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. 1994 Apr;7(2):143–151. doi: 10.1128/cmr.7.2.143

Mixed viral infections: detection and management.

J L Waner 1
PMCID: PMC358314  PMID: 8055464

Abstract

An analysis was done of the incidence and nature of mixed virus infections diagnosed in the same clinical specimen from immunocompetent patients; respiratory viruses were emphasized. Few studies have addressed mixed viral infections in any systematic fashion. The relevant studies reviewed focused on clinical relationships or diagnostic methods. Data relating to multiple infections were usually derived incidentally to the purpose of the investigations. Sixty-three percent of the reports with data on mixed infections identified them in < 5% of the total number of viral infections. Respiratory syncytial virus was the most common coinfecting virus, and respiratory syncytial virus and influenza virus were the most common virus pair identified. In considering rapid diagnostic techniques, in 87% of the reports with available data a virus was diagnosed in > 10% of specimens that were negative for the virus targeted by one method. There was no indication that mixed infections were associated with increased disease in immunocompetent patients or in certain immunocompromised patients. Immunocompromised patients, however, appeared to have a greater incidence of multiple infections. Mixed infections of single cells also occur and may have important clinical implications relative to reactivation of latent viruses and enhanced disease. The requirement for a comprehensive strategy for viral diagnosis involving multiple techniques was indicated by these findings.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Blanding J. G., Hoshiko M. G., Stutman H. R. Routine viral culture for pediatric respiratory specimens submitted for direct immunofluorescence testing. J Clin Microbiol. 1989 Jul;27(7):1438–1440. doi: 10.1128/jcm.27.7.1438-1440.1989. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Bloch W. A biochemical perspective of the polymerase chain reaction. Biochemistry. 1991 Mar 19;30(11):2735–2747. doi: 10.1021/bi00225a001. [DOI] [PubMed] [Google Scholar]
  3. Brandt C. D., Kim H. W., Rodriguez W. J., Arrobio J. O., Jeffries B. C., Parrott R. H. Simultaneous infections with different enteric and respiratory tract viruses. J Clin Microbiol. 1986 Jan;23(1):177–179. doi: 10.1128/jcm.23.1.177-179.1986. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Brandt C. D., Kim H. W., Rodriguez W. J., Arrobio J. O., Jeffries B. C., Stallings E. P., Lewis C., Miles A. J., Chanock R. M., Kapikian A. Z. Pediatric viral gastroenteritis during eight years of study. J Clin Microbiol. 1983 Jul;18(1):71–78. doi: 10.1128/jcm.18.1.71-78.1983. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. CHANOCK R. M., PARROTT R. H. ACUTE RESPIRATORY DISEASE IN INFANCY AND CHILDHOOD: PRESENT UNDERSTANDING AND PROSPECTS FOR PREVENTION. Pediatrics. 1965 Jul;36:21–39. [PubMed] [Google Scholar]
  6. Carballal G., Siminovich M., Murtagh P., Cerqueiro M. C., Avila M., Salomón H., Catalano M., Weissenbacher M. Etiologic, clinical, and pathologic analysis of 31 fatal cases of acute respiratory tract infection in Argentinian children under 5 years of age. Rev Infect Dis. 1990 Nov-Dec;12 (Suppl 8):S1074–S1080. doi: 10.1093/clinids/12.supplement_8.s1074. [DOI] [PubMed] [Google Scholar]
  7. Chao R. K., Fishaut M., Schwartzman J. D., McIntosh K. Detection of respiratory syncytial virus in nasal secretions from infants by enzyme-linked immunosorbent assay. J Infect Dis. 1979 Apr;139(4):483–486. doi: 10.1093/infdis/139.4.483. [DOI] [PubMed] [Google Scholar]
  8. Chonmaitree T., Bessette-Henderson B. J., Hepler R. E., Lucia H. L. Comparison of three rapid diagnostic techniques for detection of respiratory syncytial virus from nasal wash specimens. J Clin Microbiol. 1987 Apr;25(4):746–747. doi: 10.1128/jcm.25.4.746-747.1987. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Clouse K. A., Robbins P. B., Fernie B., Ostrove J. M., Fauci A. S. Viral antigen stimulation of the production of human monokines capable of regulating HIV1 expression. J Immunol. 1989 Jul 15;143(2):470–475. [PubMed] [Google Scholar]
