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Revision of clinical case definitions: influenza-like illness and severe acute respiratory infection

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  • Revision of clinical case definitions: influenza-like illness and severe acute respiratory infection

    Bull World Health Organ. 2018 Feb 1;96(2):122-128. doi: 10.2471/BLT.17.194514. Epub 2017 Nov 27.
    Revision of clinical case definitions: influenza-like illness and severe acute respiratory infection.

    Fitzner J1, Qasmieh S1, Mounts AW1, Alexander B2, Besselaar T1, Briand S1, Brown C3, Clark S1, Dueger E4, Gross D3, Hauge S5, Hirve S1, Jorgensen P3, Katz MA6, Mafi A7, Malik M7, McCarron M6, Meerhoff T8, Mori Y1, Mott J9, Olivera MTDC10, Ortiz JR1, Palekar R11, Rebelo-de-Andrade H12, Soetens L13, Yahaya AA14, Zhang W1, Vandemaele K1.
    Author information

    Abstract

    in English, Arabic, Chinese, French, Russian, Spanish
    The formulation of accurate clinical case definitions is an integral part of an effective process of public health surveillance. Although such definitions should, ideally, be based on a standardized and fixed collection of defining criteria, they often require revision to reflect new knowledge of the condition involved and improvements in diagnostic testing. Optimal case definitions also need to have a balance of sensitivity and specificity that reflects their intended use. After the 2009-2010 H1N1 influenza pandemic, the World Health Organization (WHO) initiated a technical consultation on global influenza surveillance. This prompted improvements in the sensitivity and specificity of the case definition for influenza - i.e. a respiratory disease that lacks uniquely defining symptomology. The revision process not only modified the definition of influenza-like illness, to include a simplified list of the criteria shown to be most predictive of influenza infection, but also clarified the language used for the definition, to enhance interpretability. To capture severe cases of influenza that required hospitalization, a new case definition was also developed for severe acute respiratory infection in all age groups. The new definitions have been found to capture more cases without compromising specificity. Despite the challenge still posed in the clinical separation of influenza from other respiratory infections, the global use of the new WHO case definitions should help determine global trends in the characteristics and transmission of influenza viruses and the associated disease burden.


    PMID: 29403115 PMCID: PMC5791775 DOI: 10.2471/BLT.17.194514
    Free PMC Article
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