Fast and Accurate H1N1 Diagnostic Test for Kids

swine flu kid

February 22, 2010 — The rapid influenza diagnostic test (RIDT) for swine-origin 2009 A (H1N1) influenza virus (S-OIV) in children may be most useful in young children who present early after symptom onset, according to the results of a large pediatric cohort study reported online February 15 in Pediatrics.

“Data on the test performance of the RIDT for S-OIV have been limited,” write Michael Hawkes, MD, from the University of Toronto in Ontario, Canada, and colleagues. “The few available reports in mixed adult-pediatric populations have shown variable sensitivity between 11% and 69%…. The rapidly evolving pandemic of novel 2009 [S-OIV] demands that accurate and practical diagnostics be urgently evaluated for their potential clinical utility.”

The goal of this study was to assess the diagnostic accuracy of RIDT and direct fluorescent antibody (DFA) assay for S-OIV, using reverse-transcription polymerase chain reaction (RT-PCR) as the reference standard. Between May 22 and July 25, 2009, the investigators prospectively recruited 820 children from birth to age 17 years who were evaluated for influenza-like illness in the emergency department of a pediatric referral hospital (n = 651) and a community pediatric clinic (n = 169).

To examine the sensitivity and specificity for S-OIV of RIDT (performed on-site) and of DFA, these tests were compared with the sensitivity and specificity of RT-PCR. In addition, the sensitivity of RIDT for S-OIV was compared with sensitivity for seasonal influenza during 2 preceding seasons.

For RIDT, sensitivity for S-OIV was 62% (95% confidence interval [CI], 52% – 70%), and specificity was 99% (95% CI, 92% – 100%). Sensitivity of DFA was 83% (95% CI, 75% – 89%), which was significantly higher than that of RIDT (P < .001). When using DFA supplemented with culture as the reference standard, RIDT sensitivity for S-OIV was similar to that for seasonal influenza. Sensitivity of RIDT for influenza viruses was significantly higher in children not older than 5 years of age (P =.003) and in those evaluated not longer than 2 days after onset of symptoms (P < .001).

“The sensitivity of RIDT for detection of S-OIV is higher than recently reported in mixed adult-pediatric populations but remains suboptimal,” the study authors write. “Nonetheless, RIDTs may have a role in clinical practice for diagnosis of S-OIV in young children who present early after symptom onset, for whom the test sensitivity is superior.”

Limitations of this study include lack of generalizability to children with preexisting medical comorbidities and possible variation in test collection methods.

“Our findings support a recent Centers for Disease Control and Prevention interim guidance statement that, when influenza viruses are circulating in a community, a positive RIDT result indicates that influenza infection is likely present; however, a negative test result does not rule out infection,” the study authors conclude. “In the face of a negative test result, a diagnosis of influenza should still be considered, empiric therapy and appropriate infection-control measures should be instituted if indicated, and confirmatory testing should be sought if necessary. Future studies are warranted to examine the clinical utility and cost-effectiveness of RIDTs in the context of the current S-OIV pandemic.”

The Canadian Institutes of Health Research/SickKids Foundation, the Canadian Institutes of Health Research, and the University of Toronto supported this study. The study authors have disclosed no relevant financial relationships.

Pediatrics. Published online February 15, 2010.

swineflupic5

Clinical Context

RT-PCR is the diagnostic test of choice for the detection of S-OIV, but it is limited by the longer turnaround for results, and commercially available RIDTs have been developed for the diagnosis of influenza A and B and S-OIV.

This is a study of the diagnostic accuracy of the RIDT and DFA tests compared with the gold standard of the RT-PCR, conducted during 2 consecutive influenza seasons in children with influenza-like illnesses.