  10. Colberg-Poley A. M., Isom H. C., Rapp F. Reactivation of herpes simplex virus type 2 from a quiescent state by human cytomegalovirus. Proc Natl Acad Sci U S A. 1979 Nov;76(11):5948–5951. doi: 10.1073/pnas.76.11.5948. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Craft A. W., Reid M. M., Gardner P. S., Jackson E., Kernahan J., McQuillin J., Noble T. C., Walker W. Virus infections in children with acute lymphoblastic leukaemia. Arch Dis Child. 1979 Oct;54(10):755–759. doi: 10.1136/adc.54.10.755. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Cruz J. R., Quiñonez E., de Fernandez A., Peralta F. Isolation of viruses from nasopharyngeal secretions: comparison of aspiration and swabbing as means of sample collection. J Infect Dis. 1987 Aug;156(2):415–416. doi: 10.1093/infdis/156.2.415. [DOI] [PubMed] [Google Scholar]
  13. Denny F. W., Clyde W. A., Jr Acute lower respiratory tract infections in nonhospitalized children. J Pediatr. 1986 May;108(5 Pt 1):635–646. doi: 10.1016/s0022-3476(86)81034-4. [DOI] [PubMed] [Google Scholar]
  14. Downham M. A., Gardner P. S., McQuillin J., Ferris J. A. Role of respiratory viruses in childhood mortality. Br Med J. 1975 Feb 1;1(5952):235–239. doi: 10.1136/bmj.1.5952.235. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Engvall E., Perlmann P. Enzyme-linked immunosorbent assay (ELISA). Quantitative assay of immunoglobulin G. Immunochemistry. 1971 Sep;8(9):871–874. doi: 10.1016/0019-2791(71)90454-x. [DOI] [PubMed] [Google Scholar]
  16. Espy M. J., Smith T. F., Harmon M. W., Kendal A. P. Rapid detection of influenza virus by shell vial assay with monoclonal antibodies. J Clin Microbiol. 1986 Oct;24(4):677–679. doi: 10.1128/jcm.24.4.677-679.1986. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Evans A. S. The clinical illness promotion factor: a third ingredient. Yale J Biol Med. 1982 May-Aug;55(3-4):193–199. [PMC free article] [PubMed] [Google Scholar]
  18. Feldman L. T., Imperiale M. J., Nevins J. R. Activation of early adenovirus transcription by the herpesvirus immediate early gene: evidence for a common cellular control factor. Proc Natl Acad Sci U S A. 1982 Aug;79(16):4952–4956. doi: 10.1073/pnas.79.16.4952. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Fishaut M., Tubergen D., McIntosh K. Cellular response to respiratory viruses with particular reference to children with disorders of cell-mediated immunity. J Pediatr. 1980 Feb;96(2):179–186. doi: 10.1016/s0022-3476(80)80799-2. [DOI] [PubMed] [Google Scholar]
  20. Fong C. K., Landry M. L. Advantages of multiple cell culture systems for detection of mixed-virus infections. J Virol Methods. 1991 Aug;33(3):283–289. doi: 10.1016/0166-0934(91)90027-w. [DOI] [PubMed] [Google Scholar]
  21. Foy H. M., Cooney M. K., Maletzky A. J., Grayston J. T. Incidence and etiology of pneumonia, croup and bronchiolitis in preschool children belonging to a prepaid medical care group over a four-year period. Am J Epidemiol. 1973 Feb;97(2):80–92. doi: 10.1093/oxfordjournals.aje.a121492. [DOI] [PubMed] [Google Scholar]
  22. Freke A., Stott E. J., Roome A. P., Caul E. O. The detection of respiratory syncytial virus in nasopharyngeal aspirates: assessment, formulation, and evaluation of monoclonal antibodies as a diagnostic reagent. J Med Virol. 1986 Feb;18(2):181–191. doi: 10.1002/jmv.1890180210. [DOI] [PubMed] [Google Scholar]
  23. Gendelman H. E., Phelps W., Feigenbaum L., Ostrove J. M., Adachi A., Howley P. M., Khoury G., Ginsberg H. S., Martin M. A. Trans-activation of the human immunodeficiency virus long terminal repeat sequence by DNA viruses. Proc Natl Acad Sci U S A. 1986 Dec;83(24):9759–9763. doi: 10.1073/pnas.83.24.9759. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Ghafoor A., Nomani N. K., Ishaq Z., Zaidi S. Z., Anwar F., Burney M. I., Qureshi A. W., Ahmad S. A. Diagnoses of acute lower respiratory tract infections in children in Rawalpindi and Islamabad, Pakistan. Rev Infect Dis. 1990 Nov-Dec;12 (Suppl 8):S907–S914. doi: 10.1093/clinids/12.supplement_8.s907. [DOI] [PubMed] [Google Scholar]
