Anyone involved with infectious disease laboratory testing has heard the above refrain from physicians in the emergency room, intensive care unit, or infectious disease service. Assay manufacturers are constantly developing rapid diagnostic tests for a large variety of infectious diseases. However, an assay's speed does not always correlate with an assay's performance. Magauran et al, in this issue of Infectious Diseases in Clinical Practice, report their experience in using rapid assays for detecting influenza and respiratory syncytial virus (RSV) in their hands during a 2-year time frame. Their laboratory, at the Cleveland Clinic Foundation in Cleveland, Ohio, USA, instituted rapid enzyme immunoassay (EIA) testing for influenza and RSV in the fall of 2004. Specimens that tested negative by the rapid EIA procedures were then subjected to standard direct immunofluorescence testing for RSV and viral culture for influenza. The rapid EIA tests failed to detect 83 of direct fluorescent antibody (DFA)-positive RSV specimens and 64 of the culture-positive influenza specimens. By the end of the 2004 to 2005 season, the clinicians had stopped requesting the rapid EIA tests. Overall, the rapid EIA assays had been performed on less than 11 of the specimens submitted for influenza or RSV analysis during the 2004 to 2005 winter season.
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