ASSOCIATE EDITORS Katalin Banki, MD Donald S. Karcher, MD Associate Professor Professor and Immediate Past Chair Department of Pathology Department of Pathology SUNY Upstate Medical University George Washington University Medical Center Syracuse, New York Washington, DC Martin H. Bluth, MD, PhD Mark S. Lifshitz, MD Chief, Blood Bank/Transfusion Services Clinical Professor Assistant Director, Clinical Laboratories Department of Pathology, Molecular, and Cell-Based Medicine Director of Translational Research Icahn School of Medicine at Mount Sinai Department of Pathology New York, New York Maimonides Medical Center Brooklyn, New York; H. Davis Massey, DDS, MD, PhD Professor of Pathology Chief, Department of Pathology and Laboratory Medicine Wayne State University School of Medicine McGuire VA Medical Center Detroit, Michigan; Associate Professor Adjunct Professor of Pathology Department of Pathology SUNY Downstate Medical Center Virginia Commonwealth University Brooklyn, New York; Richmond, Virginia Global Medical Director Kids Kicking Cancer A. Koneti Rao, MBBS, FACP, FAHA Founder, Bluth Bio Industries Sol Sherry Professor of Medicine Southfield, Michigan Professor of Clinical Pathology and Laboratory Medicine Co- Director, Sol Sherry Thrombosis Research Center Jay L. Bock, MD, PhD Director, Benign Hematology, Hemostasis and Thrombosis Professor Emeritus Lewis Katz School of Medicine at Temple University Department of Pathology Philadelphia, Pennsylvania Stony Brook Medicine Stony Brook, New York Gail L. Woods, MD Former Professor Wilbur B. Bowne, MD University of Arkansas for Medical Sciences Professor of Surgery and Chief of Oncological Surgery Chief of Pediatric Pathology Jefferson Medical Center Department of Pathology Philadelphia, Pennsylvania Arkansas Children’s Hospital Little Rock, Arkansas Robert E. Hutchison, MD Professor Department of Pathology SUNY Upstate Medical University Syracuse, New York State University of New York Upstate Medical University Syracuse, New York ii 24th EDITION HENRY ’S Clinical Diagnosis Management AND Laboratory Methods BY Richard A. McPherson, MD, MSc Professor Emeritus Department of Pathology Virginia Commonwealth University School of Medicine Richmond, Virginia Matthew R. Pincus, MD, PhD Professor Department of Pathology SUNY Downstate Medical Center Brooklyn, New York Elsevier 1600 John F. Kennedy Blvd. Ste. 1600 Philadelphia, PA 19103-2899 HENRY’S CLINICAL DIAGNOSIS AND MANAGEMENT BY LABORATORY ISBN: 978- 0- 323- 67320- 4 METHODS TWENTY- FOURTH EDITION Copyright © 2022 by Elsevier Inc. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Details on how to seek permission, further information about the Publisher’s permissions policies, and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency can be found at our website: www.elsevier.com/permissions. This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein). Previous editions copyrighted 2017, 2011, 2007, 2001, 1996, 1991, 1984, 1979, 1974, 1969, 1962, 1953, 1948,1943, 1939, 1935, 1931, 1927, 1923, 1918, 1914, 1912, 1908. Notices Knowledge and best practice in this field are constantly changing. As new research and experience broaden our understanding, changes in research methods, professional practices, or medical treatment may become necessary. Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds, or experiments described herein. In using such information or methods they should be mindful of their own safety and the safety of others, includ- ing parties for whom they have a professional responsibility. 