  25. Gleaves C. A., Smith T. F., Shuster E. A., Pearson G. R. Rapid detection of cytomegalovirus in MRC-5 cells inoculated with urine specimens by using low-speed centrifugation and monoclonal antibody to an early antigen. J Clin Microbiol. 1984 Jun;19(6):917–919. doi: 10.1128/jcm.19.6.917-919.1984. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Glezen P., Denny F. W. Epidemiology of acute lower respiratory disease in children. N Engl J Med. 1973 Mar 8;288(10):498–505. doi: 10.1056/NEJM197303082881005. [DOI] [PubMed] [Google Scholar]
  27. Glezen W. P., Loda F. A., Clyde W. A., Jr, Senior R. J., Sheaffer C. I., Conley W. G., Denny F. W. Epidemiologic patterns of acute lower respiratory disease of children in a pediatric group practice. J Pediatr. 1971 Mar;78(3):397–406. doi: 10.1016/s0022-3476(71)80218-4. [DOI] [PubMed] [Google Scholar]
  28. Glezen W. P. Viral pneumonia as a cause and result of hospitalization. J Infect Dis. 1983 Apr;147(4):765–770. doi: 10.1093/infdis/147.4.765. [DOI] [PubMed] [Google Scholar]
  29. Glezen W. P., Wulff H., Lamb G. A., Ray C. G., Chin T. D., Wenner H. A. Patterns of virus infections in families with acute respiratory illnesses. Am J Epidemiol. 1967 Sep;86(2):350–361. doi: 10.1093/oxfordjournals.aje.a120745. [DOI] [PubMed] [Google Scholar]
  30. Golden M. P., Kim S., Hammer S. M., Ladd E. A., Schaffer P. A., DeLuca N., Albrecht M. A. Activation of human immunodeficiency virus by herpes simplex virus. J Infect Dis. 1992 Sep;166(3):494–499. doi: 10.1093/infdis/166.3.494. [DOI] [PubMed] [Google Scholar]
  31. Grist N. R., Martin K., Pinkerton I. W., Ross C. A. Double infections with R.S. virus and influenza. Lancet. 1970 Nov 14;2(7681):1033–1033. doi: 10.1016/s0140-6736(70)92844-8. [DOI] [PubMed] [Google Scholar]
  32. HILLEMAN M. R., HAMPARIAN V. V., KETLER A., REILLY C. M., McCLELLAND L., CORNFELD D., STOKES J., Jr Acute respiratory illnesses among children and adults. Field study of contemporary importance of several viruses and appraisal of the literature. JAMA. 1962 May 12;180:445–453. doi: 10.1001/jama.1962.03050190007002. [DOI] [PubMed] [Google Scholar]
  33. HOLZEL A., PARKER L., PATTERSON W. H., CARTMEL D., WHITE L. L., PURDY R., THOMPSON K. M., TOBIN J. O. VIRUS ISOLATIONS FROM THROATS OF CHILDREN ADMITTED TO HOSPITAL WITH RESPIRATORY AND OTHER DISEASES, MANCHESTER 1962-4. Br Med J. 1965 Mar 6;1(5435):614–619. doi: 10.1136/bmj.1.5435.614. [DOI] [PMC free article] [PubMed] [Google Scholar]
  34. Hall C. B., Powell K. R., MacDonald N. E., Gala C. L., Menegus M. E., Suffin S. C., Cohen H. J. Respiratory syncytial viral infection in children with compromised immune function. N Engl J Med. 1986 Jul 10;315(2):77–81. doi: 10.1056/NEJM198607103150201. [DOI] [PubMed] [Google Scholar]
  35. Hall C. B., Powell K. R., Schnabel K. C., Gala C. L., Pincus P. H. Risk of secondary bacterial infection in infants hospitalized with respiratory syncytial viral infection. J Pediatr. 1988 Aug;113(2):266–271. [PubMed] [Google Scholar]
  36. Halstead D. C., Todd S., Fritch G. Evaluation of five methods for respiratory syncytial virus detection. J Clin Microbiol. 1990 May;28(5):1021–1025. doi: 10.1128/jcm.28.5.1021-1025.1990. [DOI] [PMC free article] [PubMed] [Google Scholar]
  37. Harmon M. W., Pawlik K. M. Enzyme immunoassay for direct detection of influenza type A and adenovirus antigens in clinical specimens. J Clin Microbiol. 1982 Jan;15(1):5–11. doi: 10.1128/jcm.15.1.5-11.1982. [DOI] [PMC free article] [PubMed] [Google Scholar]
