title: Early detection of influenza A and B infection in infants and children using conventional and fluorescence-based rapid testing.
abstract: BACKGROUND
  The appropriate management of infants and children with influenza depends on the accurate and timely diagnosis, ideally at the point of care (POC).
  
  
  OBJECTIVE
  To evaluate the use of simultaneous RSV/influenza rapid testing with QuickVue™ test strips as well as (the use of) novel, fluorescence-based, rapid influenza antigen testing (SOFIA™) in infants and children with influenza-like illness (ILI).
  
  
  METHODS
  The Study was conducted in a real-time surveillance program at the Charité Department of Pediatrics in collaboration with the National Reference Centre for Influenza at the Robert Koch Institute (RKI) in Berlin, Germany (Charité Influenza-Like Disease=ChILD Cohort).
  
  
  RESULTS
  During the 2010/2011 influenza season, 395 infants and children were simultaneously tested using QuickVue™ FluA&B and RSV10 rapid tests at POC compared to independent RT-PCR. Sensitivities were 62.7/67.8% for Influenza/RSV overall, but highest in infants <1 year with 76.0/76.2%. The evaluation of the fluorescence-based rapid test SOFIA™ with frozen laboratory samples (derived from the 2008/2009 and 2010/2011 national surveillance) yielded sensitivities of 97.7/86.7/86.7/81.7% for influenza A(H1N1)pdm09/A(H3N2)/B-Victoria/B-Yamagata in samples with CT values <34, and 80.2/79.8/67.5/62.5% for all CT values combined. The same method used at POC with 649 consecutive ChILD patients in 2011-2012 yielded sensitivity/specificity/PPV/NPV values of 78.9/99.7/96.6/97.3%. Again, sensitivities were highest in infants (85.7%) and small children <2 years (88%).
  
  
  CONCLUSIONS
  Fluorescence-based rapid antigen testing provides a highly sensitive and specific tool for POC diagnostics of acute influenza in the paediatric age group, especially in infants and small children <2 years, when viral loads are at their peak and treatment decisions are imminent.
authors.affiliation: Department of Paediatrics, Division of Pneumonology-Immunology, Charité University Medical Centre, Augustenburger Platz 1, Berlin, Germany. Barbara.Rath@gmail.com
authors.forename: Barbara
authors.initials: B
authors.lastname: Rath
authors.forename: Franziska
authors.initials: F
authors.lastname: Tief
authors.forename: Patrick
authors.initials: P
authors.lastname: Obermeier
authors.forename: Ewelina
authors.initials: E
authors.lastname: Tuerk
authors.forename: Katharina
authors.initials: K
authors.lastname: Karsch
authors.forename: Susann
authors.initials: S
authors.lastname: Muehlhans
authors.forename: Eleni
authors.initials: E
authors.lastname: Adamou
authors.forename: Susanne
authors.initials: S
authors.lastname: Duwe
authors.forename: Brunhilde
authors.initials: B
authors.lastname: Schweiger
mesh_terms: D000293:Adolescent; D001604:Berlin; D002648:Child; D002675:Child, Preschool; D019411:Clinical Laboratory Techniques / Q000379:methods*; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D007223:Infant; D009980:Influenza A virus / Q000302:isolation & purification*; D009981:Influenza B virus / Q000302:isolation & purification*; D007251:Influenza, Human / Q000175:diagnosis*; D008297:Male; D019095:Point-of-Care Systems; D012680:Sensitivity and Specificity; D014773:Virology / Q000379:methods*