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Early detection of influenza A and B infection in infants and children using conventional and fluorescence-based rapid testing.
J Clin Virol 2012; 55(4):329-33JC

Abstract

BACKGROUND

The appropriate management of infants and children with influenza depends on the accurate and timely diagnosis, ideally at the point of care (POC).

OBJECTIVES

To evaluate the use of simultaneous RSV/influenza rapid testing with QuickVue™ test strips as well as (the use of) novel, fluorescence-based, rapid influenza antigen testing (SOFIA™) in infants and children with influenza-like illness (ILI).

STUDY DESIGN

The Study was conducted in a real-time surveillance program at the Charité Department of Pediatrics in collaboration with the National Reference Centre for Influenza at the Robert Koch Institute (RKI) in Berlin, Germany (Charité Influenza-Like Disease=ChILD Cohort).

RESULTS

During the 2010/2011 influenza season, 395 infants and children were simultaneously tested using QuickVue™ FluA&B and RSV10 rapid tests at POC compared to independent RT-PCR. Sensitivities were 62.7/67.8% for Influenza/RSV overall, but highest in infants <1 year with 76.0/76.2%. The evaluation of the fluorescence-based rapid test SOFIA™ with frozen laboratory samples (derived from the 2008/2009 and 2010/2011 national surveillance) yielded sensitivities of 97.7/86.7/86.7/81.7% for influenza A(H1N1)pdm09/A(H3N2)/B-Victoria/B-Yamagata in samples with CT values <34, and 80.2/79.8/67.5/62.5% for all CT values combined. The same method used at POC with 649 consecutive ChILD patients in 2011-2012 yielded sensitivity/specificity/PPV/NPV values of 78.9/99.7/96.6/97.3%. Again, sensitivities were highest in infants (85.7%) and small children <2 years (88%).

CONCLUSIONS

Fluorescence-based rapid antigen testing provides a highly sensitive and specific tool for POC diagnostics of acute influenza in the paediatric age group, especially in infants and small children <2 years, when viral loads are at their peak and treatment decisions are imminent.

Authors+Show Affiliations

Department of Paediatrics, Division of Pneumonology-Immunology, Charité University Medical Centre, Augustenburger Platz 1, Berlin, Germany. Barbara.Rath@gmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Evaluation Studies
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22921515

Citation

Rath, Barbara, et al. "Early Detection of Influenza a and B Infection in Infants and Children Using Conventional and Fluorescence-based Rapid Testing." Journal of Clinical Virology : the Official Publication of the Pan American Society for Clinical Virology, vol. 55, no. 4, 2012, pp. 329-33.
Rath B, Tief F, Obermeier P, et al. Early detection of influenza A and B infection in infants and children using conventional and fluorescence-based rapid testing. J Clin Virol. 2012;55(4):329-33.
Rath, B., Tief, F., Obermeier, P., Tuerk, E., Karsch, K., Muehlhans, S., ... Schweiger, B. (2012). Early detection of influenza A and B infection in infants and children using conventional and fluorescence-based rapid testing. Journal of Clinical Virology : the Official Publication of the Pan American Society for Clinical Virology, 55(4), pp. 329-33. doi:10.1016/j.jcv.2012.08.002.
Rath B, et al. Early Detection of Influenza a and B Infection in Infants and Children Using Conventional and Fluorescence-based Rapid Testing. J Clin Virol. 2012;55(4):329-33. PubMed PMID: 22921515.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Early detection of influenza A and B infection in infants and children using conventional and fluorescence-based rapid testing. AU - Rath,Barbara, AU - Tief,Franziska, AU - Obermeier,Patrick, AU - Tuerk,Ewelina, AU - Karsch,Katharina, AU - Muehlhans,Susann, AU - Adamou,Eleni, AU - Duwe,Susanne, AU - Schweiger,Brunhilde, Y1 - 2012/08/24/ PY - 2012/07/31/received PY - 2012/08/03/accepted PY - 2012/8/28/entrez PY - 2012/8/28/pubmed PY - 2013/3/23/medline SP - 329 EP - 33 JF - Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology JO - J. Clin. Virol. VL - 55 IS - 4 N2 - BACKGROUND: The appropriate management of infants and children with influenza depends on the accurate and timely diagnosis, ideally at the point of care (POC). OBJECTIVES: To evaluate the use of simultaneous RSV/influenza rapid testing with QuickVue™ test strips as well as (the use of) novel, fluorescence-based, rapid influenza antigen testing (SOFIA™) in infants and children with influenza-like illness (ILI). STUDY DESIGN: The Study was conducted in a real-time surveillance program at the Charité Department of Pediatrics in collaboration with the National Reference Centre for Influenza at the Robert Koch Institute (RKI) in Berlin, Germany (Charité Influenza-Like Disease=ChILD Cohort). RESULTS: During the 2010/2011 influenza season, 395 infants and children were simultaneously tested using QuickVue™ FluA&B and RSV10 rapid tests at POC compared to independent RT-PCR. Sensitivities were 62.7/67.8% for Influenza/RSV overall, but highest in infants <1 year with 76.0/76.2%. The evaluation of the fluorescence-based rapid test SOFIA™ with frozen laboratory samples (derived from the 2008/2009 and 2010/2011 national surveillance) yielded sensitivities of 97.7/86.7/86.7/81.7% for influenza A(H1N1)pdm09/A(H3N2)/B-Victoria/B-Yamagata in samples with CT values <34, and 80.2/79.8/67.5/62.5% for all CT values combined. The same method used at POC with 649 consecutive ChILD patients in 2011-2012 yielded sensitivity/specificity/PPV/NPV values of 78.9/99.7/96.6/97.3%. Again, sensitivities were highest in infants (85.7%) and small children <2 years (88%). CONCLUSIONS: Fluorescence-based rapid antigen testing provides a highly sensitive and specific tool for POC diagnostics of acute influenza in the paediatric age group, especially in infants and small children <2 years, when viral loads are at their peak and treatment decisions are imminent. SN - 1873-5967 UR - https://www.unboundmedicine.com/medline/citation/22921515/Early_detection_of_influenza_A_and_B_infection_in_infants_and_children_using_conventional_and_fluorescence_based_rapid_testing_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1386-6532(12)00287-9 DB - PRIME DP - Unbound Medicine ER -