  38. Hierholzer J. C., Bingham P. G., Coombs R. A., Johansson K. H., Anderson L. J., Halonen P. E. Comparison of monoclonal antibody time-resolved fluoroimmunoassay with monoclonal antibody capture-biotinylated detector enzyme immunoassay for respiratory syncytial virus and parainfluenza virus antigen detection. J Clin Microbiol. 1989 Jun;27(6):1243–1249. doi: 10.1128/jcm.27.6.1243-1249.1989. [DOI] [PMC free article] [PubMed] [Google Scholar]
  39. Ho M. Virus infections after transplantation in man. Brief review. Arch Virol. 1977;55(1-2):1–24. doi: 10.1007/BF01314475. [DOI] [PubMed] [Google Scholar]
  40. Hornsleth A., Friis B., Andersen P., Brenøe E. Detection of respiratory syncytial virus in nasopharyngeal secretions by ELISA: comparison with fluorescent antibody technique. J Med Virol. 1982;10(4):273–281. doi: 10.1002/jmv.1890100407. [DOI] [PubMed] [Google Scholar]
  41. Hortal M., Mogdasy C., Russi J. C., Deleon C., Suarez A. Microbial agents associated with pneumonia in children from Uruguay. Rev Infect Dis. 1990 Nov-Dec;12 (Suppl 8):S915–S922. doi: 10.1093/clinids/12.supplement_8.s915. [DOI] [PubMed] [Google Scholar]
  42. Hughes J. H., Mann D. R., Hamparian V. V. Detection of respiratory syncytial virus in clinical specimens by viral culture, direct and indirect immunofluorescence, and enzyme immunoassay. J Clin Microbiol. 1988 Mar;26(3):588–591. doi: 10.1128/jcm.26.3.588-591.1988. [DOI] [PMC free article] [PubMed] [Google Scholar]
  43. Jacobs J. W., Peacock D. B., Corner B. D., Caul E. O., Clarke S. K. Respiratory syncytial and other viruses associated with respiratory disease in infants. Lancet. 1971 May 1;1(7705):871–876. doi: 10.1016/S0140-6736(71)92440-8. [DOI] [PMC free article] [PubMed] [Google Scholar]
  44. Jarvis W. R., Middleton P. J., Gelfand E. W. Significance of viral infections in severe combined immunodeficiency disease. Pediatr Infect Dis. 1983 May-Jun;2(3):187–192. doi: 10.1097/00006454-198305000-00003. [DOI] [PubMed] [Google Scholar]
  45. Johnston S. L., Bloy H. Evaluation of a rapid enzyme immunoassay for detection of influenza A virus. J Clin Microbiol. 1993 Jan;31(1):142–143. doi: 10.1128/jcm.31.1.142-143.1993. [DOI] [PMC free article] [PubMed] [Google Scholar]
  46. Johnston S. L., Siegel C. S. Evaluation of direct immunofluorescence, enzyme immunoassay, centrifugation culture, and conventional culture for the detection of respiratory syncytial virus. J Clin Microbiol. 1990 Nov;28(11):2394–2397. doi: 10.1128/jcm.28.11.2394-2397.1990. [DOI] [PMC free article] [PubMed] [Google Scholar]
  47. Lauer B. A., Masters H. A., Wren C. G., Levin M. J. Rapid detection of respiratory syncytial virus in nasopharyngeal secretions by enzyme-linked immunosorbent assay. J Clin Microbiol. 1985 Nov;22(5):782–785. doi: 10.1128/jcm.22.5.782-785.1985. [DOI] [PMC free article] [PubMed] [Google Scholar]
  48. Lavery D., Fu S. M., Lufkin T., Chen-Kiang S. Productive infection of cultured human lymphoid cells by adenovirus. J Virol. 1987 May;61(5):1466–1472. doi: 10.1128/jvi.61.5.1466-1472.1987. [DOI] [PMC free article] [PubMed] [Google Scholar]
  49. Lefkowitz L. B., Jr, Jackson G. G. Dual respiratory infection with parainfluenza and rhinovirus. The pathogenesis of transmitted infection in volunteers. Am Rev Respir Dis. 1966 Apr;93(4):519–528. doi: 10.1164/arrd.1966.93.4.519. [DOI] [PubMed] [Google Scholar]
  50. Lizardi P. M., Kramer F. R. Exponential amplification of nucleic acids: new diagnostics using DNA polymerases and RNA replicases. Trends Biotechnol. 1991 Feb;9(2):53–58. doi: 10.1016/0167-7799(91)90189-O. [DOI] [PubMed] [Google Scholar]
  51. Ljungman P., Gleaves C. A., Meyers J. D. Respiratory virus infection in immunocompromised patients. Bone Marrow Transplant. 1989 Jan;4(1):35–40. [PubMed] [Google Scholar]
  52. MINUSE E., DAVENPORT F. M. Simultaneous recovery of type A' and type C influenza viruses from a patient. J Lab Clin Med. 1951 Nov;38(5):747–750. [PubMed] [Google Scholar]
  53. Maletzky A. J., Cooney M. K., Luce R., Kenny G. E., Grayston J. T. Epidemiology of viral and mycoplasmal agents associated with childhood lower respiratory illness in a civilian population. J Pediatr. 1971 Mar;78(3):407–414. doi: 10.1016/s0022-3476(71)80219-6. [DOI] [PubMed] [Google Scholar]
