Ronan Kelly
Retired 2020
Re: One in Six Americans Have Had H1N1; 10,000 Have Died
Here's two studies based on seasonal flu;
http://nejm.highwire.org/cgi/reprint/355/1/31.pdf
The basic results of the study are;
Of 160 hospitalized pediatric patients under 5 years old who the researchers tested positive for influenza using PCR and culture assay, only 45 were diagnosed with influenza by the doctors. The remainder were diagnosed variously with bronchiolitis, viral illness, Fever/Suspected sepsis, Pneumonia, asthma and seizure.
The study was limited to children who presented with acute respiratory tract infection and fever.
and for adults;
http://www.ncbi.nlm.nih.gov/pubmed/...ed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=15
"DATA SYNTHESIS: No symptom or sign had a summary LR greater than 2 in studies that enrolled patients without regard to age. For decreasing the likelihood of influenza, the absence of fever (LR, 0.40; 95% confidence interval [CI], 0.25-0.66), cough (LR, 0.42; 95% CI, 0.31-0.57), or nasal congestion (LR, 0.49; 95% CI, 0.42-0.59) were the only findings that had summary LRs less than 0.5. In studies limited to patients aged 60 years or older, the combination of fever, cough, and acute onset (LR, 5.4; 95% CI, 3.8-7.7), fever and cough (LR, 5.0; 95% CI, 3.5-6.9), fever alone (LR, 3.8; 95% CI, 2.8-5.0), malaise (LR, 2.6; 95% CI, 2.2-3.1), and chills (LR, 2.6; 95% CI, 2.0-3.2) increased the likelihood of influenza to the greatest degree. The presence of sneezing among older patients made influenza less likely (LR, 0.47; 95% CI, 0.24-0.92). CONCLUSIONS: Clinical findings identify patients with influenza-like illness but are not particularly useful for confirming or excluding the diagnosis of influenza. Clinicians should use timely epidemiologic data to ascertain if influenza is circulating in their communities, then either treat patients with influenza-like illness empirically or obtain a rapid influenza test to assist with management decisions."
Here's two studies based on seasonal flu;
http://nejm.highwire.org/cgi/reprint/355/1/31.pdf
The basic results of the study are;
Of 160 hospitalized pediatric patients under 5 years old who the researchers tested positive for influenza using PCR and culture assay, only 45 were diagnosed with influenza by the doctors. The remainder were diagnosed variously with bronchiolitis, viral illness, Fever/Suspected sepsis, Pneumonia, asthma and seizure.
The study was limited to children who presented with acute respiratory tract infection and fever.
and for adults;
http://www.ncbi.nlm.nih.gov/pubmed/...ed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=15
"DATA SYNTHESIS: No symptom or sign had a summary LR greater than 2 in studies that enrolled patients without regard to age. For decreasing the likelihood of influenza, the absence of fever (LR, 0.40; 95% confidence interval [CI], 0.25-0.66), cough (LR, 0.42; 95% CI, 0.31-0.57), or nasal congestion (LR, 0.49; 95% CI, 0.42-0.59) were the only findings that had summary LRs less than 0.5. In studies limited to patients aged 60 years or older, the combination of fever, cough, and acute onset (LR, 5.4; 95% CI, 3.8-7.7), fever and cough (LR, 5.0; 95% CI, 3.5-6.9), fever alone (LR, 3.8; 95% CI, 2.8-5.0), malaise (LR, 2.6; 95% CI, 2.2-3.1), and chills (LR, 2.6; 95% CI, 2.0-3.2) increased the likelihood of influenza to the greatest degree. The presence of sneezing among older patients made influenza less likely (LR, 0.47; 95% CI, 0.24-0.92). CONCLUSIONS: Clinical findings identify patients with influenza-like illness but are not particularly useful for confirming or excluding the diagnosis of influenza. Clinicians should use timely epidemiologic data to ascertain if influenza is circulating in their communities, then either treat patients with influenza-like illness empirically or obtain a rapid influenza test to assist with management decisions."