Cell Culture and Electron Microscopy for Identifying Viruses in Diseases of Unknown Cause

Goldsmith, Cynthia S.; Ksiazek, Thomas G.; Rollin, Pierre E.; Comer, James A.; Nicholson, William L.; Peret, Teresa C.T.; Erdman, Dean D.; Bellini, William J.; Harcourt, Brian H.; Rota, Paul A.; Bhatnagar, Julu; Bowen, Michael D.; Erickson, Bobbie R.; McMullan, Laura K.; Nichol, Stuart T.; Shieh, Wun-Ju; Paddock, Christopher D.; Zaki, Sherif R.

During outbreaks of infectious diseases or in cases of severely ill patients, it is imperative to identify the causative agent. This report describes several events in which virus isolation and identification by electron microscopy were critical to initial recognition of the etiologic agent, which was further analyzed by additional laboratory diagnostic assays. Examples include severe acute respiratory syndrome coronavirus, and Nipah, lymphocytic choriomeningitis, West Nile, Cache Valley, and Heartland viruses. These cases illustrate the importance of the techniques of cell culture and electron microscopy in pathogen identification and recognition of emerging diseases.