  54. Mathur U., Bentley D. W., Hall C. B. Concurrent respiratory syncytial virus and influenza A infections in the institutionalized elderly and chronically ill. Ann Intern Med. 1980 Jul;93(1):49–52. doi: 10.7326/0003-4819-93-1-49. [DOI] [PubMed] [Google Scholar]
  55. McQuillin J., Gardner P. S. Rapid diagnosis of respiratory syncytial virus infection by immunofluorescent antibody techniques. Br Med J. 1968 Mar 9;1(5592):602–605. doi: 10.1136/bmj.1.5592.602. [DOI] [PMC free article] [PubMed] [Google Scholar]
  56. Meissner H. C., Murray S. A., Kiernan M. A., Snydman D. R., McIntosh K. A simultaneous outbreak of respiratory syncytial virus and parainfluenza virus type 3 in a newborn nursery. J Pediatr. 1984 May;104(5):680–684. doi: 10.1016/s0022-3476(84)80943-9. [DOI] [PubMed] [Google Scholar]
  57. Meurman O., Sarkkinen H., Ruuskanen O., Hänninen P., Halonen P. Diagnosis of respiratory syncytial virus infection in children: comparison of viral antigen detection and serology. J Med Virol. 1984;14(1):61–65. doi: 10.1002/jmv.1890140109. [DOI] [PubMed] [Google Scholar]
  58. Miller D. G., Gabrielson M. O., Horstmann D. M. Clinical virology and viral surveillance in a pediatric group practice: the use of double-seeded tissue culture tubes for primary virus isolation. Am J Epidemiol. 1968 Sep;88(2):245–256. doi: 10.1093/oxfordjournals.aje.a120883. [DOI] [PubMed] [Google Scholar]
  59. Mills R. D., Cain K. J., Woods G. L. Detection of influenza virus by centrifugal inoculation of MDCK cells and staining with monoclonal antibodies. J Clin Microbiol. 1989 Nov;27(11):2505–2508. doi: 10.1128/jcm.27.11.2505-2508.1989. [DOI] [PMC free article] [PubMed] [Google Scholar]
  60. Minnich L. L., Ray C. G. Early testing of cell cultures for detection of hemadsorbing viruses. J Clin Microbiol. 1987 Feb;25(2):421–422. doi: 10.1128/jcm.25.2.421-422.1987. [DOI] [PMC free article] [PubMed] [Google Scholar]
  61. Minnich L., Ray C. G. Comparison of direct immunofluorescent staining of clinical specimens for respiratory virus antigens with conventional isolation techniques. J Clin Microbiol. 1980 Sep;12(3):391–394. doi: 10.1128/jcm.12.3.391-394.1980. [DOI] [PMC free article] [PubMed] [Google Scholar]
  62. Nelson J. A., Reynolds-Kohler C., Oldstone M. B., Wiley C. A. HIV and HCMV coinfect brain cells in patients with AIDS. Virology. 1988 Jul;165(1):286–290. doi: 10.1016/0042-6822(88)90685-x. [DOI] [PubMed] [Google Scholar]
  63. Nichol K. P., Cherry J. D. Bacterial-viral interrelations in respiratory infections of children. N Engl J Med. 1967 Sep 28;277(13):667–672. doi: 10.1056/NEJM196709282771301. [DOI] [PubMed] [Google Scholar]
  64. Olsen M. A., Shuck K. M., Sambol A. R., Flor S. M., O'Brien J., Cabrera B. J. Isolation of seven respiratory viruses in shell vials: a practical and highly sensitive method. J Clin Microbiol. 1993 Feb;31(2):422–425. doi: 10.1128/jcm.31.2.422-425.1993. [DOI] [PMC free article] [PubMed] [Google Scholar]
  65. Olson L. C., Lexomboon U., Sithisarn P., Noyes H. E. The etiology of respiratory tract infections in a tropical country. Am J Epidemiol. 1973 Jan;97(1):34–43. doi: 10.1093/oxfordjournals.aje.a121481. [DOI] [PubMed] [Google Scholar]
  66. PARROTT R. H., VARGOSKO A. J., KIM H. W., CUMMING C., TURNER H., HUEBNER R. J., CHANOCK R. M. Respiratory syncytial virus. II. Serologic studies over a 34-month period of children with bronchiolitis, pneumonia, and minor respiratory diseases. JAMA. 1961 May 27;176:653–657. [PubMed] [Google Scholar]
  67. PORTNOY B., ECKERT H. L., SALVATORE M. A. RHINOVIRUS INFECTION IN CHILDREN WITH ACUTE LOWER RESPIRATORY DISEASE: EVIDENCE AGAINST ETIOLOGICAL IMPORTANCE. Pediatrics. 1965 Jun;35:899–905. [PubMed] [Google Scholar]
  68. Paisley J. W., Lauer B. A., McIntosh K., Glode M. P., Schachter J., Rumack C. Pathogens associated with acute lower respiratory tract infection in young children. Pediatr Infect Dis. 1984 Jan-Feb;3(1):14–19. doi: 10.1097/00006454-198401000-00005. [DOI] [PubMed] [Google Scholar]
