Diagnostic value of the rapid influenza antigen test for novel influenza A (H1N1)

Department of Family Medicine, College of Medicine, Hanyang University, Seoul, South Korea.
Scandinavian Journal of Infectious Diseases (Impact Factor: 1.64). 01/2011; 43(1):43-6. DOI: 10.3109/00365548.2010.508463
Source: PubMed

ABSTRACT We administered both the rapid antigen test and real-time reverse transcriptase polymerase chain reaction (RT-PCR) test to 2154 patients in order to assess the diagnostic value of the rapid antigen test during Korean pandemics of H1N1 2009. The overall sensitivity was 70.0%, specificity was 97.5%, positive predictive value was 97.4%, and negative predictive value was 71.2%. The sensitivity fell and the negative predictive value decreased as the RT-PCR positive rate increased.

  • [Show abstract] [Hide abstract]
    ABSTRACT: Radioactivation of Zircaloy-4 (Zry-4) and Zirlo cladding hulls after 55 GWD/tU burn-up and 10 years of cooling was simulated using the ORIGEN-S code. The simulation results revealed that 125Sb and 60Co are major contributors of both radioactivity and decay heat in the case of the Zry-4 hulls. For the Zirlo hulls, 93mNb and 125Sb consisted 82.2% of radioactivity while 125Sb and 60Co emitted 77.9% of decay heat. Although the radioactivity between the Zry-4 (1.17 Ci for 1 kg of fresh Zry-4) and Zirlo (1.38 Ci for 1 kg of fresh Zirlo) hulls was not significantly different, decay heat of the activated Zry-4 hulls (8.58 mW) was much larger than 1.62 mW of the activated Zirlo hulls. This gap might have come from the different major constituents of Zry-4 (Zr, Sn, Fe, and Cr) and Zirlo (Zr, Sn, Nb, and Fe) resulting in different radioactive nuclides after radioactivation. Chlorination reaction behavior of the activated Zry-4 and Zirlo hulls was performed using the HSC chemistry code. Constituents of recovered ZrCl4 were investigated via changes of Gibbs free energy and boiling points of resulting chlorides. The calculation results suggested that radioactivity and decay heat might decrease by 49.0 and 81.8%, respectively, in the ZrCl4 recovered from the activated Zry-4 hulls. In the case of Zirlo, it was expected that radioactivity and decay heat might decrease by 11.6 and 13.0%, respectively, after the chlorination reaction. Effect of cooling time on radioactivity and decay heat was also investigated.
    Journal of Radioanalytical and Nuclear Chemistry 06/2011; 292(3). DOI:10.1007/s10967-011-1581-1 · 1.42 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Between 2009 and 2010, the influenza H1N1 pandemic swept across the globe, disproportionately affecting the pediatric population. This pandemic strain is expected to circulate again with other seasonal influenza strains during the 2010-2011 season. This article reviews the new 2010 to 2011 Centers for Disease Control and Prevention and American Academy of Pediatrics recommendations for vaccination against the influenza virus for pediatric patients. It reviews the various testing modalities and the benefits and disadvantage of each test and offers an approach to diagnostic testing. Lastly, it reviews the indications and recommendations for treatment of children with presumed or confirmed influenza infection.
    Pediatric emergency care 08/2011; 27(8):760-9; quiz 770-1. DOI:10.1097/PEC.0b013e31822843f2 · 0.92 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Timely diagnosis of influenza can help clinical management. To examine the accuracy of rapid influenza diagnostic tests (RIDTs) in adults and children with influenza-like illness and evaluate factors associated with higher accuracy. PubMed and EMBASE through December 2011; BIOSIS and Web of Science through March 2010; and citations of articles, guidelines, reviews, and manufacturers. Studies that compared RIDTs with a reference standard of either reverse transcriptase polymerase chain reaction (first choice) or viral culture. Reviewers abstracted study data by using a standardized form and assessed quality by using Quality Assessment of Diagnostic Accuracy Studies criteria. 159 studies evaluated 26 RIDTs, and 35% were conducted during the H1N1 pandemic. Failure to report whether results were assessed in a blinded manner and the basis for patient recruitment were important quality concerns. The pooled sensitivity and specificity were 62.3% (95% CI, 57.9% to 66.6%) and 98.2% (CI, 97.5% to 98.7%), respectively. The positive and negative likelihood ratios were 34.5 (CI, 23.8 to 45.2) and 0.38 (CI, 0.34 to 0.43), respectively. Sensitivity estimates were highly heterogeneous, which was partially explained by lower sensitivity in adults (53.9% [CI, 47.9% to 59.8%]) than in children (66.6% [CI, 61.6% to 71.7%]) and a higher sensitivity for influenza A (64.6% [CI, 59.0% to 70.1%) than for influenza B (52.2% [CI, 45.0% to 59.3%). Incomplete reporting limited the ability to assess the effect of important factors, such as specimen type and duration of influenza symptoms, on diagnostic accuracy. Influenza can be ruled in but not ruled out through the use of RIDTs. Sensitivity varies across populations, but it is higher in children than in adults and for influenza A than for influenza B. Canadian Institutes of Health Research.
    Annals of internal medicine 02/2012; 156(7):500-11. DOI:10.1059/0003-4819-156-7-201204030-00403 · 16.10 Impact Factor
Show more