Swine Flu - Current Epidemic

Karishma Kulkarni*, Nikhil Thatte*, Rucha Shelgikar*, Ira Shah**
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Swine Flu - Current Epidemic - Investigations
Though it is recommended that all patients with flu like symptoms should be tested for H1N1 influenza, it may not be practically possible due to limited testing facilities. Besides, the infection is mild in most of the patients and is self limiting. Thus, one may have to test only those patients who are at a high risk group such as infants, patients with diabetes, heart disease, chronic illnesses, immunocompromised patients and chronic lung disease.

The tests available at government testing centres are real-time RT-PCR, a viral culture and tests which detect rise in the antibodies against swine flu in the given blood sample. Apart from these, your local physician may perform a rapid dip stick test to diagnose Influenza A virus, and may then refer you to the government centre to find out if you have specific Influenza A H1N1 or not.

• Throat Swab and Nasal / Naso pharyngeal Swab
• Blood for serological tests
• From an intubated patient: Lower respiratory aspirate and/or Blood for serological tests

Nasal swab: Insert dry swab into nostril and back to nasopharynx. Leave in place for a few seconds. Slowly remove swab while slightly rotating it. Use a different swab for the other nostril. Put tip of swab into vial containing viral transport medium, breaking applicator’s stick.

Throat swab:
• Ask patient to open mouth and stick their tongue out
• Use tongue spatula to press the tongue downward to floor of the mouth
• Use sterile cotton swab to swab both of the tonsillar arches and the posterior nasopharynx, without touching the sides of the mouth
• Insert swab into same transport tube containing nose swabs, break off shaft and recap tube firmly.

Storage of specimen prior to transport
Specimens should be stored at 4°C and transported within 48 hours. If the specimen cannot be transported in 48 hours it should be stored at -70 °C. Do not store in standard freezer or in refrigerator. Sera may be stored at 4 °C for approximately one week, but thereafter should be frozen at –20 °C. Specimens collected for influenza virus isolation should not be stored or shipped in dry ice (solid carbon dioxide). Carbon dioxide can rapidly inactivate influenza viruses if it gains access to the specimens through imperfect seals. is collected from the anterior turbinate.


References
Swine Flu - Current Epidemic Swine Flu - Current Epidemic 01/08/2009
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