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High performance of rapid influenza diagnostic test and variable effectiveness of influenza vaccines in Mexico

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  • High performance of rapid influenza diagnostic test and variable effectiveness of influenza vaccines in Mexico

    Int J Infect Dis. 2019 Sep 4. pii: S1201-9712(19)30355-8. doi: 10.1016/j.ijid.2019.08.029. [Epub ahead of print]
    High performance of rapid influenza diagnostic test and variable effectiveness of influenza vaccines in Mexico.

    Castillejos M1, Cabello-Gutiérrez C2, Choreño-Parra JA3, Hernández V2, Romo J1, Hernández-Sánchez F2, Martínez D1, Hernández A1, Jiménez-Álvarez L4, Hernández-Cardenas CM5, Becerril-Vargas E1, Martínez-Orozco JA1, Sandoval-Gutiérrez JL1, Guadarrama C1, Olvera-Masetto E1, Alfaro-Ramos L1, Cruz-Lagunas A4, Ramírez G4, Márquez E4, Pimentel L6, Regino-Zamarripa NE7, Mendoza-Milla C4, Goodina A6, Hernández-Montiel E6, Barquera R8, Santibañez A9, Domínguez-Cherit G10, Pérez-Padilla R1, Regalado J11, Santillán-Doherty P11, Salas-Hernández J12, Zúñiga J13.
    Author information

    1 Institutional Influenza Committee, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City, Mexico. 2 Department of Research in Virology and Mycology, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City, Mexico. 3 Laboratory of Immunobiology and Genetics, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City, Mexico; Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Mexico City, Mexico. 4 Laboratory of Immunobiology and Genetics, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City, Mexico. 5 Institutional Influenza Committee, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City, Mexico; Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Mexico City, Mexico. 6 Laboratory of Immunobiology and Genetics, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City, Mexico; Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Mexico City, Mexico. 7 Laboratory of Immunobiology and Genetics, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City, Mexico; Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Mexico City, Mexico; Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Mexico City, Mexico. 8 Laboratory of Archeogenomics, Max Planck Institute, Gena, Germany. 9 Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Mexico City, Mexico; Laboratory of Archeogenomics, Max Planck Institute, Gena, Germany. 10 Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Mexico City, Mexico; Critical Care Unit, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico. 11 Institutional Influenza Committee, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City, Mexico; Dirección Médica, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City, Mexico. 12 Institutional Influenza Committee, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City, Mexico; Dirección General, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City, Mexico. Electronic address: jorgesalash@yahoo.com. 13 Institutional Influenza Committee, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City, Mexico; Laboratory of Immunobiology and Genetics, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City, Mexico; Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Mexico City, Mexico. Electronic address: joazu@yahoo.com.

    Abstract

    OBJECTIVES:

    To evaluate the performance of a rapid influenza diagnostic tests (RIDT) and influenza vaccines' effectiveness (VE) during an outbreak setting.
    METHODS:

    We compared the performance of a RIDT with RT-PCR for influenza virus detection in influenza-like illness (ILI) patients enrolled during the 2016/17 season in Mexico City. Using the test-negative design, we estimated influenza VE in all participants and stratified by age, virus subtype, and vaccine type (trivalent vs quadrivalent inactivated vaccines). The protective value of some clinical variables was evaluated by regression analyses.
    RESULTS:

    We enrolled 592 patients. RT-PCR detected 93 cases of influenza A(H1N1)pdm09, 55 of AH3N2, 141 of B, and 13 A/B virus infections. RIDT showed 90.7% sensitivity and 95.7% specificity for influenza A virus detection, and 91.5% sensitivity and 95.3% specificity for influenza B virus detection. Overall VE was 33.2% (95% CI: 3.0 - 54.0; p = 0.02) against any laboratory-confirmed influenza infection. VE estimates against influenza B were higher for the quadrivalent vaccine. Immunization and occupational exposure were protective factors against influenza.
    CONCLUSIONS:

    The RIDT was useful to detect influenza cases during an outbreak setting. Effectiveness of 2016/17 influenza vaccines administered in Mexico was low but significant. Our data should be considered for future local epidemiological policies.
    Copyright © 2019. Published by Elsevier Ltd.


    KEYWORDS:

    Influenza vaccines; Influenza virus infection; Rapid influenza diagnostic test; Vaccine effectiveness

    PMID: 31493523 DOI: 10.1016/j.ijid.2019.08.029
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