Biographical Feature: Marie-Louise Landry, M.D.

Yi-Wei Tanga,b

aDepartment of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USAbDepartment of Pathology and Laboratory Medicine, Weill Medical College of Cornell University, New York, New York, USA

Throughout her career, Dr. Marie-Louise Landry has brought a unique combinationof actionable medical intelligence, charisma, and energy to the field of clinical

virology and infectious diseases. When asked whence her boundless energy andmotivation stems, Marie states, “My father was a French-Canadian immigrant, 1 of 12children, who left school at age 14 to work in the mills in New England during theDepression. My mother left school at 15 to work. I was the second of 5 children and,beginning at age 8, worked various jobs to earn money, including yard work, news-paper routes, and then field work in shade tobacco farms in the summers. Even as a kid,work gave me a feeling of independence, and I took great pride in having my ownmoney and being able to contribute to the family.”

Having been raised by parents who encouraged education and public service, Mariedecided to become a physician when she was only 12 years old. Marie’s work ethic andenergy undoubtedly helped her in pursuing her dream. She worked two or three jobseach summer while studying at the University of Massachusetts in Amherst. Aftergraduation, she worked as a chemist at Pratt & Whitney Aircraft by day and worked

Citation Tang Y-W. 2019. Biographical Feature:Marie-Louise Landry, M.D. J Clin Microbiol57:e01013-19. https://doi.org/10.1128/JCM.01013-19.

Editor Erik Munson, Marquette University

Copyright © 2019 American Society forMicrobiology. All Rights Reserved.

Address correspondence toyiweitangmd@gmail.com.

Accepted manuscript posted online 14August 2019Published

BIOGRAPHICAL FEATURE

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nights and weekends as a cocktail waitress to save for medical school. At GeorgetownMedical School, Marie continued as a cocktail waitress evenings and weekends, untilshe secured jobs doing admission physicals at private hospitals to pay her expenses.When she started her internal medicine internship, Marie listed 26 jobs in her résumé.“My only regret is that I have no photos in my various cocktail waitress uniforms,” Mariequips with a smile.

After medical school, Marie trained in internal medicine at Yale and has never left.There, she met her husband, Peter Aronson, a physician scientist. Upon completion ofresidency training, she spent a year as an emergency room physician at the Departmentof Veterans Affairs (VA) Connecticut Medical Center and then began an infectiousdiseases fellowship, which required 2 years of laboratory research. Although she wasinitially reluctant to spend time away from patients, Marie says, “Viruses piqued myinterest, so I sought out Edith G. D. Hsiung, Ph.D., a professor in laboratory medicine,who was doing work in clinical and diagnostic virology (1). I was accepted into her labat the VA in 1979, and to my surprise, this experience opened doors to a new andexciting world and ultimately changed my career path. Dr. Hsiung’s enthusiasm forvirology and every ‘discovery,’ no matter how small, was in itself infectious. In addition,at adult infectious disease case conferences, the faculty turned to me, a mere fellow, toask virology questions. This was the first time I had knowledge that the faculty did not,and I came to the realization that this was a transition period and that by staying invirology, I could provide a useful service.”

Forty years ago, when she started in virology, viral detection methods were confinedto virus isolation in embryonated eggs, suckling mice, or cell culture and acute- andconvalescent-phase serology by complement fixation. Marie recalls, “When I worked atthe VA hospital as a fellow, the phone in the lab never rang. Many times, I had to solicitsamples from my clinical colleagues, and by the time I isolated a virus and called theward, no one cared because there was no treatment, and the patient was either deador better.”

