Diagnostic accuracy of a rapid influenza test for pandemic influenza A H1N1.
BACKGROUND
With the current influenza A H1N1 pandemic (H1N1pdm), it is extremely important that clinicians can quickly and accurately identify influenza cases.


RESULTS
To investigate the performance of the QuickVue Influenza A+B rapid test, we conducted a prospective study of the diagnostic accuracy of the QuickVue Influenza A+B test compared to real-time reverse transcriptase-polymerase chain reaction (RT-PCR) for influenza A H1N1pdm in Nicaraguan children aged 2 to 14 years. Rapid test sensitivity and specificity compared to real-time RT-PCR were 64.1% (95% CI 53.5, 73.9) and 98.3% (95.0, 99.6), respectively. Agreement between the two tests was 86.4% (95% CI 81.7, 90.3), and kappa was calculated to be 0.67 (95% CI 0.56, 0.76). Performance of the rapid test varied by day of presentation, with a sensitivity of 41.7% (95% CI 22.1, 63.4) for samples from children presenting on the day of symptom onset and a sensitivity of 72.1% (95% CI 59.9, 82.3) for samples from children presenting one or more days post-symptom onset.


CONCLUSIONS
We found that the rapid test performed with moderate sensitivity and high specificity. Test performance varied by day of onset, with lower sensitivity on the day of symptom onset.
Gordon
Aubree
A
Division of Epidemiology, School of Public Health, University of California, Berkeley, California, United States of America.
Videa
Elsa
E
Saborío
Saira
S
López
Roger
R
Kuan
Guillermina
G
Balmaseda
Angel
A
Harris
Eva
E
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D053118:Influenza A Virus, H1N1 Subtype / Q000302:isolation & purification*; D007251:Influenza, Human / Q000175:diagnosis*; D008403:Mass Screening / Q000379:methods; D009527:Nicaragua; D058873:Pandemics; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013997:Time Factors