Does knowing the influenza epidemic threshold has been reached influence the performance of influenza case definitions?
Soldevila, Núria (Universitat de Barcelona)
Toledo, Diana (Universitat de Barcelona)
Martínez, Ana (Agència de Salut Pública de Catalunya)
Godoy, Pere (Agència de Salut Pública de Catalunya)
Torner, Núria (Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública)
Rius i Gibert, Maria Cristina (Institut d'Investigació Biomèdica Sant Pau)
Jané i Checa, Mireia (Agència de Salut Pública de Catalunya)
Domínguez, Angela (Universitat de Barcelona)
Universitat Autònoma de Barcelona

Data:	2022
Resum:	Disease surveillance using adequate case definitions is very important. The objective of the study was to compare the performance of influenza case definitions and influenza symptoms in the first two epidemic weeks with respect to other epidemic weeks. We analysed cases of acute respiratory infection detected by the network of sentinel primary care physicians of Catalonia for 10 seasons. We calculated the diagnostic odds ratio (DOR) and 95% confidence intervals (CI) for the first two epidemic weeks and for other epidemic weeks. A total of 4,338 samples were collected in the epidemic weeks, of which 2,446 (56. 4%) were positive for influenza. The most predictive case definition for laboratory-confirmed influenza was the WHO case definition for influenza-like illness (ILI) in the first two epidemic weeks (DOR 2. 10; 95% CI 1. 57-2. 81) and in other epidemic weeks (DOR 2. 31; 95% CI 1. 96- 2. 72). The most predictive symptom was fever. After knowing that epidemic threshold had been reached, the DOR of the ILI WHO case definition in children aged <5 years and cough and fever in this group increased (190%, 170% and 213%, respectively). During influenza epidemics, differences in the performance of the case definition and the discriminative ability of symptoms were found according to whether it was known that the epidemic threshold had been reached or not. This suggests that sentinel physicians are stricter in selecting samples to send to the laboratory from patients who present symptoms more specific to influenza after rather than before an influenza epidemic has been declared.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Publicat a:	PloS one, Vol. 17 Núm. 7 July (july 2022) , p. e0270740, ISSN 1932-6203

DOI: 10.1371/journal.pone.0270740
PMID: 35776716

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