As a fellow, Marie worked to optimize isolation of viruses in cell culture andevaluated the efficacy of acyclovir, then a new antiviral, using the guinea pig model ofgenital herpes (2–4). After 2 years with Dr. Hsiung, Marie spent 2 years with WilliamSummers, M.D., Ph.D., currently professor emeritus of therapeutic radiology and mo-lecular biophysics and biochemistry at Yale, learning about Southern blotting, DNAhybridization, and other pre-PCR molecular methods. In the New Haven area, therewere three deaths from culture-proven herpes encephalitis in 3 weeks in December1979, and a nurse caring for one of these patients developed a herpetic lesion on hernose. Using the restriction endonuclease mapping technique, Marie examined the viralisolates and disproved the possibility that a single strain of virus caused this cluster ofcases (5). Summers recalled some 40 years later, “This paper was only the second in theliterature to use DNA analysis to study an infectious disease outbreak and the first tobring the nascent field of molecular epidemiology to clinical virology. Marie experi-enced firsthand the swift revolution from the ‘classical’ virology of cell culture, cyto-pathic effects, Cowdry inclusion bodies, and embryonated eggs to the ‘molecular’ worldof nucleic acid chemistry, monoclonal antibodies, and laboratory automation. She wasprepared by experience, enthusiasm, and expertise to make important contributions asshe moved on in her career as an independent scholar and clinician.”

Zhi-Ming (Thomas) Zheng, M.D., Ph.D., a senior investigator and head of the tumorvirus RNA biology section at the National Cancer Institute, NIH, recalled, “I have enjoyeda long friendship with Marie since 1981. I first met her at one of Dr. Hsiung’s labmeetings shortly after I arrived at Yale to begin my clinical virology training. My firstimpression of Marie was that her questions were always relevant to the rapid diagnosisof viral infections. Her enthusiasm for improving on classical virology diagnostics byusing molecular and genotyping tools for viral infections was amazing in the early1980s, when molecular biology in medicine was just starting. At that time, we tookhandwritten protocols from one lab to another. While she was back and forth from BillSummers’s lab to Dr. Hsiung’s lab during my first year at Yale, Marie taught me

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molecular virology by hand— how to purify viral DNA, run agarose gel electrophoresis,clone a viral DNA fragment for probe preparation, and perform Southern blot hybrid-ization. She always had humor, making me laugh, and was encouraging and energeticwhen I felt lonely or tired.”

In 1984, Marie was appointed as an assistant professor of both laboratory medicineand internal medicine at Yale and worked with Dr. Hsiung to establish a virologyreference laboratory to serve the VA system. Marie subsequently directed the lab for15 years. Marie initially continued her research on the pathogenesis and treatment ofgenital herpes in the guinea pig model (6), spent many evenings meeting with patientsat “herpes help groups,” ran the diagnostic virology lab at the VA, taught the virologycourse to Yale medical students, and attended on the infectious disease service. Thiswas also the time that AIDS first was recognized, which greatly transformed bothinfectious disease practice and diagnostic virology. In 1987, Marie secured funding forthe addition of a retrovirus diagnostic section to the VA virology reference laboratory,and Brigitte Griffith, as the new HIV section chief, then introduced HIV culture in humanlymphocytes for both diagnosis and research (7). It was in this lab that HIV-2 wasisolated from the second case of HIV-2 infection diagnosed in the country, from apatient at Yale. Due to her early experience with HIV culture, she served as chair of thenational VA Biosafety Advisory Committee for Retrovirus Research from 1988 to 1990.Subsequently, through the Yale AIDS Clinical Trials Unit (ACTU), Marie was involved indeveloping a more rapid cytomegalovirus (CMV) resistance assay (8) as well as the firstapplication of nucleic acid amplification testing (NAAT) for determining HIV viral load,a much safer and more rapid method than lymphocyte culture.

