Journal Article

Predicting Influenza Infections during Epidemics with Use of a Clinical Case Definition

Guy Boivin, Isabelle Hardy, Guy Tellier and Jean Maziade

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 31, issue 5, pages 1166-1169
Published in print November 2000 | ISSN: 1058-4838
Published online November 2000 | e-ISSN: 1537-6591 | DOI: https://dx.doi.org/10.1086/317425
Predicting Influenza Infections during Epidemics with Use of a Clinical Case Definition

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Combined pharyngeal and nasal swab specimens were collected from 100 subjects who presented with a flu-like illness (fever>37.8°C plus 2 of 4 symptoms: cough, myalgia, sore throat, and headache) of <72 hours' duration at 3 different clinics in the province of Quebec, Canada, during the 1998–1999 flu season. The rate of laboratory-confirmed influenza infection was 72% according to cell culture findings and 79% according to the results of multiplex reverse-transcription polymerase chain reaction (RT-PCR) analysis (85%, influenza AH3; 15%, influenza B). All subjects for whom these results were discordant (negative culture and positive PCR) presented with a temperature ⩾38.2°C as well as 3 or 4 of the symptoms in the clinical case definition. Stepwise logistic regression showed that cough (odds ratio [OR], 6.7; 95% confidence interval [CI], 1.4–34.1; P = .02) and fever (OR, 3.1; 95% CI, 1.4–8.0; P = .01) were the only factors significantly associated with a positive PCR test for influenza. The positive predictive value, negative predictive value, sensitivity, and the specificity of a case definition including fever (temperature of >38°C) and cough for the diagnosis of influenza infection during this flu season were 86.8%, 39.3%, 77.6%, and 55.0%, respectively.

Journal Article.  2423 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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