symptomatic predictors for 2009 influenza a virus (h1n1) infection with an emphasis for patients with a negative rapid diagnostic test症状预测2009年的甲型流感病毒(h1n1)感染患者的强调负面的快速诊断测试.pdf

Symptomatic Predictors for 2009 Influenza A Virus (H1N1) Infection with an Emphasis for Patients with a Negative Rapid Diagnostic Test 1,2 1 3 3 1 Chen-Yen Kuo , Yhu-Chering Huang *, Chung-Guei Huang , Kuo-Chien Tsao , Tzou-Yien Lin 1 Department of Pediatrics, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan, 2 Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan, 3 Department of Laboratory Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan Abstract Background: The clinical diagnosis of influenza is difficult because it shares nonspecific symptoms with a variety of diseases. Emergency departments and clinics were overwhelmed by a surge of anxious patients during the 2009 influenza A virus (H1N1) outbreak. Our objective was to identify symptomatic predictors of influenza virus infection for patients with a negative rapid diagnostic test. Methodology/Principal Findings: We conducted a retrospective review of 805 patients who presented at Chang Gung Memorial Hospital, from August 1, 2009, to September 30, 2009. Respiratory specimens from these patients were subjected to rapid influenza tests and reverse-transcription polymerase chain reactions. In total, 36% of 308 children and 23% of 497 adults were positive for 2009 influenza A virus (H1N1) infection by polymerase chain reaction or virus culture. For pediatric patients, sore throat and influenza-like illness significantly increased the odds of having 2009 influenza A virus (H1N1) infection, by more than 3-fold (95% confidence interval (CI): 1.9–7.3) and 7-fold (95% CI: 4.00–14.2), respectively. For adult patients, cough and