Korean J Pediatr.  2011 Oct;54(10):405-408. 10.3345/kjp.2011.54.10.405.

Clinical characteristics of 2009 pandemic influenza A (H1N1) infection in children and the performance of rapid antigen test

• Park YJ
• Jin JY
• Yang HJ
• Lee WR
• Lee DH
• Pyun BY
• Suh ES

• KMID: 1447905
• DOI: http://doi.org/10.3345/kjp.2011.54.10.405

Abstract

PURPOSE
In autumn 2009, the swine-origin influenza A (H1N1) virus spread throughout South Korea. The aims of this study were to determine the clinical characteristics of children infected by the 2009 H1N1 influenza A virus, and to compare the rapid antigen and real-time polymerase chain reaction (PCR) tests.
METHODS
We conducted a retrospective review of patients > or =18 years of age who presented to Soonchunhyang University Hospital in Seoul with respiratory symptoms, including fever, between September 2009 and January 2010. A real-time PCR test was used to definitively diagnose 2009 H1N1 influenza A infection. Medical records of confirmed cases were reviewed for sex, age, and the time of infection. The decision to perform rapid antigen testing was not influenced by clinical conditions, but by individual factors such as economic conditions. Its sensitivity and specificity were evaluated compared to real-time PCR test results.
RESULTS
In total, 934 patients tested positive for H1N1 by real-time PCR. The highest number of patients (48.9%) was diagnosed in November. Most patients (48.2%) were aged between 6 and 10 years. Compared with the H1N1 real-time PCR test results, the rapid antigen test showed 22% sensitivity and 83% specificity. Seventy-eight patients were hospitalized for H1N1 influenza A virus infection, and fever was the most common symptom (97.4%).
CONCLUSION
For diagnosis of 2009 H1N1 influenza A virus infection, the rapid antigen test was inferior to the real-time PCR test in both sensitivity and specificity. This outcome suggests that the rapid antigen test is inappropriate for screening.

Keyword

Influenza A virus; H1N1 subtype; Rapid antigen test; Polymerase chain reaction; Child

MeSH Terms

Aged
Child
Fever
Humans
Influenza A virus
Influenza, Human
Mass Screening
Medical Records
Pandemics
Polymerase Chain Reaction
Real-Time Polymerase Chain Reaction
Republic of Korea
Retrospective Studies
Sensitivity and Specificity
Viruses