In the early years, Marie explored the use of in situ hybridization for detection andidentification of herpes simplex virus (HSV) infection in cultured cells but found thatimmunologic methods using new monoclonal antibodies were more sensitive, simpler,and cheaper than nonamplified nucleic acid hybridization techniques (9). The advent ofmonoclonal antibodies was momentous, allowing for a rapid, accurate method ofidentification of viruses beyond detection of cytopathic effects (10). Marie reminisces,“I have been very fortunate to have witnessed the transition of viral diagnostics fromthe periphery to the mainstream of laboratory testing. It’s amazing to think of how fardiagnostic virology has progressed, driven in particular by the rise of transplantation,the AIDS epidemic, herpes, hepatitis, and influenza virus therapies, as well as therepeated emergence of new viral pathogens.”

In 1989, Marie persuaded David Persing, M.D., Ph.D., then a sharp and energeticlaboratory medicine resident, to prepare a perspective article on molecular diagnosis(11). In this 30-year-old article, which is still relevant today, David and Marie made astrong prediction: “if the potential problems of sample cross-contamination can beaddressed and overcome, amplification methods may form the basis of a fully auto-mated nucleic acid detection system.” David, now executive vice president and chiefmedical and technology officer at Cepheid, said, “This has certainly proven to be correctafter 30 years of practice, due, in part, to Marie’s own efforts. Technologies enablingfully automated PCR-based detection have been developed and used in tens ofthousands of tests each day for infections due to HIV, tuberculosis, influenza, and manyothers.”

As the need for diagnostic virology services grew, in 1991 Marie was recruited toestablish a new clinical virology laboratory within the laboratory medicine departmentat Yale New Haven Hospital. Marie insisted on unifying all virology diagnostic testingwithin one laboratory and, together with David Ferguson, M.T.(ASCP), former clinicalvirology laboratory manager, was at the forefront of adopting new methods for clinicaldiagnosis. In the early 1990s, CMV pp65 antigenemia revolutionized patient manage-ment, allowing for rapid quantification of CMV viral load in blood (12–15). Marie’slaboratory at Yale was the first clinical laboratory in the United States to offer the testas a routine diagnostic test. Marie and her colleagues then applied the cytocentrifu-gation technique to direct fluorescent antibody (DFA)-based detection of virusesdirectly in clinical samples to provide a more sensitive and specific result, first for HSV

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and varicella-zoster virus (VZV) in lesion swabs and then for respiratory viruses (16).When pooled monoclonal antibodies with dual fluorescent labels became available in1998 and 1999, the lab conducted the initial clinical studies and was the first tointroduce the test into routine clinical use (17, 18). Multiple respiratory viruses couldnow be efficiently detected within 1 to 2 hours with sensitivity similar to that of culture,with an immediate impact on patient care. “Marie worked tirelessly to ensure thatsample quality, test utilization, and interpretation were optimal and well understood.Her efforts made a huge difference in how DFA testing was deployed and used at YaleNew Haven,” commented Ferguson. While virology had been appreciated by servicescaring for transplant recipients, HIV patients, and pediatric patients, the impact of rapidon-demand respiratory virus DFA testing caught the attention of hospital administra-tion and the clinical virology laboratory, and Marie’s work was suddenly recognized asa valued resource for infection prevention and bed management, especially in fluseason. Over the years, the virology laboratory grew from 3 to 18 staff.