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The Publisher Library of Congress Control Number: 2020952266 Executive Content Strategist: Michael Houston Senior Content Development Manager: Katherine DeFrancesco Publishing Services Manager: Catherine Jackson Senior Project Manager: John Casey Senior Designer: Margaret Reid Printed in Canada 9 8 7 6 5 4 3 2 1 CONTRIBUTORS Naif Z. Abraham Jr, MD, PhD Sylva Bem, MD Director, Division of Clinical Pathology Assistant Professor Assistant Professor of Pathology Department of Pathology State University of New York Upstate Medical University SUNY Upstate Medical University Syracuse, New York Syracuse, New York Katsumi Aoyagi, PhD Jonathan Ben- Ezra, MD Head, Research and Development Division Department of Pathology Fujirebio, Inc. Tel Aviv Sourasky Medical Center President and CEO Tel Aviv, Israel Advanced Life Science Institute, Inc. Hachioji- shi, Tokyo, Japan Tim B. Bigdeli, PhD Assistant Professor Yoshihiro Ashihara, PhD Department of Psychiatry President and CEO SUNY Downstate Medical Center Fujirebio Holdings, Inc. Brooklyn, New York Tokyo, Japan Martin H. Bluth, MD, PhD Jaya Ruth Asirvatham, MBBS Chief, Blood Bank/Transfusion Services Assistant Professor Assistant Director, Clinical Laboratories Department of Pathology, Immunology, and Laboratory Medicine Director of Translational Research University of Florida College of Medicine Department of Pathology Gainesville, Florida Maimonides Medical Center Brooklyn, New York; Constantine A. Axiotis, MD Professor of Pathology Professor Wayne State University School of Medicine Department of Pathology Detroit, Michigan; SUNY Downstate Health Sciences University Adjunct Professor of Pathology Brooklyn, New York SUNY Downstate Medical Center Brooklyn, New York; Yu Bai, MD, PhD Global Medical Director Professor of Pathology Kids Kicking Cancer The University of Texas Health Science Center at Houston Founder, Bluth Bio Industries McGovern Medical School Southfield, Michigan Director, Molecular Pathology at UT Outreach Pathology Houston, Texas Aleh Bobr, MD Medical Director, Blood Bank and Tissue Services Ulysses G.J. Balis, MD Associate Medical Director, Apheresis Service Professor Assistant Professor Department of Pathology Department of Pathology and Microbiology University of Michigan University of Nebraska Medical Center Ann Arbor, Michigan Omaha, Nebraska Katalin Banki, MD Jay L. Bock, MD, PhD Associate Professor Professor Emeritus Department of Pathology Department of Pathology SUNY Upstate Medical University Stony Brook Medicine Syracuse, New York Stony Brook, New York Katie V. Bean, MD Michael J. Borowitz, MD, PhD Nephrology Fellow Professor Department of Internal Medicine Department of Pathology and Oncology Virginia Commonwealth University Johns Hopkins Medical Institutions Richmond, Virginia Baltimore, Maryland Kathleen G. Beavis, MD Wilbur B. Bowne, MD Medical Director of Microbiology, Immunology, and Professor Laboratories’ Quality Director, Division of Oncological Surgery Professor of Pathology Department of Surgery University of Chicago Sidney Kimmel Medical College Chicago, Illinois Thomas Jefferson University Philadelphia, Pennsylvania v S Paul Brandt- Rauf, MD, PhD, DScD, DrPH Laura Lee Cooling, MD, MS R O Dean, School of Biomedical Engineering Professor T Drexel University Department of Pathology U B Philadelphia, Pennsylvania University of Michigan RI Ann Arbor, Michigan T Robert Bray, PhD N O Professor Lynsey Daniels, MD C Department of Pathology General Surgery Fellow Emory University School of Medicine Department of Surgery Atlanta, Georgia Drexel University College of Medicine Philadelphia, Pennsylvania Cindy L. Bredefeld, DO, FACE Attending Physician Robertson D. Davenport, MD Division of Endocrinology, Diabetes, and Metabolism Professor Assistant Professor of Clinical Medicine Department of Pathology Department of Medicine University of Michigan NYU Long Island School of Medicine Ann Arbor, Michigan Mineola, New York Robert P. DeCresce, MD, MBA, MPH Gary Briefel, MD Director of Clinical Laboratories Clinical Associate Professor Department of Pathology Department of Medicine Rush University Medical Center SUNY Downstate Medical Center Chicago, Illinois Brooklyn, New York Julio C. Delgado, MD, MS M. Jana Broadhurst, MD, PhD, DTM&H Professor Director, Nebraska Biocontainment Unit Clinical Laboratory Department of Pathology Director, Emerging Pathogens Laboratory University of Utah Assistant Professor, Pathology & Microbiology Salt Lake City, Utah University of Nebraska Medical Center Omaha, Nebraska Robert A. DeSimone, MD Assistant Professor