Medicine

Laboratory diagnosis of human seasonal and pandemic influenza virus infection

Laboratory diagnosis of human seasonal and pandemic influenza virus infection

Laboratory diagnosis of human seasonal and pandemic influenza virus infection

Abstract

Laboratory diagnosis is important in managing influenza
virus infection, either in the context of the annual winter
outbreaks or in a pandemic.1 Rapid and accurate influenza
diagnosis improves medical management by allowing timely provision
of antiviral therapy and prophylaxis, implementation of
appropriate infection control strategies for individuals and public
health responses to outbreaks, and limitation of unnecessary
investigations or antibiotic therapy.2
In the context of a threatened pandemic (whether due to the
highly pathogenic influenza A/H5N1 virus currently causing
disease among birds and some human contacts, or another novel
virus), rapid laboratory detection of the first cases or clusters in
Australia will be crucial. Australia’s early response will hinge on
containment and production of a vaccine to the pandemic strain.
These responses depend on highly sensitive strain-specific laboratory
testing that will exclude other respiratory pathogens.
Should a pandemic spread around the world with the same
impact as the 1918 pandemic, maintaining health care and other
essential services will be paramount. To make treatment decisions
in this situation, less reliance may be placed on immediate
laboratory confirmation and more on the clinical diagnosis.
Nevertheless, laboratory detection will still be required for
atypical and serious cases, for situations where there are special
public health concerns, and to determine whether circulating
strains are still sensitive to antiviral drugs or whether they are
undergoing antigenic drift.

 

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