Skip to main content
Top
Published in: BMC Infectious Diseases 1/2010

Open Access 01-12-2010 | Research article

Evaluation of an influenza-like illness case definition in the diagnosis of influenza among patients with acute febrile illness in cambodia

Authors: Matthew R Kasper, Thomas F Wierzba, Ly Sovann, Patrick J Blair, Shannon D Putnam

Published in: BMC Infectious Diseases | Issue 1/2010

Login to get access

Abstract

Background

Influenza-like illness (ILI) is often defined as fever (>38.0°C) with cough or sore throat. In this study, we tested the sensitivity, specificity, and positive and negative predictive values of this case definition in a Cambodia patient population.

Methods

Passive clinic-based surveillance was established at nine healthcare centers to identify the causes of acute undifferentiated fever in patients aged two years and older seeking treatment. Fever was defined as tympanic membrane temperature >38°C lasting more than 24 hours and less than 10 days. Influenza virus infections were identified by polymerase chain reaction.

Results

From July 2008 to December 2008, 2,639 patients were enrolled. From 884 (33%) patients positive for influenza, 652 presented with ILI and 232 acute fever patients presented without ILI. Analysis by age group identified no significant differences between influenza positive patients from the two groups. Positive predictive values (PPVs) varied during the course of the influenza season and among age groups.

