New multiplex polymerase chain reaction (PCR) technology should improve on that situation in the near future. Already in use at some teaching institutions, multiplex PCR improves the diagnostic capacity of traditional PCR by amplifying target sequences of multiple viruses all at once. The technology allows you to order a panel of 17–20 different viral tests in one batch and get the results back in a day (J. Clin. Microbiol. 2007;45:2965–70), at a cost of not much more than the $150-$200 for the current viral panel of just 6 or 7.
Another new technology on the horizon—flocked nasal swabs—will make it easier to obtain the sample from the child. Currently approved for use in adults, the swabs are made with perpendicular nylon fibers that allow you to collect epithelial cells and surrounding pathogens with a few simple twirls in the nares, a technique far more comfortable for the patient than a nasal wash. Data from the company's abstracts suggest that the sample you get from the swab is equivalent to that from the nasal wash (information available at www.copanusa.com
These new modalities together should make viral testing as simple as taking a throat culture for the group A streptococcus bacterium, and allow us to obtain timely information that is more pertinent while the child is still sick. But at the same time we need to remind our patients—and ourselves—that in the vast majority of cases we're not talking about a “killer” disease, even with adenovirus.