Recombinase polymerase amplification: a promising point-of-care detection method for enteric viruses

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Viral enteric disease imposes a considerable public health and economic burden globally in both humans and livestock. Because enteric viruses are highly transmissible and resistant to numerous control strategies, making early in-field or point-of-care detection is important. There are problems with ligand-based detection strategies (e.g., sensitivity, false positive/negatives) for virus detection. Traditional amplification-based strategies are sensitive, but not as portable or rapid. Recombinase polymerase amplification is a new isothermal technique that utilizes bacterial genome repair enzymes to rapidly amplify target sequences. This report reviews the use of recombinase polymerase amplification for virus detection, showing that the method has favorable fundamental properties supporting its promise for rapid point-of-care detection of enteric viruses.

Enteric viral diseases impose a major public health and economic burden worldwide. Human noroviruses, the leading cause of acute viral gastroenteritis globally, were estimated to cause about 685 million infections and 212,000 deaths globally in 2010 [1]. Young children are more likely to become infected with enteric viruses, and the elderly and infirm are more likely to experience severe disease. Even though vastly improved with recent vaccination campaigns, WHO estimated that 215,000 children under the age of 5 died in 2013 from rotavirus infection [2]. Collectively, norovirus, rotavirus, hepatitis A and hepatitis E enteric viruses were estimated to have killed over 620,000 people globally in 2010 [1,3]. Other enteric viruses like astrovirus, sapovirus and adenovirus have been estimated to also inflict a notable public health burden [4–6]. Enteric viruses infecting livestock also inflict significant damage. For instance, the recently identified and highly contagious porcine epidemic diarrhea virus [7] has already caused devastating outbreaks with high animal mortality [8].

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