal and entirely dependent on the nature and quality of the sample supplied. In the course of the past three decades, the application of molecular biology has aided in the development of tests that result in a more rapid detection of rabies virus. These tests enable viral strain identification from clinical specimens. Currently, there are a number of molecular tests that can be used to complement conventional tests in rabies diagnosis. Indeed the challenges in the 21st century for the development of rabies diagnostics are not of a technical nature; these tests are available now. The challenges in the 21st century for diagnostic test developers are two-fold: firstly, to achieve internationally accepted validation of a test that will then lead to its acceptance by organisations globally. Secondly, the areas of the world where such tests are needed are mainly in developing regions where financial and logistical barriers prevent their implementation. Although developing countries with a poor healthcare infrastructure recognise that molecular-based diagnostic assays will be unaffordable for routine use, the cost/benefit ratio should still be measured. Adoption of rapid and affordable rabies diagnostic tests for use in developing countries highlights the importance of sharing and transferring technology through laboratory twinning between the developed and the developing countries. Importantly for developing countries, the benefit of molecular methods as tools is the capability for a differential diagnosis of human diseases that present with similar clinical symptoms. Antemortem testing for human rabies is now possible using molecular techniques. These barriers are not insurmountable and it is our expectation that if such tests are accepted and implemented where they are most needed, they will provide substantial improvements for rabies diagnosis and surveillance. The advent of molecular biology and new technological initiatives that combine advances in biology with other disciplines will support the development of techniques capable of high throughput testing with a low turnaround time for rabies diagnosis. |
| format |
article |
| author |
Anthony R Fooks Nicholas Johnson Conrad M Freuling Philip R Wakeley Ashley C Banyard Lorraine M McElhinney Denise A Marston Akbar Dastjerdi Edward Wright Robin A Weiss Thomas Müller |
| author_facet |
Anthony R Fooks Nicholas Johnson Conrad M Freuling Philip R Wakeley Ashley C Banyard Lorraine M McElhinney Denise A Marston Akbar Dastjerdi Edward Wright Robin A Weiss Thomas Müller |
| author_sort |
Anthony R Fooks |
| title |
Emerging technologies for the detection of rabies virus: challenges and hopes in the 21st century. |
| title_short |
Emerging technologies for the detection of rabies virus: challenges and hopes in the 21st century. |
| title_full |
Emerging technologies for the detection of rabies virus: challenges and hopes in the 21st century. |
| title_fullStr |
Emerging technologies for the detection of rabies virus: challenges and hopes in the 21st century. |
| title_full_unstemmed |
Emerging technologies for the detection of rabies virus: challenges and hopes in the 21st century. |
| title_sort |
emerging technologies for the detection of rabies virus: challenges and hopes in the 21st century. |
| publisher |
Public Library of Science (PLoS) |
| publishDate |
2009 |
| url |
https://doaj.org/article/18f34de54fe84732a6eca0ce7e4c93e2 |
| work_keys_str_mv |
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