Monday 20 October 2014

Ebola or Not? Rapid Test for the Virus Not Here Yet

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With flu season approaching, finding an accurate, speedy screening method will become more important


WebMD News from HealthDay

By Alan Mozes

HealthDay Reporter

MONDAY, Oct. 20, 2014 (HealthDay News) -- "Diagnosing Ebola is very different from treating Ebola."

That assessment, by Dr. Daniel Varga, chief clinical officer at Texas Health Resources, during testimony before a Congressional panel on Thursday, sums up the critical concern at the heart of the current Ebola scare.

It was the challenge faced by staff at Texas Health Presbyterian Hospital in Dallas as they struggled in late September to identify and manage the case of Thomas Eric Duncan, the first patient ever diagnosed with Ebola on American soil. Duncan, a Liberian national, died of the disease on Oct. 8.

The problem: the absence of an accurate, rapid test for Ebola, even in the disease's symptomatic stages.

Varga, who oversees Texas Health Presbyterian Hospital, believes the hospital was "well prepared and equipped" to care for a patient diagnosed with Ebola. "Where we fell short initially was in our ability to detect and diagnose" the infection, he testified.

Complicating matters is the fact that the initial symptoms of Ebola -- high fever, headache, diarrhea, vomiting -- can seem much like those of other infectious diseases, including influenza. And with another U.S. flu season set to begin, how will worried Americans quickly know if they have that common bug -- or Ebola?

A test that can tell the difference in minutes or even a few hours just isn't available right now, experts say.

First of all, there is no test at all to determine Ebola infection in a person without symptoms.

"Ebola has an incubation period of from two to 21 days, and nothing we have is effective at picking up infection before that happens," explained Philip Tierno, a clinical professor of microbiology and pathology at NYU Langone Medical Center in New York City.

"In fact, pre-symptomatic diagnosis is really a holy grail for infectious disease," added Dr. Amesh Adalja, a spokesman for the Infectious Disease Society of America. "It would be great to have it for Ebola and influenza, and a whole host of other infectious diseases, so we could intervene fast. And it's certainly something that many people are researching. But that kind of screening ability is really still in its infancy."

But what about after symptoms begin to appear, as in Duncan's case? Again, no speedy test for Ebola yet exists.

That means that "it's going to be very difficult to distinguish influenza from Ebola," Adalja said.

"Right now," Tierno added, "there's just no simple, fast Ebola test because there's been no demand. Until now, nobody has wanted to spend the money to get a commercially available rapid test out there."

He said that "what we do have on hand is the PCR (polymerase chain reaction) test," a DNA analysis that can identify the genetic fingerprints for a host of infectious diseases. This is the type of laboratory test that's been used to diagnose symptomatic Ebola cases so far.



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