Study Highlights

  • The sample consisted of patients aged 0 to 17 years who were prospectively enrolled during 2 influenza seasons (2007 – 2008 and 2008 – 2009) in the Toronto, Ontario, Canada, community.
  • Children were recruited from a pediatric hospital and a community general pediatrics practice.
  • Inclusion criteria included 2 or more symptoms of influenza-like illnesses (fever for 1 or more weeks, myalgia, cough, headache, and fatigue) and age 17 years and younger.
  • Excluded were children with underlying conditions predisposing to serious influenza.
  • Specimens were collected using flocked nasopharyngeal swabs at the point of care.
  • Testing was performed within 1 hour, using standardized procedures.
  • During the 2007 to 2008 season, RIDT, DFA, viral isolation, and RT-PCR tests were routinely performed on all suspected influenza cases.
  • In the 2008 to 2009 season, viral culture was performed only on DFA-negative specimens.
  • Sensitivity and specificity were calculated using standard formulae.
  • A total of 820 children with influenza-like illnesses were tested for respiratory viruses during the 2 seasons (n = 194 for 2007 – 2008).
  • There were 651 samples from the pediatric hospital and 169 from the clinic.
  • Median age was 3.4 years.
  • 9.7% were younger than 1 year, 37% were aged 1 to 5 years, and 53% were older than 5 years.
  • 63% of specimens tested were positive.
  • 13% tested positive by RT-PCR (S-OIV); seasonal influenza A was detected in 13%, and influenza B in 9.4%.
  • Test performance of the RIDT was compared with DFA and DFA with viral culture.
  • The sensitivity of RIDT for detecting S-OIV was 72% when compared with DFA alone and 69% compared with DFA with viral culture. Sensitivity of DFA was 83% and superior to that of RIDT.
  • Specificity of RIDT for S-OIV was 99%.
  • Thus, a positive result for RIDT indicated that influenza infection was likely, but a negative result did not rule out influenza infection.
  • RIDT performed better (more sensitive) in children younger than 5 years for all 3 influenza strains.
  • RIDT was more sensitive in those tested within 2 days of symptom onset.
  • The independent predictive value of RIDT for the 3 strains was 2.8 in those participants who were 5 years or younger vs those 5 years or older (P = .003), and the adjusted odds for symptom duration 2 days or less vs longer than 2 days was 2.9 (P = .024).
  • The sensitivity did not vary by site (hospital vs outpatient).
  • The authors concluded that although RIDT performed reasonably in children younger than 5 years, it was still suboptimal compared with DFA and RT-PCR.

Clinical Implications

  • DFA is superior to RIDT for sensitivity to detect S-OIV in children.
  • RIDT has a higher sensitivity in children younger than 5 years with symptom duration of 2 or fewer days.
MedscapeCME Clinical Briefs © 2010 MedscapeCME
==========

Fight VIRUSES the Natural Way with Alfa HFI

Alfa HFi is a high quality humic and fulvic acid supplement that has been the subject of extensive scientific research, and is an important part of a daily plan used the world-over to aid the body’s ability to maintain overall health.

The chelating action of humic and fulvic acid has indicated an ability to both deliver healthy minerals, facilitating their absorption, while attracting and trapping heavy metals to remove them. This unique dual activity has shown to improve energy and overall health.

The vital connection between the immune system and the humates, found in Alfa HFI, is the ability to increase complex sugars (glyconutrients) within the body. The abundance of these glyconutrients allows the immune system to react quickly and correctly to foreign invaders.

Alfa HFI Counters Deadly Obesity Virus

fat shadow man

Obesity or simply the state of exceeding the ideal body weight by 100 lbs. for males, or 80 lbs. for females, is associated with a higher risk of disease, which leads to early death. Apparently, with the numbers rising to approximately 350 million obese people around the world, wherein about 500, 000 of them are Filipinos; it is alarming to note that some of these patients are very young and need surgical intervention.

Interestingly, while many of us are trying to take pleasure in an unhealthy diet and in a lifestyle with less or no exercise, these patients are beginning to feel the pains and emotional regrets of being obese. Largely affected are women who suffer ridicule and discrimination that significantly affect their self-confidence and integrity. Studies have shown that obese people also experience complications like diabetes, heart problems, osteoarthritis, stroke, cancers, weak stamina, and chronic depression, among others.

It is well-known that increased food intake and decreased physical activity eventually result in obesity. In the recent years, however, scientific research discovered another possible reason; they identified an epidemic known as the Human Adenovirus 36 (Ad-36) or the Obesity Virus, which can be caught as easily as a common cold from other people’s coughs, sneezes and dirty hands.

burger

Dr. Nikhil Dhurandhar, an associate professor at the Pennington Biomedical Research Center, in Lousiana, said the parasitic virus, causes sniffles and sore throats as it infects the lungs then whisks around the body forcing fat cells to become fatter and multiply at a tremendous rate. In their experiments, Ad-36 has been shown to cause obesity in chicken, mice and monkey. In one test, Ad-36 infected 30% of obese humans but only 11% of thinner humans and these subjects are heavier compared with their Ad36-negative counterparts.

Ad-36 was first described in 1980, when it was originally isolated from a German girl with diabetes. Afterwards, prevalence of obesity increased by 30% between 1980 and 1990, and by 61% between 1990 and 2000; with no indication that this numbers are lessening.

Understanding the alarming growth of the obese population worldwide, health advocate Mr. Hans Palacios and Civic Leader for Public Awareness and Education Mr. Jake Ortiz indulge in efforts to spread a public awareness campaign about obesity and the Ad-36 virus, at DWIZ every Sunday at 10-11:00 AM, in partnership with www.thebignm.com - the only network management website for Filipinos.

Obesity virus attacks the body’s immune system, and interferes with its normal functions. This in turn makes the body more vulnerable to other deadly viruses like influenza, typhoid, dengue, hepatitis, hanta virus, chicken pox, herpes, gastroenteritis, swine flu (A H1N1), and HIV/AIDS. Researchers reported some 50 adenovirus strains that cause respiratory and eye infections, and various vaccines for these are not yet developed.

abdomens

Backed by 15 years of study and clinical tests, Alfa HFI is a breakthrough discovery and was created by scientists as the nature’s most powerful broad spectrum antiviral solution to address this concern. It is an all-natural, pure and safe dietary supplement. It is refined and formulated from the powerful plant and animal bio-molecules found in ancient deposits of decomposed organic matter, which are humus layers of the earth’s soil that play an important role in the transfer of minerals within the living organism.

