title: Effect of rapid influenza diagnostic testing on antiviral treatment decisions for patients with influenza-like illness: southwestern U.S., May-December 2009.
abstract: Rapid influenza diagnostic tests (RIDTs) had low test sensitivity for detecting 2009 pandemic influenza A (H1N1pdm09) infection, causing public health authorities to recommend that treatment decisions be based primarily upon risk for influenza complications. We used multivariate Poisson regression analysis to estimate the contribution of RIDT results and risk for H1N1pdm09 complications to receipt of early antiviral (AV) treatment among 290 people with influenza-like illness (ILI) who received an RIDT ≤48 hours after symptom onset from May to December 2009 at four southwestern U.S. facilities. RIDT results had a stronger association with receipt of early AVs (rate ratio [RR] = 3.3, 95% confidence interval [CI] 2.4, 4.6) than did the presence of risk factors for H1N1pdm09 complications (age <5 years or high-risk medical conditions) (RR=1.9, 95% CI 1.3, 2.7). Few at-risk people (28/126, 22%) who had a negative RIDT received early AVs, suggesting the need for sustained efforts by public health to influence clinician practices.
authors: Centers for Disease Control and Prevention, Scientific Education and Professional Development Program Office (proposed), Epidemic Intelligence Service, Atlanta, GA.
authors: Anil
authors: A
authors: Suryaprasad
authors: Indian Health Service, Division of Epidemiology and Disease Prevention, Albuquerque, NM.
authors: John T
authors: JT
authors: Redd
authors: Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Division of Tuberculosis Elimination, Atlanta, GA.
authors: Philip M
authors: PM
authors: Ricks
authors: Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Division of Tuberculosis Elimination, Atlanta, GA.
authors: Laura Jean
authors: LJ
authors: Podewils
authors: University of New Mexico School of Medicine, Albuquerque, NM.
authors: Meghan
authors: M
authors: Brett
authors: Tuba City Regional Health Care Corporation, Tuba City, AZ.
authors: Jane
authors: J
authors: Oski
authors: Indian Health Service, Whiteriver Service Unit, Whiteriver, AZ.
authors: Wanda
authors: W
authors: Minenna
authors: Winslow Indian Health Care Center, Winslow, AZ.
authors: Frank
authors: F
authors: Armao
authors: Sells Indian Health Service Hospital, Sells, AZ.
authors: Barbara J
authors: BJ
authors: Vize
authors: Indian Health Service, Division of Epidemiology and Disease Prevention, Albuquerque, NM.
authors: James E
authors: JE
authors: Cheek
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000998:Antiviral Agents / Q000627:therapeutic use; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D008297:Male; D058873:Pandemics; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012737:Sex Factors; D012959:Socioeconomic Factors; D015206:Southwestern United States; D013997:Time Factors; D055815:Young Adult
chemical_list: D000998:Antiviral Agents