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Clinical Infectiuos Diseases
Diagnosis of 2009 Pandemic Influenza A (pH1N1) and Seasonal Influenza Using Rapid Influenza Antigen Tests, San Antonio, Texas, April?June 2009
1. Pauline M. Lucas1,
2. Oliver W. Morgan2,
3. Thomas F. Gibbons1,
4. Alicia C. Guerrero1,4,
5. Genny M. Maupin1,5,
6. Jenny L. Butler1,4,
7. Linda C. Canas1,
8. Vincent P. Fonseca3,
9. Sonja J. Olsen2, and
10. Victor H. MacIntosh1
+ Author Affiliations
1.
1Department of Defense Global Laboratory-based Influenza Surveillance Program, United States Air Force School of Aerospace Medicine, Brooks City-Base, San Antonio, Texas
2.
2Division of Preparedness and Emerging Infections, Centers for Disease Control and Prevention, Atlanta, Georgia
3.
3Texas Department of State Health Services, Austin, Texas
4.
4Conceptual Mind Works, San Antonio, Texas
5.
5Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee
1. Correspondence: Victor H. MacIntosh, M.D., Epidemiology Consult Service, USAF School of Aerospace Medicine, 2513 Kennedy Cir, Bldg 180, Brooks City-Base, TX 78235 (victor.macintosh@us.af.mil); Dr Oliver Morgan, Division of Emerging Infections and Surveillance Services, Centers for Disease Control and Prevention, MS C-12, 1600 Clifton Rd NE, Atlanta, GA 3033 (omorgan@cdc.gov).
Abstract
Clinicians frequently use influenza rapid antigen tests for diagnostic testing. We tested nasal wash samples from 1 April to 7 June 2009 from 1538 patients using the QuickVue Influenza A+B (Quidel) rapid influenza antigen test and compared the results with real-time reverse transcription polymerase chain reaction (rRT-PCR) assay (gold standard). The prevalence of 2009 pandemic influenza A (pH1N1) was 1.98%, seasonal influenza type A .87%, and seasonal influenza type B 2.07%. The sensitivity and specificity of the rapid test for pH1N1 was 20% (95% CI, 8?39) and 99% (95% CI, 98?99), for seasonal influenza type A 15% (95% CI, 2?45) and 99% (95% CI, 98?99), and for influenza type B was 31% (95% CI, 9?61) and 99% (95% CI, 98?99.7). Rapid influenza antigen tests were of limited use at a time when the prevalence of pH1N1 and seasonal influenza in the United States was low. Clinicians should instead rely on clinical impression and laboratory diagnosis by rRT-PCR.
Diagnosis of 2009 Pandemic Influenza A (pH1N1) and Seasonal Influenza Using Rapid Influenza Antigen Tests, San Antonio, Texas, April?June 2009
1. Pauline M. Lucas1,
2. Oliver W. Morgan2,
3. Thomas F. Gibbons1,
4. Alicia C. Guerrero1,4,
5. Genny M. Maupin1,5,
6. Jenny L. Butler1,4,
7. Linda C. Canas1,
8. Vincent P. Fonseca3,
9. Sonja J. Olsen2, and
10. Victor H. MacIntosh1
+ Author Affiliations
1.
1Department of Defense Global Laboratory-based Influenza Surveillance Program, United States Air Force School of Aerospace Medicine, Brooks City-Base, San Antonio, Texas
2.
2Division of Preparedness and Emerging Infections, Centers for Disease Control and Prevention, Atlanta, Georgia
3.
3Texas Department of State Health Services, Austin, Texas
4.
4Conceptual Mind Works, San Antonio, Texas
5.
5Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee
1. Correspondence: Victor H. MacIntosh, M.D., Epidemiology Consult Service, USAF School of Aerospace Medicine, 2513 Kennedy Cir, Bldg 180, Brooks City-Base, TX 78235 (victor.macintosh@us.af.mil); Dr Oliver Morgan, Division of Emerging Infections and Surveillance Services, Centers for Disease Control and Prevention, MS C-12, 1600 Clifton Rd NE, Atlanta, GA 3033 (omorgan@cdc.gov).
Abstract
Clinicians frequently use influenza rapid antigen tests for diagnostic testing. We tested nasal wash samples from 1 April to 7 June 2009 from 1538 patients using the QuickVue Influenza A+B (Quidel) rapid influenza antigen test and compared the results with real-time reverse transcription polymerase chain reaction (rRT-PCR) assay (gold standard). The prevalence of 2009 pandemic influenza A (pH1N1) was 1.98%, seasonal influenza type A .87%, and seasonal influenza type B 2.07%. The sensitivity and specificity of the rapid test for pH1N1 was 20% (95% CI, 8?39) and 99% (95% CI, 98?99), for seasonal influenza type A 15% (95% CI, 2?45) and 99% (95% CI, 98?99), and for influenza type B was 31% (95% CI, 9?61) and 99% (95% CI, 98?99.7). Rapid influenza antigen tests were of limited use at a time when the prevalence of pH1N1 and seasonal influenza in the United States was low. Clinicians should instead rely on clinical impression and laboratory diagnosis by rRT-PCR.