Alfa HFI works by penetrating the invading ultramicroscopic viruses and preventing their attachment into healthy cells through agents called Viral Fusion Inhibitors, which block and wrap the viruses in a coating substance. If the virus cannot attach to the cell’s DNA, it cannot survive and reproduce. Alfa HFi also has the amazing Alert Mode Ability that signals the immune system to flush the viruses out.

Alfa HFi also works both as preventive and immune system supportive and will be a valuable support for people seeking relief from nutritional imbalances, immune system disorders and viral diseases. It has anti-inflammatory, antibacterial, antibiotic, anti-allergic, anti-arthritic, anti-ulcerogenic, immuno-modulatory and other health benefis.

As a potent chelator and detoxifier, it attracts and attaches itself to toxic heavy metals and other toxins and removes them from the body as waste. It contains trace amounts of 70 mineral phyto-nutrients that give more energy. It increases polysaccharide sugars and combats the spread of free radicals in the body. It improves stress resistance, appetite, and the ability to focus during strenuous activities.

Consumption of Alfa HFI immediately restores and supercharges the body’s resistance to disease and infection by helping the body in manufacturing necessary glycoproteins within. It also perks up the gastrointestinal tract as pro-biotic, strengthens the joints and bones, provides amino acids and electrolytes, and boosts oxygen for the red blood cells.

Enzacta prides itself on having Alfa HFI Humic/Fuvic Acid Supplement as a product of their state-of-the-art technology and special proprietary process called BioReady Nutrients© (BRNs).  BRNs are nutritional complexes extracted, concentrated and naturally-enhanced for better bio-availability.

For more information, visit www.enzacta.com or call Enzacta at 706-5876 and look for Ms. Arra Inayon, company nurse and corporate researcher.

An Introduction to Viral Fusion Inhibitors

virus

Early year 2009, alert was raised in almost all parts of the globe as Swine flu rapidly spread among humans. The flu was caused by a new virus strain Influenza A subtype H1N1. Origin of the virus, according to a report from the New York Times, probably developed in pigs in Asia and then carried by human to America. This flu virus is highly contagious though its virulence is classified as mild. However, it caused panic among nations when it established a second wave during the cold since the mortality rates went up. While there was face mask shortage during its first attack, today, there is a shortage in vaccines.

Vaccines were developed since the 1770s. These were used as biological preparations for a disease, classically employed to prevent small pox and other types of flu. To prevent a certain type of disease, a vaccine – which is a milder version of the virus causing the disease – is injected to a person early on. This alerts and strengthens the immune system.

Though vaccines are acceptable, many still debates about its safety. Actually, in 1976, a swine flu vaccine was already developed and was used to immunize nearly the entire US population. However, according to Center of Disease Control and Prevention, it had been found to be linked with the development of Guillain-Barré syndrome (GBS) – an autoimmune disorder affecting the peripheral nervous system, usually triggered by an acute infectious process.

The latest issue about swine flu vaccines today is that the US stock for this immunizer is running dry. The priority recipients of the vaccines are children and pregnant women only. Healthy individuals infected by the virus are advised to take other forms of medications.

Other options to prevent or control swine flu include the medication Oseltamivir Phosphate and the most popular brand for it is the Tamiflu. It acts by interfering with the production and release of virus from cells that line the respiratory tract. This may slow the spread of the infection within the airways and lungs.

INTRODUCING: Viral Fusion Inhibitors

As an additional anti-viral solution to address the Swine flu hitch, a group of scientists developed a product which was derived from a naturally occurring substance, the Alfa HFi.

Against viruses, Alfa HFi works by encapsulating the invader with a coating carried out by agents called Viral Fusion Inhibitors. Because of the coating, viruses will not be able to penetrate a healthy cell and reproduce from it. What’s more is that Alfa HFi exhibits an Alert Mode Ability wherein the immune system is given a signal about the invader prompting it to dispatch the cause of the disease.

Alfa HFI bottle2

Alfa HFi is a very small but powerful naturally occurring water-soluble substance which has the ability to transform the molecular structure of water enabling it to better carry dissolve and transport elements to or from the cell. Thus, cells are effectively provided with nutrients while waste products are carried away from it. Furthermore, this Alfa HFi-activated water molecules help in neutralizing toxins and invaders.

Nutritional experts suggest that the breakthrough discovery of the Hfi substance is a vitally important nutrient, together with vitamins and minerals. This helps the body increase its resistance to colds and flu, and infections.

Moreover, Alfa HFi aids in supercharging the immune system; cleansing, neutralizing and removal of toxins and the purging of parasites, pathogens and viruses.