No abstract

An enzyme-linked immunosorbent assay (ELISA) for respiratory syncytial virus antigens was applied to the rapid diagnosis of acute infections in children and was compared with viral culture and immunofluorescence tests. The ELISA test employed commercially available reagents and was run on a day-today basis as specimens were received in the laboratory. Sensitivity and specificity by ELISA were 82 and 95%, respectively, compared with culture. In the same specimens, the sensitivity and specificity by immunofluorescence were 86 and 96%, respectively. Nasopharyngeal aspirates were proven to be a better source of viral antigen than were nasopharyngeal swabs. ELISA-positive samples remained positive even when left unrefrigerated for a week or mailed to the laboratory in plastic containers. Respiratory syncytial virus ELISA, like culture, became negative as the disease progressed and showed no superiority over culture for diagnosis late in the illness.

An analysis of 32 hospitalized infants and children from whom rhinoviruses were isolated in our diagnostic laboratories in 1982-83 suggests that these agents are associated with lower respiratory tract disease with focal findings in susceptible patients. In 23 cases, an acute lower respiratory disease was the cause for admission, while nine patients were cultured after new respiratory symptoms developed during hospitalization. Presenting signs and symptoms included cough (23), fever (19), rhinorrhea (19), respiratory distress (14), and decreased feeding (15). Seventeen of 25 chest x-rays showed new focal abnormalities. Twenty-five patients had a significant underlying disease including seven with malignancies, six with respiratory tract abnormalities, and four with congenital heart lesions. Six of the remaining seven patients were less than 2 1/2 months of age. In no cases were significant bacterial or fungal pathogens isolated; two did have concomitant viral isolates. Rhinoviruses in the appropriate clinical setting are associated with significant pulmonary disease.

The high level of Epstein-Barr virus (EBV) replication found in hairy leukoplakia (HL) provides a unique opportunity to study EBV expression in the oral epithelium. Screening of a cDNA library from an HL biopsy revealed expression of two genes not previously described in vivo: BMRF-2 and BDLF-3. Sequence analysis of the cDNAs demonstrated several nucleotide changes from the B95-8 sequence. In all six different HL strains studied, only one amino acid change was found in BMRF-2 relative to B95-8 and two amino acid changes were found in the BDLF-3 ORF. mRNA expression of both genes was localized to the lower prickle cell layer of the tongue epithelium. BMRF-2 protein expression was primarily detected in the cell nuclei of the upper prickle cell layer; immunoelectron microscopy revealed that BMRF-2 was associated with the nuclear chromatin. BDLF-3 protein expression was observed in the perinuclear space and cytoplasm of the prickle cells. BDLF-3 has recently been identified as a virion-associated protein, but the functions of BMRF-2 and BDLF-3 have not been elucidated.