Symptomatic predictors for 2009 influenza a virus (H1N1) infection with an emphasis for patients with a negative rapid diagnostic test

Chen Yen Kuo, Yhu Chering Huang, Chung Guei Huang, Kuo Chien Tsao, Tzou Yien Lin

研究成果: 雜誌貢獻回顧型文獻

6 引文 斯高帕斯(Scopus)

摘要

Background: The clinical diagnosis of influenza is difficult because it shares nonspecific symptoms with a variety of diseases. Emergency departments and clinics were overwhelmed by a surge of anxious patients during the 2009 influenza A virus (H1N1) outbreak. Our objective was to identify symptomatic predictors of influenza virus infection for patients with a negative rapid diagnostic test. Methodology/Principal Findings: We conducted a retrospective review of 805 patients who presented at Chang Gung Memorial Hospital, from August 1, 2009, to September 30, 2009. Respiratory specimens from these patients were subjected to rapid influenza tests and reverse-transcription polymerase chain reactions. In total, 36% of 308 children and 23% of 497 adults were positive for 2009 influenza A virus (H1N1) infection by polymerase chain reaction or virus culture. For pediatric patients, sore throat and influenza-like illness significantly increased the odds of having 2009 influenza A virus (H1N1) infection, by more than 3-fold (95% confidence interval (CI): 1.9-7.3) and 7-fold (95% CI: 4.00-14.2), respectively. For adult patients, cough and constitutional symptoms increased the odds of having 2009 influenza A virus (H1N1) by greater than 5-fold (95% CI: 3.1-10.2) and 3-fold (95% CI: 2.1-6.7), respectively. The negative likelihood ratio of the combination of fever and cough was 0.096 (95% CI: 0.01-0.69) for children with negative results of rapid influenza diagnostic tests. Conclusion/Significance: In influenza epidemic settings, clinicians should be aware that rapid influenza diagnostic tests are relatively insensitive for the diagnosis of influenza virus infection. For patients with negative rapid influenza diagnostic tests, those lacking fever and cough have a low probability of influenza virus infection. The management strategy should be made individually and depend on the severity of illness.
原文英語
文章編號e28102
期刊PLoS One
6
發行號12
DOIs
出版狀態已發佈 - 十二月 2 2011
對外發佈Yes

ASJC Scopus subject areas

  • Medicine(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

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