Bird Flu: Diagnosis
Central to the problem of dealing with bird flu is diagnosis. A
number of upper respiratory infections have similar symptoms--at
least at the onset of the illness, including the common cold,
seasonal influenza, and bird flu. Seasonal flu and bird flu have
almost identical symptoms--including fever, cough, malaise
(feeling unwell), nausea, vomiting, and diarrhea. This is,
needless to say, a gigantic problem in accurately diagnosing
bird flu--which is critical to beginning appropriate treatment
as well as initiating infection control procedures and public
health measures.
Currently, accurate testing for bird flu and other vial
infections that can cause similar symptoms is difficult and
requires specialized testing. This testing is time consuming and
only available in specialized reference laboratories, which are
few and far between. Fortunately, this may change in the near
future.
According to Richard Janeczko, Ph.D., executive vice-president
and chief scientific officer, Tm Bioscience, located In Toronto,
Canada, is feverishly working to complete the final stage of
development of an amazing test--not only for bird flu, but for
more than 15 other viral infections (including severe acute
respiratory syndrome or SARS), many of which can mimic the
symptoms of bird flu (personal communication). (Tm Bioscience is
a DNA-based diagnostics company developing a suite of genetic
tests. Tm Bioscience's product pipeline includes tests for
genetic disorders, drug metabolism, and infectious diseases.
Additional information about Tm Bioscience can be found at
http://www.tmbioscience.com.)
The test, called the Multiplexed Respiratory Test, discriminates
influenza A from influenza B and identifies the H5-subtype of
influenza A (bird flu is "H5N1") from all other H subtypes. In
addition, it can identify almost all the other common--and some
uncommon--viruses that cause influenza-like illnesses. This is
extremely important in managing patients, communities and
economic issues. Other tests have lower clinical sensitivities
and specificities which can lead to both false positives and
false negatives. By incorrectly identifying an outbreak as due
to H5N1, patients could be treated with anti-virals
unnecessarily (thus raising the chances of selecting for
drug-resistant strains), unneeded vaccination programs in
asymptomatic individuals could be initiated, and damage to local
and national economies--through such measures as culling of
commercial poultry operations--could occur. Conversely a
false-negative test result could lead to catastrophic outcomes,
including a pandemic. The assay utilizes swab specimens taken
from the nose and takes less than 5 hours to perform. It was
developed for use as a diagnostic tool and for infection control
in hospitals. The assay has been slated for expedited review by
the Food and Drug Administration (FDA), and TM Bioscience is
hoping to have an FDA-cleared test available by the end of
January 2006. If this assay delivers what it claims, it will
have huge applicability on a global basis and save many lives.
Bradford Frank, M.D., M.P.H., M.B.A. The Frank Group P.O. Box
138 Lakewood, NY 14750 http://www.AvoidBirdFlu.com