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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Bibliographic Details
Published in:PLoS Neglected Tropical Diseases
Main Authors: 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
Format: Article in Journal/Newspaper
Language:English
Published: Public Library of Science (PLoS) 2009
Subjects:
Online Access:https://doi.org/10.1371/journal.pntd.0000530
https://doaj.org/article/18f34de54fe84732a6eca0ce7e4c93e2
Description
Summary: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. ...