Performance of suspected influenza case definition before and during the COVID-19 pandemic

Murillo-Zamora, Efrén; Hernandez-Suarez, Carlos

doi:10.1101/2020.06.01.20119446

Cited by 1 publication

(1 citation statement)

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“…The case definition used for influenza surveillance may be helpful during the COVID-19 pandemic as timely use of antiviral influenza drugs together with booster influenza vaccination can reduce the social and economic burden of influenza [22].…”

Section: Plos Onementioning

confidence: 99%

Does knowing the influenza epidemic threshold has been reached influence the performance of influenza case definitions?

Soldevila

Toledo²,

Martı́nez³

et al. 2022

PLoS ONE

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Background Disease surveillance using adequate case definitions is very important. The objective of the study was to compare the performance of influenza case definitions and influenza symptoms in the first two epidemic weeks with respect to other epidemic weeks. Methods We analysed cases of acute respiratory infection detected by the network of sentinel primary care physicians of Catalonia for 10 seasons. We calculated the diagnostic odds ratio (DOR) and 95% confidence intervals (CI) for the first two epidemic weeks and for other epidemic weeks. Results A total of 4,338 samples were collected in the epidemic weeks, of which 2,446 (56.4%) were positive for influenza. The most predictive case definition for laboratory-confirmed influenza was the WHO case definition for influenza-like illness (ILI) in the first two epidemic weeks (DOR 2.10; 95% CI 1.57–2.81) and in other epidemic weeks (DOR 2.31; 95% CI 1.96–2.72). The most predictive symptom was fever. After knowing that epidemic threshold had been reached, the DOR of the ILI WHO case definition in children aged <5 years and cough and fever in this group increased (190%, 170% and 213%, respectively). Conclusions During influenza epidemics, differences in the performance of the case definition and the discriminative ability of symptoms were found according to whether it was known that the epidemic threshold had been reached or not. This suggests that sentinel physicians are stricter in selecting samples to send to the laboratory from patients who present symptoms more specific to influenza after rather than before an influenza epidemic has been declared.

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Section: Plos Onementioning

confidence: 99%