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Feb 01, 2023
On November 29, 2022, Eunsin Bae, M.D., who leads the Institute of Clinical Research at Seegene inc., contributed an article to the Healthcare-in-Europe¹ about solutions to manage the surge in respiratory illnesses as concerns over “multi-demic” rises.
Below is the full text of her editorial.
1) Healthcare-in-Europe (HiE): A platform to communicate with the
latest medical technology trends and advances in medical research in Europe.
Multiplex Testing: A Solution to Manage Surge in Respiratory Illnesses as Concerns over “Multi-demic” Rise
Eunsin Bae, M.D. specializes in
laboratory medicine and leads the Institute of Clinical Research at Seegene
Inc. Her research focuses on microbiology, molecular biology, and hematology.
Dr. Bae is currently working toward implementing a global clinical study and
establishing an international network of clinical investigations.
What should we expect during this year’s
flu season?
Dr Bae: 'Over the past three years, we
have been paying particular attention to personal hygiene such as frequent hand
washing and the use of face masks. Due to reduced exposure and lowered immunity
to respiratory viruses including influenza and colds during the pandemic, we
have become more vulnerable to such illnesses.
The UK Health Security Agency says that
emergency department attendances for acute respiratory infections and
influenza-like illness have increased. According to the Centers for Disease
Control and Prevention, early increases in seasonal influenza activity have
been reported in most of the United States. South Korea has also seen a surge
in influenza cases outside of their expected season. In addition, South Korea
and the United States are both witnessing the early and fast spread of
respiratory syncytial virus which usually causes mild, cold-like symptoms but
can sometimes cause serious complications especially in very young infants and
older adults.
Health officials are especially
concerned about the early return of influenza in Australia this year. The
intensity of the flu season in Europe and North America can often be predicted
by the flu season in the southern hemisphere. This year, Australia experienced
its worst flu season in five years. At its height in June, more than 30,000
cases were reported each week. Australian Influenza Surveillance Report shows
that the most prominent flu strain during their winter was influenza A (H3N2),
which is more likely to lead to severe morbidity and increased mortality than
influenza B or seasonal A (H1N1) strains.1
It is expected that the circulation of
respiratory viruses could return to pre-pandemic levels spreading widely at the
same time, fueling concerns of a potential winter “multi-demic”, which is why
multiplex testing is more important than ever this year.'
What is multiplex testing?
'Multiplex
testing in molecular tests refers to PCR tests that simultaneously detect
multiple pathogens in a single reaction with one sample. While most singleplex
PCR tests for respiratory infection only detect a single pathogen such as COVID-19 or Influenza A and B,
multiplex PCR tests for respiratory infection can detect and differentiate
COVID-19, influenza and respiratory syncytial virus using a single tube.
However, some will extend beyond that to include adenovirus, parainfluenza
virus, human rhinovirus and metapneumovirus.'
About
Seegene’s Allplex™ SARS-CoV-2/FluA/FluB/RSV Assay
What are the benefits of using multiplex
testing?
Clinicians and laboratories
'Multiplex PCR testing enables
clinicians to make informed decisions for patient management, including the
need for isolation and ap propriate treatment. The ability to identify
infectious pathogens using a single assay rather than multiple tests will allow
laboratories to create an efficient workflow and conserve important testing
materials that are in short supply.
Multiplex testing can also identify
coinfections. Research in 2020 found that people diagnosed with flu and
COVID-19 at the same time had an increased risk of death compared to those who
only tested positive for COVID-19.2 Based on a meta-analysis result,
coinfection of COVID-19 and flu was associated with a higher risk of ICU admission
compared with infections caused by COVID-19 only.3'
Patients and health authorities
'Getting multiple results from a single
test means less discomfort and lower costs for patients. Respiratory illnesses
may present similar symptoms such as cough, sneezing, stuffy or runny nose,
sore throat, and fever. Despite the similarities in symptoms and signs, there
are preferred treatment options for each respiratory virus. Influenza B virus,
for example, is highly resistant to amantadine and rimantadine, antiviral drugs
that are used to treat Influenza A virus.
Multiplex testing also helps early
detection of outbreaks by screening multiple viruses in a single test, enabling
rapid public health response to limit spread, particularly in hospitals and long-term
care facilities.'
Can we apply molecular diagnostics to
other disease diagnosis areas?
'Conventional laboratory tests for the
detection of infectious pathogens are based on microbiological culture, which
requires long incubation times, special facilities, and laboratory personnel
highly trained in clinical microbiology. Furthermore, many bacteria and viruses
require specific conditions for growth and are, therefore, difficult to
culture. In this respect, rapid and highly accurate molecular diagnostic tests
will be excellent alternatives for clinical microbiology laboratories.
Other than respiratory illnesses, there
is a demand for multiplex molecular diagnostic tests for infectious diseases
such as gastrointestinal tract infections, sexually transmitted infections,
human papillomavirus infections, meningitis, and urinary tract infections. High
multiplex PCR tests covering these disease areas could offer speed and
sensitivity that was impossible to achieve with standard microbiology and play
a significant role in improving clinical care for patients.'