Poor Clinical Sensitivity of Rapid Antigen Test for Influenza A Pandemic (H1N1) 2009 Virus

Drexler, Jan Felix; Helmer, Angelika; Kirberg, Heike; Reber, Ulrike; Panning, Marcus; Müller, Marcel A.; Höfling, Katja; Matz, Bertfried; Drosten, Christian; Eis‐Hübinger, Anna Maria

doi:10.3201/eid1510.091186

Cited by 171 publications

(125 citation statements)

References 12 publications

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“…This goes in line with the results assessing the performance of BinaxNOW Influenza A&B Rapid Test® in PCR-positive clinical specimens [3,5]. A positive correlation between sensitivity and viral load has also been found in studies assessing rapid tests during a regular influenza season [3].…”

Section: Performance Of Influenzatop®supporting

confidence: 83%

Performance characteristics of a rapid immunochromatographic assay for detection of pandemic influenza A (H1N1) virus in children

et al. 2010

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Rapid tests for diagnosis of influenza are valuable assets in the management of influenza in pediatric patients. However, test performance fluctuates with virus subtypes. We assessed the test characteristics of Influenzatop®, a rapid immunochromatographic influenza A and B test, in detecting pandemic 2009 influenza A (H1N1) in children up to 18 years of age, using reverse transcriptase polymerase chain reaction (RT-PCR) as the gold standard. Three hundred and one pediatric outpatients with influenzalike illness were included into the study. Overall sensitivity of Influenzatop® was 64% (95% confidence interval (CI) 56-71%) but increased to 92% (95% CI, 80-97%) when performed between 24 and 48 h after onset of symptoms. Positive Influenzatop® results among RT-PCR-positive patients were associated with higher viral load. No significant variation in test performance could be detected when analyzed by age and high versus low prevalence period. Overall test specificity was 99% (95% CI, 95-100%); positive and negative predictive values were 98% (95% CI, 93-99%) and 70% (95% CI, 63-76%), respectively. Conclusion: Influenzatop® rapid influenza test is a sound tool in the diagnosis of H1N1 in pediatric patients when employed 24-48 h after onset of symptoms.

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Section: Performance Of Influenzatop®supporting

confidence: 83%

Performance characteristics of a rapid immunochromatographic assay for detection of pandemic influenza A (H1N1) virus in children

et al. 2010

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“…Rapid antigen tests generally have low sensitivity (11%-69%) for detecting pandemic H1N1/09 (50)(51)(52)(53)(54). The sensitivity of all rapid tests decreased markedly with decreasing virus titres in specimens (51).…”

Section: Laboratory Diagnosismentioning

confidence: 99%

Pandemic influenza A (H1N1) 2009: the experience of the first six months

Maritz

Maree²,

Preiser³

2009

Clinical Chemistry and Laboratory Medicine

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After a break of 41 years, 2009 saw the first influenza pandemic of the 21st century caused by a triple-reassortant influenza A (H1N1) virus. The current estimated case fatality rate is lower than that of previous influenza pandemics, but this may change as the pandemic evolves. Illness frequently occurs in previously healthy, young adults with a wide range of clinical presentations. The majority of circulating pandemic viruses remain susceptible to neuraminidase inhibitors, although all strains are intrinsically resistant to the adamantanes. Monovalent vaccines against the pandemic strain are available in both live attenuated and inactivated forms. This review aims to summarise important virological, epidemiological and clinical aspects of the pandemic influenza A (H1N1) virus for physicians and other clinical personnel. Clin Chem Lab Med 2010;48:11-21.

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“…H1N1 was diagnosed by a positive result of an influenza A test kit (rapid test) or by clinical symptoms, not by culture or molecular diagnostic techniques. The sensitivity of the rapid test is said to be about 50%, and an extreme report found only 11% sensitivity compared with PCR 15) . Thus, diagnosis using only the rapid test may miss a large number of true infections.…”

Section: Discussionmentioning

confidence: 99%

An Effective Quarantine Measure Reduced the Total Incidence of Influenza A H1N1 in the Workplace: Another Way to Control the H1N1 Flu Pandemic

Miyaki

Sakurazawa²,

Mikurube

et al. 2011

Journal of Occupational Health

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The incidences of influenza A H1N1 and those of the subgroups whose families got ILI in both cohorts were compared by a Cox regression model and log-rank test. Results: There were 189 and 270 workers who got H1N1 infection during the follow-up period in each cohort. In this period 317 workers in Cohort 1 were asked to wait at home for several days (100% obeyed). The intervention group (Cohort 1) showed a statistically significant lower risk (p for log-rank test=0.033) compared with the control (Cohort 2), and the hazard ratio of the intervention was 0.799 [0.658-0.970] after adjusting for age, sex, BMI and smoking status. The workers who were asked to wait at home showed H1N1 infection more frequently (49 out of 317) compared with the workers whose family got ILI but were not asked to wait and work regularly (77 out of 990,). Conclusions: The waiting on full pay policy in the workplace reduced the overall risk of influenza A H1N1 by about 20% in one flu season in Japan. This kind of non-vaccine measure will be a promising option in workplaces to control the next flu pandemic. (J Occup Health 2011; 53: 287-292)

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Poor Clinical Sensitivity of Rapid Antigen Test for Influenza A Pandemic (H1N1) 2009 Virus

Cited by 171 publications

References 12 publications

Performance characteristics of a rapid immunochromatographic assay for detection of pandemic influenza A (H1N1) virus in children

Performance characteristics of a rapid immunochromatographic assay for detection of pandemic influenza A (H1N1) virus in children

Pandemic influenza A (H1N1) 2009: the experience of the first six months

An Effective Quarantine Measure Reduced the Total Incidence of Influenza A H1N1 in the Workplace: Another Way to Control the H1N1 Flu Pandemic

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