Giuseppe
Emeritus
PUBLIC HOSPITAL-BASED LABORATORY EXPERIENCE DURING AN OUTBREAK OF PANDEMIC INFLUENZA A (H1N1) VIRUS. (J Clin Microbiol., abstract, edited)
1. J Clin Microbiol. 2010 Feb 10. [Epub ahead of print]
PUBLIC HOSPITAL-BASED LABORATORY EXPERIENCE DURING AN OUTBREAK OF PANDEMIC INFLUENZA A (H1N1) VIRUS.
Leonardi GP, Mitrache I, Pigal A, Freedman L. - Virology Laboratory, Department of Pathology & Laboratories, Nassau University Medical Center. 2201 Hempstead Tnpk., East Meadow, New York, 11554. USA.
The experience of a public-hospital virology laboratory is described during a springtime outbreak of a novel influenza A (H1N1) virus in New York, 2009. Influenza was isolated from 145 of 613 respiratory swab specimens. Symptoms of fever (102.7 +/- .32oF), cough, URI, myalgia and headache were reported. Atypical symptoms of nausea/vomiting and diarrhea were also observed. Illness occurred mainly in patients <= 21 years (85/145). Only 2 patients were >= 65 years old. Compared to traditional culture methods, a rapid chromatographic influenza A + B immunoassay and rapid shell-vial culture sensitivities were 70.3% and 98.6%, respectively. In 50 specimens also tested by direct fluorescent antibodies (DFA), a sensitivity of 80% was obtained. Adequate cell numbers observed in the DFA slides suggests the low sensitivity of the chromatographic immunoassay may result from its intrinsic nature and not from improper specimen collection. Off-site rt-PCR assay yielded 21 novel (H1N1) and 2 seasonal (H3N2) influenza- positive results in 45 specimens tested. The mean time interval of 5.69 +/- .37 days from specimen collection to rt-PCR results limited the value of this assay in patient-care. In laboratories lacking on-site molecular capabilities, shell vial techniques can rapidly (about 1 day) confirm negative and/or identify false-negative chromatographic immunoassay results. Laboratories lacking culture capabilities may also use DFA to confirm or replace results from these immunoassays. Increasing testing demands caused shortages in commodities and manpower. Alternate testing strategies and planning are necessary in order to optimize viral detection and ensure appropriate resource allocation.
PMID: 20147645 [PubMed - as supplied by publisher]
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1. J Clin Microbiol. 2010 Feb 10. [Epub ahead of print]
PUBLIC HOSPITAL-BASED LABORATORY EXPERIENCE DURING AN OUTBREAK OF PANDEMIC INFLUENZA A (H1N1) VIRUS.
Leonardi GP, Mitrache I, Pigal A, Freedman L. - Virology Laboratory, Department of Pathology & Laboratories, Nassau University Medical Center. 2201 Hempstead Tnpk., East Meadow, New York, 11554. USA.
The experience of a public-hospital virology laboratory is described during a springtime outbreak of a novel influenza A (H1N1) virus in New York, 2009. Influenza was isolated from 145 of 613 respiratory swab specimens. Symptoms of fever (102.7 +/- .32oF), cough, URI, myalgia and headache were reported. Atypical symptoms of nausea/vomiting and diarrhea were also observed. Illness occurred mainly in patients <= 21 years (85/145). Only 2 patients were >= 65 years old. Compared to traditional culture methods, a rapid chromatographic influenza A + B immunoassay and rapid shell-vial culture sensitivities were 70.3% and 98.6%, respectively. In 50 specimens also tested by direct fluorescent antibodies (DFA), a sensitivity of 80% was obtained. Adequate cell numbers observed in the DFA slides suggests the low sensitivity of the chromatographic immunoassay may result from its intrinsic nature and not from improper specimen collection. Off-site rt-PCR assay yielded 21 novel (H1N1) and 2 seasonal (H3N2) influenza- positive results in 45 specimens tested. The mean time interval of 5.69 +/- .37 days from specimen collection to rt-PCR results limited the value of this assay in patient-care. In laboratories lacking on-site molecular capabilities, shell vial techniques can rapidly (about 1 day) confirm negative and/or identify false-negative chromatographic immunoassay results. Laboratories lacking culture capabilities may also use DFA to confirm or replace results from these immunoassays. Increasing testing demands caused shortages in commodities and manpower. Alternate testing strategies and planning are necessary in order to optimize viral detection and ensure appropriate resource allocation.
PMID: 20147645 [PubMed - as supplied by publisher]
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