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Clinical predictors of novel influenza A (H1N1)infection in Korea

 Choon Ok Kim  ;  Chung Mo Nam  ;  Duk-Chul Lee  ;  Sang Hoon Han  ;  Ji Won Lee 
 YONSEI MEDICAL JOURNAL, Vol.51(6) : 895-900, 2010 
Journal Title
Issue Date
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Influenza A Virus, H1N1 Subtype/metabolism* ; Influenza, Human/diagnosis* ; Influenza, Human/epidemiology* ; Influenza, Human/virology ; Male ; Middle Aged ; Pandemics ; Predictive Value of Tests ; Republic of Korea ; Reverse Transcriptase Polymerase Chain Reaction ; Sensitivity and Specificity
Influenza A virus (H1N1 subtype) ; criteria ; diagnosis
PURPOSE: Pandemic influenza A (H1N1) virus has spread rapidly and prompt diagnosis is needed for successful treatment and prevention of transmission. We investigated clinical predictors, validated the use of previous criteria with laboratory tests, and evaluated the clinical criteria for H1N1 infection in the Korean population.

MATERIALS AND METHODS: We analyzed clinical and laboratory evaluation data from outpatient clinics at Severance Hospital in Seoul, Korea between November 11 and December 5, 2009.

RESULTS: This analysis included a total of 828 patients. Of these, 372 (44.9%) patients were confirmed with H1N1 infection by real-time reverse transcriptase-polymerase chain reaction (RT-PCR). The most common and predictive symptom was cough (90.3%, OR 8.87, 95% CI 5.89- 13.38) and about 40% of H1N1-positive patients were afebrile. The best predictive model of H1N1 infection was cough plus fever or myalgia. The sensitivities, specificities, positive predictive values, and negative predictive values of our suggested criteria were 73.9%, 69.5%, 66.4%, and 76.6%, respectively.

CONCLUSION: Cough was the most common independent symptom in patients with laboratory-confirmed H1N1 infection, and while not perfect, the combination of cough plus fever or myalgia is suggested as clinical diagnostic criteria. Health care providers in Korea should suspect a cough without fever to be an early symptom of H1N1 infection.
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6. Others (기타) > Dept. of Clinical Pharmacology (임상시험센터) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Family Medicine (가정의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Preventive Medicine (예방의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Choon Ok(김춘옥) ORCID logo https://orcid.org/0000-0002-2319-1108
Nam, Chung Mo(남정모) ORCID logo https://orcid.org/0000-0003-0985-0928
Lee, Duk Chul(이덕철) ORCID logo https://orcid.org/0000-0001-9166-1813
Lee, Ji Won(이지원) ORCID logo https://orcid.org/0000-0002-2666-4249
Han, Sang Hoon(한상훈) ORCID logo https://orcid.org/0000-0002-4278-5198
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