Swine flu tests reserved for scientific analysis

| 06/08/2009

(CNS): With literally thousands of cases of swine flu or H1N1 flu virus health officials have confirmed that testing now will be as a means to monitor whether or not the virus is mutating in any way and not for diagnosis. In accordance with World Health Organization recommendations and the fact that over 2/3 of flu cases tested are coming up positive for H1N1 the Medical Officer of Health Dr. Kiran Kumar confirmed tests are no longer required prior to treatment.

 “Since 4 June we have confirmed 87 cases but know that in addition we have well over 2000 other cases in the Cayman Islands based on clinical presentation and our usual surveillance system,” he said. “This reinforces WHO’s guidance that testing is not used for diagnostic purpose; our doctors know to make a clinical diagnosis and manage any flu case as if it is H1N1.  This is similar to strategies employed in the UK and other countries throughout the world.”

He added that while people want to know if they have H1N1 or not, now that it is known the H1N1 virus is present locally, we no longer need the test to confirm that.  “If they have fever and symptoms of the flu, then we know they have the virus. Thus we are now focused on caring for those who are ill and on preventing the spread of the virus. It is important to know that reduced testing does not mean reduced vigilance or treatment,” Dr. Kumar said.

He did note that, as per the CAREC guidelines, the laboratory in Trinidad will continue to accept swabs from all cases admitted to the hospital as well as six additional samples per week as part of the WHO routine monitoring programme.

The WHO has identified a network of laboratories worldwide to produce data on the current influenza pandemic. CAREC is Cayman’s designated centre to do the testing to help track the regional outbreak of H1N1 2009. While local testing can only establish the presence of Influenza A or B, the CAREC laboratory runs a Polymerase Chain Reaction (PCR) test to identify the actual flu strain, e.g. the 2009 H1N1. This laboratory also has the capability to culture the virus.

 “PCRs are very useful in testing not only for H1N1 but also for diseases such as dengue fever, hepatitis and HIV. We are always working to expand the hospital’s capabilities to improve health care for the nation.  Since the emergence of this new virus, we have been working to see how we can bring this specialized laboratory capability to the HSA even though currently we do not have the space, equipment, or human resources available to support it,” said HSA Medical Director Dr. Greg Hoeksema.  “People must just keep in mind that even if we had the PCR capability now, we would not be able to perform the test locally because the pandemic H1N1 test kits are in very limited supply.  In the meantime, we will continue to work with the CAREC lab and the experts at the Pan American Health Organization to meet the challenge of the H1N1 pandemic.


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