Robert P. Carty, PhD Department of Pathology and Laboratory Medicine Associate Professor Weill Medical College of Cornell University Department of Biochemistry New York- Presbyterian Hospital SUNY Downstate Medical Center New York, New York Brooklyn, New York Margaret A. DiGuardo, MD Angela Ceribelli, MD, PhD Medical Director Unit of Rheumatology Immunohematology Laboratory Department of Internal Medicine Division of Transfusion Medicine Humanitas Clinical and Research Center – IRCCS Mayo Clinic Rozzano, Milan, Italy Rochester, Minnesota Edward K.L. Chan, PhD Jorge A. Di Paola, MD Professor Professor of Pediatrics and Molecular Genetics and Genomics Department of Oral Biology Elizabeth Finney McDonnell Endowed Chair in Pediatric Hematology University of Florida Oncology Gainesville, Florida Division Chief, Pediatric Hematology and Oncology Washington University School of Medicine in St. Louis Angella Charnot- Katsikas, MD St. Louis, Missouri Medical Director, MolDx Chief Medical Officer, Palmetto GBA Theresa Downs, BS Columbia, South Carolina Laboratory Supervisor Pathology Blood Bank Sindhu Cherian, MD University of Michigan Associate Professor Ann Arbor, Michigan Department of Laboratory Medicine University of Washington M. Tarek Elghetany, MD Seattle, Washington Professor of Pathology and Immunology and Pediatrics Department of Pathology Spencer Chiang, PhD Baylor College of Medicine Graduate Research Assistant Texas Children’s Hospital Weldon School of Biomedical Engineering Houston, Texas Purdue University West Lafayette, Indiana Matthew B. Elkins, MD, PhD Associate Professor William L. Clapp, MD Department of Pathology Professor of Pathology SUNY Upstate Medical University Director of Renal Pathology Syracuse, New York Department of Pathology, Immunology, and Laboratory Medicine University of Florida College of Medicine Ayman Fanous, MD Gainesville, Florida Professor and Chairman Department of Psychiatry SUNY Downstate Medical Center Brooklyn, New York vi Marvin J. Fritzler, PhD, MD Julie Woolworth Hirschhorn, PhD, HCLD S Professor Assistant Professor R O Department of Medicine Department of Pathology and Laboratory Medicine T Cumming School of Medicine Medical University of South Carolina U B University of Calgary Charleston, South Carolina RI Calgary, Alberta, Canada T N Catherine A. Hogan, MDCM, MSc O Howard M. Gebel, PhD Instructor C Professor Department of Pathology Department of Pathology Stanford University Emory University Hospital Stanford, California Atlanta, Georgia Joseph Holup, PhD, (D)ABMLI Eve Goldstein, MD Assistant Clinical Professor General Surgery Fellow Department of Pathology Department of Surgery NYU Grossman School of Medicine Drexel University College of Medicine New York, New York Philadelphia, Pennsylvania Henry A. Homburger, MD Susan S. Graham, MS Professor Emeritus Associate Professor and Chair Mayo College of Medicine Department of Clinical Laboratory Science Department of Laboratory Medicine and Pathology SUNY Upstate Medical University Mayo Clinic Syracuse, New York Rochester, Minnesota Wayne W. Grody, MD, PhD Yen- Michael S. Hsu, MD, PhD Professor Director of Immunologic Monitoring and Cellular Products Laboratory Department of Pathology & Laboratory Medicine, Pediatrics, and Associate Professor of Medicine Human Genetics Division of Hematology and Oncology UCLA School of Medicine University of Pittsburgh School of Medicine Los Angeles, California UPMC Hillman Cancer Center Pittsburgh, Pennsylvania Helena A. Guber, MD Chief, Department of Endocrinology, Metabolism and Diabetes M. Mahmood Hussain, PhD NY Harbor Healthcare System Director Assistant Professor of Medicine Diabetes and Obesity Research Center Department of Endocrinology NYU Langone Hospital–Long Island SUNY Downstate Health Sciences University Endowed Chair Brooklyn, New York Department of Foundations of Medicine NYU Long Island School of Medicine Gaurav Gupta, MD Mineola, New York; Associate Professor Distinguished Professor Emeritus Department of Internal Medicine Department of Cell Biology Virginia Commonwealth University SUNY