  69. Parks W. P., Queiroga L. T., Melnick J. L. Studies of infantile diarrhea in Karachi, Pakistan. II. Multiple virus isolations from rectal swabs. Am J Epidemiol. 1967 May;85(3):469–478. doi: 10.1093/oxfordjournals.aje.a120709. [DOI] [PubMed] [Google Scholar]
  70. Popow-Kraupp T., Kern G., Binder C., Tuma W., Kundi M., Kunz C. Detection of respiratory syncytial virus in nasopharyngeal secretions by enzyme-linked immunosorbent assay, indirect immunofluorescence, and virus isolation: a comparative study. J Med Virol. 1986 Jun;19(2):123–134. doi: 10.1002/jmv.1890190204. [DOI] [PubMed] [Google Scholar]
  71. Portnoy B., Eckert H. L., Hanes B., Salvatore M. A. Multiple respiratory virus infections in hospitalized children. Am J Epidemiol. 1965 Nov;82(3):262–272. doi: 10.1093/oxfordjournals.aje.a120548. [DOI] [PubMed] [Google Scholar]
  72. Puthavathana P., Wasi C., Kositanont U., Suwanjutha S., Chantarojanasiri T., Kantakamalakul W., Kantawateera P., Thongcharoen P. A hospital-based study of acute viral infections of the respiratory tract in Thai children, with emphasis on laboratory diagnosis. Rev Infect Dis. 1990 Nov-Dec;12 (Suppl 8):S988–S994. doi: 10.1093/clinids/12.supplement_8.s988. [DOI] [PubMed] [Google Scholar]
  73. Rabalais G. P., Stout G. G., Ladd K. L., Cost K. M. Rapid diagnosis of respiratory viral infections by using a shell vial assay and monoclonal antibody pool. J Clin Microbiol. 1992 Jun;30(6):1505–1508. doi: 10.1128/jcm.30.6.1505-1508.1992. [DOI] [PMC free article] [PubMed] [Google Scholar]
  74. Rabalais G. P., Stout G. G., Ladd K. L., Cost K. M. Rapid diagnosis of respiratory viral infections by using a shell vial assay and monoclonal antibody pool. J Clin Microbiol. 1992 Jun;30(6):1505–1508. doi: 10.1128/jcm.30.6.1505-1508.1992. [DOI] [PMC free article] [PubMed] [Google Scholar]
  75. Rahman M., Huq F., Sack D. A., Butler T., Azad A. K., Alam A., Nahar N., Islam M. Acute lower respiratory tract infections in hospitalized patients with diarrhea in Dhaka, Bangladesh. Rev Infect Dis. 1990 Nov-Dec;12 (Suppl 8):S899–S906. doi: 10.1093/clinids/12.supplement_8.s899. [DOI] [PubMed] [Google Scholar]
  76. Rando R. F., Pellett P. E., Luciw P. A., Bohan C. A., Srinivasan A. Transactivation of human immunodeficiency virus by herpesviruses. Oncogene. 1987 Mar;1(1):13–18. [PubMed] [Google Scholar]
  77. Ray C. G., Minnich L. L. Efficiency of immunofluorescence for rapid detection of common respiratory viruses. J Clin Microbiol. 1987 Feb;25(2):355–357. doi: 10.1128/jcm.25.2.355-357.1987. [DOI] [PMC free article] [PubMed] [Google Scholar]
  78. Ray C. G., Minnich L. L., Holberg C. J., Shehab Z. M., Wright A. L., Barton L. L., Taussig L. M. Respiratory syncytial virus-associated lower respiratory illnesses: possible influence of other agents. The Group Health Medical Associates. Pediatr Infect Dis J. 1993 Jan;12(1):15–19. [PubMed] [Google Scholar]
  79. Rice G. P., Schrier R. D., Oldstone M. B. Cytomegalovirus infects human lymphocytes and monocytes: virus expression is restricted to immediate-early gene products. Proc Natl Acad Sci U S A. 1984 Oct;81(19):6134–6138. doi: 10.1073/pnas.81.19.6134. [DOI] [PMC free article] [PubMed] [Google Scholar]
  80. Saiki R. K., Gelfand D. H., Stoffel S., Scharf S. J., Higuchi R., Horn G. T., Mullis K. B., Erlich H. A. Primer-directed enzymatic amplification of DNA with a thermostable DNA polymerase. Science. 1988 Jan 29;239(4839):487–491. doi: 10.1126/science.2448875. [DOI] [PubMed] [Google Scholar]
  81. Sarkkinen H. K., Halonen P. E., Arstila P. P., Salmi A. A. Detection of respiratory syncytial, parainfluenza type 2, and adenovirus antigens by radioimmunoassay and enzyme immunoassay on nasopharyngeal specimens from children with acute respiratory disease. J Clin Microbiol. 1981 Feb;13(2):258–265. doi: 10.1128/jcm.13.2.258-265.1981. [DOI] [PMC free article] [PubMed] [Google Scholar]
