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Pseudo-epidemics a concern with quick tests

Infection Control Monitor, January 26, 2007

New molecular tests are coming into increasing use and can provide healthcare officials with a quick answer in diagnosing diseases like whooping cough, Legionnaire's, bird flu, tuberculosis, and SARS, reported the New York Times.

But the new tests can lead to false alarms when health officials are trying to decide whether an epidemic is under way, the newspaper reported. The Times cited the case at Dartmouth-Hitchcock Medical Center in New Hampshire last April where it was believed there was a large whooping cough outbreak. Almost 1,000 hospital workers were tested, 142 people were told they appeared to have the disease, and thousands were given antibiotics and a vaccine for protection. Eight months later, the hospital said it was a false alarm when not a single case of whooping cough was confirmed with a more definitive test, growing the bacterium, Bordetella pertussis, in the laboratory.

The new molecular tests are quick, but technically demanding, and their sensitivity creates false positives that can make it seem like there is an epidemic, infectious disease specialists cautioned.

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