Introduction
Screening of diseases more so contagious diseases capable of creating epidemics is a critical and controversial part of modern public health. Chapter 11 of Friis and Sellers (2014) is an elaborate evaluation of the process of disease screening from the perspective of contagious diseases and epidemics. The chapter delves into the important concepts of disease screening such as the necessity for screening and available procedures. Controversies relating to the screening process are also canvassed including the concepts of false positives and negatives. Chapter 12 of Friis and Sellers (2014) on the other hand is dedicated to the epidemiology of infectious diseases and epidemics within a community. The chapter evaluates the different types of infectious diseases including bacteria, viruses, and fungi. The epidemiology and life cycles of common infectious diseases and the three primary factors for infectious diseases being the host, environment and agent are also canvassed in the chapter. Finally, CDC. (2017) is an article by the Centers for Disease Control and Prevention relating specifically to Rapid influenza diagnostic tests (RIDTs) used to screen for influenza, an epidemic that is endemic to the USA. From the totality of the three sources above, screening comes out as a critical aspect in the management of epidemics but remains controversial due to propensity for error.
The Screening Test
The screening test selected for the instant research paper is the Rapid influenza diagnostic tests (RIDTs) used in screening for influenza. Influenza is a seasonal epidemic in America that runs annual cycles leading to tens of thousands of deaths annually in spite of elaborate preventative measures. RIDTs enables the testing of patients so as to enable proper treatment for the respective patients and control of the epidemic within the general population. CDC is an agency of the federal government, responsible for public safety and public health thus placing it in a position to understand both influenza and RIDTs. However, as a government agency, CDC can also be expected to seek to be politically correct in its evaluation. According to CDC (2017), RIDTs are capable of detecting the presence of the influenza virus within respiratory specimens in less than 15 minutes thus, making the test extremely fast. A simple swab from the nose or throat followed by a minimal wait of just a few minutes will thus enable a patient to learn whether or not they are suffering from influenza. However, the efficiency of the tests is compromised by the low level of accuracy, more so when compared to other elaborate, more expensive, and more time-consuming screening tests.
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According to the CDC, influenza is highly prevalent in the USA and also to some extent seasonal with the annual prevalence being estimated at about three million cases. However, the prevalence of the disease is higher in some segments of the US than others and also varies depending on the season. The sensitivity of RIDT in screening for influenza is between 50 and 70%. Among the bearing factors for sensitivity includes nature of the virus as type B has a higher sensitivity than type A. Further, the prevalence of the disease depending on the time of the year also affects sensitivity. The specific of RIDTs is relatively high at between 90 and 95%. Whereas CDC (2017) does not provide exact figures and percentages for the propensity for false negatives and false positives, it does categorically indicate that the former are more common than the latter. Further, the propensity of false negatives and false positives will also differ based on the specific prevalence of influenza as at the time the test is being undertaken. The false positives and negatives are thus a variable factor, which exponentially reduces the reliability and viability of RIDTs. Based on the totality of the above, RIDTs provide a simple, speedy, less intrusive and economically friendly means of screening for influenza but compromises on accuracy due to the inability to provide a definitive value of false positives and negatives.
Conclusion
Based on the totality of the readings outlined above, great progress has been made in the management and control of epidemics yet there is still a lot of room for improvement. For example, the bacterial epidemics that heretofore ravaged the world have now been placed under general control through antibiotics. However, viral epidemics such as the flu remain an active and recurring threat. Proper screening is an important form of intervention for all epidemics in general and in the modern times specifically for viral epidemics. Screening enables proper intervention process on the propagation of the epidemic so as to mitigate the spread and adverse effects of the epidemic. RIDTs is a reflection of modern advancements in the screening of communicable diseases, but reflects on a related possible controversy. In just less than 15 minutes and without extreme forms of physical intrusion such as breaking the skin, RIDTs enables the screening for influenza. From a general perspective, RIDTs thus reflects how screening process can be simplified and speeded up to enable the ability to screen more people in less time and at less inconvenience. However, the level of accuracy in RIDTs is a major cause of concern. It is very telling that the accuracy of RIDTs has not been narrowed down to a specific percentage figure even by the CDC itself. In spite of this challenge, RIDTs play an important public health role due to its ease and speed. With a higher number of people being both willing and capable to undergo a screening test, then the test will have a definitive effect on the general impact of the epidemic as it will see more people accept screening and by extension treatment. In spite of its reliability challenges, therefore, RIDTs remains an invaluable tool in the fight against influenza.
References
CDC. (2017, January 18). Influenza (Flu). Retrieved from https://www.cdc.gov/flu/professionals/diagnosis/clinician_guidance_ridt.htm
Friis, R. H., & Sellers, T. A. (2014). Epidemiology for Public Health Practice (5th ed.). Burlington, MA: Jones & Bartlett Learning.
