Display options
Cite
Brouqui P, Vu Hai V, Nougairede A, et al. Improving the diagnostic efficiency of H1N1 2009 pandemic flu: analysis of predictive clinical signs through a prospective cohort. PLoS Curr. 2009;1:RRN1120doi: 10.1371/currents.rrn1120.
Brouqui, P., Vu Hai, V., Nougairede, A., Lagier, J. C., Botelho, E., Ninove, L., Zandotti, C., Charrel, R. N., De Lamballerie, X., & Raoult, D. (2009). Improving the diagnostic efficiency of H1N1 2009 pandemic flu: analysis of predictive clinical signs through a prospective cohort. PLoS currents, 1RRN1120. https://doi.org/10.1371/currents.rrn1120
Brouqui, Philippe, et al. "Improving the diagnostic efficiency of H1N1 2009 pandemic flu: analysis of predictive clinical signs through a prospective cohort." PLoS currents vol. 1 (2009): RRN1120. doi: https://doi.org/10.1371/currents.rrn1120
Brouqui P, Vu Hai V, Nougairede A, Lagier JC, Botelho E, Ninove L, Zandotti C, Charrel RN, De Lamballerie X, Raoult D. Improving the diagnostic efficiency of H1N1 2009 pandemic flu: analysis of predictive clinical signs through a prospective cohort. PLoS Curr. 2009 Oct 21;1:RRN1120. doi: 10.1371/currents.rrn1120. PMID: 20029658; PMCID: PMC2766591.
Copy Download .nbib Format: NLM
Share it on

PLoS Curr. 2009 Oct 21;1:RRN1120. doi: 10.1371/currents.rrn1120.

Improving the diagnostic efficiency of H1N1 2009 pandemic flu: analysis of predictive clinical signs through a prospective cohort.

PLoS currents

Philippe Brouqui, Vinh Vu Hai, Antoine Nougairede, Jean-Christophe Lagier, Elisabeth Botelho, Laetitia Ninove, Christine Zandotti, Remi N Charrel, Xavier De Lamballerie, Didier Raoult

Affiliations

  1. Infectious Diseases and Tropical Medicine at Service des Maladies Infectieuses et Tropicales, CHU Nord AP-HN, URMITE CNRS/RD 6236, Faculté de Médecine, Université de la Méditérranée, Marseille, France.

PMID: 20029658 PMCID: PMC2766591 DOI: 10.1371/currents.rrn1120

Abstract

In late June 2009, we set up a dedicated flu-like illness outpatient consultation in the Infectious Diseases and Tropical Medicine department of Marseille university hospital to detect the new A/H1N1 pandemic influenza and to contain efficiently the A/H1N1 infected patients. For 3 months, we compiled data corresponding to a total of 307 patients who presented with a flu-like syndrome. 31 of them were positive for H1N1 pandemic flu through real-time RT-PCR (rRT-PCR); among them, 19 were positive for a rapid influenza detection test (RIDT). We report here the significant clinical characteristics of A/H1N1 pandemic flu patients compared with other flu-like illnesses, which were used to improve the predictive value of the diagnosis in the current epidemiological situation. We found that regardless of the prevalence of A/H1N1 positive cases in the suspected patients, the absence of cough rejects the diagnosis of A/H1N1 infection in 100% of cases. Among patients referred for flu-like illness, those with cough should be tested for A/H1N1 by RIDT. In the current situation, the PPV and NPV of RIDT for H1N1 reached 90.5% and 95.8 %, respectively. It is important to notice that the 2 RIDT-positive that were negative for H1N1 were seasonal H3N2 influenza indicating that specificity and PPV of RIDT for all influenza was 100%. Therefore, positive RIDT does not require rRT-PCR confirmatory test. Only negative RIDT should be tested with rRT-PCR assay. Respecting this algorithm would have saved up to 70,000 Euros ( 100.000 USD) for the 307 patients and would have resulted in a significant gain of time to transmit the laboratory results to the clinical ward.

References

  1. J Clin Virol. 2009 Jul;45(3):191-5 - PubMed
  2. Euro Surveill. 2009 Aug 20;14(33): - PubMed
  3. Vector Borne Zoonotic Dis. 2010 Apr;10(3):237-40 - PubMed
  4. PLoS Curr. 2009 Sep 21;1:RRN1039 - PubMed
  5. MMWR Morb Mortal Wkly Rep. 2009 Aug 7;58(30):826-9 - PubMed
  6. Lancet. 2009 Aug 8;374(9688):451-8 - PubMed

Publication Types