State can now do own flu testing


POSTED: Saturday, May 09, 2009

The state Health Department's Laboratories Division can now confirm swine flu cases without sending specimens to the U.S. Centers for Disease Control and Prevention, which is speeding up the detection process.





Hawaii has three influenza type A strains — including the swine flu (H1N1 strain, pictured at right — and one type B strain.


; The two seasonal type A flu strains were subtyped H1 and H3.


In the first week of tests up to May 1, Diagnostic Laboratories found 75.7 percent were negative for influenza, and 14 percent were positive for type A flu.


Of the positive influenza A specimens, one-third were H1, and two-thirds were H3 normal circulating strains.


The rest of the specimens, 10.3 percent, were type B, also a seasonal strain.


Source: Dr. Matthew Bankowski, Diagnostic Laboratories




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“;We had a day or two lag time after we confirmed a case because we had to wait for CDC to test and get back to us,”; said health spokeswoman Janice Okubo. “;We no longer need to do that.”;

The department also will not be reporting a “;probable”; swine flu case as it has been doing, she said, explaining it will either be “;suspected”; or “;confirmed.”;

The Health Department is still trying to identify the source of two cases identified Thursday in an ongoing review of influenza data from community laboratories, Okubo said. About 100 electronic reports of influenza are received daily, she said.

An investigation is initiated for any rapid or molecular test indicating positive A influenza, she said. “;We're contacting those individuals ... so when tests are further tested at the state laboratory and come out positive, we already know the individuals and can jump on it that much faster.”;

Five confirmed cases of swine flu were needed to ensure the tests were performing well before the CDC deemed the state laboratory qualified to make the final determination, explained Dr. Matthew Bankowski, vice president and technical director of microbiology and diagnostic services at Diagnostic Laboratory Services.

He said the state has good collaboration with the private laboratories. All directors of private and hospital labs met Thursday to fine-tune the system, he said.

Bankowski said Diagnostic Laboratories runs molecular tests on a specimen multiple times during a day, seven days a week, and sends any positive specimens to the state laboratory, which does subtyping for swine flu.

“;We're sending over the original specimen and also the extracted nucleic acid for the molecular test. That's an advantage. ... They can take what we did and immediately re-type it.”;

He expects to see more swine flu.

“;If we have five (now six) cases on the island, we're not in a vacuum. You're going to expose somebody.”;

But Hawaii also has 18 respiratory diseases other than the four influenza strains, Bankowski pointed out.

“;So when you think you have influenza illness ... it may be other viruses. So don't jump to the Tamiflu. If it's a normal H-1 strain circulating and not a variant, it's totally resistant to it.”;

Dr. Chris Whelan, state Laboratories Division chief, is attending the annual meeting of the Association of Public Health Laboratories in Anchorage, Alaska, but has been in constant contact with the laboratory here, said Gail Kunimoto, chief of the medical microbiology branch.

“;We have a very good pandemic preparedness plan we're following,”; she said, “;and we've already positioned ourselves so we have private commercial labs doing initial screening”; and sending positive specimens to the state lab.

“;This frees us up from doing routine testing of rare specimens,”; she said.