title: Evaluation of direct immunofluorescence test with PCR for detection of novel influenza A (H1N1) virus during 2009 pandemic.
abstract: During the 2009 novel influenza (H1N1) pandemic, the sensitivity of direct immunofluorescence assay (DFA) for H1N1 infection was 62% (266/429) of that of the polymerase chain reaction (PCR) test. The sensitivity of the DFA differed significantly with the age of patients: the sensitivity was the highest (71.8%) for patients aged <10 years and the lowest for patients aged ≥30 years. The sensitivity of DFA in patients aged ≥30 years was 40.7%. Furthermore, the sensitivity (67.3%, 171/254) of DFA was higher for patients who had a high temperature at admission. An increase in the incidence of H1N1 infection did not influence the sensitivity of DFA (62.1% vs. 62%; p=0.984) test, but resulted in a decrease in the negative predictive value, from 92.4% (700/757) to 69.6% (247/355). PCR may be useful as the initial test for diagnosing H1N1 infection in patients aged ≥30 years with a normal temperature at presentation.
authors.affiliation: Department of Internal Medicine, Wonkwang University College of Medicine, 344-2 Sinyong-dong, Iksan 570-749, Korea. john7026@wku.ac.kr
authors.forename: Jae Hoon
authors.initials: JH
authors.lastname: Lee
authors.forename: Sae Ron
authors.initials: SR
authors.lastname: Shin
authors.forename: Ji Hyun
authors.initials: JH
authors.lastname: Cho
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001831:Body Temperature; D002648:Child; D005334:Fever / Q000821:virology; D019085:Fluorescent Antibody Technique, Direct; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype / Q000235:genetics / Q000302:isolation & purification*; D007251:Influenza, Human / Q000453:epidemiology / Q000821:virology*; D058873:Pandemics; D016133:Polymerase Chain Reaction; D012680:Sensitivity and Specificity