Clinical Signs and Symptoms Predicting Influenza Infection

Abstract

When influenza is circulating within the community, patients with an influenza-like illness who have both cough and fever within 48 hours of symptom onset are likely to have influenza and the administration of influenza antiviral therapy may be appropriate to consider. Arch Intern Med. 2000;160:3243-3247.

Performance of rapid influenza testing in hospitalized children

“…Specifically, the detection of influenza infection presenting with both fever and cough was observed to have sensitivities ranging between 64 and 86%, specificities between 55 and 67%, and PPVs ranging between 48 and 87% [5,6,19,20]. This contrasts other studies which reported that no clinical signs or symptoms are specific for influenza virus infection [21,22].…”

“…The combination of fever and cough was reported to increase the likelihood that respiratory disease was influenza, especially in adults [5,6] However, the clinical signs and symptoms of influenza infection among children frequently overlap with those caused by other viral infections present among the community [7]. Rapid diagnosis for influenza is useful in order to minimize nosocomial infections, thus allowing the timely institution of infection control measures [8].…”

Identifying viral infections in vaccinated Chronic Obstructive Pulmonary Disease (COPD) patients using clinical features and inflammatory markers

“…This indicates that while rhinorrhoea is associated with allergic rhinitis and may occur through the year that sore throat had greater specificity for viral infection. In contrast to influenza surveillance studies 11 , 12 few patients in this study reported ‘ fever and myalgia ’. This undoubtedly reflects the very low levels of influenza infection in our vaccinated COPD patient population.…”

“…Influenza surveillance programmes use a clinical case‐definition of viral infection to collect data on seasonal fluctuations in the incidence of acute respiratory illness in the community. Case definitions provide a rapid, non‐invasive and inexpensive way to alert surveillance programmes of potential increases in the rate of circulating influenza 10 , 11 , 12 , 13 . At times of high influenza circulation symptom‐based case definitions have been reported to be 60–70% accurate.…”

Pathogen-directed Therapy in Acute Exacerbations of Chronic Obstructive Pulmonary Disease

“…Influenza serves as a prototypical agent for this approach. A retrospective, pooled analysis of phase II and III clinical trials that enrolled mainly adults (mean age, 35 yr) with an ''influenza-like illness'' (defined as fever or feverishness and at least 2 of the following symptoms: headache, myalgia, cough, or sore throat) has been published (149). Of the 3,744 subjects enrolled, 2,470 (66%) were confirmed to have influenza infection.…”