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Respiratory Virus Testing Options

Respiratory Virus Testing Options. Neelam Dhiman, Ph.D. 11-15-2011. Current Practice for Influenza Testing. Rapid detection (Binax NOW A/B) (In-house) NPH flocked swab in saline TAT:<1 hour Confirmation: Respiratory viral culture/Influenza viral culture By request only

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Respiratory Virus Testing Options

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  1. Respiratory Virus Testing Options Neelam Dhiman, Ph.D. 11-15-2011

  2. Current Practice for Influenza Testing • Rapid detection (Binax NOW A/B) (In-house) • NPH flocked swab in saline • TAT:<1 hour • Confirmation: • Respiratory viral culture/Influenza viral culture • By request only • Requires collection of an additional NPH swab in VTM

  3. Advantages Rapid High specificity High PPV during peak season Disadvantages Low sensitivity (~40%) Negative Rapid tests do not exclude influenza (Poor NPV) False negatives Confirmation of negatives by culture recommended Sensitivity varies with population tested Cross reaction with RSV

  4. Confirmation • Negatives tested by culture only by request (Children’s) • TAT (set up once a day at 2.30 pm) • Respiratory virus culture: 4 days (72 hours in culture) • Influenza, Parainfluenza, Adenovirus, RSV and Human Metapneumovirus • Cost (~$120 + $40) • Influenza virus culture: 2-3 days (48 hours in culture) • Cost (~$65) • Empirically treating based on clinical • Information helpful for Infection control/Hospitalized patient management

  5. PCR • Highly sensitive (Home brew methods) • Influenza A & B • NPH flocked swab • 12-24 hours • M-F dayshift only • Cost: $154.00 • Adenovirus: $52.50 • Human Metapneumovirus: $55.50 • Courier times • 7.30 am/2.30 pm • STAT: $11.00 (Does not help)

  6. Conclusions • Treat empirically if clinically indicated • No testing indicated by CDC • Summit County Influenza Surveillance system • Rapid card tests • Limited sensitivity • Clinical judgment used for treatment • Current alternatives • Viral culture • PCR (week days only) Use only when changes the clinical care of the patient/requires hospitalization/infection control practices

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