Downstate Medical Center Richmond, Virginia Brooklyn, New York Robert G. Hamilton, PhD, D(ABMLI) Robert E. Hutchison, MD Professor Professor Department of Medicine and Pathology Department of Pathology Johns Hopkins University School of Medicine SUNY Upstate Medical University Baltimore, Maryland Syracuse, New York Amanda Harrington, PhD, D(ABMM) Peter C. Iwen, PhD, D(ABMM), F(AAM) Associate Professor Professor Department of Pathology and Laboratory Medicine Department of Pathology and Microbiology Loyola University Chicago University of Nebraska Medical Center Maywood, Illinois Omaha, Nebraska Neil Selwyn Harris, MBChB, MD Shilpa Jain, MD Clinical Professor Associate Professor Department of Pathology, Immunology, and Laboratory Medicine Department of Pathology and Immunology University of Florida College of Medicine Director of Gastrointestinal Pathology Gainesville, Florida Baylor College of Medicine Houston, Texas Rong He, MD Consultant, Department of Laboratory Medicine and Pathology Roohi Jeelani, MD (Hematopathology) Director of Research and Education Co- Director, Molecular Hematopathology Laboratory Reproductive Endocrinology and Infertility Mayo Clinic Vios Fertility Institute Rochester, Minnesota Chicago, Illinois Tim Hilbert, MD, PhD, JD J. Charles Jennette, MD Medical Director Professor Blood Bank Department of Pathology and Laboratory Medicine NYU Langone Medical Center University of North Carolina at Chapel Hill New York, New York Chapel Hill, North Carolina vii S Jeffrey S. Jhang, MD, MBA Attila Kumánovics, MD R O Professor and Vice Chair Senior Associate Consultant T Department of Pathology, Molecular and Cell- Based Medicine Department of Laboratory Medicine and Pathology U B Icahn School of Medicine at Mount Sinai Mayo Clinic RI Medical Director, Center for Clinical Laboratories Rochester, Minnesota NT Mount Sinai Health System O New York, New York Anthony Kurec, MS, MASCP, MLT(ASCP)H, DLM C Clinical Associate Professor, Emeritus Donald S. Karcher, MD Clin Lab Science Professor and Immediate Past Chair SUNY Upstate Medical University Department of Pathology Syracuse, New York George Washington University Medical Center Washington, DC Charles LaDoulis, MD Chairman Emeritus Yasushi Kasahara, PhD, DMSc Department of Pathology Visiting Professor Maimonides Medical Center Department of Clinical Pathology Brooklyn, New York Showa University School of Medicine Tokyo, Japan Raymond G. Lau, MD Clinical Assistant Professor Samuel W. Kaskovich Director of Medical Weight Management MD/MSc Candidate Division of Endocrinology, Diabetes, and Metabolism Medicine & Biomedical Informatics Division of Bariatric Surgery University of Chicago Department of Medicine Chicago, Illinois NYU Long Island School of Medicine Mineola, New York Craig M. Kessler, MD, MACP Professor of Medicine and Pathology Eszter Lázár- Molnár, PhD Director, Division of Coagulation Assistant Professor Georgetown University Medical Center Department of Pathology Washington, DC University of Utah Salt Lake City, Utah Marian Khalili, MD General Surgery Fellow Grace Ming Lee, MD Department of Surgery Assistant Professor Drexel University College of Medicine Division of Hematology Philadelphia, Pennsylvania Department of Medicine Duke University Jason Kidd, MD Durham, North Carolina Associate Professor Department of Internal Medicine, Division of Nephrology Peng Lee, MD, PhD Virginia Commonwealth University Medical Center Professor of Pathology and Urology Richmond, Virginia New York University Langone Medical Center and School of Medicine Chief, Pathology and Laboratory Medicine Service Michael J. Klein, MD VA NY Harbor Healthcare System Pathologist- in- Chief and Director Emeritus New York, New York Department of Pathology and Laboratory Medicine Hospital for Special Surgery Jing Li, PhD Professor of Pathology and Laboratory Medicine Professor Department of Pathology and Laboratory Medicine Department of Oncology Weill Cornell School of Medicine Karmanos Cancer Institute New York, New York Wayne State University School of Medicine Detroit, Michigan Katrin