This article was published in Scientific American’s former blog network and reflects the views of the author, not necessarily those of Scientific American
Flu season is here. If it's similar to last year, 49 million Americans could soon come down with the illness.
For most people, the flu is merely a nuisance. They'll have a fever, cough and body aches for a few days. But some will have it far worse. Last year, the flu killed more than 80,000 Americans and caused a record-breaking 900,000 hospitalizations. All told, the disease costs the economy more than $10 billion annually.
To lessen the flu's burden, people must get tested and treated. To aid that effort, the medical community should embrace a faster, more accurate method of diagnosing the disease: point-of-care molecular testing.
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Historically, doctors have relied on a technique known as lateral flow testing to diagnose the flu. It's simple, inexpensive and widely available. Clinicians swab the back of the nose to collect a sample and then test it for antigens, or molecules indicating a person has the flu.
For the most part, these tests get the job done. But they have some limitations when it comes to speed and accuracy.
Molecular tests conducted at the point of care are the way of the future. A clinician starts by swabbing the nasal passages, just as she would for a lateral flow test. But molecular tests provide a more in-depth look by amplifying the sample, boosting accuracy.
Some molecular tests are faster than lateral flow, too. This allows physicians to begin treating infected patients more quickly with antiviral medication, which is most effective when administered soon after the onset of symptoms. One study of 1,500 patients revealed that folks who took a common flu medication within 12 hours of getting symptoms were sick three days fewer than those who waited 48 hours.
Getting treatment early can also prevent more serious problems. An analysis published in The Lancet found that the same medication slashed hospital admissions by 63 percent and respiratory infections by 44 percent. And folks who took a placebo instead of the medication were nearly twice as likely to develop flu-related complications.
A molecular test's speed and accuracy can also help save money and permit doctors to treat more patients. One German study of a point-of-care molecular test developed by my company, Abbott, found that over a 14-week influenza season, a large hospital screening roughly 60,000 patients could save $40,000 and see about nine additional patients per ward. The analysis concluded that molecular testing improves patient flow, reduces the need for room space for flu-ridden patients, and cuts the cost of managing those patients.
The more accurate diagnoses enabled by molecular tests can also protect communities at large.
If a test falsely declares a patient flu-free, he may resume his normal activities and spread the virus to others, who may then need medical care. This can be especially problematic if the patient works with young children, the elderly or people with compromised immune systems.
A false negative result on a flu test could also lead a doctor to conclude that a patient's symptoms are the product of a bacterial infection. The clinician may then prescribe antibiotics, which aren't effective against the flu.
It has been found that inappropriate antibiotic prescription could incrementally contribute to the growth of drug-resistant bacteria, which is considered by public health leaders to be one of the major challenges facing the world. A study published this year in Health Affairs revealed that the share of antibiotic-resistant infections among U.S. patients with self-reported and treated bacterial infections more than doubled between 2002 and 2014—from 5 percent to 11 percent.
Antibiotic resistance can lead to longer and more expensive treatment cycles. Such infections cost our nation more than $2 billion annually.
Many health professionals believe that delivering more accurate diagnoses through point-of-care molecular testing could help combat antimicrobial resistance.
Despite its advantages, molecular testing isn't widely used. In a 2015 study of hospitals and laboratories across 15 states, researchers found that only one quarter offered molecular tests. While that figure has grown in recent years, far more institutions need to get on board.
The flu can be an expensive, even fatal, disease. Widespread adoption of the latest point-of-care molecular tests could rein in health care spending and improve lives.