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Dr Orrange received her BA in Biology at the University of California San Diego and a Masters Degree in Health Sciences at the Johns Hopkins University School of Public Health She received her MD from the USC Keck School of…
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Swine Flu, Should I be Tested if I have a Fever and Sore Throat?
We have started to see patients in clinic this week with symptoms of common viral upper respiratory infections and many are asking: should I be tested for Swine flu? Remember by far the majority of these are common viral upper respiratory infections but since so much time has been given to Influenza AH1N1 I wanted to briefly post indications for testing and what tests can be done.
Patients presenting to any medical settings with influenza-like illness should be screened for swine flu using the following criteria:
Consider influenza A H1N1 infection in the differential diagnosis of patients with influenza-like illness which would mean: temperature ≥37.8ºC (100ºF) and a cough and/or sore throat WHO ALSO MEET ANY OF THE FOLLOWING CRITERIA:
1) Are a contact to a confirmed influenza A H1N1 case or are part of a cluster of people reported with Influenza like illness.
OR
2) Traveled to affected areas in the 7 days preceding illness onset. In addition to Mexico, affected areas in the U.S. and elsewhere can be found at the CDC's swine flu website at www.cdc.gov/swineflu/investigation.htm
OR
3) Were in close contact with persons with Influenza like illness who were in affected areas during the 7 days preceding illness onset. Close contact is defined as being within 6 feet of an ill person who is a confirmed or suspected case of swine influenza A (H1N1) virus infection.
OR
5) Are hospitalized with Influenza like illness or pneumonia.
WHAT ARE THE OPTIONS FOR TESTING IN ADULTS?
A Nasal swab is done and and transported at room temperature and there are three tests available.
1. Rapid Test (also known as Rapid membrane EIA) where the turnaround time is 30 minutes with a sensitivity of 75%.
2. Direct Fluorescent antibody stain which is a direct stain of nasal cells where the turnaround time is approximately 4 hours with a test sensitivity of 92%
3. Viral culture: Turnaround time for a preliminary report is 24 hrs and a final report at 10 days. This is the most sensitive test with 95% sensitivity.
We will start testing in Los Angeles when indicated and I'll keep you posted on our experience.
Dr O.
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Displaying comments 18-1 of 18
Got a Question?
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Lisa
Hannelore56: No extra precautions, just avoid anyone who is sneezing or coughing right next to you and strict hand washing.
Mixi: I hear your concern...thats why Influenza viruses make the news, they are very capable at mutating and causing us problems. Generally though your risk is VERY VERY low that you will face this issue thank goodness.
Babybirdkelly: No, no worries as the porcine eardrum (and porcine valves, etc) is sterile when he receives it.
Appleby: Its a good point, an ER is not where you want to be. Any outpatient medical clinic (urgent care clinic) is better than an ER.
Dr O.
We're told not to worry, but those of us in vulnerable groups can't HELP but worry.
I have COPD and asthma.
In 2005, a strain of flu hit my county and we were assured that it posed no serious threat......
The vulnerable among us had been vaccinated the previous Autumn, but many of us ended up being rushed into the ED, suffering serious breathing difficulties and other complications - including oedema in the lower extremities.
I'm not given to panic, but I do worry because the standard vaccine is clearly inadequate in coping with the constant mutation of the devilishly adaptable flu virus.
And that is only the cases they are admitting.
This is spreading very quickly among those 20-39 years of age who flatly refuse to be quarantined or stop clubbing; and if male, they refuse to stay home from work or wash their hands.
Personally I have never had the flu, and I had my shot for the regular flu because of my heart condition. But at this rate we will have cases of swine flu at the office (we have 12 floors of employees) by the weekend. Considering on an ordinary day it takes up to 15 hours in the ER to be seen, the whole hospital will be infected before the first patient has been confirmed with swine flu. (Family doctor? We socialist proles aint got no family doctor!)