ArticleJournal of the Pediatric Infectious Diseases Society2013
Clinical Predictors of Influenza in Young Children: The Limitations of "Influenza-Like Illness".
Article in Journal of the Pediatric Infectious Diseases Society, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pooled it
- Influenza Among Young Children in Bangladesh: Clinical Characteristics and Outcomes From a Randomized Clinical Trial.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2017Trial
- Trends and Non-Clinical Predictors of Respiratory Syncytial Virus (RSV) and Influenza Diagnosis in an Urban Pediatric Population.International journal of pediatric research · 2023Article
- Performance of case definitions and clinical predictors for influenza surveillance among patients followed in a rural cohort in Senegal.BMC infectious diseases · 2021Article
- Estimating the efficacy of symptom-based screening for COVID-19.NPJ digital medicine · 2020Article
- Communicable Disease Outbreaks in Michigan Child Care Centers Compared With State and Regional Epidemics, 2014-2017.American journal of public health · 2019Article
- The impact of influenza infection on young children, their family and the health care system.Influenza and other respiratory viruses · 2019Article
- Evaluating oseltamivir prescriptions in Centers for Medicare and Medicaid Services medical claims records as an indicator of seasonal influenza in the United States.Influenza and other respiratory viruses · 2018Article
- Influenza in Infants Born to Women Vaccinated During Pregnancy.Pediatrics · 2016Article
- MoSAIC: Mobile Surveillance for Acute Respiratory Infections and Influenza-Like Illness in the Community.American journal of epidemiology · 2014Article
Corrections and comments
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Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundInfluenza-like illness (ILI) definitions have been infrequently studied in young children. Despite this, clinical definitions of ILI play an important role in influenza surveillance. This study aims to identify clinical predictors of influenza infection in children ≤5 years old from which age-specific ILI definitions are then constructed.
methodsChildren aged 6-59 months with a history of fever and acute respiratory symptoms were recruited in the Western Australia Influenza Vaccine Effectiveness (WAIVE) Study. Clinical data and per-nasal specimens were obtained from all children. Logistic regression identified significant predictors of influenza infection. Different ILI definitions were compared for diagnostic accuracy.
resultsChildren were recruited from 2 winter influenza seasons (2008-2009; n = 944). Of 919 eligible children, 179 (19.5%) had laboratory-confirmed influenza infection. Predictors of infection included increasing age, lack of influenza vaccination, lower birth weight, fever, cough, and absence of wheeze. An ILI definition comprising fever ≥38°C, cough, and no wheeze had 58% sensitivity (95% confidence interval [CI], 50-66), 60% specificity (95% CI, 56-64), 26% positive predictive value (95% CI, 21-31), and 86% negative predictive value (95% CI, 82-89). The addition of other symptoms or higher fever thresholds to ILI definition had little impact. The Centers for Disease Control and Prevention definition of ILI (presence of fever [≥37.8°C] and cough and/or sore throat) was sensitive (92%; 95% CI, 86-95), yet lacked specificity (10%; 95% CI, 8-13) in this population.
conclusionsInfluenza-like illness is a poor predictor of laboratory-confirmed influenza infection in young children but can be improved using age-specific data. Incorporating age-specific ILI definitions and/or diagnostic testing into influenza surveillance systems will improve the accuracy of epidemiological data.
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