The Virus Reference Laboratory

IN the winter of 1956 plans were laid for the development of a Virus Reference Laboratory in the Department of Microbiology, the Queen's University, Belfast, to be run jointly by the University and the Northern Ireland Hospitals Authority. This has gradually come into operation over the past eighteen months, and a report of the work done by this Reference Laboratory up till the end of December, 1957, is presentecl in this journal, page 53. It is the purpose of this note to discuss the kind of work a virus reference laboratory may be expected to do. It should be emphasised at the outset that a virus reference laboratory is not (like most bacteriological laboratories) prepared routinely to attempt virological diagnosis of all clinical diseases suspected to be of viral atiology. Virology, with the exception of a few conditions, is still in a stage of "research" diagnosis rather than "routine" diagnosis. Experience of many virus reference laboratories has shown that the investigation of a single patient believed to be suffering from a virus disease may take months of detailed work and is often a waste of time and money. On the other hand, investigations of an outbreak of a few cases or of an epidemic are usually rewarding in the diagnostic help which the virus laboratory can give to the clinician or the Medical Officer of Health. For the investigation of virus infection there are two kinds of test availablevirus isolation and serological tests. Virus isdlation provides the most useful rapid result for some diseases such as poliomyelitis (and other enteric viruses such as Echo and Coxsackie viruses). This is the case also, for example, in smallpox where it is of great public health importance to be able to provide an immediate diagnosis. On the other hand, isolation of virus would not normally be-attempted in such conditions as influenza, Q fever or infection with adenoviruses. The reasons for this are (a) that specimens from patients suffering from infections with these viruses are often taken after the period of infectiousness and the specimen will contain no virus; (b) the isolation of a virus and its identification may take weeks of work. For such infections, and also for survey work, the less time-consuming serological tests, are more convenient. Serological tests may be used for diagnosis of a recent virus infection or for the purpose of surveying the prevalence of a disease in the community. For the diagnosis of a clinical infection two samples of clotted blood are required, these are usually referred to as paired sera. The first sample should be taken during the acute phase of the illness and the second sample two or three weeks later during 47