Effect of Rapid Diagnosis of Influenza Virus Type A on the Emergency Department Management of Febrile Infants and Toddlers

Sharma, Vidya; Dowd, M. Denise; Slaughter, Andrew J.; Simon, Stephen D.

doi:10.1001/archpedi.156.1.41

Cited by 111 publications

(71 citation statements)

References 15 publications

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“…Fever, cough and acute onset were found to be most useful predictors of influenza infection in adults [17,20,21]. In the present study, univariate analysis showed that adult patients with fever ≥38°C, cough and abnormal breathing sounds were 2.6, 3.09, and 1.7 times more likely to have influenza.…”

supporting

confidence: 49%

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Differences in clinical predictors of influenza in adults and children with influenza-like illness

Sočan¹,

Prosenc²,

Nagode

2010

Open Medicine

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AbstractInfluenza contributes significantly to morbidity and mortality in the winter season. The aim of the study was to identify clinical signs and symptoms most predictive of influenza infection in children and adults with influenza-like illness. A prospective systematic sampling analysis of clinical data collected through sentinel surveillance system for influenza in 32 primary care centers and one tertiary care hospital in Slovenia during two consecutive influenza seasons (2004/2005 and 2005/2006) was carried out. Children and adults who had influenza-like illness, defined as febrille illness with sudden onset, prostration and weakness, muscle and joint pain and at least (cough, sore throat, coryza) were included and tested for influenza A and B virus, adenovirus, respiratory syncytial virus and enterovirus by RT-PCR. Clinical data were evaluated in statistical models to identify the best predictors for the confirmation of influenza for children (under age of 15) and adults. Of 1,286 patients with influenza-like symptoms in both seasons 211 were confirmed to have influenza A or B alone and compared to 780 influenza-negative patients. A fever over 38°C, chills, headache, malaise and sore eyes revealed a significant association with positive RT-PCR test for influenza virus in children. In adults, only three symptoms were significantly related to PCR-confirmed influenza infection: fever, cough and abnormal breath sounds. The stepwise logistic regression analysis showed that four symptoms predicted influenza in children: fever (38°C or more) (p=0.010), headache (p=0.030), cough (p=0.044) and absence of abnormal breathing sounds (p=0.015) with sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 5.1%, 98.1%, 57.1% and 80.1%, respectively. For adults, the strongest impact on influenza positivity was found for fever (p=0.008) and cough (p=0.085). The model for adults had less favorable characteristics, with sensitivity, specificity, PPV and NPV of 0%, 100%, 0% and 76.4%, respectively. Differences in clinical predictors of influenza in children compared to adults were found. The model for adults was acceptable but not a good one. The model for children was found to be more reliable than the prediction model for adults.

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confidence: 49%

“…Yet, influenza infection is a considerable cause of morbidity and health care utilisation in paediatric population. Attack rates in healthy children are estimated to be between 10% and 40% [21]. There is a wide range of clinical symptoms associated with influenza in infants and toddlers, making the clinical management difficult.…”

mentioning

confidence: 99%

Differences in clinical predictors of influenza in adults and children with influenza-like illness

Sočan¹,

Prosenc²,

Nagode

2010

Open Medicine

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“…Moreover, rapid identification of influenza cases may contribute to the limitation of unnecessary antibiotic use and prevention of nosocomial transmission of the virus to high risk hospitalized population groups [16][17][18].…”

Section: Discussionmentioning

confidence: 99%

Performance of rapid influenza testing in hospitalized children

Stripeli

Sakkou

Papadopoulos

et al. 2010

Eur J Clin Microbiol Infect Dis

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“…(10) Some small studies have shown that a positive RAT spurs changes in clinical practice. (11)(12)(13) In this study, we investigated the effect of RAT for influenza on the proportion of antibiotic administration, additional diagnostic tests, and the length of stay (LOS) in the ED. The symptoms investigated included shivering, rhinorrhea, headache, sore throat, malaise, cough, sputum, myalgia, and gastrointestinal symptoms.…”

Section: Introductionmentioning

confidence: 99%

The Effect of the Rapid Antigen Test for Influenza on Clinical Practice in the Emergency Department: A Comparison of Periods before and After the 2009 H1N1 Influenza Pandemic

2016

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Effect of Rapid Diagnosis of Influenza Virus Type A on the Emergency Department Management of Febrile Infants and Toddlers

Abstract: Rapid confirmation of influenza virus type A infection seems to decrease ancillary tests and antibiotic use in febrile infants and toddlers in the ED. A prospective study with a larger group is needed to confirm these findings.

Cited by 111 publications

References 15 publications

Differences in clinical predictors of influenza in adults and children with influenza-like illness

Differences in clinical predictors of influenza in adults and children with influenza-like illness

Performance of rapid influenza testing in hospitalized children

The Effect of the Rapid Antigen Test for Influenza on Clinical Practice in the Emergency Department: A Comparison of Periods before and After the 2009 H1N1 Influenza Pandemic

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