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Movements, leaders, victories and the continuing fight for equality.
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Wilmington, North Carolina once had a thriving Black middle class and an elected interracial government. In 1898 white supremacists used violence to overthrow that government, kill Black residents and drive many others from the city.
MORE →Reflects the personal views, recollections, and perspective of the author, Mike Davis.
This is a personal recollection on the Move fire on May 13, 1985
| Rapid strep test | |
|---|---|
 Rapid strep test kit | |
| MedlinePlus | 003745 |
| LOINC | 78012-2 |
The rapid strep test (RST) is a rapid antigen detection test (RADT) that is widely used in clinics to assist in the diagnosis of bacterial pharyngitis caused by group A streptococci (GAS), sometimes termed strep throat. There are currently several types of rapid strep test in use, each employing a distinct technology. However, they all work by detecting the presence of GAS in the throat of a person by responding to GAS-specific antigens on a throat swab.
A rapid strep test may assist a clinician in deciding whether to prescribe an antibiotic to a person with pharyngitis, a common infection of the throat.[1] Viral infections are responsible for the majority of pharyngitis, but a significant proportion (20% to 40% in children and 5% to 15% in adults) is caused by bacterial infection.[2] The symptoms of viral and bacterial infection may be indistinguishable, but only bacterial pharyngitis can be effectively treated by antibiotics. Since the major cause of bacterial pharyngitis is GAS, the presence of this organism in a person's throat may be seen as a necessary condition for prescribing antibiotics.[3] GAS pharyngitis is a self-limiting infection that will usually resolve within a week without medication. However, antibiotics may reduce the length and severity of the illness and reduce the risk of certain rare but serious complications, including rheumatic heart disease.[2]
RSTs may also have a public health benefit. In addition to undesirable side-effects in individuals, inappropriate antibiotic use is thought to contribute to the development of drug-resistant strains of bacteria. By helping to identify bacterial infection, RSTs may help to limit the use of antibiotics in viral illnesses, where they are not beneficial.[3]
Some clinical guidelines recommend the use of RSTs in people with pharyngitis, but others do not. US guidelines are more consistently in favor of their use than their European equivalents. The use of RSTs may be most beneficial in the third world, where the complications of streptococcal infection are most prevalent, but their use in these regions has not been well studied.[2]
Microbial culture from a throat swab is a reliable and affordable alternative to an RST which has high sensitivity and specificity. However, a culture requires special facilities and usually takes 48 hours to give a result, whereas an RST can give a result within several minutes.[3]
The person’s throat is first swabbed to collect a sample of mucus. In most RSTs, this mucus sample is then exposed to a reagent containing antibodies that will bind specifically to a GAS antigen. A positive result is signified by a certain visible reaction. There are three major types of RST: First, a latex fixation test, which was developed in the 1980s and is largely obsolete. It employs latex beads covered with antigens that will visibly agglutinate around GAS antibodies if these are present. Second, a lateral flow test, which is currently the most widely used RST. The sample is applied to a strip of nitrocellulose film and, if GAS antigens are present, these will migrate along the film to form a visible line of antigen bound to labeled antibodies. Third, optical immunoassay is the newest and more expensive test. It involves mixing the sample with labeled antibodies and then with a special substrate on a film which changes colour to signal the presence or absence of GAS antigen.[4]
The specificity of RSTs for the presence of GAS is at least 95%,[3] with some studies finding close to 100% specificity.[5] Therefore, if the test result is positive, the presence of GAS is highly likely. However, 5% to 20% of individuals carry GAS in their throats without symptomatic infection, so the presence of GAS in an individual with pharyngitis does not prove that this organism is responsible for the infection.[2] The sensitivity of lateral flow RSTs is somewhat low at 65% to 80%.[2] Therefore, a negative result from such a test cannot be used to exclude GAS pharyngitis, a considerable disadvantage compared with microbial culture, which has a sensitivity of 90% to 95%.[3] However, optical immunoassay RSTs have been found to have a much higher sensitivity of 94%.[6]
Although an RST cannot distinguish GAS infection from asymptomatic carriage of the organism, most authorities recommend antibiotic treatment in the event of a positive RST result from a person with a sore throat.[4] US guidelines recommend following up a negative result with a microbial culture,[7] whereas European guidelines suggest relying on the negative RST.[8]
Source: Wikipedia. Article content is retrieved live through the MediaWiki API.
