Symptomatic predictors of influenza virus positivity in children during the influenza season
Symptomatic predictors of influenza virus positivity in children during the influenza season
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DOI：
10.1086/506352
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发表时间：
2006-09-01
影响因子：
11.8
通讯作者：
Monto, Arnold S.
中科院分区：
文献类型：
--
作者：
Ohmit, Suzanne E.;Monto, Arnold S.
背景。当需要快速采取行动治疗时（例如流感或炭疽病例），或者需要隔离患者（例如严重急性呼吸系统综合症（SARS）病例），传染病病因的症状预测因子是必要的。此前已在抗病毒药物扎那米韦的成人研究中评估了流感季节期间流感病毒感染的预测因子；咳嗽和体温 >= 37.8 摄氏度可预测 79% 的评估者呈流感病毒阳性。方法。检查发烧和其他呼吸道症状以确定它们在预测儿童流感病毒阳性状态中的价值。分析的数据来自扎那米韦在 5-12 岁儿童中的临床试验和奥司他韦在 1-12 岁儿童中的试验。结果。在扎那米韦的儿科研究中，与成人扎那米韦研究一样，咳嗽和发烧是流感病毒感染的最佳预测因子；体温 >= 38.2 摄氏度加上咳嗽可预测 83%（95% CI，79%-88%）的疾病被确定为流感病毒阳性。在奥司他韦试验中，咳嗽（阳性预测值，70%；95% CI，64%-75%）而非发烧是 5-12 岁儿童流感病毒阳性状态的最佳预测因子，但咳嗽和发烧都不是 1-4 岁幼儿的成功预测因子。后者的发现似乎是本试验招募的患者症状多样性较少的结果，因此被确定为流感病毒阳性的受试者和流感病毒阴性的受试者具有相似的症状。结论。这些研究的结果表明，在流感季节，流感病毒感染的症状预测因子适用于儿童病例的识别，尽管1-4岁受试者的预测值的确认可能需要进一步研究其他体征/症状。
Background. Symptomatic predictors of the etiology of infectious diseases are necessary when quick action is required in treatment, as with cases of influenza or anthrax, or for when patient isolation is required, as with cases of severe acute respiratory syndrome (SARS). Predictors of influenza virus infection during the influenza season have previously been evaluated in adult studies of the antiviral agent zanamivir; cough and temperature >= 37.8 degrees C predicted influenza virus positivity in 79% of those evaluated.Methods. Fever and other respiratory symptoms were examined to determine their value in predicting influenza virus-positive status in children. Data analyzed were from a clinical trial of zanamivir in children 5-12 years of age and from a trial of oseltamivir in children 1-12 years of age.Results. In the pediatric study of zanamivir, as in the adult zanamivir study, cough and fever were the best predictors of influenza virus infection; a temperature >= 38.2 degrees C plus cough predicted 83% (95% CI, 79%-88%) of illnesses that were determined to be influenza virus positive. Cough (positive predictive value, 70%; 95% CI, 64%-75%), but not fever, was the best predictor of influenza virus-positive status in children aged 5-12 years in the oseltamivir trials, but neither cough nor fever were successful predictors in young children 1-4 years of age. The latter findings appeared to be the result of less symptomatic diversity among patients recruited for this trial, such that subjects who were determined to be influenza virus positive and subjects who were influenza virus negative had similar symptoms.Conclusions. The results of these studies suggest that, during the influenza season, symptomatic predictors of influenza virus infection are applicable to identification of cases in children, although confirmation of predictive values in subjects 1-4 years of age may require further study of additional signs/symptoms.