  82. Sarkkinen H. K., Halonen P. E., Salmi A. A. Detection of influenza A virus by radioimmunoassay and enzyme-immunoassay from nasopharyngeal specimens. J Med Virol. 1981;7(3):213–220. doi: 10.1002/jmv.1890070305. [DOI] [PubMed] [Google Scholar]
  83. Schochetman G., Ou C. Y., Jones W. K. Polymerase chain reaction. J Infect Dis. 1988 Dec;158(6):1154–1157. doi: 10.1093/infdis/158.6.1154. [DOI] [PubMed] [Google Scholar]
  84. Skolnik P. R., Pomerantz R. J., de la Monte S. M., Lee S. F., Hsiung G. D., Foos R. Y., Cowan G. M., Kosloff B. R., Hirsch M. S., Pepose J. S. Dual infection of retina with human immunodeficiency virus type 1 and cytomegalovirus. Am J Ophthalmol. 1989 Apr 15;107(4):361–372. doi: 10.1016/0002-9394(89)90659-4. [DOI] [PubMed] [Google Scholar]
  85. Smith M. C., Creutz C., Huang Y. T. Detection of respiratory syncytial virus in nasopharyngeal secretions by shell vial technique. J Clin Microbiol. 1991 Mar;29(3):463–465. doi: 10.1128/jcm.29.3.463-465.1991. [DOI] [PMC free article] [PubMed] [Google Scholar]
  86. Stott E. J., Bell E. J., Eadie M. B., Ross C. A., Grist N. R. A comparative virological study of children in hospital with respiratory and diarrhoeal illnesses. J Hyg (Lond) 1967 Mar;65(1):9–23. doi: 10.1017/s0022172400045484. [DOI] [PMC free article] [PubMed] [Google Scholar]
  87. Stout C., Murphy M. D., Lawrence S., Julian S. Evaluation of a monoclonal antibody pool for rapid diagnosis of respiratory viral infections. J Clin Microbiol. 1989 Mar;27(3):448–452. doi: 10.1128/jcm.27.3.448-452.1989. [DOI] [PMC free article] [PubMed] [Google Scholar]
  88. Subbarao E. K., Griffis J., Waner J. L. Detection of multiple viral agents in nasopharyngeal specimens yielding respiratory syncytial virus (RSV). An assessment of diagnostic strategy and clinical significance. Diagn Microbiol Infect Dis. 1989 Jul-Aug;12(4):327–332. doi: 10.1016/0732-8893(89)90098-9. [DOI] [PubMed] [Google Scholar]
  89. Swenson P. D., Kaplan M. H. Rapid detection of respiratory syncytial virus in nasopharyngeal aspirates by a commercial enzyme immunoassay. J Clin Microbiol. 1986 Mar;23(3):485–488. doi: 10.1128/jcm.23.3.485-488.1986. [DOI] [PMC free article] [PubMed] [Google Scholar]
  90. Swierkosz E. M., Flanders R., Melvin L., Miller J. D., Kline M. W. Evaluation of the Abbott TESTPACK RSV enzyme immunoassay for detection of respiratory syncytial virus in nasopharyngeal swab specimens. J Clin Microbiol. 1989 Jun;27(6):1151–1154. doi: 10.1128/jcm.27.6.1151-1154.1989. [DOI] [PMC free article] [PubMed] [Google Scholar]
  91. Takiff H. E., Straus S. E., Garon C. F. Propagation and in vitro studies of previously non-cultivable enteral adenoviruses in 293 cells. Lancet. 1981 Oct 17;2(8251):832–834. doi: 10.1016/s0140-6736(81)91104-1. [DOI] [PubMed] [Google Scholar]
  92. Takimoto S., Grandien M., Ishida M. A., Pereira M. S., Paiva T. M., Ishimaru T., Makita E. M., Martinez C. H. Comparison of enzyme-linked immunosorbent assay, indirect immunofluorescence assay, and virus isolation for detection of respiratory viruses in nasopharyngeal secretions. J Clin Microbiol. 1991 Mar;29(3):470–474. doi: 10.1128/jcm.29.3.470-474.1991. [DOI] [PMC free article] [PubMed] [Google Scholar]
  93. Tevethia M. J., Spector D. J. Heterologous transactivation among viruses. Prog Med Virol. 1989;36:120–190. [PubMed] [Google Scholar]
  94. Thomas E. E., Book L. E. Comparison of two rapid methods for detection of respiratory syncytial virus (RSV) (Testpack RSV and ortho RSV ELISA) with direct immunofluorescence and virus isolation for the diagnosis of pediatric RSV infection. J Clin Microbiol. 1991 Mar;29(3):632–635. doi: 10.1128/jcm.29.3.632-635.1991. [DOI] [PMC free article] [PubMed] [Google Scholar]
  95. Tristram D. A., Miller R. W., McMillan J. A., Weiner L. B. Simultaneous infection with respiratory syncytial virus and other respiratory pathogens. Am J Dis Child. 1988 Aug;142(8):834–836. doi: 10.1001/archpedi.1988.02150080040017. [DOI] [PubMed] [Google Scholar]
