Rapid influenza antigen test for diagnosis of pandemic (H1N1) 2009

DOI: 10.3201/eid1605.091794
Suggested citation for this article: 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 May; [Epub ahead of print]
Rapid Influenza Antigen Test for Diagnosis of Pandemic (H1N1) 2009
Janice K. Louie, Hugo Guevara, Erica Boston, Melissa Dahlke, Maria Nevarez, Tong Kong, Robert Schechter, Carol A. Glaser, and David P. Schnurr

Author affiliation: California Department of Public Health, Richmond, California, USA
We compared the QuickVue Influenza Test with PCR for diagnosing pandemic (H1N1) 2009 in 404 persons with influenza-like illness. Overall sensitivity, specificity, and positive and negative predictive values were 66%, 84%, 84%, and 64%, respectively. Rapid test results should be interpreted cautiously when pandemic (H1N1) 2009 virus is suspected.

Since its emergence, the pandemic (H1N1) 2009 virus has spread rapidly throughout the world. To diagnose influenza at the point-of-care, many clinicians rely on commercial rapid enzyme immunoassay tests, which are currently unable to differentiate between influenza A virus subtypes (1). Compared with PCR and viral culture, the sensitivity of rapid tests for seasonal influenza varies from 70% to 90% in children and <40% to 60% in adults (2,3). The positive and negative predictive values (PPVs and NPVs) of rapid tests depend on the prevalence of influenza viruses among the population being tested (2,3).

We compare PCR with a rapid influenza test to better characterize the diagnostic utility of the rapid test during the current pandemic. The QuickVue Influenza Test (Quidel Corp., San Diego, CA, USA) detects influenza A and B viruses but does not distinguish between them. Clinicians may use the test in their offices because it is waived from Clinical Laboratory Improvements Amendment requirements based on documentation that test results by persons without formal laboratory training are in concordance with results by trained laboratorians.
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