title: Detection of 2009 pandemic influenza A(H1N1) virus Infection in different age groups by using rapid influenza diagnostic tests.
abstract: BACKGROUND
  The performance of rapid influenza diagnostic tests (RIDTs) in detecting influenza A(H1N1) 2009 has varied widely. Evaluations of RIDTs among infected individuals across all age groups have not been described in depth.
  
  
  OBJECTIVE
  Determine RIDT clinical sensitivity in comparison with influenza detection using real-time RT-PCR among patients infected with influenza A(H1N1) 2009 across all age groups.
  
  
  METHODS
  This study analyzed respiratory specimens received by the New Hampshire Public Health Laboratories (NHPHL) from September 1, 2009, through December 31, 2009. RIDT performance was evaluated among different age groups of patients determined to be infected with influenza A (H1N1) 2009, and the association between age and RIDT sensitivity was determined.
  
  
  RESULTS
  Of 1373 specimens examined, 269 tested positive for influenza A(H1N1) 2009 by real-time RT-PCR (rRT-PCR) and had RIDT results available. Overall clinical sensitivity and specificity of RIDTs were 53·9 and 98·5%, respectively. By age group, clinical sensitivity was 85·7% in patients <2 years old, 60·3% in patients between 2- and 39 years old, and 33·3% in patients aged 40 and older. Logistic regression analysis indicated that increasing age was negatively associated with RIDT performance.
  
  
  CONCLUSIONS
  Rapid influenza diagnostic test sensitivity decreased significantly with increasing age. Findings from this study may impact a clinician's interpretation of RIDT test results and ultimately have implications in clinical decision-making.
authors: Division of Public Health Services, New Hampshire Department of Health and Human Services, Concord, NH 03301, USA. fgao@dhhs.state.nh.us
authors: Fengxiang
authors: F
authors: Gao
authors: Carol
authors: C
authors: Loring
authors: Michael
authors: M
authors: Laviolette
authors: Denise
authors: D
authors: Bolton
authors: Elizabeth R
authors: ER
authors: Daly
authors: Christine
authors: C
authors: Bean
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D053118:Influenza A Virus, H1N1 Subtype / Q000235:genetics / Q000302:isolation & purification*; D007251:Influenza, Human / Q000175:diagnosis* / Q000453:epidemiology / Q000821:virology*; D008297:Male; D008875:Middle Aged; D009513:New Hampshire; D058873:Pandemics; D020133:Reverse Transcriptase Polymerase Chain Reaction / Q000379:methods*; D012680:Sensitivity and Specificity; D055815:Young Adult