New point of care test is high specific but less sensitive for influenza virus A and B in children and adults

Virology Division, Department of Microbiology, SEALS, The Prince of Wales Hospital, Randwick, and School of Medical Sciences, University of New South Wales, Kensington, Sydney, Australia.
Journal of Medical Virology (Impact Factor: 2.35). 09/2004; 74(1):127-31. DOI: 10.1002/jmv.20155
Source: PubMed


The importance of rapid diagnosis of influenza has increased with the availability of neuraminidase inhibitors, which need to be commenced within 48 hr of symptom onset. Furthermore, the recent development of influenza-like clinical syndromes with novel aetiologies (severe acute respiratory syndrome, SARS) has increased the need for rapid and accurate near-patient diagnosis. A new, modified point of care (POC) diagnostic test (ZstatFlu) was assessed on 469 nasopharyngeal aspirates (NPAs) and 260 nose/throat swabs (TS) taken from children and adults. The test was specific (77-98%) for all specimen types for influenza virus A and B, depending upon incubation conditions. However, it was less sensitive, detecting 65-77% of specimens confirmed as positive on culture, direct immunofluorescence or PCR testing. A positive test is useful, for both directing initiation of therapy in the clinician's office, and making a positive diagnosis of influenza in patients with influenza-like clinical syndromes.

7 Reads
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The rapid detection of influenza viruses is important for forming preventative strategies, directing initiation of anti-viral therapy, detecting potential avian influenza viruses, and excluding influenza-like pathogens, such as SARS. The ImmunoCard STAT! Flu A and B Plus test (Meridian Bioscience, Cincinnati, OH) is a new point of care (POC) test utilizing influenza-specific monoclonal antibodies for rapid diagnosis. The performance of this assay was compared to the established POC Binax NowFlu A and NowFlu B test, and the reference diagnostic standards of viral culture, indirect immunofluorescence (IFA), and RT-PCR where appropriate. Testing of nasopharyngeal aspirates (NPA) from children, throat swabs, and nasal swabs from adults indicated ImmunoCard STAT! specificity of 98% and 100% for influenza A and B, respectively in 224 specimens. The Binax test showed specificity of 99% and 100%, respectively for influenza A and B. Sensitivity results were identical for both rapid detection kits (80% and 47% for Flu A and B, respectively). Overall results were very similar for both testing devices with the advantage of ImmunoCard STAT! Flu A and B Plus test detecting influenza A and B with sharp and easy to read results.
    Journal of Medical Virology 05/2006; 78(5):619-22. DOI:10.1002/jmv.20584 · 2.35 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Nasopharyngeal aspiration (NPA) is the preferred method for collecting specimens for viral culture in patients with respiratory tract infection. As virus identification may influence admission and treatment decisions, it is important to perform NPA in the emergency department. The test may be uncomfortable and poorly tolerated. This prospective study investigated patients' perceptions of NPA. Patients in the emergency department with upper respiratory tract infection undergoing NPA between 9 March 2005 and 12 August 2005 were included. 86 patients (mean (SD) age 47 (23) years; 49 women) were recruited. 22 (26%) patients complained that NPA was very uncomfortable, 59 (69%) reported that it was mildly uncomfortable and 5 (6%) patients reported no discomfort. On a 10-point scale, the median discomfort score was 4. 29 (34%) patients stated that NPA was more uncomfortable than blood taking, 19 (22%) patients felt that both were similar and 38 (44%) patients felt that NPA was less uncomfortable (p value not significant). NPA performed in the emergency department is well tolerated and should be considered in emergency departments when results may influence patient management.
    Emergency Medicine Journal 02/2007; 24(1):35-6. DOI:10.1136/emj.2006.039701 · 1.84 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: A wide range of viruses affect the respiratory tract of transplant recipients, including adenovirus, influenza, human metapneumovirus, parainfluenza virus, respiratory syncytial virus (RSV) and rhinovirus. Prospective studies using contemporary diagnostic techniques have recently improved our understanding of the epidemiology and importance of these respiratory viruses among transplant recipients. From these studies, rhinovirus, in particular, has been shown to be one of the most common causes of infection in stem cell and lung transplant recipients. In addition to epidemiological data, recent studies have also advanced our understanding of management of influenza, adenovirus, and RSV infections among transplant recipients.
    Antiviral therapy 02/2007; 12(4 Pt B):627-38. DOI:10.1097/01.mot.0000186962.26493.31 · 3.02 Impact Factor
Show more