Initially, NAAT was confined to viruses that were dangerous, slow, or difficult to growin culture, and there were few commercial products. In 2000, Marie’s laboratory beganto offer laboratory-developed conventional PCR for herpesviruses with gel-based am-plicon detection in the clinical laboratory, followed by nucleic acid sequence-basedamplification (NASBA) for enteroviruses (19–22). Then, the floodgates opened when thelaboratory transitioned to real-time TaqMan PCR (23–28). Marie implemented thereal-time assays, using protocols originally from the CDC as well as those published byother international experts. Marie credits the generous guidance of many experts,especially Fred Lakeman, Greg Storch, Christine Ginocchio, Dean Erdman, and RickHodinka, and the friendly, collaborative atmosphere of the Annual Clinical VirologySymposium in Clearwater Beach, FL, instituted by Steve Specter in 1985 and cospon-sored by the Pan American Society for Clinical Virology. Within a few years, the clinicalvirology laboratory at the Yale New Haven Hospital was offering testing for all commonviral pathogens. Even today, as better, faster, and simpler commercial NAATs havebecome available, advantages remain for lab-developed tests, including lower cost,excellent performance characteristics, efficient use of a single platform, the ability toestimate viral load in real-time qualitative assays, and the ability to update quickly inresponse to pathogen diversity and change (29). “We now have many rapid andaccurate tests for viruses, but some are quite expensive,” Marie notes. “The challengeis discerning how we can best impact patient outcomes and then implement the mostcost-effective approach.” The wealth of clinical samples arriving in the Yale laboratoryalso allowed collaborations with other researchers that led to the detection of newviruses and the development of new methods, including, most recently, with EllenFoxman, M.D., Ph.D., an assistant professor of laboratory medicine and immunobiologyat Yale, the recognition of virus infections by identification of an antiviral host responserather than by detection of a specific virus (30–33).

Those of you who know Marie only through clinical microbiology may not be awareof her extraordinary career as a medical educator. For almost 40 years, in addition tobeing director of medical studies for the department, she has essentially single-handedly taught the virology course within the preclinical curriculum at Yale School ofMedicine. She has been an extraordinarily successful and beloved teacher, the onlytwo-time winner so far of the Bohmfalk award for basic science teaching at Yale, andher evaluations glow with the students’ praise of her. In addition to being extremelyorganized and clear, her lectures are distinguished by her use of personal reflectionsand anecdotes, particularly of viral illnesses that have affected her and her family. Whenshe received her first Bohmfalk award, she was traveling, so she sent her young sons toaccept it on her behalf, since many of her slides of viral illnesses included pictures ofthem as affected children. She now includes stories from the next generation, hergrandchildren, to help students remember the plethora of viral pathogens.

In addition to her academic career, Marie has been active in her community as aLittle League baseball coach and a Cub Scout den leader and assistant scoutmaster. Shehosted in her home a Fresh Air Fund child in the summer and high school students in

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the town of Guilford’s “A Better Chance” (ABC) program during the school year. For14 years, she served on the Guilford ABC board of directors as secretary and asacademic advisor and mentor to a number of talented young women of color frominner cities who attended the town’s high school as ABC scholars and went on to obtaincollege and graduate degrees.

Marie has also been an invaluable mentor to young Yale faculty, giving guidance,support, and the occasionally needed push. In the Department of Laboratory Medicine,where she is vice chair, her influence extends far beyond clinical virology to other areasof the laboratory-clinical interface. Marie brings the same attention to detail andthoroughness to her administrative and director roles, including as cochair of thehospital system Laboratory Formulary Committee, as she does to her academic en-deavors. She will review guidelines, internal data, and internal and external expertopinions to determine best practices for moving forward. David Peaper, M.D., Ph.D., andSheldon Campbell, M.D., Ph.D., other Yale clinical microbiologists, are only half-jokingwhen they say they wear bracelets with the abbreviation “WWMD,” for “What wouldMarie do?” David and Sheldon emphasize, “When confronted with a difficult adminis-trative, educational, clinical, or quality problem in the laboratory, asking ‘WWMD?’ maynot lead to the easiest, most expedient, or simplest answer, but it will almost alwayslead to the best answer.” The quality of the work being done around Marie is elevatedto her high standards by dint of her leadership and the example she sets.

Marie states, “I have been very fortunate to have participated in the transformationof viral diagnostics over the past 4 decades. In the past, virology was distinct from therest of microbiology due to the need for cell culture expertise. As cell culture has beenincreasingly abandoned in routine labs, I am concerned that NAAT testing for viralpathogens may be dispersed to molecular labs, core labs, or to the point of care (34)and viral serology dispersed to chemistry or immunology labs, and as a result, expertisein use and interpretation of viral diagnostics as a whole may be lost. So I am gratefulthat I have been able to specialize in clinical virology during a very exciting andtransformative time.” Marie’s contributions to the field include recognition and earlyadoption of new methods in routine clinical practice and, by starting new virologylaboratories, building laboratory capacity to support patient care.

