title: Sensitivity and specificity of rapid influenza testing of children in a community setting.
abstract: BACKGROUND
  Rapid influenza testing (RFT) allows for a rapid point-of-care diagnosis of influenza. The Quidel QuickVue Influenza A+B test (QuickVue) has a reported manufacturer's sensitivity and specificity of 73% and 96%, respectively, with nasal swabs. However, investigators have shown sensitivities ranging from 22% to 77% in community settings.
  
  
  METHODS
  The QuickVue rapid influenza test was evaluated in a population of elementary (K-5) school children, using testing in the home, as part of the Pittsburgh Influenza Prevention Project during the 2007-2008 influenza season. The QuickVue test was performed with nasal swab in full accordance with package instructions and compared with the results of nasal swab semi-quantitative RT-PCR.
  
  
  RESULTS
  Sensitivity of the QuickVue was found to be 27% in this sample. There was no statistically valid correlation between the semi-quantitative PCR result and the QuickVue result.
  
  
  CONCLUSIONS
  This study is consistent with the low sensitivity of the QuickVue test also reported by others. Viral load, technique, and the use of nasal swabs were examined as contributing factors but were not found to be explanations for this result. Community testing includes patients who are on the lower spectrum of illness which would not be the case in hospital or clinic samples. This suggests that RFT is less sensitive for patients at the lower spectrum of illness, with less severe disease.
authors.affiliation: Center for Public Health Practice, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA. stebbins@pitt.edu
authors.forename: Samuel
authors.initials: S
authors.lastname: Stebbins
authors.forename: James H
authors.initials: JH
authors.lastname: Stark
authors.forename: Ramakrishna
authors.initials: R
authors.lastname: Prasad
authors.forename: William W
authors.initials: WW
authors.lastname: Thompson
authors.forename: Kiren
authors.initials: K
authors.lastname: Mitruka
authors.forename: Charles
authors.initials: C
authors.lastname: Rinaldo
authors.forename: Charles J
authors.initials: CJ
authors.lastname: Vukotich
authors.forename: Derek A T
authors.initials: DA
authors.lastname: Cummings
mesh_terms: D002648:Child; D006801:Humans; D007251:Influenza, Human / Q000175:diagnosis*; D009297:Nasal Mucosa / Q000821:virology; D019095:Point-of-Care Systems; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012680:Sensitivity and Specificity