1887
Surveillance and outbreak report Open Access
Like 0

Abstract

International case definitions recommended by the Centers for Disease Control and Prevention (CDC), the European Centre for Disease Prevention and Control (ECDC), and the World Health Organization (WHO) are commonly used for influenza surveillance. We evaluated clinical factors associated with the laboratory-confirmed diagnosis of influenza and the performance of these influenza case definitions by using a complete dataset of 14,994 patients with acute respiratory infection (ARI) from whom a specimen was collected between August 2009 and April 2014 by the Groupes Régionaux d’Observation de la Grippe (GROG), a French national influenza surveillance network. Cough and fever ≥ 39 °C most accurately predicted an influenza infection in all age groups. Several other symptoms were associated with an increased risk of influenza (headache, weakness, myalgia, coryza) or decreased risk (adenopathy, pharyngitis, shortness of breath, otitis/otalgia, bronchitis/ bronchiolitis), but not throughout all age groups. The WHO case definition for influenza-like illness (ILI) had the highest specificity with 21.4%, while the ECDC ILI case definition had the highest sensitivity with 96.1%. The diagnosis among children younger than 5 years remains challenging. The study compared the performance of clinical influenza definitions based on outpatient surveillance and will contribute to improving the comparability of data shared at international level.

Loading

Article metrics loading...

/content/10.2807/1560-7917.ES.2017.22.14.30504
2017-04-06
2024-11-19
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2017.22.14.30504
Loading
Loading full text...

Full text loading...

/deliver/fulltext/eurosurveillance/22/14/eurosurv-22-30504-5.html?itemId=/content/10.2807/1560-7917.ES.2017.22.14.30504&mimeType=html&fmt=ahah