Conclusion

The ILI case definition can be used to identify a significant percentage of patients with influenza infection during the influenza season in Cambodia, assisting healthcare providers in its diagnosis and treatment. However, testing samples based on the criteria of fever alone increased our case detection by 34%.
Appendix
Available only for authorised users
Literature
1.
go back to reference Russell CA, Jones TC, Barr IG, Cox NJ, Garten RJ, Gregory V, Gust ID, Hampson AW, Hay AJ, Hurt AC, et al: The global circulation of seasonal influenza A (H3N2) viruses. Science. 2008, New York, NY, 320 (5874): 340-346. 10.1126/science.1154137. Russell CA, Jones TC, Barr IG, Cox NJ, Garten RJ, Gregory V, Gust ID, Hampson AW, Hay AJ, Hurt AC, et al: The global circulation of seasonal influenza A (H3N2) viruses. Science. 2008, New York, NY, 320 (5874): 340-346. 10.1126/science.1154137.
2.
go back to reference Nicholson KG, Wood JM, Zambon M: Influenza. Lancet. 2003, 362 (9397): 1733-1745. 10.1016/S0140-6736(03)14854-4.CrossRefPubMed Nicholson KG, Wood JM, Zambon M: Influenza. Lancet. 2003, 362 (9397): 1733-1745. 10.1016/S0140-6736(03)14854-4.CrossRefPubMed
3.
4.
go back to reference Dawood FS, Jain S, Finelli L, Shaw MW, Lindstrom S, Garten RJ, Gubareva LV, Xu X, Bridges CB, Uyeki TM: Emergence of a novel swine-origin influenza A (H1N1) virus in humans. The New England journal of medicine. 2009, 360 (25): 2605-2615. 10.1056/NEJMoa0903810.CrossRefPubMed Dawood FS, Jain S, Finelli L, Shaw MW, Lindstrom S, Garten RJ, Gubareva LV, Xu X, Bridges CB, Uyeki TM: Emergence of a novel swine-origin influenza A (H1N1) virus in humans. The New England journal of medicine. 2009, 360 (25): 2605-2615. 10.1056/NEJMoa0903810.CrossRefPubMed
5.
go back to reference Dilantika C, Sedyaningsih ER, Kasper MR, Agtini M, Listiyaningish E, Uyeki TM, Burgess TH, Blair PJ, Putnam SD: Influenza virus infection among pediatric patients reporting diarrhea and influenza-like illness. BMC infectious diseases. 10 (1): 3-10.1186/1471-2334-10-3. Dilantika C, Sedyaningsih ER, Kasper MR, Agtini M, Listiyaningish E, Uyeki TM, Burgess TH, Blair PJ, Putnam SD: Influenza virus infection among pediatric patients reporting diarrhea and influenza-like illness. BMC infectious diseases. 10 (1): 3-10.1186/1471-2334-10-3.
6.
go back to reference Foy HM, Cooney MK, Allan ID, Albrecht JK: Influenza B in households: virus shedding without symptoms or antibody response. American journal of epidemiology. 1987, 126 (3): 506-515.PubMed Foy HM, Cooney MK, Allan ID, Albrecht JK: Influenza B in households: virus shedding without symptoms or antibody response. American journal of epidemiology. 1987, 126 (3): 506-515.PubMed
7.
go back to reference Hayden FG, Fritz R, Lobo MC, Alvord W, Strober W, Straus SE: Local and systemic cytokine responses during experimental human influenza A virus infection. Relation to symptom formation and host defense. The Journal of clinical investigation. 1998, 101 (3): 643-649. 10.1172/JCI1355.CrossRefPubMedPubMedCentral Hayden FG, Fritz R, Lobo MC, Alvord W, Strober W, Straus SE: Local and systemic cytokine responses during experimental human influenza A virus infection. Relation to symptom formation and host defense. The Journal of clinical investigation. 1998, 101 (3): 643-649. 10.1172/JCI1355.CrossRefPubMedPubMedCentral
8.
go back to reference Stelzer-Braid S, Oliver BG, Blazey AJ, Argent E, Newsome TP, Rawlinson WD, Tovey ER: Exhalation of respiratory viruses by breathing, coughing, and talking. Journal of medical virology. 2009, 81 (9): 1674-1679. 10.1002/jmv.21556.CrossRefPubMed Stelzer-Braid S, Oliver BG, Blazey AJ, Argent E, Newsome TP, Rawlinson WD, Tovey ER: Exhalation of respiratory viruses by breathing, coughing, and talking. Journal of medical virology. 2009, 81 (9): 1674-1679. 10.1002/jmv.21556.CrossRefPubMed
9.
go back to reference Cate TR: Clinical manifestations and consequences of influenza. The American journal of medicine. 1987, 82 (6A): 15-19. 10.1016/0002-9343(87)90555-9.CrossRefPubMed Cate TR: Clinical manifestations and consequences of influenza. The American journal of medicine. 1987, 82 (6A): 15-19. 10.1016/0002-9343(87)90555-9.CrossRefPubMed
10.
go back to reference Call SA, Vollenweider MA, Hornung CA, Simel DL, McKinney WP: Does this patient have influenza?. JAMA. 2005, 293 (8): 987-997. 10.1001/jama.293.8.987.CrossRefPubMed Call SA, Vollenweider MA, Hornung CA, Simel DL, McKinney WP: Does this patient have influenza?. JAMA. 2005, 293 (8): 987-997. 10.1001/jama.293.8.987.CrossRefPubMed
11.
go back to reference 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): 1166-1169. 10.1086/317425.CrossRefPubMed 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): 1166-1169. 10.1086/317425.CrossRefPubMed
12.
go back to reference Navarro-Mari JM, Perez-Ruiz M, Cantudo-Munoz P, Petit-Gancedo C, Jimenez-Valera M, Rosa-Fraile M: Influenza-like illness criteria were poorly related to laboratory-confirmed influenza in a sentinel surveillance study. Journal of clinical epidemiology. 2005, 58 (3): 275-279. 10.1016/j.jclinepi.2004.08.014.CrossRefPubMed Navarro-Mari JM, Perez-Ruiz M, Cantudo-Munoz P, Petit-Gancedo C, Jimenez-Valera M, Rosa-Fraile M: Influenza-like illness criteria were poorly related to laboratory-confirmed influenza in a sentinel surveillance study. Journal of clinical epidemiology. 2005, 58 (3): 275-279. 10.1016/j.jclinepi.2004.08.014.CrossRefPubMed
13.
