The limitations of point of care testing for pandemic influenza: what clinicians and public health professionals need to know.
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.
Hatchette
Todd F
TF
Division of Microbiology, QE II Health Science Centre, 5788 University Avenue, Room 315, Halifax, NS B3H 1V8. todd.hatchette@cdha.nshealth.ca
Bastien
Nathalie
N
Berry
Jody
J
Booth
Tim F
TF
Chernesky
Max
M
Couillard
Michel
M
Drews
Steven
S
Ebsworth
Anthony
A
Fearon
Margaret
M
Fonseca
Kevin
K
Fox
Julie
J
Gagnon
Jean-Nicolas
JN
Guercio
Steven
S
Horsman
Greg
G
Jorowski
Cathy
C
Kuschak
Theodore
T
Li
Yan
Y
Majury
Anna
A
Petric
Martin
M
Ratnam
Sam
S
Smieja
Marek
M
Van Caeseele
Paul
P
D002170:Canada; D018929:Cell Culture Techniques; D002460:Cell Line; D002648:Child; D004196:Disease Outbreaks; D006801:Humans; D009980:Influenza A virus / Q000235:genetics / Q000302:isolation & purification*; D009981:Influenza B virus / Q000235:genetics / Q000302:isolation & purification*; D007251:Influenza, Human / Q000175:diagnosis* / Q000453:epidemiology* / Q000821:virology; D021141:Nucleic Acid Amplification Techniques; D019095:Point-of-Care Systems; D017410:Practice Guidelines as Topic; D011237:Predictive Value of Tests; D015995:Prevalence; D011634:Public Health; D012367:RNA, Viral / Q000032:analysis*; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012621:Seasons; D012680:Sensitivity and Specificity; D013997:Time Factors
D012367:RNA, Viral