In the US alone, influenza (the flu) is responsible for killing 20,000 people and hospitalising a further 100,000 people each year. Over the past three years, it has been said that flu has generally maintained a relatively low profile in the Western World. This winter, however, the flu has hit back in a ferocious way with Asia so far bearing the brunt of this avian flu (H5N1) outbreak. At the time of writing, the likes of Cambodia, China, Indonesia, Japan, Laos, Pakistan, South Korea, Taiwan and Vietnam have all been affected. With the death toll currently standing at 19 – and rising – all avenues which could assist in the containment of this viral infection are being explored.
MORE OFTEN THAN NOT it is the very young, elderly or immuno-compromised who are the most susceptible to this illness. Furthermore, this viral respiratory infection tends to be seasonal, first appearing in early winter and lasting through to early spring. The common flu patient normally suffers from a severe bout of chills, congestion, coughs. exhaustion, fever, headaches, muscle pains and a sore throat. However, this latest outbreak of highly pathogenic avian influenza (HPAI) A H5N1 has proved to be fatal.
Urgency calls for the rapid test?Some experts suggest that rapid tests should play a part in the containment procedures of this current flu outbreak. The latest generation of rapid tests is considered to be of a high level of sensitivity and may be used to rule out the presence of an influenza infection in suspected cases who are showing some of the worrying symptoms. These easyto- use tests, widely available on the internet and costing around $10 – $15 per test, are capable of giving an almost immediate response. Crucially, at the point of care (POC). However, these tests may still be too expensive for widespread use in developing countries. In affected areas, both the local population and relief workers could benefit from employing these tests. Indeed, checking a chicken farmer or a bird shop owner in rural Asia for infection would necessitate a rapid response. Otherwise, awaiting laboratory confirmation could result in the person falling into an even more critical state. In addition to ensuring faster patient management, faster results would curb the prescription of antibiotics in inappropriate cases and reduce the build-up of antibiotic resistance.
Bonus for the rapid flu test market?Before this outbreak, sales for rapid influenza tests were traditionally limited to the winter and spring months. Whilst the media attention given to this serious outbreak has undoubtedly afforded the influenza POC test industry some unexpected exposure, this may just represent another blip in the longterm growth of this market. Following the multiple discoveries of anthrax in letters a few years ago in the US, there was an upsurge in the demand for rapid flu tests. Since anthrax and flu symptoms are highly similar, rapid flu tests were used to ease the concern of worried people. By confirming the person did have the flu, these tests were coincidentally able to rule out the more dreaded anthrax infection. Since 2001, the market for rapid influenza tests has settled down again. In 2003, the US market was estimated at less than $10 million by Frost & Sullivan, whereby rapid flu tests accounted for approximately a fifth of all respiratory rapid tests sold in the US. In Europe, the demand for rapid flu tests remains minimal, principally due to a lack of awareness and a continued reliance on laboratory analysis.
Increased uptake of tests?Through a combination of mass culling of chickens and ducks, banning the import of poultry meat and eggs, improved personal hygiene and thorough cooking, this avian flu has, thus far, been restricted to Asia. Although current efforts are focused on preventing a pandemic, and not on diagnostics, the rapid flu test may yet have a greater role to play before this outbreak is finally contained.
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