go back to reference Nicholson KG: Clinical features of influenza. Seminars in respiratory infections. 1992, 7 (1): 26-37.PubMed Nicholson KG: Clinical features of influenza. Seminars in respiratory infections. 1992, 7 (1): 26-37.PubMed
14.
go back to reference Monto AS, Gravenstein S, Elliott M, Colopy M, Schweinle J: Clinical signs and symptoms predicting influenza infection. Arch Intern Med. 2000, 160 (21): 3243-3247. 10.1001/archinte.160.21.3243.CrossRefPubMed Monto AS, Gravenstein S, Elliott M, Colopy M, Schweinle J: Clinical signs and symptoms predicting influenza infection. Arch Intern Med. 2000, 160 (21): 3243-3247. 10.1001/archinte.160.21.3243.CrossRefPubMed
15.
go back to reference Ohmit SE, Monto AS: Symptomatic predictors of influenza virus positivity in children during the influenza season. Clin Infect Dis. 2006, 43 (5): 564-568. 10.1086/506352.CrossRefPubMed Ohmit SE, Monto AS: Symptomatic predictors of influenza virus positivity in children during the influenza season. Clin Infect Dis. 2006, 43 (5): 564-568. 10.1086/506352.CrossRefPubMed
16.
go back to reference Babcock HM, Merz LR, Dubberke ER, Fraser VJ: Case-control study of clinical features of influenza in hospitalized patients. Infect Control Hosp Epidemiol. 2008, 29 (10): 921-926. 10.1086/590663.CrossRefPubMed Babcock HM, Merz LR, Dubberke ER, Fraser VJ: Case-control study of clinical features of influenza in hospitalized patients. Infect Control Hosp Epidemiol. 2008, 29 (10): 921-926. 10.1086/590663.CrossRefPubMed
17.
go back to reference Babcock HM, Merz LR, Fraser VJ: Is influenza an influenza-like illness? Clinical presentation of influenza in hospitalized patients. Infect Control Hosp Epidemiol. 2006, 27 (3): 266-270. 10.1086/501539.CrossRefPubMed Babcock HM, Merz LR, Fraser VJ: Is influenza an influenza-like illness? Clinical presentation of influenza in hospitalized patients. Infect Control Hosp Epidemiol. 2006, 27 (3): 266-270. 10.1086/501539.CrossRefPubMed
18.
go back to reference Thursky K, Cordova SP, Smith D, Kelly H: Working towards a simple case definition for influenza surveillance. J Clin Virol. 2003, 27 (2): 170-179. 10.1016/S1386-6532(02)00172-5.CrossRefPubMed Thursky K, Cordova SP, Smith D, Kelly H: Working towards a simple case definition for influenza surveillance. J Clin Virol. 2003, 27 (2): 170-179. 10.1016/S1386-6532(02)00172-5.CrossRefPubMed
19.
go back to reference Blair PJ, Wierzba TF, Touch S, Vonthanak S, Xu X, Garten RJ, Okomo-Adhiambo MA, Klimov AI, Kasper MR, Putnam SD: Influenza epidemiology and characterization of influenza viruses in patients seeking treatment for acute fever in Cambodia. Epidemiology and infection. 2009, 1-11. Blair PJ, Wierzba TF, Touch S, Vonthanak S, Xu X, Garten RJ, Okomo-Adhiambo MA, Klimov AI, Kasper MR, Putnam SD: Influenza epidemiology and characterization of influenza viruses in patients seeking treatment for acute fever in Cambodia. Epidemiology and infection. 2009, 1-11.
20.
go back to reference Proff R, Gershman K, Lezotte D, Nyquist AC: Case-based surveillance of influenza hospitalizations during 2004-2008, Colorado, USA. Emerging infectious diseases. 2009, 15 (6): 892-898. 10.3201/eid1506.081645.CrossRefPubMedPubMedCentral Proff R, Gershman K, Lezotte D, Nyquist AC: Case-based surveillance of influenza hospitalizations during 2004-2008, Colorado, USA. Emerging infectious diseases. 2009, 15 (6): 892-898. 10.3201/eid1506.081645.CrossRefPubMedPubMedCentral
21.
go back to reference Thompson WW, Shay DK, Weintraub E, Brammer L, Bridges CB, Cox NJ, Fukuda K: Influenza-associated hospitalizations in the United States. Jama. 2004, 292 (11): 1333-1340. 10.1001/jama.292.11.1333.CrossRefPubMed Thompson WW, Shay DK, Weintraub E, Brammer L, Bridges CB, Cox NJ, Fukuda K: Influenza-associated hospitalizations in the United States. Jama. 2004, 292 (11): 1333-1340. 10.1001/jama.292.11.1333.CrossRefPubMed
22.
go back to reference Abdullah Brooks W, Erdman D, Terebuh P, Klimov A, Goswami D, Sharmeen AT, Azim T, Luby S, Bridges C, Breiman R: Human metapneumovirus infection among children, Bangladesh. Emerging infectious diseases. 2007, 13 (10): 1611-1613.CrossRefPubMedPubMedCentral Abdullah Brooks W, Erdman D, Terebuh P, Klimov A, Goswami D, Sharmeen AT, Azim T, Luby S, Bridges C, Breiman R: Human metapneumovirus infection among children, Bangladesh. Emerging infectious diseases. 2007, 13 (10): 1611-1613.CrossRefPubMedPubMedCentral
23.
go back to reference Broor S, Parveen S, Bharaj P, Prasad VS, Srinivasulu KN, Sumanth KM, Kapoor SK, Fowler K, Sullender WM: A prospective three-year cohort study of the epidemiology and virology of acute respiratory infections of children in rural India. PLoS One. 2007, 2 (6): e491-10.1371/journal.pone.0000491.CrossRefPubMedPubMedCentral Broor S, Parveen S, Bharaj P, Prasad VS, Srinivasulu KN, Sumanth KM, Kapoor SK, Fowler K, Sullender WM: A prospective three-year cohort study of the epidemiology and virology of acute respiratory infections of children in rural India. PLoS One. 2007, 2 (6): e491-10.1371/journal.pone.0000491.CrossRefPubMedPubMedCentral
Metadata
Title
Evaluation of an influenza-like illness case definition in the diagnosis of influenza among patients with acute febrile illness in cambodia
Authors
Matthew R Kasper
Thomas F Wierzba
Ly Sovann
Patrick J Blair
Shannon D Putnam
Publication date
01-12-2010
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2010
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/1471-2334-10-320

Other articles of this Issue 1/2010

BMC Infectious Diseases 1/2010 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.