Detection of 2009 pandemic influenza A(H1N1) virus Infection in different age groups by using rapid influenza diagnostic tests

Gao, Fei; Loring, Carol; Laviolette, M; Bolton, Denise; Bean, Christine

doi:10.1111/j.1750-2659.2011.00313.x

Cited by 19 publications

(21 citation statements)

References 13 publications

(28 reference statements)

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“…We were unable to compare the RIDT performance among specimen types because the specimens included in this study were all throat swabs. Although data show that RIDT sensitivity decreases significantly with increasing age,19 no significant differences were found among children of varying age in our study. Our results are consistent with other studies that have found children with H1N1 and negative RIDT to have lower viral loads compared to those with positive RIDT 20…”

Section: Discussioncontrasting

confidence: 94%

Clinical diagnosis of pandemic A(H1N1) 2009 influenza in children with negative rapid influenza diagnostic test by lymphopenia and lower C‐reactive protein levels

Wang

Chang

Lee

et al. 2013

Influenza Resp Viruses

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BackgroundThe sensitivity of rapid influenza diagnostic test (RIDT) of children with influenza-like illness (ILI) remains low.ObjectiveWe compare the parameters between pandemic A(H1N1) 2009 influenza with negative RIDT and ILI not H1N1 for improving the low sensitivity of RIDT for children with ILI.MethodsIn a cohort of consecutive laboratory-confirmed H1N1 influenza, we identified 150 H1N1 children with positive RIDT, 152 H1N1 children with negative RIDT, and 75 children with ILI not H1N1. Viral load in throat, complete blood count (CBC), and C-reactive protein (CRP) levels between H1N1 children with negative RIDT and children with ILI not H1N1 were assessed.ResultsThe diagnostic sensitivity of the RIDT was 45·5%. An analysis of CBC and CRP levels indicated that H1N1 children with negative RIDT had lower total leukocyte, neutrophil, lymphocyte, and basophil counts, and serum CRP levels (P < 0·01). Lymphocyte counts less than 1500 cells/mm3 and CRP levels <15 mg/l, determined by a receiver operating characteristic curve, showed a diagnostic sensitivity of 52·5% and 80·7%, respectively. Combining the lymphocyte counts and CRP levels provided a diagnostic sensitivity of 91·5%. Moreover, H1N1 children with negative RIDT had a lower viral load than those with positive RIDT (3·33 versus 4·48 log10 copies/ml, P < 0·001); the viral load was negatively correlated to the lymphocyte count (P < 0·001).ConclusionsA combination of a low lymphocyte count and a low CRP level could, in the early disease phase, provide a useful screening for H1N1 children with false-negative RIDT, potentially facilitating differential diagnoses.

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Section: Discussioncontrasting

confidence: 94%

Clinical diagnosis of pandemic A(H1N1) 2009 influenza in children with negative rapid influenza diagnostic test by lymphopenia and lower C‐reactive protein levels

Wang

Chang

Lee

et al. 2013

Influenza Resp Viruses

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“…The emergence of a variant virus in 2009 highlighted the need to evaluate the reactivity of RIDTs as the NP from influenza A(H1N1)pdm09 originated from swine rather than human viruses 5 . Reduced reactivity of RIDTs with influenza A(H1N1)pdm09 in comparison with seasonal influenza viruses 6–10 is of public health concern. Rapid influenza diagnostic tests were found to be capable of detecting influenza A(H1N1)pdm09 in respiratory specimens, but many infections could be missed, especially in specimens with low viral loads 10…”

Section: Introductionmentioning

confidence: 99%

Analytical detection of influenza A(H3N2)v and other A variant viruses from the USA by rapid influenza diagnostic tests

