Clinical Predictors for Diagnosing Pandemic (H1N1) 2009 and Seasonal Influenza (H3N2) in Fever Clinics in Beijing,China

作     者：DAI Xiao Qiu LIU Min ZHANG Tuo Hong YANG Xue Song LI Song Lin LI Xiao Guang LI Yu Ling KADEERBAI Hai San WU Huang 

作者机构：Department of Epidemiology and Bio-statistics School of Public Health Peking University Health Science Center Beijing 100191 China Department of Health Policy and Management School of Public Health Peking University Health Science Center Beijing 100191 China Third Hospital Peking University Beijing 100191 China Civil Aviation General Hospital Beijing 100025 China 

出 版 物：《Biomedical and Environmental Sciences》 (生物医学与环境科学（英文版）)

年 卷 期：2012年第25卷第1期

页      面：61-68页

核心收录：

学科分类：090603[农学-临床兽医学] 081702[工学-化学工艺] 08[工学] 0817[工学-化学工程与技术] 09[农学] 0906[农学-兽医学] 

基　　金：supported by Chinese National Programs for High Technology Research and Development (863 Program 2008AA02Z416) 

主　　题：Diagnosis Fever Influenza A, H1N1 H3N2 Signs, Symptoms 

摘      要：Objective Symptomatic predictors of influenza could assess risks and improve decisions about isolation and outpatient treatment. To develop such predictors, we undertook a prospective analysis of pandemic （HIN1） 2009 and seasonal influenza （H3N2） in patients attending fever clinics. Methods From 1 May 2009 to 1 January 2010, all adult patients admitted to fever clinics for suspected influenza, confirmed by real time RT-PCR, were enrolled. Predictors of influenza virus infection were selected with logistic regression models. Measures of sensitivity, specificity, positive and negative likelihood ratios （LRs） were calculated to identify the best predictors. Results The clinical features and routine blood test results of influenza （H1N1） 2009 and seasonal influenza were similar. The positive and negative LRs of current US CDC influenza-like illness （ILl） criteria were modest in predicting influenza infection. Our modified clinic predictors improved the ability of the positive and negative LRs to recognize pandemic （HIN1） 2009 and seasonal influenza. The revised criteria are： fever ~ 38 ~C accompanied by at least one of the following--cough, arthralgia or relative iymphopenia. Conclusion Patients with symptoms and signs that meet the new criteria are likely to have influenza and timely antiviral therapy may be appropriate. In addition, physicians should ascertain if influenza is circulating within the community or if there is a contact history of influenza and combine this information with the newly developed criteria to clinically diagnose influenza.