A Licensed Clinical Laboratory has been established to perform specialized viral cultures for the detection and characterization of stealth adapted viruses. Testing is performed on selected patients with unusual clinical manifestations suggestive of a possible underlying viral illness. Please inquire about sample requirements, shipping instruction and billing. Clinical information will be requested on the patient to help in the choice of appropriate tests.

Suggested Medical Indications for Stealth Viral Cultures

A limited number of cultures from patients suspected as having a "stealth virus" infection will be performed within the Center for Complex Infectious Diseases (CCID) on the understanding that the cost of testing is borne either by the requesting physician or by the patient's insurance. In the latter case, it is necessary for the requesting physician to certify that the testing is medically indicated.

The present indications for testing are:

1. To help distinguish a virally induced illness from a "psychosomatic" disorder. This distinction is especially difficult in cases of unexplained fatigue. Virally infected patients are more likely to show cognitive impairment and other symptoms of sub-cortical brain dysfunction. Other common symptoms associated with stealth viral infections include headaches, muscle aches, arthralgia, genitourinary pain, irritable bowel, dry mouth, mild endocrine and/or liver dysfunction. A negative blood culture does not exclude a viral infection which may be localized to the brain.

2. To identify the probable cause of more severe encephalopathies. Examples of acute onset illness in adults and of congenital infections in newborn infants have been seen. The illnesses may be mistaken for a Herpes simplex or enteroviral encephalitis/meningitis. Typically the CSF will show only minimal changes. Many of these patients can have long term sequelae including a CFS illness.

3. To identify a potential contributing factor to various psychiatric illnesses, including manic depression, depression, schizophrenia, autism, panic and anxiety attacks, etc.

4. To identify a potential contributing factor to various chronic neurologic and neuromuscular illnesses, including multiple sclerosis, Parkinsonism, Alzheimer's disease, peripheral neuropathies, myopathies, etc.

5. To identify a potential co-factor in HIV infected patients, especially those in whom evidence of brain dysfunction is seen.

6. To identify a potential contributing factor to various auto-immune diseases, including SLE, Sjogren's syndrome, vitiligo, etc.

7. To assess family members and household pets for evidence of transmission of viral infection.

8. To enroll patients into clinical therapeutic trials of anti-viral agents, especially those agents shown to be inhibitory to the virus cultured from the patient. Post therapy testing may be useful in the assessment of efficacy.

9. To search for the possible contribution of stealth viral infections in various malignancies and other chronic degenerative diseases including renal disease and atherosclerosis.

10. To identify individuals at potential risk for transmission of disease to other persons.

Instructions For Sending Samples for Stealth Virus Testing

Cultures from patients suspected as having a stealth virus infection will be performed on the understanding that the cost of testing is borne either by the requesting physician or by the patient's insurance. In the latter case, it is necessary for the requesting physician to certify that the testing is medically indicated. Testing consists of culturing patient's blood or CSF on several indicator cell lines in a manner suitable to elicit a cytopathic effect (CPE) typical of that associated with stealth viruses. The culture methods will also detect several human viruses incluing, cytomegalovirus, enteroviruses, adenoviruses, varicella zoster virus, Herpes simplex virus and others. Immunological and molecular probe based assays may be used to further characterize selected stealth viral isolates. When requested, research assays for susceptibility to anti-viral agents and partial sequencing of polymerase chain reaction (PCR) amplified regions of the stealth viral genome can be attempted. Once sequence data are available, isolate specific PCR assays can be devised to help monitor disease progress and to evaluate tissue biopsies for the presence of virus.

To request initial blood testing, please submit a 10 ml Yellow top (ACD) tube sent at room temperature via Federal Express or by courier to:

CSF samples should be sent on ice. Throat swabs, urine and tissue biopsies can also be processed. Please provide the patient's name, requesting physician, date of collection, specimen type, clinical diagnosis and insurance billing information. Preliminary results will be available within 4 weeks.

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