Mumbai: If there is one place the city has to thank for early warnings on H1N1, leptospirosis and dengue, or for quicker HIV diagnoses, it is a laboratory tucked away in Kasturba Hospital on Arthur Road. The BMC’s Polymerase Chain Reaction (PCR) laboratory, the go-to place fordoctors to decide the course of treatment for thousands of patients, added a milestone this year: it turned 10 in April.
“Earlier, we used to carry out antibody tests. However in any infection, it takes five to seven days for antibodies to show up. This is where the PCR tests make a difference. They detect the infection even before the antibodies are formed, and soon after the symptoms appear,” said Dr. Jayanthi Shastri, head of the laboratory.
Nearly 20,000 tests are carried out every year in the laboratory, she said. In 2016, the lab carried out35,999 molecular tests, up from 29,100 in 2012. “We cover all the acute febrile [fever-based] illnesses like leptospirosis, dengue, malaria etc,” Dr. Shastri said. Early detection is the key to starting the right treatment, she added.
The PCR laboratory is the first of its kind in a public set-up that offers free testing for BMC-hospital patients while samples sent from private hospitals are tested on subsidised rates as compared to private laboratories. For example, the H1N1 test costs about Rs 5,000 in the private sector. At the Kasturba lab, there is no charge to BMC patients while private patients are charged Rs. 2,500. Before this lab came into existence, samples for virological diagnosis would be sent to National Institute of Virology in Pune and some confirmatory tests would be carried out at a laboratory in Port Blair.
The lab was upgraded to carry out H1N1 tests after the massive outbreak in Maharashtra in 2009. The facility has clocked extra hours during the 2015 outbreak too, when its staff worked in three shifts to give out reports on bulk samples from BMC hospitals. The same year, the laboratory worked through a leptospirosis outbreak as well as a spurt in dengue cases.
In 2015, nearly 16 deaths within 24 to 48 hours of patients’ admission to BMC hospitals led to a confusion on whether patients had leptospirosis or malaria. Finally, all the 16 samples tested in the PCR laboratory confirmed leptospirosis, a bacterial infection that is transmitted to humans through rat and cattle urine. The infection is transmitted through unhealed wounds in skin, abrasions and cuts, mostly after the patients show a history of wading through water.
“This lab has taken advanced diagnostic tests to the people. The reports come out within 24 to 36 hours and work-wise, it is superior to any other laboratory in the city,” said Dr. Nitin Karnik, Head of the Medicine Department at Sion Hospital. The lab gets samples from four major BMC hospitals and 16 peripheral hospitals apart from private hospitals. “When a private laboratory has to carry out a certain test, they wait to open the testing kit till they get a certain number of samples. But in the PCR lab, they already have plenty of samples due to which they don’t spend time waiting,” said Dr. Karnik.
Infectious disease specialist Dr. Om Shrivastav said the lab has changed the dynamics of diagnosis duringthe monsoon, when the patient load is extremely high. “The PCR lab has been of tremendous support in infectious diseases by providing confirmatory results in a matter of hours,” he said.
