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Rapid testing for upcoming barrels, despite lack of data

In medicine, children are often “assumed to be miniature versions of adults,” said Jennifer Dien Bard, director of the clinical microbiology and virology laboratory at Children’s Hospital Los Angeles. “But they’re not just little adults. It is really important that with any test available, that there are specific strategies for children and their specific needs.

In the rush to clear treatments, vaccines, and diagnostics for widespread use, companies often neglect to include children in early trials that test whether products or therapies are safe and effective. But tests for viruses, bacteria and other infectious microbes that give stellar results for adults don’t always translate perfectly for children.

The reasons for these differences are not always obvious, Dr Pollock said. For example, children’s immune systems might be better able to spot and sequester certain infectious invaders, making them more difficult to detect with standard tests.

In a study, published in the Journal of Clinical Microbiology in October, Dr. Pollock and her team gathered data from nine pediatric hospitals across the country, all of which reported relatively low numbers of viruses in children without symptoms. Another, which has yet to be published in a peer-reviewed scientific journal, alludes to a similar trend in sick children.

Laboratory tests, such as those that use a technique called polymerase chain reaction, or PCR, are sensitive enough to uncover these low-level infections, Dr Pollock said. But the virus may not be present in high enough amounts to be discovered by a rapid test, such as those that detect only relatively large amounts of coronavirus antigens or protein fragments. The Binax NOW is one of those tests.

Many of these children “are going to be negative on rapid tests,” said Dr Pollock. “This has an impact on our way of thinking about schools and daycares.”

Some children may be naturally predisposed to harboring fewer viruses. It was also possible that the children in those studies were all taken too late in their infections, when the virus was already gone. If this were the case, Dr Pollock said, these children may have already carried or even transmitted the virus in large quantities, but they were not tested during this time. It would be difficult to disentangle these scenarios without testing many more children, she said.

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