Viral Cultures: Investigation Strategies and Methods

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Investigation strategies and methods

Viral cultures

May 2007

Laboratory Training for FieldEEpidemiologists


P I D E M I C A L E R T A N D R E S P O N S E
Learning objectives

At the end of the presentation, participants should:


• Understand the principle of cultivating viruses

• Understand the methods and problems with cultivating viruses

Laboratory Training for FieldEEpidemiologists


P I D E M I C A L E R T A N D R E S P O N S E
Techniques to identify viruses
It can take a few hours to weeks to identify a virus

Techniques include:
• PCR (single round) or nested/semi-nested PCR
• Real-time PCR
• Direct electronic microscopy
• Antigen capture
• Isolation
– Long process

– Gold standard for viruses that can be cultured


Laboratory Training for FieldEEpidemiologists
P I D E M I C A L E R T A N D R E S P O N S E
Virus culture
Is based upon amplification of potentially infectious pathogens

Implies intracellular replication of viruses in the cytoplasm or


in the nucleus

Is controlled by regulations (i.e. bio-safety level 2, 3 or 4)

Allows for:

• Identification

• Further studies
(e.g., Pathogenicity, antiviral sensitivity, research)

Laboratory Training for FieldEEpidemiologists


P I D E M I C A L E R T A N D R E S P O N S E
Virus culture

Long process
• Not always possible for front-line diagnosis

Primary objective for the diagnosis of an unknown disease

No generic protocol

Laboratory Training for FieldEEpidemiologists


P I D E M I C A L E R T A N D R E S P O N S E
How to go about virus culture?
Obtain suitable specimens

• Identified specimens with suitable information

Evaluate of chances of success of the process before start

Make sure transportation used cold chain

• 4°C

• -20°C

• Dry ice (-79°C)

Use suitable culture protocol

• In vitro/in vivo cell cultures

Laboratory Training for FieldEEpidemiologists


P I D E M I C A L E R T A N D R E S P O N S E
Culture procedure
Use of a variety of cell sources and techniques

Treatment of the specimen prior to inoculation

Follow-up

Viral detection:

• Non specific

– Cytopathogenic effect (microscope)

– Electronic microscopy identification (morphology)

• Specific

– Immunological detection: antigen detection, PCR, IFA…

Viral load estimation (titration, plaque assay)


Laboratory Training for FieldEEpidemiologists
P I D E M I C A L E R T A N D R E S P O N S E
Limitations of cultures to
identify viruses
Absence of detection system for the agent

Inappropriate culture systems

Viruses that cannot be cultured

A negative viral culture results does not mean that the


agent is absent
• Need of other tests

• PCR can detect the viral genome in absence of the


complete virus

Laboratory Training for FieldEEpidemiologists


P I D E M I C A L E R T A N D R E S P O N S E
Specimens used to culture viruses

Blood specimens Stools, rectal swabs

• EDTA Urine
• Heparin Saliva
• Serum
Cerebro-spinal fluid
Stool
Biopsy
Throat swabs • Skin (filoviridae)
Naso-paryngeal aspirates • Organs (fixation with
formaldehyde 10%)

Laboratory Training for FieldEEpidemiologists


P I D E M I C A L E R T A N D R E S P O N S E
Potentially infectious specimen forms

Laboratory Training for FieldEEpidemiologists


P I D E M I C A L E R T A N D R E S P O N S E
Sequencing
Analysis of sequence of nucleic acid fragment after
PCR amplification

Comparison of the alignment of nucleotides with other


sequences present in different data bases for the
identification of an agent

Confirmatory analysis
• Final DNA fingerprint is molecular signature of the micro-organism

Laboratory Training for FieldEEpidemiologists


P I D E M I C A L E R T A N D R E S P O N S E
Investigation strategies and methods

Developed by the Department of Epidemic and


Pandemic Alert and Response of the World Health
Organization with assistance from:

European Program for Intervention


Epidemiology Training

Canadian Field Epidemiology Program

Thailand Ministry of Health

Institut Pasteur

Laboratory Training for FieldEEpidemiologists


P I D E M I C A L E R T A N D R E S P O N S E

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