New York mystery solved
During October–December 2004, the cause of a cluster of influenza-like illnesses in New York State could not be identified, as samples taken from the affected individuals tested negative for both A- and B-type influenza virus by real-time reverse transcription (RT) PCR, and culture tests for other respiratory viruses also proved negative. Concerned that a novel pathogen might have been involved, the clinical virologists involved contacted Ian Lipkin. Lipkin and his team at Columbia University have pioneered the use of MassTag, a multiplex RT-PCR system for the differential diagnosis of infectious diseases that can detect 22 different respiratory pathogens, including bacteria and viruses. Lipkin and colleagues first re-analysed 151 samples using conventional methods, and a positive result was obtained for 72 samples. The remaining 79 samples were then analysed using the MassTag system. The pathogens detected included enterovirus, metapneumovirus, Haemophilus influenzae and Streptococcus pneumoniae. Additionally, the incidence of rhinovirus infection that was detected was unexpectedly high, and a new rhinovirus genotype was identified in 8 of the samples. These results indicate that the MassTag system could prove extremely useful as both a surveillance tool and a diagnostic tool during outbreaks. JID
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