Balish

Garten

Klimov

et al. 2012

Influenza Resp Viruses

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Please cite this paper as: Balish et al. (2012) Analytical detection of influenza A(H3N2)v and other A variant viruses from the USA by rapid influenza diagnostic tests. Influenza and Other Respiratory Viruses 7(4), 491–496. Background The performance of rapid influenza diagnostic tests (RIDTs) that detect influenza viral nucleoprotein (NP) antigen has been reported to be variable. Recent human infections with variant influenza A viruses that are circulating in pigs prompted the investigation of the analytical reactivity of RIDTs with these variant viruses. Objectives To determine analytical reactivity of seven FDA‐cleared RIDTs with influenza A variant viruses in comparison with the reactivity with recently circulating seasonal influenza A viruses. Methods Tenfold serial dilutions of cell culture–grown seasonal and variant influenza A viruses were prepared and tested in duplicate with seven RIDTs. Results All RIDTs evaluated in this study detected the seasonal influenza A(H3N2) virus, although detection limits varied among assays. All but one examined RIDT identified the influenza A(H1N1)pdm09 virus. However, only four of seven RIDTs detected all influenza A(H3N2)v, A(H1N2)v, and A(H1N1)v viruses. Reduced sensitivity of RIDTs to variant influenza viruses may be due to amino acid differences between the NP proteins of seasonal viruses and the NP proteins from viruses circulating in pigs. Conclusions Clinicians should be aware of the limitations of RIDTs to detect influenza A variant viruses. Specimens from patients with influenza‐like illness in whom H3N2v is suspected should be sent to public health laboratories for additional diagnostic testing.

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“…Similar findings were observed in the US; clinicians were less likely to provide anti-influenza agents to adults ≥65 years old with influenza, compared with younger adults [15]. The low oseltamivir utilization in elderly may be explained by atypical presentation in this age group and/or decreased sensitivity of rapid influenza diagnostic testing [16-18]. The use of rapid diagnostic tests would ensure oseltamivir were only prescribed to people with confirmed influenza, reducing inappropriate use [18].…”

Section: Discussionmentioning

confidence: 59%

“…The use of rapid diagnostic tests would ensure oseltamivir were only prescribed to people with confirmed influenza, reducing inappropriate use [18]. However, reliance on typical influenza symptoms and rapid influenza diagnostic tests for clinical decision-making may lead to many influenza infections going untreated or causing a treatment delay [16]. A global pooled analysis showed the relative risk of death was highest in the age groups 50–64 and ≥65 years and the presence of chronic illness increased the likelihood of death [17].…”

Section: Discussionmentioning

confidence: 99%

Oseltamivir use and outcomes during the 2009 influenza A H1N1 pandemic in Taiwan

Liu

Wang

Su³

et al. 2013

BMC Public Health

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BackgroundThe Taiwan CDC provided free oseltamivir to all patients with influenza infections confirmed by rapid testing or who had clinical warning symptoms during the 2009 H1N1 influenza pandemic in Taiwan. However, oseltamivir utilization patterns, cost, and outcomes among oseltamivir-treated patients remained unclear.MethodA population-level, observational cohort study was conducted using the Taiwan National Health Insurance Database from January to December 2009 to describe the use of oseltamivir.ResultPrescription trend over weeks increased after a change in government policy and responded to the influenza virus activity. The overall prescription rate was 22.33 per 1000 persons, with the highest prescription rate of 116.5 for those aged 7–12 years, followed by 69.0 for those aged 13–18 years, while the lowest rate was 1.7 for those aged ≥ 65 years. As influenza virus activity increased, the number of prescriptions for those aged ≤18 years rose significantly, whereas no substantial change was observed for those aged ≥65 years. There were also regional variations in terms of oseltamivir utilization and influenza complication rates.ConclusionsOseltamivir was widely used in the 2009 H1N1 influenza pandemic in Taiwan, particularly in those aged 7–18 years. The number of prescriptions for oseltamivir increased with a change in government policy and with increasing cases of pandemic influenza. Further study is needed to examine whether there is an over- or under-use of anti-influenza drugs in different age groups or regions and to examine the current policy of public use of anti-influenza drugs to reduce influenza-associated morbidity and mortality.

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Detection of 2009 pandemic influenza A(H1N1) virus Infection in different age groups by using rapid influenza diagnostic tests

Cited by 19 publications

References 13 publications

Clinical diagnosis of pandemic A(H1N1) 2009 influenza in children with negative rapid influenza diagnostic test by lymphopenia and lower C‐reactive protein levels

Clinical diagnosis of pandemic A(H1N1) 2009 influenza in children with negative rapid influenza diagnostic test by lymphopenia and lower C‐reactive protein levels

Analytical detection of influenza A(H3N2)v and other A variant viruses from the USA by rapid influenza diagnostic tests

Oseltamivir use and outcomes during the 2009 influenza A H1N1 pandemic in Taiwan

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