During her career in diagnostic virology, she has received the Diagnostic VirologyAward from the Pan American Society for Clinical Virology in 2005 and the OutstandingTeacher Award, Yale Pathology and Laboratory Medicine Residents in 2012. She hasserved as councilor, secretary-treasurer, and then president of the Pan American Societyof Clinical Virology. She relates that she has particularly enjoyed being the virologyvolume editor of the Manual of Clinical Microbiology from ASM Press for the past 4editions, because she gets to carefully read, and then reread, all the virology chapters(35). She is the quintessential academic physician, exhibiting the same boundlessenergy and conviction as when I first met her at the Annual Clinical Virology Sympo-sium in 1997 at Clearwater Beach; may her living legacy continue.

ACKNOWLEDGMENTSI express sincere gratitude to Marie Landry for her provision of time and biblio-

graphic items to this biographical feature and for liberally sharing her wealth ofexperience and insight. I thank and acknowledge the following colleagues who pro-vided tremendous assistance to this biography: Sheldon Campbell, David Ferguson,David Peaper, David Persing, Bill Summers, and Thomas Zhi-Ming Zheng.

REFERENCES1. Landry ML. 1989. G.D. Edith Hsiung, Ph.D.: virologist and teacher. Yale J

Biol Med 62:62–77.2. Landry ML, Mayo DR, Hsiung GD. 1982. Comparison of guinea pig embryo

cells, rabbit kidney cells, and human embryonic lung fibroblast cell strainsfor isolation of herpes simplex virus. J Clin Microbiol 15:842–847.

3. Landry ML, Madore HP, Fong CK, Hsiung GD. 1981. Use of guinea pig

embryo cell cultures for isolation and propagation of group A coxsacki-eviruses. J Clin Microbiol 13:588 –593.

4. Landry ML, Lucia HL, Hsiung GD, Pronovost AD, Dann PR, August MJ,Mayo DR. 1982. Effect of acyclovir on genital infection with herpessimplex virus types 1 and 2 in the guinea pig. Am J Med 73:143–150.https://doi.org/10.1016/0002-9343(82)90080-8.

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5. Landry ML, Berkovits N, Summers WP, Booss J, Hsiung GD, Summers WC.1983. Herpes simplex encephalitis: analysis of a cluster of cases byrestriction endonuclease mapping of virus isolates. Neurology 33:831– 835. https://doi.org/10.1212/wnl.33.7.831.

6. Landry ML, Zibello TA. 1988. Ability of herpes simplex virus (HSV) types1 and 2 to induce clinical disease and establish latency following pre-vious genital infection with the heterologous HSV type. J Infect Dis158:1220 –1226. https://doi.org/10.1093/infdis/158.6.1220.

7. Mellors JW, Griffith BP, Ortiz MA, Landry ML, Ryan JL. 1991. Tumornecrosis factor-alpha/cachectin enhances human immunodeficiency vi-rus type 1 replication in primary macrophages. J Infect Dis 163:78 – 82.https://doi.org/10.1093/infdis/163.1.78.

8. Landry ML, Stanat S, Biron K, Brambilla D, Britt W, Jokela J, Chou S, DrewWL, Erice A, Gilliam B, Lurain N, Manischewitz J, Miner R, Nokta M,Reichelderfer P, Spector S, Weinberg A, Yen-Lieberman B, Crumpacker C.2000. A standardized plaque reduction assay for determination of drugsusceptibilities of cytomegalovirus clinical isolates. Antimicrob AgentsChemother 44:688 – 692. https://doi.org/10.1128/aac.44.3.688-692.2000.