M. Klemm, MD Medical Director Mark S. Lifshitz, MD Aperian Laboratory Solutions Clinical Professor Medical Director Department of Pathology, Molecular, and Cell-Based Medicine EAMC Hospital Laboratory Icahn School of Medicine at Mount Sinai Department of Pathology New York, New York East Alabama Medical Center Opelika, Alabama Bo Lin, MD, PhD Resident Physician Stefanie Krick, MD, PhD Department of Pathology Assistant Professor SUNY Downstate Medical Center Department of Medicine Brooklyn, New York The University of Alabama at Birmingham Birmingham, Alabama Ronald P. Mageau, MD KWB Pathology Associates Scott Krummey, MD, PhD Tallahassee, Florida Assistant Professor Johns Hopkins School of Medicine Mariana Markell, MD Baltimore, Maryland Professor Department of Medicine SUNY Downstate Health Sciences University Brooklyn, New York viii H. Davis Massey, DDS, MD, PhD Dejan Nikolic, MD, PhD S Chief Director of Microbiology and Immunology R O Department of Pathology and Laboratory Medicine Site Pathology Residency Program Director T McGuire VA Medical Center Department of Pathology and Laboratory Services U B Associate Professor Cooper University Health Care RI Department of Pathology Assistant Professor of Pathology T N Virginia Commonwealth University Cooper Medical School of Rowan University O Richmond, Virginia Camden, New Jersey C Blaine A. Mathison, BS, M(ASCP) Frederick S. Nolte, PhD Scientist Professor and Vice- Chair for Laboratory Medicine Institute for Clinical and Experimental Pathology Department of Pathology and Laboratory Medicine ARUP Laboratories Medical University of South Carolina Salt Lake City, Utah Charleston, South Carolina Sharad C. Mathur, MD Man S. Oh, MD Associate Chief of Staff for Education Professor VA Medical Center Department of Medicine Kansas City, Missouri; SUNY Downstate Medical Center Professor Brooklyn, New York Department of Pathology and Laboratory Medicine University of Kansas Medical Center Juan P. Olano, MD Kansas City, Kansas Professor Department of Pathology Richard A. McPherson, MD, MSc University of Texas Medical Branch Professor Emeritus Galveston, Texas Department of Pathology Virginia Commonwealth University School of Medicine Mihaela Oprea, MD Richmond, Virginia Attending Physician Department of Endocrinology Lauren A. McVoy, MD, PhD NY Harbor Healthcare System Vice Chair of Clinical Integration Brooklyn, New York Department of Laboratory Medicine Memorial Sloan Kettering Cancer Center Thomas L. Ortel, MD, PhD New York, New York Professor Departments of Medicine and Pathology Kimberly Merkel, MD Duke University Medical Center Adjunct Assistant Professor Durham, North Carolina Department of Dermatology University of Florida College of Medicine Zheng Ouyang, PhD Gainesville, Florida Professor Department of Precision Instrument Jacquelyn L. Meyers, PhD Tsinghua University Assistant Professor Beijing, China Department of Psychiatry SUNY Downstate Medical Center Mary Ann Perle, PhD Brooklyn, New York Director of Cytogenetics Department of Pathology W. Greg Miller, PhD NYU School of Medicine, Bellevue Hospital Center Professor New York, New York Department of Pathology Virginia Commonwealth University Roseann E. Peterson, PhD Richmond, Virginia Assistant Professor Virginia Commonwealth University Paul D. Mintz, MD Virginia Institute for Psychiatric and Behavioral Genetics Chief Medical Officer Richmond, Virginia Senior Vice President Verax Biomedical Inc. Matthew R. Pincus, MD, PhD Marlborough, Massachusetts Professor Department of Pathology Golam Mohi, PhD SUNY Downstate Medical Center Professor Brooklyn, New York Department of Biochemistry and Molecular Genetics University of Virginia School of Medicine Benjamin A. Pinsky, MD, PhD Charlottesville, Virginia Associate Professor Departments of Pathology and Medicine (Infectious Diseases) Angela Mojica, MD Stanford University School of Medicine Assistant Professor Director, Clinical Virology Laboratory Department of Pediatrics Stanford Health Care and Stanford Children’s Health SUNY Upstate Medical University Stanford, California Syracuse, New