Molecular and clinical insights into seasonal and pandemic influenza
- Jairo Gooskens
- 2 december 2015
2311 GJ Leiden
Promotor(s): Prof.dr. A.C.M. Kroes
Influenza viruses have caused significant pandemics and epidemics throughout history and continue to be a health problem in humans. New molecular diagnostic assays can be used in the clinical setting to explore relevant clinical manifestations, virus characteristics, and virus epidemiology. This thesis focuses on a variety of subjects related to the molecular diagnosis and clinical consequences of seasonal and pandemic influenza virus infections. Our findings demonstrate that molecular assays are highly sensitive and afford practical detection of resistance mutations, virulence markers and virus expression. We show that computational phylogenetics can provide accurate confirmation of an institutional influenza outbreak. Clinical observational studies reveal that immunocompromised patients can display remarkable prolonged influenza virus excretion with common antiviral resistance development, and that resistant viruses can be transmissible and pathogenic. We demonstrate that host immune responses correlate with virus-associated symptoms and sustained viral clearance. The results described in this thesis confirm that molecular diagnostic assays should be widely implemented in the clinical setting to improve influenza virus laboratory diagnostics. The inherent viral genetic variability and antigenic plasticity is a continuous incentive for new clinical and molecular research to keep up with relevant mutations and to improve our medical understanding of influenza virus infections.
Inès van Arkel, Adviseur wetenschapscommunicatie
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