9. Landry ML, Zibello TA, Hsiung GD. 1986. Comparison of in situ hybrid-ization and immunologic staining with cytopathology for detection andidentification of herpes simplex virus infection in cultured cells. J ClinMicrobiol 24:968 –971.

10. Zhao LS, Landry ML, Balkovic ES, Hsiung GD. 1987. Impact of cell culturesensitivity and virus concentration on rapid detection of herpes simplexvirus by cytopathic effects and immunoperoxidase staining. J Clin Mi-crobiol 25:1401–1405.

11. Persing DH, Landry ML. 1989. In vitro amplification techniques for thedetection of nucleic acids: new tools for the diagnostic laboratory. YaleJ Biol Med 62:159 –171.

12. Landry ML, Ferguson D. 1993. Comparison of quantitative cytomegalo-virus antigenemia assay with culture methods and correlation withclinical disease. J Clin Microbiol 31:2851–2856.

13. Landry ML, Ferguson D, Stevens-Ayers T, de Jonge MW, Boeckh M. 1996.Evaluation of CMV Brite kit for detection of cytomegalovirus pp65antigenemia in peripheral blood leukocytes by immunofluorescence. JClin Microbiol 34:1337–1339.

14. Landry ML, Cohen S, Huber K. 1997. Comparison of EDTA and acid-citrate-dextrose collection tubes for detection of cytomegalovirus anti-genemia and infectivity in leukocytes before and after storage. J ClinMicrobiol 35:305–306.

15. Landry ML, Ferguson D. 2000. 2-hour cytomegalovirus pp65 antigen-emia assay for rapid quantitation of cytomegalovirus in blood samples.J Clin Microbiol 38:427– 428.

16. Landry ML, Ferguson D, Wlochowski J. 1997. Detection of herpes simplexvirus in clinical specimens by cytospin-enhanced direct immunofluores-cence. J Clin Microbiol 35:302–304.

17. Landry ML, Ferguson D. 2000. SimulFluor respiratory screen for rapiddetection of multiple respiratory viruses in clinical specimens by immu-nofluorescence staining. J Clin Microbiol 38:708 –711.

18. Campbell S, Landry ML. 2018. Rapid micriobial antigen tests, p 99 –126.In Tang Y-W, Stratton CW (ed), Advanced techniques in diagnosticmicrobiology, 3rd ed, vol 2. Springer-Nature Publishing, New York, NY.

19. Landry ML, Ferguson D, Cohen S, Peret TC, Erdman DD. 2005. Detectionof human metapneumovirus in clinical samples by immunofluorescencestaining of shell vial centrifugation cultures prepared from three differ-ent cell lines. J Clin Microbiol 43:1950 –1952. https://doi.org/10.1128/JCM.43.4.1950-1952.2005.

20. Landry ML, Garner R, Ferguson D. 2003. Comparison of the NucliSensBasic kit (nucleic acid sequence-based amplification) and the ArgeneBiosoft Enterovirus Consensus reverse transcription-PCR assays for rapiddetection of enterovirus RNA in clinical specimens. J Clin Microbiol41:5006 –5010. https://doi.org/10.1128/jcm.41.11.5006-5010.2003.

21. Landry ML, Garner R, Ferguson D. 2003. Rapid enterovirus RNA detectionin clinical specimens by using nucleic acid sequence-based amplifica-tion. J Clin Microbiol 41:346 –350. https://doi.org/10.1128/jcm.41.1.346-350.2003.

22. Landry ML, Garner R, Ferguson D. 2005. Real-time nucleic acid sequence-based amplification using molecular beacons for detection of enterovi-rus RNA in clinical specimens. J Clin Microbiol 43:3136 –3139. https://doi.org/10.1128/JCM.43.7.3136-3139.2005.

