Herpes viruses are responsible for a wide spectrum of infections ranging from cold sores, genital herpes, and chicken pox to disseminated herpes infections in normal and more commonly in immunocompromised patients. Symptoms range from mildly distressing and uncomfortable to severe and life-threatening. The sophistication of virological methods is increasing. Specific types, classes, and subclasses of antibodies to viruses can now be determined, as well as the reactivity of T-lymphocytes. It is possible to detect herpes virus type-specific antibodies (to HSV-l or HSV-2) in a blood sample using the simple and inexpensive enzyme-linked immunosorbent assay (ELISA). The virus is usually type-determined rapidly and currently susceptibility or resistance to antiviral compounds can be defined in vitro. Such assays of antiviral resistance have been shown to be quick and effective. Effective antiviral therapies have been developed against a number of viral diseases. The concomitant need for isolation and evaluation of resistance patterns of herpes virus against different antiviral compounds appears to be of considerable importance. Pure clinical observations are no longer sufficient to distinguish the types, since HSV-l may be present in the genital region and HSV-2 at upper parts of the body–contrary to common belief.

It should be pointed out that during the interviews most of the experts had positive expectations of ESM. The developers are more generally enthusiastic than the prospective users and affected parties who, especially in respect of the diffusion of ESM into practical application, only show a limited optimism.

However, the representatives of the medical profession and the health insurance industry were convinced that ESM might contribute to cost-neutral increases of quality in out-patient and in-patient medicine. But we also understood them to say that they consider other developments in medicine to be overriding, for example, a tendency of general medicine towards a more family-oriented medicine and a reduced emphasis on technology-oriented medicine. In respect of the conception shared by developers as well as potential users that over-enthusiastic expectations should rather be restrained, we consider such a balanced expectation of positive effects of ESM to be adequate to the actual knowledge of the subject.

The third King's Fund Forum was held in London from 8 to 10 April 1987. A panel of 12 from a range of backgrounds listened to evidence from experts in public sessions attended by 200 people, including representatives from many consumer and voluntary organizations as well as health care and social service professionals. After closed sessions the panel discussed its report with the audience; the agreed consensus statement was then presented at a press conference.

May and June were busy months in Europe for technology assessors. Following the International Society meeting in Rotterdam, many people went on to the quality assurance meeting at WHO in Copenhagen and the International Hospital Federation Congress in Helsinki. “Modern Technology—How Much and for Whom,” was one of the main themes of the congress; with an attendance of about 400 there was an opportunity to get the ideas about technology assessment across to a large group of health care managers and professionals. For those of us who spoke it was also a chance to meet members of the Finnish Society for Technology Assessment. This may be the only national society for health technology assessment, and with 70 members, it is clearly going to be influential.