The rapid strep test (RST) is a rapid antigen detection test (RADT) that is widely used in clinics to assist in the diagnosis of bacterial pharyngitis caused by group A streptococci (GAS), sometimes termed strep throat. There are currently several types of rapid strep test in use, each employing a distinct technology. However, they all work by detecting the presence of GAS in the throat of a person by responding to GAS-specific antigens on a throat swab.
A rapid antigen test (RAT), sometimes called a rapid antigen detection test (RADT), antigen rapid test (ART), or loosely just a rapid test, is a rapid diagnostic test suitable for point-of-care testing that directly detects the presence or absence of an antigen. RATs are a type of lateral flow test detecting antigens, rather than antibodies (antibody tests) or nucleic acid (nucleic acid tests). Rapid tests generally give a result in 5 to 30 minutes, require minimal training or infrastructure, and have significant cost advantages. Rapid antigen tests for the detection of SARS-CoV-2, the virus that causes COVID-19, have been commonly used since the COVID-19 pandemic. For many years, an early and major class of RATs—the rapid strep tests for streptococci—were so often the referent when RATs or RADTs were mentioned that the two latter terms were often loosely treated as synonymous with those. Since the COVID-19 pandemic, awareness of RATs is no longer limited to health professionals and COVID-19 has become the expected referent, so more precise usage is required in other circumstances. RATs are based on the principle of antigen-antibody interaction. They detect antigens (generally a protein on the surface of a virus). A linear chromatography substrate (a porous piece of material) bears an indicator line, onto which antibodies directed against the target antigen are fixed. Antibodies are also fixed to a visualisation marker (generally a dye, though sometimes these antibodies are modified to fluoresce), to which the sample is added. Any virus particles present will bind to these markers. This mix then travels through the substrate through capillarity. When it reaches the indicator line, virus particles are immobilised by the antibodies fixed there, along with the visualisation marker, allowing concentration and thus visual detection of significant levels of virus in a sample. A positive result with an antigen test should generally be confirmed by RT-qPCR or some other test with higher sensitivity and specificity.
Tonsillitis is inflammation of the tonsils in the upper part of the throat. It can be acute or chronic. Acute tonsillitis typically has a rapid onset. Symptoms may include sore throat, fever, enlargement of the tonsils, trouble swallowing, and enlarged lymph nodes around the neck. Complications include peritonsillar abscess (quinsy). Tonsillitis is most commonly caused by a viral infection, and about 5% to 40% of cases are caused by a bacterial infection. When caused by the bacterium group A streptococcus, it is classed as streptococcal tonsillitis also referred to as strep throat. Rarely, bacteria such as Neisseria gonorrhoeae, Corynebacterium diphtheriae, or Haemophilus influenzae may be the cause. Typically, the infection is spread between people through the air. A scoring system, such as the Centor score, may help separate possible causes. Confirmation may be by a throat swab or rapid strep test. Treatment efforts aim to improve symptoms and decrease complications. Paracetamol (acetaminophen) and ibuprofen may be used to help with pain. If strep throat is present the antibiotic penicillin by mouth is generally recommended. In those who are allergic to penicillin, cephalosporins or macrolides may be used. In children with frequent episodes of tonsillitis, tonsillectomy modestly decreases the risk of future episodes. Approximately 7.5% of people experience a sore throat in any three months, and 2% visit a doctor for tonsillitis each year. It is most common in school-aged children and typically occurs in the colder months of autumn and winter. The majority of people recover with or without medication. In 82% of people, symptoms resolve within one week, regardless of whether bacteria or viruses were present. Antibiotics probably reduce the number of people experiencing sore throat or headache, but the balance between modest symptom reduction and the potential hazards of antimicrobial resistance must be recognised.
A throat culture is a laboratory diagnostic test that evaluates for the presence of a bacterial or fungal infection in the throat. A sample from the throat is collected by swabbing the throat and placing the sample into a special cup (culture) that allows infections to grow. If an organism grows, the culture is positive and the presence of an infection is confirmed. The type of infection is found using a microscope, chemical tests, or both. If no infection grows, the culture is negative. Common infectious organisms tested for by a throat culture include Candida albicans, known for causing thrush, and Group A streptococcus, known for causing strep throat, scarlet fever, and rheumatic fever. Throat cultures are more sensitive (81% sensitive) than the rapid strep test (70%) for diagnosing strep throat, but are nearly equal in terms of specificity.
Before the 1921 destruction of Tulsa’s Greenwood District, Black residents had created a remarkable center of business and community life. The district included stores, professional offices, entertainment venues and homes owned by Black citizens. Understanding Greenwood means learning what was built—not only what was burned.
MORE →Joe Louis.