23. Habib-Bein NF, Beckwith WH, III, Mayo D, Landry ML. 2003. Comparison ofSmartCycler real-time reverse transcription-PCR assay in a public healthlaboratory with direct immunofluorescence and cell culture assays in amedical center for detection of influenza A virus. J Clin Microbiol 41:3597–3601. https://doi.org/10.1128/JCM.41.8.3597-3601.2003.

24. Landry ML, Cohen S, Ferguson D. 2008. Real-time PCR compared toBinax NOW and cytospin-immunofluorescence for detection of influenzain hospitalized patients. J Clin Virol 43:148 –151. https://doi.org/10.1016/j.jcv.2008.06.006.

25. Landry ML, Cohen S, Ferguson D. 2008. Prospective study of humanmetapneumovirus detection in clinical samples by use of light diagnos-tics direct immunofluorescence reagent and real-time PCR. J Clin Micro-biol 46:1098 –1100. https://doi.org/10.1128/JCM.01926-07.

26. Landry ML, Ferguson D. 2009. Polymerase chain reaction and the diag-nosis of viral gastrointestinal disease due to cytomegalovirus, herpessimplex virus and adenovirus. J Clin Virol 45:83– 84. https://doi.org/10.1016/j.jcv.2009.02.007.

27. Landry ML, Ferguson D. 2010. Cytospin-enhanced immunofluorescenceand impact of sample quality on detection of novel swine origin (H1N1)influenza virus. J Clin Microbiol 48:957–959. https://doi.org/10.1128/JCM.01678-09.

28. Landry ML, Ferguson D. 2014. Comparison of Simplexa Flu A/B & RSVPCR with cytospin-immunofluorescence and laboratory-developed Taq-Man PCR in predominantly adult hospitalized patients. J Clin Microbiol52:3057–3059. https://doi.org/10.1128/JCM.00738-14.

29. Landry ML, Tang Y-W. 2016. Immunologic and molecular assays for viraldiagnosis, p 538 –549. In Detrick B, Schmitz JL, Hamilton RG (ed), Manualof molecular and clinical laboratory immunology, 8th ed. ASM Press,Washington, DC.

30. Esper F, Weibel C, Ferguson D, Landry ML, Kahn JS. 2005. Evidence of anovel human coronavirus that is associated with respiratory tract diseasein infants and young children. J Infect Dis 191:492– 498. https://doi.org/10.1086/428138.

31. Zhu Z, Tang W, Ray A, Wu Y, Einarsson O, Landry ML, Gwaltney J, Jr, EliasJA. 1996. Rhinovirus stimulation of interleukin-6 in vivo and in vitro.Evidence for nuclear factor kappa B-dependent transcriptional activa-tion. J Clin Invest 97:421– 430. https://doi.org/10.1172/JCI118431.

32. Zhao J, Liu J, Vemula SV, Lin C, Tan J, Ragupathy V, Wang X, Mbondji-Wonje C, Ye Z, Landry ML, Hewlett I. 2016. Sensitive detection andsimultaneous discrimination of influenza A and B viruses in nasopharyn-geal swabs in a single assay using next-generation sequencing-baseddiagnostics. PLoS One 11:e0163175. https://doi.org/10.1371/journal.pone.0163175.

33. Landry ML, Foxman EF. 2018. Antiviral response in the nasopharynxidentifies patients with respiratory virus infection. J Infect Dis 217:897–905. https://doi.org/10.1093/infdis/jix648.

34. Azar MM, Landry ML. 2018. Detection of influenza A and B viruses andrespiratory syncytial virus by use of Clinical Laboratory ImprovementAmendments of 1988 (CLIA)-waived point-of-care assays: a paradigmshift to molecular tests. J Clin Microbiol 56. https://doi.org/10.1128/JCM.00367-18.

35. Pfaller MA, Carroll KC, Funke G, Landry ML, Richter SS, Warnock D (ed). 2019.Manual of clinical microbiology, 12th ed. ASM Press, Washington, DC.

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