Respiratory viruses remain a frequent cause of epidemic and pandemic spread causing significant disease. The clinical phenotype varies significantly between individuals, and this variation is associated with virus, host and community factors. The SARS-CoV-2 pandemic, beginning in late 2019 has led to considerable review of virus diagnosis, prevention and treatment of COVID-19, and of other respiratory pathogens. This thesis reports research aiming to inform guidelines and clinical practice

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... unding i) prevention of infection, ii) antibody detection and humoral immunity, and iii) the effect of emerging SARS-CoV-2 Variants of Concern (VOC) on immunotherapeutics. In order to address prevention of infection from preterm infants fed with banked breast milk, viral viability and inactivation was assessed in the context of human milk. Performed in collaboration with Lifeblood Milk (Australian Red Cross Lifeblood), this work demonstrated the safety of milk banking processes, alleviating concerns of potential SARS-CoV-2 vertical transmission and allowing for the continuation of clinical services throughout the pandemic. The performance of high-throughput commercially available SARS-CoV-2 serology assays used by diagnostic laboratories was evaluated, including the correlation of enzyme immunoassay (EIA) results with neutralising antibody titres, and the detection of antibodies from more convenient samples such as dried blood spots. These data informed end-users on the performance of newly developed assays and led to additional applications for EIAs as surrogate tests for informing antibody functionality. The suitability of dried blood spots for antibody detection has expanded access to SARS CoV2 serological testing, which is important for improving surveillance of outbreaks caused by emerging variants of concern. The effect of the SARS-CoV-2 Omicron variant on therapeutic monoclonal antibodies used for the prevention and treatment of COVID-19 was evaluated. A significant loss of activity in vitro by many monoclonal antib [...]