References

  1. World Health Organization (WHO). WHO global technical consultation: global standards and tools for influenza surveillance 8-10 March 2011. Geneva: WHO; 2011. http://www.who.int/influenza/resources/documents/technical_consultation/en/
  2. Aguilera JF, Paget WJ, Mosnier A, Heijnen ML, Uphoff H, van der Velden J, et al. Heterogeneous case definitions used for the surveillance of influenza in Europe. Eur J Epidemiol. 2003;18(8):751-4.  https://doi.org/10.1023/A:1025337616327  PMID: 12974549 
  3. Kasper MR, Wierzba TF, Sovann L, Blair PJ, Putnam SD. Evaluation of an influenza-like illness case definition in the diagnosis of influenza among patients with acute febrile illness in Cambodia. BMC Infect Dis. 2010;10(1):320.  https://doi.org/10.1186/1471-2334-10-320  PMID: 21054897 
  4. Boivin G, Hardy I, Tellier G, Maziade J. Predicting influenza infections during epidemics with use of a clinical case definition. Clin Infect Dis. 2000;31(5):1166-9.  https://doi.org/10.1086/317425  PMID: 11073747 
  5. Call SA, Vollenweider MA, Hornung CA, Simel DL, McKinney WP. Does this patient have influenza? JAMA. 2005;293(8):987-97.  https://doi.org/10.1001/jama.293.8.987  PMID: 15728170 
  6. Choi SH, Cho SY, Chung JW. Poor performance of a national clinical case definition of influenza infection during an outbreak of 2009 pandemic H1N1. J Infect. 2011;62(4):325-7.  https://doi.org/10.1016/j.jinf.2011.02.011  PMID: 21382415 
  7. Gupta V, Dawood FS, Rai SK, Broor S, Wigh R, Mishra AC, et al. Validity of clinical case definitions for influenza surveillance among hospitalized patients: results from a rural community in North India. Influenza Other Respi Viruses. 2013;7(3):321-9.  https://doi.org/10.1111/j.1750-2659.2012.00401.x  PMID: 22804843 
  8. Yang TU, Cheong HJ, Song JY, Lee JS, Wie SH, Kim YK, et al. Age- and influenza activity-stratified case definitions of influenza-like illness: experience from hospital-based influenza surveillance in South Korea. PLoS One. 2014;9(1):e84873.  https://doi.org/10.1371/journal.pone.0084873  PMID: 24475034 
  9. Monto AS, Gravenstein S, Elliott M, Colopy M, Schweinle J. Clinical signs and symptoms predicting influenza infection. Arch Intern Med. 2000;160(21):3243-7.  https://doi.org/10.1001/archinte.160.21.3243  PMID: 11088084 
  10. Heinonen S, Peltola V, Silvennoinen H, Vahlberg T, Heikkinen T. Signs and symptoms predicting influenza in children: a matched case-control analysis of prospectively collected clinical data. Eur J Clin Microbiol Infect Dis. 2012;31(7):1569-74.  https://doi.org/10.1007/s10096-011-1479-4  PMID: 22080425 
  11. Navarro-Marí JM, Pérez-Ruiz M, Cantudo-Muñoz P, Petit-Gancedo C, Jiménez-Valera M, Rosa-Fraile M, et al. Influenza-like illness criteria were poorly related to laboratory-confirmed influenza in a sentinel surveillance study. J Clin Epidemiol. 2005;58(3):275-9.  https://doi.org/10.1016/j.jclinepi.2004.08.014  PMID: 15768487 
  12. Carrat F, Tachet A, Rouzioux C, Housset B, Valleron AJ. Evaluation of clinical case definitions of influenza: detailed investigation of patients during the 1995-1996 epidemic in France. Clin Infect Dis. 1999;28(2):283-90.  https://doi.org/10.1086/515117  PMID: 10064245 
  13. Levy-Bruhl D, Vaux SInfluenza A(H1N1)v investigation teams. Modified surveillance of influenza A(H1N1)v virus infections in France. Euro Surveill. 2009;14(29):19276. PMID: 19643054 
  14. Hannoun C, Dab W, Cohen JM. A new influenza surveillance system in France: the Ile-de-France "GROG". 1. Principles and methodology. Eur J Epidemiol. 1989;5(3):285-93.  https://doi.org/10.1007/BF00144828  PMID: 2792306 
  15. Duchamp MB, Casalegno JS, Gillet Y, Frobert E, Bernard E, Escuret V, et al. Pandemic A(H1N1)2009 influenza virus detection by real time RT-PCR: is viral quantification useful? Clin Microbiol Infect. 2010;16(4):317-21.  https://doi.org/10.1111/j.1469-0691.2010.03169.x  PMID: 20121827 
  16. Casalegno JS, Frobert E, Escuret V, Bouscambert-Duchamp M, Billaud G, Mekki Y, et al. Beyond the influenza-like illness surveillance: The need for real-time virological data. Euro Surveill. 2011;16(1):19756. PMID: 21223833 
  17. Beaute J, Zucs P, Korsun N, Bragstad K, Enouf V, Kossyvakis A, et al. Age-specific differences in influenza virus type and subtype distribution in the 2012/2013 season in 12 European countries. Epidemiol Infect. 2014;143(14):2950-8. PMID: 25648399 
  18. Mosnier A, Caini S, Daviaud I, Nauleau E, Bui TT, Debost E, et al. Clinical Characteristics Are Similar across Type A and B Influenza Virus Infections. PLoS One. 2015;10(9):e0136186.  https://doi.org/10.1371/journal.pone.0136186  PMID: 26325069 
  19. Falsey AR, Baran A, Walsh EE. Should clinical case definitions of influenza in hospitalized older adults include fever? Influenza Other Respi Viruses. 2015;9(Suppl 1):23-9.  https://doi.org/10.1111/irv.12316  PMID: 26256292 
  20. Mackowiak PA. Concepts of fever. Arch Intern Med. 1998;158(17):1870-81. https://doi.org/10.1001/archinte.158.17.1870  PMID: 9759682 
  21. Thursky K, Cordova SP, Smith D, Kelly H. Working towards a simple case definition for influenza surveillance. J Clin Virol. 2003;27(2):170-9.  https://doi.org/10.1016/S1386-6532(02)00172-5  PMID: 12829039 
  22. Jiang L, Lee VJ, Lim WY, Chen MI, Chen Y, Tan L, et al. Performance of case definitions for influenza surveillance. Euro Surveill. 2015;20(22):21145.  https://doi.org/10.2807/1560-7917.ES2015.20.22.21145  PMID: 26062645 
/content/10.2807/1560-7917.ES.2017.22.14.30504
Loading

Data & Media loading...

Submit comment
Close
Comment moderation successfully completed
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error