Molecular techniques should not now replace cell culture in diagnostic virology laboratories

The value of molecular techniques for virology is not in dispute; the issue debated here is whether or not to abandon virus isolation altogether. Mode rn clinical virology relies on rapid virus detection for timely infection c ontrol and antiviral therapy. The role of virus isolation, inevitably a slo wer process as it involves replication in cell cultures, is most significan t in providing epidemiological data, in the diagnosis of new or unexpected infection, and in yielding infectious virus for further study. Examples inc lude identification of enterovirus serotypes in outbreaks, diagnosis of aty pical virus infections, and provision of virus isolates for phenotypic anti viral susceptibility assays. Many can be detected after overnight culture u sing the centrifugation-enhanced (shell vial) technique. In contrast to thi s established track record, the commercial development of molecular assays has been concentrated on blood-borne viruses, and standardisation of proced ures for other viruses is lacking. Accreditation of molecular techniques is just beginning, and few external quality assurance schemes are available y et. In my view, it is premature to abandon routine virus isolation, althoug h as molecular diagnosis expands, the facilities for cell culture and isola tion work may become more centralised to retain expertise and to provide th e range and quality of service required. Copyright (C) 2001 John Wiley & So ns, Ltd.