York Anna R. Plourde, MD, MPH Michel R. Nasr, MD Director, Clinical Microbiology Laboratory Interim Chair of Pathology and Laboratory Medicine Clinical Assistant Professor Director of Clinical Pathology and Genomics Department of Pathology SUNY Upstate Medical University SUNY Downstate Health Sciences University Syracuse, New York Brooklyn, New York ix S Bobbi S. Pritt, MD, MSc, (D)TMH Shabnam Seydhafkan, MD R O Professor Resident Physician T Department of Laboratory Medicine and Pathology Department of Pathology U B Mayo Clinic SUNY Downstate Medical Center RI Rochester, Minnesota Brooklyn, New York T N O Simon Rabinowitz, PhD, MD Haseeb A. Siddiqi, PhD C Vice Chairman Professor Department of Pediatrics Departments of Cell Biology, Pathology, and Medicine SUNY Downstate Children’s Hospital SUNY Downstate Health Sciences University Brooklyn, New York Brooklyn, New York Nikita Raje, MD, MSc Natthapol Songdej, MD, MPH Section of Allergy/Asthma/Immunology Assistant Professor of Medicine and Pediatrics Department of Pediatrics Department of Medicine Children’s Mercy Penn State Health Milton S Hershey Medical Center University of Missouri Kansas City Hershey, Pennsylvania Kansas City, Missouri Constance H. Stein, PhD Jacob H. Rand, MD Professor Emeritus Professor Department of Pathology Department of Pathology and Laboratory Medicine SUNY Upstate Medical University Weill Medical College of Cornell University Department of Clinical Pathology New York- Presbyterian Hospital University Hospital New York, New York Syracuse, New York A. Koneti Rao, MBBS, FACP, FAHA Lisa M. Stempak, MD Sol Sherry Professor of Medicine System Director of Clinical Pathology Professor of Clinical Pathology and Laboratory Medicine Department of Pathology Co- Director, Sol Sherry Thrombosis Research Center University Hospitals Cleveland Medical Center Director, Benign Hematology, Hemostasis and Thrombosis Clinical Assistant Professor Lewis Katz School of Medicine at Temple University Case Western Reserve University Philadelphia, Pennsylvania Cleveland, Ohio Roger S. Riley, MD, PhD H. Clifford Sullivan, MD, D(ABHI) Professor Assistant Professor Department of Pathology Department of Pathology and Laboratory Medicine Co- Director, Hematology Laboratory Emory University School of Medicine Director, Hemostasis Laboratory Atlanta, Georgia Program Director, Hematopathology Fellowship Virginia Commonwealth University School of Medicine George R. Thompson III, MD, FIDSA Richmond, Virginia Associate Professor of Medicine Division of Infectious Diseases Rhonda K. Roby, PhD, MPH Department of Internal Medicine Technical Leader/Supervising DNA Criminalist University of California–Davis Medical Center Crime Laboratory Forensic Biology Unit Sacramento, California Alameda County Sheriff’s Office Oakland, California Neerja Vajpayee, MD Laboratory Director Kyle G. Rodino, PhD Oneida Health Assistant Professor Oneida, New York Department of Pathology and Laboratory Medicine University of Pennsylvania Perelman School of Medicine David S. Viswanatha, MD Philadelphia, Pennsylvania Consultant, Department of Laboratory Medicine and Pathology (Hematopathology) Yan Xue Russell, MD Co- Director, Molecular Hematopathology and Clinical Genome Fellow Sequencing Laboratories Department of Endocrinology Mayo Clinic NY Harbor Healthcare System Rochester, Minnesota Brooklyn, New York Carlos Alberto von Mühlen, MD, PhD Ravi Sarode, MD Chairman of the Board Director, Division of Transfusion and Hemostasis Department of Immunology Professor of Pathology and Internal Medicine (Hematology/Oncology) Brazilian Society of Autoimmunity UT Southwestern Medical Center Porto Alegre, Rio Grande do Sul, Brazil; Dallas, Texas Consultant Immunology and Rheumatology Cynthia A. Schandl, MD, PhD San Diego, California Professor Department of Pathology and Laboratory Medicine David H. Walker, MD Medical University of South Carolina Professor Charleston, South Carolina Department of Pathology Executive Director Center for Biodefense and Emerging Infectious Diseases University of Texas Medical Branch Galveston, Texas x