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Laboratory surge response to pandemic (H1N1) 2009 outbreak, New York City metropolitan area, USA.

Crawford JM, Stallone R, Zhang F, Gerolimatos M, Korologos DD, Sweetapple C, de Geronimo M, Dlugacz Y, Armellino DM, Ginocchio CC - Emerging Infect. Dis. (2010)

Bottom Line: The influenza A pandemic (H1N1) 2009 outbreak began in this area on April 24, 2009, and within weeks respiratory virus testing increased 7.5 times.Daily review by leadership of data from emergency rooms, hospital facilities, and the Health System Laboratories enabled real-time management of unfolding events.The ability of System laboratories to rapidly increase to high-volume comprehensive diagnostics, including influenza A subtyping, provided key epidemiologic information for local and state public health departments.

View Article: PubMed Central - PubMed

Affiliation: North Shore-Long Island Jewish Health System Laboratories, Manhasset, New York, USA.

ABSTRACT
The North Shore-Long Island Jewish Health System Laboratories serve 15 hospitals and affiliated regional physician practices in the New York City metropolitan area, with virus testing performed at a central reference laboratory. The influenza A pandemic (H1N1) 2009 outbreak began in this area on April 24, 2009, and within weeks respiratory virus testing increased 7.5 times. In response, laboratory and client service workforces were increased, physical plant build-out was completed, testing paradigms were converted from routine screening tests and viral culture to a high-capacity molecular assay for respiratory viruses, laboratory information system interfaces were built, and same-day epidemiologic reports were produced. Daily review by leadership of data from emergency rooms, hospital facilities, and the Health System Laboratories enabled real-time management of unfolding events. The ability of System laboratories to rapidly increase to high-volume comprehensive diagnostics, including influenza A subtyping, provided key epidemiologic information for local and state public health departments.

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Related in: MedlinePlus

Cumulative virology test volumes and influenza A–positive results, North Shore–Long Island Jewish Health System, New York City metropolitan area, USA, April 24–May 15, 2009. INFA RAP, rapid antigen test for influenza A; DFA, direct immunofluorescent antibody test; VCR, rapid respiratory virus culture by R-Mix (Diagnostic Hybrids Inc., Athens, OH, USA); RVP, Luminex xTAG Respiratory Virus Panel (Luminex Molecular Diagnostics, Toronto, Canada). White bars, number of tests with negative results for influenza A.; black bars, number of test results positive for influenza A. Actual numbers are included above the bars. For influenza A, the percentages of samples positive for influenza A are shown in parentheses.
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Figure 2: Cumulative virology test volumes and influenza A–positive results, North Shore–Long Island Jewish Health System, New York City metropolitan area, USA, April 24–May 15, 2009. INFA RAP, rapid antigen test for influenza A; DFA, direct immunofluorescent antibody test; VCR, rapid respiratory virus culture by R-Mix (Diagnostic Hybrids Inc., Athens, OH, USA); RVP, Luminex xTAG Respiratory Virus Panel (Luminex Molecular Diagnostics, Toronto, Canada). White bars, number of tests with negative results for influenza A.; black bars, number of test results positive for influenza A. Actual numbers are included above the bars. For influenza A, the percentages of samples positive for influenza A are shown in parentheses.

Mentions: A detailed scientific analysis of the virology of the outbreak, especially the sensitivities and specificities of the tests, is described elsewhere (8); for this publication, summary results are given. Figure 2 shows the total number of positive and negative RVP influenza A test results during April 24–May 15, 2009. Of the total 979 RVP test results, 320 were negative and 677 were positive for any identifiable respiratory virus. A variety of viruses were identified in the 677 samples, including nonsubtypeable influenza A (345 samples), seasonal influenza A subtype H3 (126 samples), seasonal influenza A subtype H1 (5 samples), influenza B (3 samples), rhinovirus/enterovirus group (112 samples), human metapneumovirus (24 samples), parainfluenza viruses 1–4 (40 samples), adenovirus (9 samples), coronaviruses (8 samples), and respiratory syncytial virus (5 samples). Multiple viruses were identified in 41 patients. The outbreak began to subside at the end of June 2009; 8,766 rapid influenza A tests, 8,754 rapid influenza B tests, 8,858 DFA assays, 5,786 viral cultures, and 4,853 RVP assays (36.9% with nonsubtypeable influenza A results) had been performed. This finding represented a total of 34,017 tests for 11,624 patients, a volume that would normally equal the amount of testing performed over a 1-year period.


