With the approach of winter and its effect on respiratory illness, Simon Parker of Roche Diagnostics looks at the role of point-of-care PCR influenza assays in facilitating significant improvements in clinical decision-making.
Seasonal influenza represents a significant healthcare burden in terms of morbidity, mortality and related costs.1 Statistics show that the last winter outbreak (2018/19) was relatively mild,2 with 1340 outbreaks compared to 2149 the previous year, the highest reported since the appearance of swine influenza.3 Although this could be partly attributed to the failure of the influenza vaccine to protect against some key strains, the severity of the winter influenza season in the UK is unpredictable.3
National statistics showed that there were 50,000 excess winter deaths4 in 2017/18, the worst since 1975/76, and clearly the impact of the winter season can add to these numbers and exacerbate the pressure already placed on the NHS.
Identifying patients as influenza-positive can help prevent nosocomial transmission, improve the use of antiviral drugs and safeguard the use of antibiotics. Clinically, influenza can be difficult to diagnose, but significant improvements in the sensitivity of point-of-care testing using reverse transcriptase polymerase chain reaction (RT-PCR) provides an excellent opportunity to obviate the pressure of influenza testing in the winter months.5 There is strong evidence that the RT-PCR revolution in rapid, near-patient testing has enabled emergency departments and acute medicine centres to correctly triage patients who require isolation, treatment or discharge. This has helped in preventing the spread of infection, freeing space in emergency departments and improving patient outcomes.6
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