Pediatr Allergy Respir Dis.  2012 Mar;22(1):21-26.

The Sensitivity according to the Time Gap between Fever Onset and the Performance of Rapid Antigen Test for 2009 H1N1 Influenza

Affiliations
  • 1Department of Pediatrics, Busan St. Mary's Medical Center, Busan, Korea. sbdph1@paran.com

Abstract

PURPOSE
Rapid antigen test (RAT) is used to screen influenza rapidly. The clinical sensitivity of RAT was poor for 2009 H1N1 influenza. The aim of this study was to identify the correlation of time gap (TG) between fever onset and the sensitivity of RAT for 2009 H1N1 influenza.
METHODS
Data were collected retrospectively during the pandemic H1N1 2009 influenza season between October 2009 and February 2010. The RAT was done by using SD Bioline influenza antigen (Standard Diagnostics Inc.) in nasopharyngeal swab. The 2009 H1N1 influenza was confirmed by real-time reverse transcriptase polymerase chain reaction (rRT-PCR). Specimens were categorized according to the TG between fever onset and performance of RAT. They were classified into <24 hours (TG1), 24 to 48 hours (TG2), 48 to 72 hours (TG3), 72 to 96 hours (TG4), 96 to 120 hours (TG5), >120 hours (TG6).
RESULTS
The overall sensitivity of RAT was 69.9%. The TG dependent sensitivity of RAT at TG1, TG2, TG3, TG4, TG5, and TG6 was 64.3%, 73.3%, 61.1%, 88.9%, 83.3%, and 61.1% respectively. The sensitivity of RAT was the highest when the TG was 72 to 96 hours. But this result was not statistically significant.
CONCLUSION
Correlation of TG between fever onset and the sensitivity of RAT for 2009 H1N1 influenza was not statistically significant. But our study suggested that 72 to 96 hours after fever onset is the most sensitive time of RAT. Timely optimal performance of the RAT could have a significant impact on improving results. Further evaluation for better sensitivity would be needed.

Keyword

Rapid antigen test; Sensitivity; Time gap; 2009 H1N1 influenza; rRT-PCR

MeSH Terms

Animals
Fever
Influenza, Human
Pandemics
Rats
Retrospective Studies
Reverse Transcriptase Polymerase Chain Reaction
Seasons

Figure

  • Fig. 1. The time dependent sensitivity of rapid antigen test (RAT). Our result showed that 72 to 96 hours after fever onset was the most sensitive time for RAT, but there was no statistical significance.


