Much of the economic impact of influenza results primarily from lost work time and reduced productivity of patients and caregivers and increased use of medical resources.  Although most people are back on their feet within a week after having the influenza, certain people are more susceptible to complications, especially our aging population who are uniquely at risk for influenza-related morbidity and mortality.  The Centers for Disease Control (CDC) estimates that the burden of illness during the past 2017–2018 season was high with an estimated 48.8 million people getting sick with influenza, 22.7 million people going to a health care provider, 959,000 hospitalizations, and 79,400 deaths from influenza.  This burden was higher than any season since the 2009 pandemic serving as a reminder of how severe seasonal influenza disease can become (https://www.cdc.gov/flu/about/burden/2017-2018.htm). 

In order to assure that influenza is diagnosed accurately so that patients can receive the care they need, appropriate specimens must be collected.  COPAN’s UTM™ Universal Transport Media is a collection and transport system suitable for collection, transport, maintenance and long-term freezer storage of clinical specimens containing viruses, chlamydia and mycoplasma or ureaplasma. The transport medium comes in a plastic, screw cap tube and maintains organism viability for 48 hours at room or refrigerated temperature.  COPAN’s FLOQSwabs™ consist of a molded plastic applicator stick with variable tips, uniquely anatomically designed, coated with nylon fibers to create a thin absorbent layer which allows for quick sample uptake and complete sample elution into UTM™. 

The clinical study by Walsh, et al., showed that UTM™ paired with COPAN FLOQSwabs™  significantly outperformed the traditional use of nasal aspirates in terms of PCR-based virus detection and that samples were easier for clinicians to evaluate, store, and transport ⁽¹⁾.  Another study compared a kit containing a nasopharyngeal FLOQSwabs with UTM™ to a kit containing a plastic-shafted rayon-budded swab and a sponge reservoir of viral transport medium for the molecular detection of influenza viruses in children.  The study concluded that the kit containing the FLOQSwab™/ UTM™ allowed easier and more rapid collection and processing of specimens ⁽²⁾.  Indeed, nasal FLOQSwabs™ (fNS) when compared against nasopharyngeal aspirates (NPA) show that NPA and fNS were equally sensitive for detection of respiratory agents by multiplex PCR, and the two sampling methods did not differ significantly regarding discomfort perceived by patients ⁽³⁾.  More and more diagnostic laboratories are turning to highly sensitive molecular testing for the detection of influenza viruses.  Many studies have shown that FLOQSwabs™ and UTM™ work well with a variety of molecular methods for the detection of influenza and many other respiratory viruses ^{(4,5,6,7,8,9)}. 

Health officials have already confirmed that the first influenza-related death of the 2019/2020 influenza season occurred in a 74 year old San Diego man, with additional medical issues, who died on August 15 due to complications from Influenza B (https://www.kpbs.org/news/2019/aug/21/county-confirms-first-flu-death-20192020-season/). 

It’s too early to assess the 2019-2020 season, but general practitioners are seeing more influenza-like illness for this time of year than in previous ones.  The 2019 influenza season in Australia started with high levels of influenza-like illness over their mid-seasonal period, but there has been an overall decrease in influenza-like illness in the community recently and it is now below their 5-year average.  The impact that the 2019-2020 influenza season will have on the Northern Hemisphere cannot currently be predicted. But it is important to be prepared.  Having superior collection devices, like UTM™ and FLOQSwabs™, in doctor’s offices, clinics and emergency rooms will assure appropriate specimen collection from ill patients, and it will assist the laboratory in detecting influenza viruses with greater accuracy.   

NOTE:  COPAN manufactures private label UTM® for Healthlink, Diagnostic Hybrids-Quidel, Quest Diagnostics Inc., and labeled as UVT for Becton Dickinson.

References:

1. Walsh P, Overmyer CL, Pham K, Michaelson S, Gofman L, DeSalvia L, Tran T, Gonzalez D, Pusavat J, Feola M, Iacono KT, Mordechai E, Adelson ME.  2008.  J Clin Microbiol. 46(7):2374-6.
2. Esposito S, Molteni CG, Daleno C, Valzano A, Cesati L, Gualtieri L, Tagliabue C, Bosis S and Principi N.  2010.  Comparison of nasopharyngeal nylon flocked swabs with universal transport medium and rayonbud swabs with a sponge reservoir of viral transport medium in the diagnosis of paediatric influenza.  Journal of Medical Microbiology 59, 96–99.
3. Hansen KB1, Westin J2, Andersson LM2, Lindh M2, Widell A3, Nilsson AC1. Flocked nasal swab versus nasopharyngeal aspirate in adult emergency room patients: similar multiplex PCR respiratory pathogen results and patient discomfort.  2016.  Infect Dis (Lond).48(3):246-50.
4. Silva A, LaCount R, Ballard L, Milham B.  Performance and Cost-Effectiveness of VERIGENE RP Flex.  2016.   ASM Microbe meeting.  
5. J. Jeremiah Bell^a,b and Rangaraj Selvarangan. 2014.  Evaluation of the Alere i Influenza A&B Nucleic Acid Amplification Test by Use of Respiratory Specimens Collected in Viral Transport Medium.  J Clin Microbiol 52(11): 3992–3995.
6. ThomasValentin, PetraKieslinger, EvelynStelzl, Brigitte I.Santner, AndreaGroselj-Strele, Harald H.Kessler, BeateTiran.  2019.  Prospective evaluation of three rapid molecular tests for seasonal influenza in patients presenting at an emergency unit Journal of Clinical Virology. Go to table of contents for this volume/issue Vol.111; 29-32.
7. XiaohuiZou, KangChang, YemingWang, MengxueLi, WangZhang, ChunleiWang, BinghuaiLu, ZhujiaXiong, JiajingHan, YulinZhang, JiankangZhao, BinCao  for CAP-China Network.  2018.  Comparison of the Cepheid Xpert Xpress Flu/RSV assay and commercial real-time PCR for the detection of influenza A and influenza B in a prospective cohort from China.  International Journal of Infectious Diseases, Vol. 80;92-97
8. Daniel M. Cohen, Jennifer Kline, Larissa S. May, Glenn Eric Harnett, Jane Gibson, Stephen Y. Liang, Zubaid Rafique, Carina A. Rodriguez, Kevin M. McGann, Sr., Charlotte A. Gaydos, Donna Mayne, David Phillips, Jason Cohen.  2018.  Accurate PCR Detection of Influenza A/B and Respiratory Syncytial Viruses by Use of Cepheid Xpert Flu+RSV Xpress Assay in Point-of-Care Settings: Comparison to Prodesse ProFlu+.   J Clin Microbiol. 56(2) e01237-17. 
9. Bharti Malhotra, M. Anjaneya Swamy, P. V. Janardhan Reddy, Neeraj Kumar, and Jitendra Kumar Tiwari.  2016. Evaluation of custom multiplex real - time RT - PCR in comparison to fast - track diagnostics respiratory 21 pathogens kit for detection of multiple respiratory viruses. Virol J. 2016; 13: 91.