Laboratory surge response to pandemic (H1N1) 2009 outbreak, New York City metropolitan area, USA.

Crawford JM, Stallone R, Zhang F, Gerolimatos M, Korologos DD, Sweetapple C, de Geronimo M, Dlugacz Y, Armellino DM, Ginocchio CC - Emerging Infect. Dis. (2010)

Cumulative virology test volumes and influenza A–positive results, North Shore–Long Island Jewish Health System, New York City metropolitan area, USA, April 24–May 15, 2009. INFA RAP, rapid antigen test for influenza A; DFA, direct immunofluorescent antibody test; VCR, rapid respiratory virus culture by R-Mix (Diagnostic Hybrids Inc., Athens, OH, USA); RVP, Luminex xTAG Respiratory Virus Panel (Luminex Molecular Diagnostics, Toronto, Canada). White bars, number of tests with negative results for influenza A.; black bars, number of test results positive for influenza A. Actual numbers are included above the bars. For influenza A, the percentages of samples positive for influenza A are shown in parentheses.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2874380&req=5

Figure 2: Cumulative virology test volumes and influenza A–positive results, North Shore–Long Island Jewish Health System, New York City metropolitan area, USA, April 24–May 15, 2009. INFA RAP, rapid antigen test for influenza A; DFA, direct immunofluorescent antibody test; VCR, rapid respiratory virus culture by R-Mix (Diagnostic Hybrids Inc., Athens, OH, USA); RVP, Luminex xTAG Respiratory Virus Panel (Luminex Molecular Diagnostics, Toronto, Canada). White bars, number of tests with negative results for influenza A.; black bars, number of test results positive for influenza A. Actual numbers are included above the bars. For influenza A, the percentages of samples positive for influenza A are shown in parentheses.
Mentions: A detailed scientific analysis of the virology of the outbreak, especially the sensitivities and specificities of the tests, is described elsewhere (8); for this publication, summary results are given. Figure 2 shows the total number of positive and negative RVP influenza A test results during April 24–May 15, 2009. Of the total 979 RVP test results, 320 were negative and 677 were positive for any identifiable respiratory virus. A variety of viruses were identified in the 677 samples, including nonsubtypeable influenza A (345 samples), seasonal influenza A subtype H3 (126 samples), seasonal influenza A subtype H1 (5 samples), influenza B (3 samples), rhinovirus/enterovirus group (112 samples), human metapneumovirus (24 samples), parainfluenza viruses 1–4 (40 samples), adenovirus (9 samples), coronaviruses (8 samples), and respiratory syncytial virus (5 samples). Multiple viruses were identified in 41 patients. The outbreak began to subside at the end of June 2009; 8,766 rapid influenza A tests, 8,754 rapid influenza B tests, 8,858 DFA assays, 5,786 viral cultures, and 4,853 RVP assays (36.9% with nonsubtypeable influenza A results) had been performed. This finding represented a total of 34,017 tests for 11,624 patients, a volume that would normally equal the amount of testing performed over a 1-year period.

Bottom Line: The influenza A pandemic (H1N1) 2009 outbreak began in this area on April 24, 2009, and within weeks respiratory virus testing increased 7.5 times.Daily review by leadership of data from emergency rooms, hospital facilities, and the Health System Laboratories enabled real-time management of unfolding events.The ability of System laboratories to rapidly increase to high-volume comprehensive diagnostics, including influenza A subtyping, provided key epidemiologic information for local and state public health departments.

View Article: PubMed Central - PubMed

Affiliation: North Shore-Long Island Jewish Health System Laboratories, Manhasset, New York, USA.

ABSTRACT
The North Shore-Long Island Jewish Health System Laboratories serve 15 hospitals and affiliated regional physician practices in the New York City metropolitan area, with virus testing performed at a central reference laboratory. The influenza A pandemic (H1N1) 2009 outbreak began in this area on April 24, 2009, and within weeks respiratory virus testing increased 7.5 times. In response, laboratory and client service workforces were increased, physical plant build-out was completed, testing paradigms were converted from routine screening tests and viral culture to a high-capacity molecular assay for respiratory viruses, laboratory information system interfaces were built, and same-day epidemiologic reports were produced. Daily review by leadership of data from emergency rooms, hospital facilities, and the Health System Laboratories enabled real-time management of unfolding events. The ability of System laboratories to rapidly increase to high-volume comprehensive diagnostics, including influenza A subtyping, provided key epidemiologic information for local and state public health departments.

Show MeSH
Related in: MedlinePlus