title: Comparison of rapid detection methods for influenza A virus and their value in health-care management of institutionalized geriatric patients.
abstract: Respiratory specimens from 160 geriatric patients with suspected influenza illness were used to evaluate the abilities of two enzyme immunoassays (EIAs; Directigen FLU-A [Becton Dickinson Microbiology Systems, Cockeysville, Md.] and Prima EIA [Baxter/Bartels Diagnostics, Inc., Issaquah, Wash.]) and direct immunofluorescence testing (immunofluorescence assay [IFA]) to identify influenza A virus. In comparison with culture isolation, the sensitivities and specificities of the IFA, Directigen FLU-A, and Prima EIA were 92.5 and 97.2%, 86.8 and 99.1%, and 92.5 and 98.1%, respectively. In contrast to EIA, IFA was labor intensive and required a high degree of technical expertise, and the results of IFA were difficult to interpret. These factors may preclude the use of IFA for testing large numbers of specimens. A retrospective epidemiologic survey of influenza infection was done in six geriatric institutions which had used either rapid and culture testing or culture alone. Preventable cases of influenza A virus infection ranged from 9 to 38% of all cases in facilities which used culture testing only and which had not instituted amantadine prophylaxis. The use of direct specimen testing is recommended as an adjunct to culture isolation for the identification of influenza A virus. Use of a combination of these methods permits the timely administration of appropriate antiviral therapy and infection control measures, while it also permits the antigenic surveillance of circulating influenza strains, which is necessary for present vaccine efficacy evaluations and the creation of future effective vaccine formulations.
authors.affiliation: Department of Pathology, Nassau County Medical Center, East Meadow, New York 11554.
authors.forename: G P
authors.initials: GP
authors.lastname: Leonardi
authors.forename: H
authors.initials: H
authors.lastname: Leib
authors.forename: G S
authors.initials: GS
authors.lastname: Birkhead
authors.forename: C
authors.initials: C
authors.lastname: Smith
authors.forename: P
authors.initials: P
authors.lastname: Costello
authors.forename: W
authors.initials: W
authors.lastname: Conron
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004196:Disease Outbreaks; D015200:Fluoroimmunoassay; D006299:Health Services for the Aged; D006707:Homes for the Aged; D006801:Humans; D007124:Immunoenzyme Techniques; D009980:Influenza A virus / Q000254:growth & development / Q000302:isolation & purification*; D007251:Influenza, Human / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control; D009305:Nasopharynx / Q000382:microbiology; D010347:Patient Care Planning; D010614:Pharynx / Q000382:microbiology; D011933:Reagent Kits, Diagnostic; D012189:Retrospective Studies; D014776:Virus Cultivation
chemical_list: D011933:Reagent Kits, Diagnostic