Yonsei Med J.  2011 Jul;52(4):680-682. 10.3349/ymj.2011.52.4.680.

Evaluation of Direct Immunofluorescence Test with PCR for Detection of Novel Influenza A (H1N1) Virus during 2009 Pandemic

• Lee JH
• Shin SR
• Cho JH

• KMID: 1728003
• DOI: http://doi.org/10.3349/ymj.2011.52.4.680

Abstract

During the 2009 novel influenza (H1N1) pandemic, the sensitivity of direct immunofluorescence assay (DFA) for H1N1 infection was 62% (266/429) of that of the polymerase chain reaction (PCR) test. The sensitivity of the DFA differed significantly with the age of patients: the sensitivity was the highest (71.8%) for patients aged <10 years and the lowest for patients aged > or =30 years. The sensitivity of DFA in patients aged > or =30 years was 40.7%. Furthermore, the sensitivity (67.3%, 171/254) of DFA was higher for patients who had a high temperature at admission. An increase in the incidence of H1N1 infection did not influence the sensitivity of DFA (62.1% vs. 62%; p=0.984) test, but resulted in a decrease in the negative predictive value, from 92.4% (700/757) to 69.6% (247/355). PCR may be useful as the initial test for diagnosing H1N1 infection in patients aged > or =30 years with a normal temperature at presentation.

Keyword

Influenza A (H1N1); direct immunofluorescence assay

MeSH Terms

Adolescent
Adult
Age Factors
Body Temperature
Child
Fever/virology
*Fluorescent Antibody Technique, Direct
Humans
Influenza A Virus, H1N1 Subtype/genetics/*isolation & purification
Influenza, Human/epidemiology/*virology
Pandemics
*Polymerase Chain Reaction
Sensitivity and Specificity

Reference

1. Vasoo S, Stevens J, Singh K. Rapid antigen tests for diagnosis of pandemic (Swine) influenza A/H1N1. Clin Infect Dis. 2009. 49:1090–1093.

2. Steininger C, Redlberger M, Graninger W, Kundi M, Popow-Kraupp T. Near-patient assays for diagnosis of influenza virus infection in adult patients. Clin Microbiol Infect. 2009. 15:267–273.

3. Habib-Bein NF, Beckwith WH 3rd, Mayo D, Landry ML. Comparison of SmartCycler real-time reverse transcription-PCR assay in a public health laboratory with direct immunofluorescence and cell culture assays in a medical center for detection of influenza A virus. J Clin Microbiol. 2003. 41:3597–3601.

4. Pollock NR, Duong S, Cheng A, Han LL, Smole S, Kirby JE. Ruling out novel H1N1 influenza virus infection with direct fluorescent antigen testing. Clin Infect Dis. 2009. 49:e66–e68.

5. Abu-Diab A, Azzeh M, Ghneim R, Ghneim R, Zoughbi M, Turkuman S, et al. Comparison between pernasal flocked swabs and nasopharyngeal aspirates for detection of common respiratory viruses in samples from children. J Clin Microbiol. 2008. 46:2414–2417.

6. Lee N, Chan PK, Hui DS, Rainer TH, Wong E, Choi KW, et al. Viral loads and duration of viral shedding in adult patients hospitalized with influenza. J Infect Dis. 2009. 200:492–500.