Herbert F Bravo,MD, FAAP Pediatrics@Nite, LLC; DULLES TOWN CENTER, 21010 Dulles Town Circle, Dulles VA 20166, (571)434-0400.
CONFIDENTIALITY NOTICE: This e-mail contains information that is private and confidential. The information is legally privileged
and is the property of the sender and is to be used only by its intended recipient. If you are not the intended recipient, please delete the e-mail and any attachments from your computer and network and notify us immediately. Any use, disclosure, copying, distribution, or the taking of any action in reliance on the contents of this information is strictly prohibited. The physician/patient and workproduct privileges are not waived by the transmission of this e-mail.
--- On Fri, 7/31/09, [log in to unmask] <[log in to unmask]> wrote:
From: [log in to unmask] <[log in to unmask]>
Subject: H1N1 Health Alert
To: [log in to unmask]
Date: Friday, July 31, 2009, 5:31 PM
COMMONWEALTH of VIRGINIA
Department of Health
July 31, 2009
Rapid Influenza Testing Results May Be Misleading and
Pregnancy Risks with Novel Influenza A (H1N1)
Please find below important information just released from the CDC which, because of its importance for your clinical decision making, I and your local health director wanted to quickly share with you.
Rapid influenza diagnostic tests (point of care tests) can be extremely convenient; however they can miss a significant number of true infections. Their ability to detect an infection (sensitivity) ranges from 10 to 70%, i.e. such testing can miss from 30 to 90% of true positives. Though a positive result usually means the patient is infected, a negative result is not very useful. The decision to treat a patient suspected of having influenza must rely primarily on the clinical assessment of the patient and that patient's risk factors for complications of influenza. Clinical assessments of influenza have been shown to have greater diagnostic accuracy than the rapid tests, especially during an outbreak.
The following figure from recent CDC guidance summarizes the clinical decision making.
Figure. Algorithm to assist in the interpretation of RIDT results during periods when influenza viruses are circulating in the community
The entire report is available at http://www.cdc.gov/h1n1flu/guidance/rapid_testing.htm
Pregnancy and Novel H1N1 Flu Infection
An article entitled "H1N1 2009 Influenza Virus Infection During Pregnancy in the USA" has been published in the online edition of The Lancet on July 29, 2009 at http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)61304-0/fulltext.CDC has a number of guidance documents on its website related to pregnancy. These are available at www.cdc.gov/h1n1flu.Pregnant women with suspected or confirmed influenza infection need prompt treatment with antiviral medication.Pregnant women are at an increased risk for pregnancy complications if infected with an influenza virus.Pregnant women who are otherwise healthy have been severely impacted by the novel H1N1 influenza virus.Pregnant women who have been infected with novel H1N1 influenza virus have had a higher rate of hospitalization than the general population.Of 45 deaths reported to CDC during the first two months of the outbreak, 6 (13%) were in pregnant women.Treatment of fever in pregnant women is
also important as high fevers may cause problems in a developing fetus, including neural tube defects.CDC has posted clinical guidance for treatment and prophylaxis of pregnant women with suspected or confirmed novel H1N1 influenza at the following link:http://www.cdc.gov/h1n1flu/clinician_pregnant.htm
Karen Remley, MD, MBA, FAAP
State Health Commissioner
109 Governor Street
Richmond, VA 23219
You are receiving this email because you are a health professional currently registered with the Virginia Department of Health Professions. If you have received this email in error or no longer wish to receive email regarding Public Health Communication from the Virginia Department of Health, please update your contact information with the Virginia Department of Health Professions at http://dhp.virginia.gov
For more information, send mail to [log in to unmask] with the message: info PED-EM-L
The URL for the PED-EM-L Web Page is: