We have found that the rapid test for influenza is only 70% sensitive for detecting H1N1 when compared to PCR. Therefore we have stopped using the rapid test.
(sent from mobile phone)
Division Chief, Emergency Medicine
Children's National Medical Center
From: "SANTIAGO MINTEGUI RASO" <[log in to unmask]>
Date: Tue Aug 11, 2009 9:12
To: "[log in to unmask]" <[log in to unmask]>
We are attending some patients with novel H1N1 influenza in Bilbao (Basque Country, Spain). Fortunately, number of cases is decreasing, probably because we are on holidays and it is very common here to go to certain sunny places to spend the holidays. In this way, a large amount of population has gone out and we have no overcrowding in the ED. However, an increase is expected next month, when people come back and children return to school. However I should want to comment the following. We can read that the risk for severe complications from seasonal influenza among children younger than 5 years old is highest among children younger than 2 years old. We have introduced the rapid influenza test (RIT) for the management of young children with fever without source during last years and our experience is quite good. In our experience, around 30% of young children with FWS will have influenza, whereas the rate of incidence of influenza remains above 100 per 100,00
inhabitants. In this way, children under 2 years (including those less than three months) with FWS, well appearing and positive RIT may have a different approachment in the ED. In the last 6 years we have not detected any serious complication due to seasonal influenza, although we have not undergone any specific study analyzing this. This year, it is possible to have seasonal influenza and novel H1N1 influenza during the same period of time, and I should want to clarify, if possible, some doubts: 1. - will you maintain RIT in the management of young children with FWS? 2. - will you consider testing for novel H1N1 influenza young children with FWS? If positive and child appears well, will you prescribe oseltamivir or admit the child? 3. - will you consider testing for novel H1N1 influenza infants less than 3 months with FWS? 4. - will you administer oseltamivir to children under 2 years (20 months i.e.) with a febrile upper respiratory tract infection who ap
ear well? Best regards Santi Mintegi Pediatric Emergency Department Cruces Hospital. Bilbao. Basque Country Antes de imprimir este correo, piense en su responsabilidad y compromiso con el MEDIO AMBIENTE Inprimatu baino lehen, zure INGURUMENAREKIKO konpromezu eta erantzukizunaz pentsatu For more information, send mail to [log in to unmask] with the message: info PED-EM-L The URL for the PED-EM-L Web Page is: http://listserv.brown.edu/ped-em-l.html
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