Comprehensive diagnostics for respiratory virus infections after transplantation or after potential exposure to swine flu A/H1N1: what else is out there?

V|rus infections of the respiratory tract have received signi¢cant public attention in the last decade through the SARS epidemic in 2003, the increasing pandemic threat of avian in£uenza H5N1 since 2005, and now the unexpected striking of in£uenza A/H1N1 in 2009 (erroneously called ‘swine £u’ in North America and Europe). As happened with the Spanish Pandemic of 1918, the emergence of previously unknownviruses such as SARS has catalyzed important progress in clinical virology: 1) Development and stringent application of case de¢nitions and infection control measures to limit transmission and eventually contain the spread in disease; 2) International communication and collaboration for the speedy identi¢cation and characterization of the implicated infectious agent; 3) Introduction of rapid nucleic acid testing (NAT) of high sensitivity and speci¢city with a turn-around time of o 24 h for clinical management; and 4) Freely accessible information £ow through speci¢c websites on all of these issues. These points e¡ectively synergized during the recent emergence of the new ‘swine £u’ in£uenza A/H1N1 and appeared to permit, under close surveillance, a seemingly attenuated entry into a new in£uenza pandemic after more than 30 years. Although the overall clinical course of the ‘swine £u’ appears unexpectedly mild, mostly younger healthy adults between 25 and 45 years of age seem to be a¡ected, similar to the Spanish H1N1 pandemic of 1918. However, it is still way too early to give the ‘all-clear’: