title: Predictors of H1N1 influenza in the emergency department: proposition for a modified H1N1 case definition.
abstract: Reliable and rapid diagnosis of influenza A H1N1 is essential to initiate appropriate antiviral therapy and preventive measures. We analysed the differences in clinical presentation and laboratory parameters between emergency department patients with PCR-confirmed H1N1 influenza infection (n = 199) and those with PCR-negative influenza-like illness (ILI; n = 252). Cough, wheezing, leucopenia, eosinopenia and a lower C-reactive protein remained significant predictors of H1N1 influenza. Proposed combinations of clinical symptoms with simple laboratory parameters (e.g. reported or measured fever and either cough or leucocytes <8.5 × 10(9) /L) were clearly superior to currently used official ILI case definitions that use clinical criteria alone.
authors.affiliation: Division of Pulmonology, Medical University Hospital of Graz, Graz, Austria.
authors.forename: H
authors.initials: H
authors.lastname: Flick
authors.forename: M
authors.initials: M
authors.lastname: Drescher
authors.forename: J
authors.initials: J
authors.lastname: Prattes
authors.forename: K
authors.initials: K
authors.lastname: Tovilo
authors.forename: H H
authors.initials: HH
authors.lastname: Kessler
authors.forename: K
authors.initials: K
authors.lastname: Vander
authors.forename: K
authors.initials: K
authors.lastname: Seeber
authors.forename: M
authors.initials: M
authors.lastname: Palfner
authors.forename: R B
authors.initials: RB
authors.lastname: Raggam
authors.forename: A
authors.initials: A
authors.lastname: Avian
authors.forename: R
authors.initials: R
authors.lastname: Krause
authors.forename: M
authors.initials: M
authors.lastname: Hoenigl
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D019411:Clinical Laboratory Techniques / Q000379:methods; D015510:Clinical Medicine / Q000379:methods; D004635:Emergency Medicine / Q000379:methods*; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D053118:Influenza A Virus, H1N1 Subtype / Q000302:isolation & purification*; D007251:Influenza, Human / Q000175:diagnosis* / Q000473:pathology / Q000821:virology*; D008297:Male; D008875:Middle Aged; D055815:Young Adult
keywords: Berlin; H1N1; PCR; clinical presentation; influenza A; laboratory values