Clinical scientists participate in and oversee the development and implementation of infectious disease detection, result reporting and interpretation

Although the basic structure of all viruses is simply comprised of nucleic acid and protein, these infectious pathogens are a significant, and often severe, burden on public health globally. The inherent ability of most viruses to undergo continual molecular evolution, and regular reporting of ‘new’ previously undetected viruses, means that detection of these pathogens is a growing and rapidly changing field of expertise. The ability to detect and characterise an infectious disease offers insight into the host-pathogen interaction, directly influences assay design and directs research and monitoring of drug therapy targets. Diagnostic testing uses this host-pathogen interaction to specifically detect the viral immunological response in the host and/or the nucleic acid and antigens of the viral pathogen. Following an initial diagnosis, viral molecular characterisation can be used to monitor antiviral therapy, viral evolution and the emergence of new pathogenic strains.

The virology service in Ireland is delivered by a range of medical, nursing, allied health and support staff. Clinical scientists contribute to this care pathway by providing expert result interpretation, progressing assay development, ensuring that laboratory testing algorithms are in-line with clinical best practice initiatives and finally supporting and contributing to clinical and laboratory research. The National Virus Reference Laboratory (NVRL) is located at University College Dublin (http://nvrl.ucd.ie) and was initially established to support the diagnosis and treatment of poliovirus. However, since this time, its testing repertoire and surveillance remit has expanded greatly.

Molecular Virology

Molecular virology is defined as the specific detection of virus nucleic acid and other associated host single nucleotide polymorphisms in clinical specimens. All specimens potentially positive following infection may be screened by a number of different RT-PCR technologies, both laboratory developed and commercially available. Molecular virology provides a pathway for the detection of viral pathogens associated with the following conditions and clinical presentations meningitis, encephalitis, rash, gastroenteritis, respiratory symptoms, and bloodborne and sexually transmitted infections. In addition, the monitoring of infection in high-risk patients such as transplant recipients plays a significant role in patient care. Clinical scientists lead in the development of molecular methodologies thereby ensuring testing is not only carried out in accordance with clinical best practice, but also using the most efficient and up-to-date technologies available. Furthermore, quality-driven expert result interpretation and clinical validation of the test service is essential to this role.