The development and implementation of a molecular technology based service for the diagnosis of respiratory viral infection in Wales

The manuscripts submitted in this thesis describe the early development and implementation work for a molecular technology based service for the diagnosis of respiratory viral infection in Wales. The service allowed for a greater understanding of the spectrum of disease caused by respiratory viruses as molecular methods were proven rapid and sensitive when compared to traditional laboratory methods. This work transformed the understanding of respiratory virus infection in both vulnerable and healthy patients in the community and hospital setting and eventually informed on the most appropriate way to deliver a 2lst century respiratory virus diagnostic service.

Implementation of the service has had a direct impact on public health by improving the detection and monitoring of respiratory virus outbreaks and by providing information regarding the circulation of respiratory viruses in the community. The service in Cardiff became part of a network of laboratories that responds to new and emerging respiratory viral infections across the UK and the expertise gained proved instrumental in the Welsh laboratory response to the influenza A (H1N1) 2009 virus pandemic and the issues that arose as a direct consequence including an oseltamivir resistant outbreak. Ongoing developments in the field of molecular diagnostics together with the increasing repertoire of respiratory viruses means that the service is constantly improved to ensure that Wales continues to have a first-class service for the diagnosis of respiratory viral infection.