Campe H, Heinzinger S, Hartberger C, Sing A
Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit,Oberschleißheim,Germany.
Epidemiol Infect. 2016 Apr;144(5):1045-51. doi: 10.1017/S0950268815002228. Epub 2015 Sep 21.
For influenza surveillance and diagnosis typical clinical symptoms are traditionally used to discriminate influenza virus infections from infections by other pathogens. During the 2013 influenza season we performed a multiplex assay for 16 different viruses in 665 swabs from patients with acute respiratory infections (ARIs) to display the variety of different pathogens causing ARI and to test the diagnostic value of both the commonly used case definitions [ARI, and influenza like illness (ILI)] as well as the clinical judgement of physicians, respectively, to achieve a laboratory-confirmed influenza diagnosis. Fourteen different viruses were identified as causing ARI/ILI. Influenza diagnosis based on clinical signs overestimated the number of laboratory-confirmed influenza cases and misclassified cases. Furthermore, ILI case definition and physicians agreed in only 287/651 (44%) cases with laboratory confirmation. Influenza case management has to be supported by laboratory confirmation to allow evidence-based decisions. Epidemiological syndromic surveillance data should be supported by laboratory confirmation for reasonable interpretation.
在流感监测和诊断中，传统上使用典型的临床症状来区分流感病毒感染与其他病原体感染。在2013年流感季节，我们对665例急性呼吸道感染（ARI）患者的拭子进行了16种不同病毒的多重检测，以展示导致ARI的不同病原体种类，并分别测试常用病例定义[ARI和流感样疾病（ILI）]以及医生的临床判断对实现实验室确诊流感诊断的诊断价值。共鉴定出14种不同病毒可导致ARI/ILI。基于临床症状的流感诊断高估了实验室确诊的流感病例数并对病例进行了错误分类。此外，ILI病例定义与医生的判断仅在287/651（44%）的实验室确诊病例中达成一致。流感病例管理必须得到实验室确诊的支持，以便做出基于证据的决策。流行病学综合征监测数据应得到实验室确诊的支持，以便进行合理的解释。
