Rapid H1N1 Flu Test Found to Be of Limited Value in Children

Poor sensitivity suggests pediatricians should not solely rely on test to make treatment decisions
By Rick Ansorge
HealthDay Reporter

MONDAY, Feb. 15 (HealthDay News) -- In the diagnosis of pediatric H1N1 influenza A virus infection, the rapid influenza diagnostic test has poor sensitivity but excellent specificity, according to a study published online Feb. 15 in Pediatrics.

Andrea T. Cruz, M.D., of the Baylor College of Medicine in Houston, and colleagues conducted a cross-sectional diagnostic-accuracy study of 3,030 pediatric specimens, pairing rapid influenza diagnostic test results with real-time reverse-transcriptase polymerase chain reaction and viral culture results.

Compared to real-time reverse-transcriptase polymerase chain reaction, the researchers found that the rapid influenza diagnostic test had a sensitivity of 45 percent and specificity of 98.6 percent, and that its sensitivity was significantly higher in children under the age of 2 years. Compared to viral culture, they found that the rapid influenza diagnostic test had a sensitivity of 55.5 percent and a specificity of 95.6 percent.

"Treatment of children at high risk who experience influenza-like illness during periods of high prevalence of influenza in the community should not rely solely on the results of the rapid influenza diagnostic test," the authors conclude. "Empiric antiviral therapy and careful clinical evaluation should be considered for these patients, and confirmatory testing with real-time reverse-transcriptase polymerase chain reaction or viral culture should be performed, when available, especially if the patient is severely ill, requires hospitalization, or does not respond as anticipated."

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