The limitations of point of care testing for pandemic influenza: what clinicians and public health professionals need to know.

Abstract

As the world prepares for the next influenza pandemic, governments have made significant funding commitments to vaccine development and antiviral stockpiling. While these are essential components to pandemic response, rapid and accurate diagnostic testing remains an often neglected cornerstone of pandemic influenza preparedness. Clinicians and Public Health Practitioners need to understand the benefits and drawbacks of different influenza tests in both seasonal and pandemic settings. Culture has been the traditional gold standard for influenza diagnosis but requires from 1-10 days to generate a positive result, compared to nucleic acid detection methods such as real time reverse transcriptase polymerase chain reaction (RT-PCR). Although the currently available rapid antigen detection kits can generate results in less than 30 minutes, their sensitivity is suboptimal and they are not recommended for the detection of novel influenza viruses. Until point-of-care (POC) tests are improved, PILPN recommends that the best option for pandemic influenza preparation is the enhancement of nucleic acid-based testing capabilities across Canada.

• Authors: Todd F Hatchette, Nathalie Bastien, Jody Berry, Tim F Booth, Max Chernesky, Michel Couillard, Steven Drews, Anthony Ebsworth, Margaret Fearon, Kevin Fonseca, Julie Fox, Jean-Nicolas Gagnon, Steven Guercio, Greg Horsman, Cathy Jorowski, Theodore Kuschak, Yan Li, Anna Majury, Martin Petric, Sam Ratnam, Marek Smieja, Paul Van Caeseele, Pandemic Influenza Laboratory Preparedness Network
• Journal: Canadian journal of public health = Revue canadienne de sante publique (Can J Public Health) 2009 May-Jun Vol. 100 Issue 3 Pg. 204-7 ISSN: 0008-4263 [Print] Switzerland
• PMID: 19507723 (Publication Type: Comparative Study, Evaluation Study, Journal Article)

Chemical References

• RNA, Viral

Topics

• Canada
• Cell Culture Techniques
• Cell Line
• Child
• Disease Outbreaks
• Humans
• Influenza A virus (genetics, isolation & purification)
• Influenza B virus (genetics, isolation & purification)
• Influenza, Human (diagnosis, epidemiology, virology)
• Nucleic Acid Amplification Techniques
• Point-of-Care Systems
• Practice Guidelines as Topic
• Predictive Value of Tests
• Prevalence
• Public Health
• RNA, Viral (analysis)
• Reverse Transcriptase Polymerase Chain Reaction
• Seasons
• Sensitivity and Specificity
• Time Factors