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Acute paediatrics
Effect of a rapid influenza diagnosis
  1. S Esposito1,
  2. P Marchisio1,
  3. P Morelli2,
  4. P Crovari2,
  5. N Principi1
  1. 1Paediatric Department I, University of Milan, Italy
  2. 2Department of Public Health, University of Genoa, Italy
  1. Correspondence to:
    Dr N Principi, Paediatric Department I, University of Milan, Via Commenda 9, 20122 Milan, Italy;
    Nicola.Principi{at}unimi.it

https://doi.org/10.1136/adc.88.6.525

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    Managing children with influenza-like illness is associated with costly and painful interventions because, in order to distinguish viral from bacterial infections, diagnostic tests (including routine blood examinations and chest radiographs) are frequently performed,1,2 and the empirical use of antimicrobial agents is common.3

    Various rapid diagnostic techniques for the detection of influenza viruses have been developed, but few data are available on their impact on child care.2,4,5 The aim of this study was to assess the effect of a rapid diagnosis of influenza infection on the management of children with influenza-like illness in an emergency department.

    METHODS

    All patients seen for influenza-like illness from 6 January to 27 February 2002, at the paediatric emergency department of the University of Milan, Italy, were enrolled and blindly randomly assigned in a 1:1 ratio to undergo a rapid test for the detection of influenza viruses or no rapid test. Influenza-like illness was defined as an axillary temperature of ⩾37.8°C and at least one symptom of acute upper or lower respiratory tract disease.6 The patients who underwent the test had their throats swabbed after vigorously rubbing both tonsillar surfaces and the posterior pharynx; the swab was then immediately submitted to the Quickvue influenza test (Quidel, Milan, Italy) for the rapid detection of influenza A and B viruses. The test, which has an overall sensitivity of 74–95% and an overall specificity of 76–98%,5,7,8 was performed by a postgraduate student in accordance with the manufacturer’s recommendations. The results were available after 10 …

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