In:
Influenza and Other Respiratory Viruses, Wiley, Vol. 8, No. 1 ( 2014-01), p. 91-98
Abstract:
The sensitivity of rapid influenza diagnostic test ( RIDT ) of children with influenza‐like illness ( ILI ) remains low. Objective We compare the parameters between pandemic A( H 1 N 1) 2009 influenza with negative RIDT and ILI not H 1 N 1 for improving the low sensitivity of RIDT for children with ILI . Methods In a cohort of consecutive laboratory‐confirmed H 1 N 1 influenza, we identified 150 H 1 N 1 children with positive RIDT , 152 H 1 N 1 children with negative RIDT , and 75 children with ILI not H 1 N 1. Viral load in throat, complete blood count ( CBC ), and C ‐reactive protein ( CRP ) levels between H 1 N 1 children with negative RIDT and children with ILI not H 1 N 1 were assessed. Results The diagnostic sensitivity of the RIDT was 45·5%. An analysis of CBC and CRP levels indicated that H 1 N 1 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/mm 3 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, H 1 N 1 children with negative RIDT had a lower viral load than those with positive RIDT (3·33 versus 4·48 log 10 copies/ml, P 〈 0·001); the viral load was negatively correlated to the lymphocyte count ( P 〈 0·001). Conclusions A combination of a low lymphocyte count and a low CRP level could, in the early disease phase, provide a useful screening for H 1 N 1 children with false‐negative RIDT , potentially facilitating differential diagnoses.
Type of Medium:
Online Resource
ISSN:
1750-2640
,
1750-2659
DOI:
10.1111/irv.2013.8.issue-1
Language:
English
Publisher:
Wiley
Publication Date:
2014
detail.hit.zdb_id:
2272349-3
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