  96. VERVILLE E., CONNOR J. D., SIGEL M. M. Double infection of tissue culture cells with CA virus and adenovirus. Virology. 1961 Feb;13:260–262. doi: 10.1016/0042-6822(61)90063-0. [DOI] [PubMed] [Google Scholar]
  97. Valenti W. M., Clarke T. A., Hall C. B., Menegus M. A., Shapiro D. L. Concurrent outbreaks of rhinovirus and respiratory syncytial virus in an intensive care nursery: epidemiology and associated risk factors. J Pediatr. 1982 May;100(5):722–726. doi: 10.1016/s0022-3476(82)80571-4. [DOI] [PubMed] [Google Scholar]
  98. Vogt M. W., Hartshorn K. L., Furman P. A., Chou T. C., Fyfe J. A., Coleman L. A., Crumpacker C., Schooley R. T., Hirsch M. S. Ribavirin antagonizes the effect of azidothymidine on HIV replication. Science. 1987 Mar 13;235(4794):1376–1379. doi: 10.1126/science.2435003. [DOI] [PubMed] [Google Scholar]
  99. Waner J. L., Todd S. J., Shalaby H., Murphy P., Wall L. V. Comparison of Directigen FLU-A with viral isolation and direct immunofluorescence for the rapid detection and identification of influenza A virus. J Clin Microbiol. 1991 Mar;29(3):479–482. doi: 10.1128/jcm.29.3.479-482.1991. [DOI] [PMC free article] [PubMed] [Google Scholar]
  100. Waner J. L., Whitehurst N. J., Jonas S., Wall L., Shalaby H. Isolation of viruses from specimens submitted for direct immunofluorescence test for respiratory syncytial virus. J Pediatr. 1986 Feb;108(2):249–250. doi: 10.1016/s0022-3476(86)80993-3. [DOI] [PubMed] [Google Scholar]
  101. Waner J. L., Whitehurst N. J., Todd S. J., Shalaby H., Wall L. V. Comparison of directigen RSV with viral isolation and direct immunofluorescence for the identification of respiratory syncytial virus. J Clin Microbiol. 1990 Mar;28(3):480–483. doi: 10.1128/jcm.28.3.480-483.1990. [DOI] [PMC free article] [PubMed] [Google Scholar]
  102. Whelchel J. D., Pass R. F., Diethelm A. G., Whitley R. J., Alford C. A., Jr Effect of primary and recurrent cytomegalovirus infections upon graft and patient survival after renal transplantation. Transplantation. 1979 Dec;28(6):443–446. [PubMed] [Google Scholar]
  103. Whitley R. J., Levin M., Barton N., Hershey B. J., Davis G., Keeney R. E., Whelchel J., Diethelm A. G., Kartus P., Soong S. J. Infections caused by herpes simplex virus in the immunocompromised host: natural history and topical acyclovir therapy. J Infect Dis. 1984 Sep;150(3):323–329. doi: 10.1093/infdis/150.3.323. [DOI] [PubMed] [Google Scholar]
  104. Wittwer C. T., Garling D. J. Rapid cycle DNA amplification: time and temperature optimization. Biotechniques. 1991 Jan;10(1):76–83. [PubMed] [Google Scholar]
  105. Wolcott M. J. Advances in nucleic acid-based detection methods. Clin Microbiol Rev. 1992 Oct;5(4):370–386. doi: 10.1128/cmr.5.4.370. [DOI] [PMC free article] [PubMed] [Google Scholar]
  106. Wolontis S., Stenbeck J., Fransén H. Multiple virus isolations in a group of children hospitalized with acute respiratory illness. Scand J Infect Dis. 1969;1(2):119–126. doi: 10.3109/inf.1969.1.issue-2.08. [DOI] [PubMed] [Google Scholar]
  107. Yolken R. H., Bishop C. A., Townsend T. R., Bolyard E. A., Bartlett J., Santos G. W., Saral R. Infectious gastroenteritis in bone-marrow-transplant recipients. N Engl J Med. 1982 Apr 29;306(17):1010–1012. doi: 10.1056/NEJM198204293061701. [DOI] [PubMed] [Google Scholar]
  108. Yolken R. H. Nucleic acids or immunoglobulins: which are the molecular probes of the future? Mol Cell Probes. 1988 Jun;2(2):87–96. doi: 10.1016/0890-8508(88)90030-8. [DOI] [PubMed] [Google Scholar]
  109. Yolken R. H., Stopa P. J. Analysis of nonspecific reactions in enzyme-linked immunosorbent assay testing for human rotavirus. J Clin Microbiol. 1979 Nov;10(5):703–707. doi: 10.1128/jcm.10.5.703-707.1979. [DOI] [PMC free article] [PubMed] [Google Scholar]
  110. Zahradnik J. M., Spencer M. J., Porter D. D. Adenovirus infection in the immunocompromised patient. Am J Med. 1980 May;68(5):725–732. doi: 10.1016/0002-9343(80)90262-4. [DOI] [PubMed] [Google Scholar]

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