Book Review

Clinical Virology

N Engl J Med 1998; 338:135January 8, 1998

Article

Clinical Virology
Edited by Douglas D. Richman, Richard J. Whitley, and Frederick G. Hayden. 1355 pp., illustrated. New York, Churchill Livingstone, 1997. $180. ISBN: 0-443-07653-7

In 1928, Thomas Rivers edited an authoritative book entitled Filterable Viruses (Baltimore: Williams and Wilkins) that summarized virologic knowledge of the time. Leading virologists who contributed chapters included Alexis Carrel (tissue culture), Edmund Cowdry (intranuclear pathology), Harold Amos (poliomyelitis), Peter Olitsky (foot and mouth disease), and Ernest Goodpasture (fowlpox). Additional chapters were devoted to descriptions of viruses of insects, plants, and bacteria. Since that time, there have been tremendous advances in our knowledge of the large number of viruses that infect humans and the pathologic consequences of these infections, and viruses have served as tools in the discovery of many of the fundamental processes of life. Today, books on virology generally address only one particular aspect of the subject, such as basic virology, epidemiology, pathogenesis, diagnostic virology, or as in the book under review, clinical virology.

This book is large (over 1350 pages), and more than 80 authors contributed to its 54 chapters. It deals exclusively with viral infections of humans and concentrates on infections that are clinically important and produce disease. For example, parvovirus B19, which causes erythema infectiosum in children, is described in detail, but adenoassociated parvoviruses, which infect humans frequently but are not clearly associated with any disease, are discussed very briefly. The book begins with a short introductory chapter that, without going into the details of viral structure or genetics, presents a table of taxonomy of human viruses. It then moves directly into descriptions of viral syndromes (hemorrhagic fevers, viral hepatitis, and several others) and a discussion of general principles (e.g., antiviral agents, viral diagnosis, and immune response). These two topics constitute section 1 of the book. Section 2, which is the main focus of the book, deals with individual viral groups in 38 chapters. All chapters follow a uniform format and are divided into the following sections: introduction, virology, epidemiology, pathogenesis, clinical manifestations, laboratory diagnosis, prevention, and treatment. The last two chapters are on subviral agents, one on hepatitis D virus and the other on transmissible spongiform encephalopathies. Some chapters cite over 600 references.

There is considerable variation in the amount of space devoted to the different components of the chapters, but the information is well organized and easy to find. Issues most important in clinical virology, such as clinical manifestations, epidemiology, and laboratory diagnosis, are discussed in a comprehensive way. The editors have done an outstanding job in selecting the contributors to the book. They are among the leading investigators in their respective fields, and it is obvious that they have put considerable effort and thought into the preparation of the chapters. For example, the chapter on chronic fatigue syndrome is a lucid exposition of the various competing views on the etiology of this confusing disease. Almost all chapters are well written, and they provide up-to-date and relevant data as well as the authors' interpretation of what the data mean. Illustrations are appropriate and of high quality, although their sources are not always acknowledged. The book has its share of typographical and other errors, which is perhaps not unusual for a first edition.

Before beginning the review of this book, I selected four topics in clinical virology (hepatitis G, hantavirus pulmonary syndrome, Kaposi's sarcoma–associated herpesvirus, and Creutzfeldt–Jakob disease associated with bovine spongiform encephalopathy) as test cases to see how well the book covered newly acquired information in these areas. The first three topics are covered very well and in great detail, and the fourth is discussed as an unresolved issue.

This excellent book will be of considerable value to all who want to know about human viral infection, and especially clinicians, students, and virologists interested in infectious diseases. The book should find its place beside Fields's Virology (third edition, edited by Bernard N. Fields; New York: Raven Press, 1996) and Viral Pathogenesis (edited by Neal Nathanson; Philadelphia: Lippincott-Raven, 1997) as a valued resource in virology.

Keerti V. Shah, M.D., Dr.P.H.
Johns Hopkins School of Public Health, Baltimore, MD 21205