Predictors of H1N1 influenza in the emergency department: proposition for a modified H1N1 case definition

Clin Microbiol Infect. 2014 Feb;20(2):O105-8. doi: 10.1111/1469-0691.12352. Epub 2013 Sep 4.

Abstract

Reliable and rapid diagnosis of influenza A H1N1 is essential to initiate appropriate antiviral therapy and preventive measures. We analysed the differences in clinical presentation and laboratory parameters between emergency department patients with PCR-confirmed H1N1 influenza infection (n = 199) and those with PCR-negative influenza-like illness (ILI; n = 252). Cough, wheezing, leucopenia, eosinopenia and a lower C-reactive protein remained significant predictors of H1N1 influenza. Proposed combinations of clinical symptoms with simple laboratory parameters (e.g. reported or measured fever and either cough or leucocytes <8.5 × 10(9) /L) were clearly superior to currently used official ILI case definitions that use clinical criteria alone.

Keywords: Berlin; H1N1; PCR; clinical presentation; influenza A; laboratory values.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Child, Preschool
  • Clinical Laboratory Techniques / methods
  • Clinical Medicine / methods
  • Emergency Medicine / methods*
  • Emergency Service, Hospital*
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Influenza A Virus, H1N1 Subtype / isolation & purification*
  • Influenza, Human / diagnosis*
  • Influenza, Human / pathology
  • Influenza, Human / virology*
  • Male
  • Middle Aged
  • Young Adult