Reference

References

1. Novel Swine-Origin Influenza A (H1N1) Virus Investigation Team. Dawood FS, Jain S, Finelli L, Shaw MW, Lindstrom S, et al. Emergence of a novel swine-origin influenza A (H1N1) virus in humans. N Engl J Med. 2009; 360:2605–15.
Article
2. World Health Organization [Internet]. Geneva: World Health Organization;c2012. [cited 2010 May 18]. First confirmed case of influenza A (H1N1) in Republic of Korea. Available from:. http://www.wpro.who.int/internet/templates/M. ED_News_or_Press_Release.aspx?NRMODE=P ublished&NRNODEGUID=%7B25EF48D3-DD8 F-4AE4-B247–11D7EFA2EB0E%7D&NRORIG INALURL=%2Fmedia_centre%2Fnews%2Fne ws_20090503.htm&NRCACHEHINT=Guest.
3. World Health Organization [Internet]. Geneva: World Health Organization;c2012. [cited 2010 May 18]. Republic of Korea raises alert level as Pandemic (H1N1) 2009 spreads. Available from:. http://www.wpro.who.int/media_centre/news/news_20090723.htm.
4. World Health Organization [Internet]. Geneva: World Health Organization;c2012. [cited 2010 May 18]. World now at the start of 2009 influenza pandemic. Available from:. http://www.who.int/mediacentre/news/statements/2009/h1. n1_pandemic_phase6_20090611/en/.
5. Korean Centers for Disease Control and Prevention [Internet]. Cheongwon: Korean Centers for Disease Control and Prevention;c2012. [cited 2010 Apr 7]. Influenza weekly report. Available from:. http://www.cdc.go.kr/kcdchome/jsp/observation/influenza/out/INFLOUT1200. Detail.jsp?menuid=110253&contentid=6286& boardid=null&appid=kcdcinfl&pageNum=1&su b=4&tabinx=1&q_had01=A&q_had02=2009& q_gunCode_tmp=null&q_disCode_tmp=null&q_popupOn=null&q_disguntexts_tmp=&q_discod etexts_tmp=&q_discodetexts_tmp=','HTML','r esizable=no scrollbars=yes.
6. World Health Organization [Internet]. Geneva: World Health Organization;c2012. [cited 2010 Apr 7]. WHO information for laboratory diagnosis of pandemic (H1N1) 2009 virus in humans-revised. Available from:. http://www.who.int/csr/resources/publications/swineflu/WHO_Diagnostic_RecommendationsH1N1_20090521.pdf.
7. Pabbaraju K, Wong S, Wong AA, Appleyard GD, Chui L, Pang XL, et al. Design and validation of real-time reverse transcription-PCR assays for detection of pandemic (H1N1) 2009 virus. J Clin Microbiol. 2009; 47:3454–60.
Article
8. Mai LQ, Hien PT, Hang NL, Oh JS, Ha GW, Kwon JA, et al. Evaluation of two lateral-flow chromatographic membrane immunoassays for rapid detection of influenza virus in limited respiratory specimens. J Lab Med Qual Assur. 2005; 27:243–9.
9. Bang HI, Shin JW, Choi TY, Park R, Shin YJ. Comparison of SD BIOLINE rapid influenza antigen test using two different specimens, Nasopharyngeal swabs and nasopharyngeal aspirates. Korean J Clin Microbiol. 2010; 13:147–50.
Article
10. Hurt AC, Alexander R, Hibbert J, Deed N, Barr IG. Performance of six influenza rapid tests in detecting human influenza in clinical specimens. J Clin Virol. 2007; 39:132–5.
Article
11. van Elden LJ, van Essen GA, Boucher CA, van Loon AM, Nijhuis M, Schipper P, et al. Clinical diagnosis of influenza virus infection: evaluation of diagnostic tools in general practice. Br J Gen Pract. 2001; 51:630–4.
12. Kok J, Blyth CC, Foo H, Patterson J, Taylor J, McPhie K, et al. Comparison of a rapid antigen test with nucleic acid testing during cocirculation of pandemic influenza A/H1N1 2009 and seasonal influenza A/H3N2. J Clin Microbiol. 2010; 48:290–1.
Article
13. Druce J, Tran T, Kelly H, Kaye M, Chibo D, Kostecki R, et al. Laboratory diagnosis and surveillance of human respiratory viruses by PCR in Victoria, Australia, 2002–2003. J Med Virol. 2005; 75:122–9.
Article
14. Blyth CC, Iredell JR, Dwyer DE. Rapid-test sensitivity for novel swine-origin influenza A (H1N1) virus in humans. N Engl J Med. 2009; 361:2493.
Article
15. Cheng CK, Cowling BJ, Chan KH, Fang VJ, Seto WH, Yung R, et al. Factors affecting QuickVue Influenza A+B rapid test performance in the community setting. Diagn Microbiol Infect Dis. 2009; 65:35–41.
16. Drexler JF, Helmer A, Kirberg H, Reber U, Panning M, Müller M, et al. Poor clinical sensitivity of rapid antigen test for influenza A pandemic (H1N1) 2009 virus. Emerg Infect Dis. 2009; 15:1662–4.
Article
17. Louie JK, Guevara H, Boston E, Dahlke M, Nevarez M, Kong T, et al. Rapid influenza antigen test for diagnosis of pandemic (H1N1) 2009. Emerg Infect Dis. 2010; 16:824–6.
Article
18. Sambol AR, Abdalhamid B, Lyden ER, Aden TA, Noel RK, Hinrichs SH. Use of rapid influenza diagnostic tests under field conditions as a screening tool during an outbreak of the 2009 novel influenza virus: practical considerations. J Clin Virol. 2010; 47:229–33.
Article
19. Vasoo S, Stevens J, Singh K. Rapid antigen tests for diagnosis of pandemic (Swine) influenza A/H1N1. Clin Infect Dis. 2009; 49:1090–3.
Article
20. Velasco JM, Montesa-Develos ML, Jarman RG, Lopez MN, Gibbons RV, Valderama MT, et al. Evaluation of QuickVue influenza A+B rapid test for detection of pandemic influenza A/H1N1 2009. J Clin Virol. 2010; 48:120–2.
Article
21. Watcharananan S, Kiertiburanakul S, Chantra-tita W. Rapid influenza diagnostic test during the outbreak of the novel influenza A/H1N1 2009 in Thailand: an experience with better test performance in resource limited setting. J Infect. 2010; 60:86–7.
Article
22. Centers for Disease Control and Prevention (CDC). Evaluation of rapid influenza diagnostic tests for detection of novel influenza A (H1N1) virus-United States, 2009. MMWR Morb Mortal Wkly Rep. 2009; 58:826–9.
23. Ginocchio CC, Zhang F, Manji R, Arora S, Born-freund M, Falk L, et al. Evaluation of multiple test methods for the detection of the novel 2009 influenza A (H1N1) during the New York City outbreak. J Clin Virol. 2009; 45:191–5.
Article
24. Rodriguez WJ, Schwartz RH, Thorne MM. Evaluation of diagnostic tests for influenza in a pediatric practice. Pediatr Infect Dis J. 2002; 21:193–6.
Article
25. Agoritsas K, Mack K, Bonsu BK, Goodman D, Salamon D, Marcon MJ. Evaluation of the Quidel QuickVue test for detection of influenza A and B viruses in the pediatric emergency medicine setting by use of three specimen collection methods. J Clin Microbiol. 2006; 44:2638–41.
Article
26. Biggs C, Walsh P, Overmyer CL, Gonzalez D, Feola M, Mordechai E, et al. Performance of influenza rapid antigen testing in influenza in emergency department patients. Emerg Med J. 2010; 27:5–7.
Article
27. Chan KH, Peiris JS, Lim W, Nicholls JM, Chiu SS. Comparison of nasopharyngeal flocked swabs and aspirates for rapid diagnosis of respiratory viruses in children. J Clin Virol. 2008; 42:65–9.
Article
28. Stevenson HL, Loeffelholz MJ. Poor positive accuracy of QuickVue rapid antigen tests during the influenza A (H1N1) 2009 pandemic. J Clin Microbiol. 2010; 48:3729–31.
Article
29. Choi YJ, Kim HJ, Park JS, Oh MH, Nam HS, Kim YB, et al. Evaluation of new rapid antigen test for detection of pandemic influenza A/H1N1 2009 virus. J Clin Microbiol. 2010; 48:2260–2.
Article
30. Cheng PK, Wong KK, Mak GC, Wong AH, Ng AY, Chow SY, et al. Performance of laboratory diagnostics for the detection of influenza A (H1N1) virus as correlated with the time after symptom onset and viral load. J Clin Virol. 2010; 47:182–5.
31. Lee CS, Lee JH, Kim CH. Time-dependent sensitivity of a rapid antigen test in patients with 2009 H1N1 influenza. J Clin Microbiol. 2011; 49:1702.
Article
Full Text Links
  • PARD
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr