Symptoms of Influenza Virus Infection in Hospitalized Patients

2008 ◽  
Vol 29 (4) ◽  
pp. 314-319 ◽  
Author(s):  
C. van den Dool ◽  
E. Hak ◽  
J. Wallinga ◽  
A. M. van Loon ◽  
J. W. J. Lammers ◽  
...  
Keyword(s):  
Influenza Virus ◽  
Virus Infection ◽  
Confidence Interval ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
Tertiary Care ◽  
Influenza Virus Infection ◽  
Hospitalized Patients ◽  
Care Hospital ◽  
Influenza Activity

Background.During influenza outbreaks, fever and cough are the most accurate symptoms in predicting influenza virus infection in the community.Objective.To determine the usefulness of fever, cough, and other symptoms for diagnosing influenza virus infection in hospitalized patients.Design.Prospective cohort study.Setting.Three wards (pulmonology, internal medicine and infectious diseases, and geriatrics) of a tertiary care hospital in the Netherlands.Patients.All patients staying in the wards during peak national influenza activity in the 2005-2006 and 2006-2007 influenza seasons.Methods.During peak influenza activity, the presence of fever, cough, and/or other symptoms possibly associated with influenza was monitored for all patients, and nose and throat swab samples were taken twice weekly for virologic analysis.Results.Of 264 patients, 23 (9%) tested positive for influenza virus. The positive predictive value of fever and cough for the diagnosis of influenza virus infection was 23% (95% confidence interval, 0%-62%), and the sensitivity was 35% (95% confidence interval, 11%-58%). The combination of symptoms with the highest positive predictive value (40%) was that of cough, chills, and obstructed nose or coryza. The combination of cough and chills or fever had the highest sensitivity (60%). None of the combinations of symptoms had both a positive predictive value and a sensitivity higher than 40%.Conclusions.Both the sensitivity and the positive predictive value of fever, cough, and/or other symptoms for the diagnosis of influenza virus infection in hospitalized patients are low. The use of these common symptoms for treatment decisions and infection control management will probably be insufficient to contain a nosocomial outbreak, because many influenza cases will remain unidentified.

scholarly journals Evaluation of a New Rapid Antigen Detection Test for the Diagnosis of Influenza Virus Infection in a Tertiary Care Hospital of Southern India

2021 ◽  
Author(s):  
Harika Vangara ◽  
Usha Kalawat ◽  
B Siddhartha Kumar ◽  
Manohar Badur ◽  
Mukkara Madhusudan ◽  
...  
Keyword(s):  
Influenza Virus ◽  
Virus Infection ◽  
Predictive Value ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Influenza Virus Infection ◽  
Family Welfare ◽  
Care Hospital ◽  
Rt Pcr ◽  
Antigen Testing

Introduction: Rapid antigen testing can help in early diagnosis of Influenza in resource limited settings in patients presenting with Influenza Like Illness (ILI). Aim: To evaluate the usefulness of Rapid Influenza Direct antigen Testing (RIDT) in comparison to Real Time Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) for diagnosis of Influenza virus infection in clinically suspected patients with ILI in a tertiary care hospital. Material and Methods: A prospective observational independent study was done to evaluate RIDT for Influenza virus infection, considering RT-PCR as gold standard. Throat swabs and nasal swabs from patients meeting Category 3 definition of ILI by Ministry Of Health and Family Welfare (MOHFW) were collected from July 20th, 2019 to October 20th, 2019 from hospitals in and around the study area. Onsite Rapid test (Biogenix, China) was used as per manufactures instructions for rapid detection of Influenza antigen. RNA extraction was done using Qiagen kit followed by RT-PCR using primer, probes recommended by National Institute of Virology (NIV, Pune) as per their protocols. Data was recorded on a predesigned proforma and managed using Microsoft Excel 2018 (Microsoft Corp, Redmond, WA). The Statistical software MedCalc version 9.1 for Windows was used for data analysis. Results: The overall sensitivity of the RIDT was 37.9% and specificity was 94.4%. The Positive Predictive Value (PPV) and Negative Predictive Value (NPV) were 73.3% and 78.8%, respectively. Kappa was calculated to be 0.37 that suggested a fair agreement between RIDT and RT-PCR. When the Cycle threshold (Ct) values were compared to the results of RIDT, there were more false positives at low Ct value and more false negatives at high Ct values. Conclusion: The RIDT is not useful in screening during an outbreak in acute care settings. The negative result of RIDT should be followed up with RT-PCR. With a strong clinical suspicion, it is better to start antivirals than wait for laboratory report in severely ill patients with ILI.

scholarly journals Performance of case definitions and clinical predictors for influenza surveillance among patients followed in a rural cohort in Senegal

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mamadou Aliou Barry ◽  
Florent Arinal ◽  
Cheikh Talla ◽  
Boris Gildas Hedible ◽  
Fatoumata Diene Sarr ◽  
...  
Keyword(s):  
Influenza Virus ◽  
Virus Infection ◽  
Sore Throat ◽  
Predictive Value ◽  
Influenza Infection ◽  
Clinical Signs ◽  
Influenza Virus Infection ◽  
Nasal Discharge ◽  
Age Group ◽  
Case Definitions

Abstract Background Influenza is a major cause of morbidity and mortality in Africa. However, a lack of epidemiological data remains for this pathology, and the performances of the influenza-like illness (ILI) case definitions used for sentinel surveillance have never been evaluated in Senegal. This study aimed to i) assess the performance of three different ILI case definitions, adopted by the WHO, USA-CDC (CDC) and European-CDC (ECDC) and ii) identify clinical factors associated with a positive diagnosis for Influenza in order to develop an algorithm fitted for the Senegalese context. Methods All 657 patients with a febrile pathological episode (FPE) between January 2013 and December 2016 were followed in a cohort study in two rural villages in Senegal, accounting for 1653 FPE observations with nasopharyngeal sampling and influenza virus screening by rRT-PCR. For each FPE, general characteristics and clinical signs presented by patients were collected. Sensitivity, Specificity, Positive Predictive Value (PPV) and Negative Predictive Value (NPV) for the three ILI case definitions were assessed using PCR result as the reference test. Associations between clinical signs and influenza infection were analyzed using logistic regression with generalized estimating equations. Sore throat, arthralgia or myalgia were missing for children under 5 years. Results WHO, CDC and ECDC case definitions had similar sensitivity (81.0%; 95%CI: 77.0–85.0) and NPV (91.0%; 95%CI: 89.0–93.1) while the WHO and CDC ILI case definitions had the highest specificity (52.0%; 95%CI: 49.1–54.5) and PPV (32.0%; 95%CI: 30.0–35.0). These performances varied by age groups. In children < 5 years, the significant predictors of influenza virus infection were cough and nasal discharge. In patients from 5 years, cough, nasal discharge, sore throat and asthenia grade 3 best predicted influenza infection. The addition of “nasal discharge” as a symptom to the WHO case definition decreased sensitivity but increased specificity, particularly in the pediatric population. Conclusion In summary, all three definitions studies (WHO, ECDC & CDC) have similar performance, even by age group. The revised WHO ILI definition could be chosen for surveillance purposes for its simplicity. Symptomatic predictors of influenza virus infection vary according the age group.

Anti-influenza Activity of Dihydroquercetin Against Lethal Influenza Virus Infection

2010 ◽  
Vol 86 (1) ◽  
pp. A50
Author(s):  
Vladimir Zarubaev ◽  
Angela Garshinina ◽  
Nelly Kalinina ◽  
Vadim Anikin ◽  
Vasily Babkin ◽  
...  
Keyword(s):  
Influenza Virus ◽  
Virus Infection ◽  
Influenza Virus Infection ◽  
Influenza Activity

scholarly journals Is Influenza an Influenza-Like Illness? Clinical Presentation of Influenza in Hospitalized Patients

2006 ◽  
Vol 27 (3) ◽  
pp. 266-270 ◽  
Author(s):  
Hilary M. Babcock ◽  
Liana R. Merz ◽  
Victoria J. Fraser
Keyword(s):  
Influenza Virus ◽  
Virus Infection ◽  
Sore Throat ◽  
Clinical Presentation ◽  
Ventilatory Support ◽  
Influenza Virus Infection ◽  
Hospitalized Patients ◽  
Series Data ◽  
Influenza B ◽  
Influenza Like Illness

Background.Early recognition of influenza virus infection in hospitalized patients can prevent nosocomial transmission.Objective.To determine the clinical presentation of influenza in hospitalized patients.Design.Case series. Data were collected retrospectively from medical records and included demographic information, comorbidities, clinical symptoms and signs, microbiologic test results, and outcomes (including pneumonia and intensive care unit [ICU] admission).Setting.A 1,400-bed teaching hospital.Patients.A total of 207 inpatients who received a diagnosis of influenza virus infection during 3 seasons from 2000 to 2003.Results.Over the course of 3 seasons, 207 patients received a diagnosis of influenza (186 were infected with influenza A virus, and 21 were infected with influenza B virus). The most commonly reported symptoms were cough (186 patients [90%]) and subjective fever (137 patients [66%]); 124 patients (60%) had a documented temperature of 37.8°C or greater before influenza was diagnosed. Sore throat was uncommon (44 patients [21%]). Centers for Disease Control and Prevention (CDC) criteria for influenza-like illness (ILI)–temperature 37.8°C or greater and either cough or sore throat–were met by 107 patients (51%). There were no differences in the proportion of patients who met ILI criteria with respect to age, sex, season, influenza virus type, or time to diagnosis in the hospital. Most patients (150 [72%]) received acetaminophen. Only 41 patients (20%) had positive results of clinical cultures; 178 patients (86%) received antibiotic therapy. Fifty-six patients (27%) had pneumonia: 36 (17%) required admission to the ICU, and 25 (12%) required ventilatory support. Patients with pulmonary disease were more likely to require ventilatory support (12 [26%] vs 13 [8%]; P = .003).Conclusions.Only half of hospitalized patients with influenza met CDC criteria for ILI. These criteria may be more appropriate in outpatient settings. A high index of suspicion is needed to recognize influenza in hospitalized patients.

scholarly journals 920 Hospitalized Patients with H1N1 Influenza Virus Infection During Pregnancy in Two Public Hospital in Porto Alegre, Brazil

2010 ◽  
Vol 68 ◽  
pp. 460-460
Author(s):  
Foresti M Jiménez ◽  
P El Beitune ◽  
Pontremoli M Salcedo ◽  
Veleda A Von Ameln ◽  
Pinto F Mastalir ◽  
...  
Keyword(s):  
Influenza Virus ◽  
Virus Infection ◽  
Public Hospital ◽  
Influenza Virus Infection ◽  
H1n1 Influenza ◽  
Hospitalized Patients ◽  
H1n1 Influenza Virus ◽  
Porto Alegre

Severe lymphopenia in hospitalized patients with influenza virus infection as a marker of a poor outcome

2019 ◽  
Vol 51 (7) ◽  
pp. 543-546 ◽  
Author(s):  
Antonio Lalueza ◽  
Dolores Folgueira ◽  
Carmen Díaz-Pedroche ◽  
Pilar Hernández-Jiménez ◽  
Blanca Ayuso ◽  
...  
Keyword(s):  
Influenza Virus ◽  
Virus Infection ◽  
Influenza Virus Infection ◽  
Hospitalized Patients ◽  
Poor Outcome

Comparison of a Handheld Device vs Endotracheal Tube–Based Neuromonitoring for Recurrent Laryngeal Nerve Stimulation

2021 ◽  
pp. 019459982110137
Author(s):  
Derek Kai Kong ◽  
Amanda M. Kong ◽  
Raymond L. Chai
Keyword(s):  
Positive Predictive Value ◽  
Recurrent Laryngeal Nerve ◽  
Endotracheal Tube ◽  
Predictive Value ◽  
Tertiary Care ◽  
Laryngeal Nerve ◽  
Care Hospital ◽  
Predictive Values ◽  
Handheld Device ◽  
Difficulty Score

Objective To measure the effect of thyroidectomy difficulty on intraoperative neuromonitoring false loss of signal (LOS) and to compare intraoperative endotracheal tube–based neuromonitoring (ETNM) and Checkpoint palpation-based direct stimulation (pDS) signals with postoperative laryngoscopy. We hypothesized that pDS has higher a positive predictive value for postdissection confirmation of recurrent laryngeal nerve function than ETNM and that this difference is accentuated with increasing thyroidectomy difficulty. Study Design Prospective single-arm cross-sectional study comparing ETNM and pDS for patients undergoing hemi-, total, or completion thyroidectomy from July 2018 to March 2020. Setting Single-surgeon series at a tertiary care hospital. Methods Percentage concordance and positive and negative predictive values were measured. Each thyroidectomy was assigned a validated thyroidectomy difficulty score, and recorded recurrent laryngeal nerve signals were compared with postoperative vocal fold mobility. Results Percentage concordance was 90.09%. Positive and negative predictive values were 0.19 (95% CI, 0.09-0.31) and 1.0 for ETNM and 0.59 (95% CI, 0.35-0.82) and 1.0 for pDS. The difference in positive predictive value was significant (0.40 [95% CI, 0.33-0.47], P < .001). False LOS rates for ETNM and pDS were 13.19% versus 3.30% (9.89% [95% CI, 1.80%-18.62%], P = .0155), 44.11% versus 0% (44.11% [95% CI, 25.80%-60.54%], P < .001), and 73.33% versus 13.33% (60% [95% CI, 24.76%-78.46%], P = .001) for the second through fourth thyroidectomy difficulty score quartiles, respectively. False LOS with ETNM was linearly correlated with increasing difficulty ( R2 = 0.97). Conclusion ETNM was subject to high rates of postdissection false LOS that increased with thyroidectomy difficulty score. pDS is a reliable alternative that has higher positive predictive value than ETNM, particularly in more challenging cases such as those with posteriorly fixed thyroid cancers and fibrotic glands. Evidence level 2.

scholarly journals Diagnostic performance of the extended focused assessment with sonography for trauma (EFAST) patients in a tertiary care hospital of Nepal

2020 ◽  
Vol 5 (1) ◽  
pp. e000438
Author(s):  
Samjhana Basnet ◽  
Sanu Krishna Shrestha ◽  
Alok Pradhan ◽  
Roshana Shrestha ◽  
Anmol Purna Shrestha ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Injury Severity ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
University Hospital ◽  
Care Hospital ◽  
Abdominal Injuries ◽  
Contrast Enhanced Ct

BackgroundThoracoabdominal trauma presents a diagnostic challenge for the emergency physician. The introduction of bedside ultrasonography (USG) provides a screening tool to detect hemoperitoneum, hemothorax, pneumothorax and pericardial effusion in torso injuries.AimTo evaluate the accuracy of extended focused assessment with sonography for trauma (EFAST) for chest and abdominal injuries performed by first responders in a tertiary care hospital of Nepal.MethodsThis was a prospective study including all trauma patients who obtained either an Injury Severity Score ≥15 or direct trauma to the trunk in 1 year period in the emergency department (ED) of Dhulikhel Hospital-Kathmandu University Hospital. The results of the EFAST were then compared with contrast-enhanced CT (CECT), radiology ultrasound (USG)/chest X-ray, or intraoperative findings when the EFAST was positive. The negative EFAST cases were observed for a minimum of 4 hours in the ED. Descriptive statistics and sensitivity, specificity, positive predictive value, negative predictive value and accuracy were calculated.ResultsOut of 267 cases, 261 patients underwent an EFAST examination. The sensitivity and specificity were 94.8% and 99.5%, respectively. The negative predictive value was 98.53% whereas the positive predictive value was 98.21%. The overall accuracy was 99.4%.ConclusionThe results of this study suggest that EFAST examination performed by first-line healthcare providers is a useful method for assessment of thoracic and abdominal injuries. EFAST was found to have a high specificity (99.5%) and positive predictive value (98.21%) which indicates that it is an effective technique for detecting intra-abdominal or thoracic injuries. However, the effectiveness of EFAST is limited by its being operator dependent, and thereby human error. For negative EFAST cases, we recommend a monitoring period of at least 4 hours, serial fast scan, or further investigation through other methods such as a CECT.Level of evidenceLevel I

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