The problem, the consequences, and rapid testing solutions
Each year, influenza (flu) causes serious infection and death around the globe, usually in the winter months (seasonal influenza). Latest figures suggest that worldwide, these annual epidemics result in about three to five million cases of severe illness, and about 250,000 to 500,000 deaths.1
Influenza symptoms are similar to those of other common respiratory infections. Patients presenting with these symptoms are commonly treated empirically, without a formal diagnosis.
The problem in relation to antimicrobial stewardship is twofold. Patients with Influenza-Like Illness (ILI), a medical diagnosis based on symptoms alone, are often treated with antibiotics, even though the most common cause for this set of symptoms is influenza, a viral infection. Antibiotics are not effective against viruses.
Alternatively, these patients are often automatically prescribed with influenza antivirals, which will be unnecessary if influenza is not the cause of infection and are only effective if prescribed within 48 hours of onset of symptoms.
Resistance to influenza anitivirals is emerging. Many strains of influenza have already developed resistance to the older class of flu antivirals, the adamantanes. After four decades of effective use in the prophylaxis and treatment of influenza, global resistance to these drugs has increased dramatically among influenza viruses of the A/H3N2 subtype in recent years.2
The new class of influenza antivirals, neuraminidase inhibitors, oseltamivir (Tamiflu) and zanamivir (Relenza), are currently suitable for all strains. However, sporadic resistance has already been observed with oseltamivir, and we have no further line of defence currently. During the 2007-2008 influenza season, oseltamivir resistance among influenza A(H1N1) viruses increased significantly for the first time worldwide.3
Your patient has had flu-like symptoms for 36 hours. You do not know if the cause is viral or bacterial, but you suspect influenza. Which diagnostic pathway do you choose for your patient?
By testing patients and providing results quickly, antibiotics can be withheld and antivirals can be prescribed only where appropriate. Physician awareness of a rapid diagnosis of influenza decreases antibiotic use.4 Traditional diagnosis of influenza by viral culture or polymerase chain reaction (PCR) is too lengthy to be useful in generating treatment options.4
ID NOW™ Influenza A & B 2 (formerly Alere™ i Influenza A & B) is a molecular flu test which provides accurate results in less than 13 minutes on the ID NOW platform. Significantly faster than other molecular methods and more accurate than conventional rapid testing, ID NOW Influenza A & B 2 enables you to deliver actionable flu results to your patients in any setting and empowers the appropriate use of antibiotics and antivirals.
ID NOW Influenza A & B 2 is CLIA Waived!
- World Health Organization (WHO) Influenza [Online] Available from: http://www.who.int/mediacentre/factsheets/fs211/en/index.html Accessed: 06 Mar 13
- Nelson, M.I. et al. The origin and global emergence of adamantine resistant A/H3N2 influenza viruses. Virology 2009. 388,270-278
- Dharan, N.J. et al. Infections With Oseltamivir-Resistant Influenza A (H1N1) Virus in the United States. JAMA 2009. Vol. 301 No. 2
- Bonner, A.B. et al. Impact of the Rapid Diagnosis of Influenza on Physician Decision-Making and Patient Management in the Pediatric Emergency Department: Results of a Randomized, Prospective, Controlled Trial. Pediatrics. 2003 Vol. 112 No. 2.