Survey of influenza and other respiratory viruses diagnostic testing in US hospitals, 2012-2013

doi:10.1111/irv.12355

. 2016 Mar;10(2):86-90.

doi: 10.1111/irv.12355. Epub 2016 Jan 29.

Survey of influenza and other respiratory viruses diagnostic testing in US hospitals, 2012-2013

Su Su^{1

2}, Alicia M Fry¹, Pam Daily Kirley³, Deborah Aragon⁴, Kimberly Yousey-Hindes⁵, James Meek⁵, Kyle Openo⁶, Oluwakemi Oni⁷, Ruta Sharangpani⁸, Craig Morin⁹, Gary Hollick¹⁰, Krista Lung¹¹, Matt Laidler¹², Mary Lou Lindegren¹³, William Schaffner¹³, Annette Atkinson¹⁴, Sandra S Chaves¹

Affiliations

¹ Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA.
² Atlanta Research and Education Foundation, Atlanta, GA, USA.
³ California Emerging Infections Program, Oakland, CA, USA.
⁴ Colorado Department of Public Health and Environment, Denver, CO, USA.
⁵ Connecticut Emerging Infectious Program, Yale School of Public Health, New Haven, CT, USA.
⁶ Georgia Emerging Infections Program and the Atlanta Research and Education Foundation, Atlanta, GA, USA.
⁷ Iowa Department of Public Health, Des Moines, IA, USA.
⁸ Michigan Department of Health and Human Services, Lansing, MI, USA.
⁹ Minnesota Department of Health, St. Paul, MN, USA.
¹⁰ University of Rochester Center for Community Health, Minneapolis, MN, USA.
¹¹ Ohio Department of Health, Columbus, OH, USA.
¹² Oregon Public Health Division, Portland, OR, USA.
¹³ Vanderbilt University School of Medicine, Nashville, TN, USA.
¹⁴ Utah Department of Health, Salt lake city, UT, USA.

PMID: 26505742
PMCID: PMC4746564
DOI: 10.1111/irv.12355

Survey of influenza and other respiratory viruses diagnostic testing in US hospitals, 2012-2013

Su Su et al. Influenza Other Respir Viruses. 2016 Mar.

. 2016 Mar;10(2):86-90.

doi: 10.1111/irv.12355. Epub 2016 Jan 29.

Authors

Affiliations

¹ Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA.
² Atlanta Research and Education Foundation, Atlanta, GA, USA.
³ California Emerging Infections Program, Oakland, CA, USA.
⁴ Colorado Department of Public Health and Environment, Denver, CO, USA.
⁵ Connecticut Emerging Infectious Program, Yale School of Public Health, New Haven, CT, USA.
⁶ Georgia Emerging Infections Program and the Atlanta Research and Education Foundation, Atlanta, GA, USA.
⁷ Iowa Department of Public Health, Des Moines, IA, USA.
⁸ Michigan Department of Health and Human Services, Lansing, MI, USA.
⁹ Minnesota Department of Health, St. Paul, MN, USA.
¹⁰ University of Rochester Center for Community Health, Minneapolis, MN, USA.
¹¹ Ohio Department of Health, Columbus, OH, USA.
¹² Oregon Public Health Division, Portland, OR, USA.
¹³ Vanderbilt University School of Medicine, Nashville, TN, USA.
¹⁴ Utah Department of Health, Salt lake city, UT, USA.

PMID: 26505742
PMCID: PMC4746564
DOI: 10.1111/irv.12355

Abstract

Background: Little is known about laboratory capacity to routinely diagnose influenza and other respiratory viruses at clinical laboratories and hospitals.

Aims: We sought to assess diagnostic practices for influenza and other respiratory virus in a survey of hospitals and laboratories participating in the US Influenza Hospitalization Surveillance Network in 2012-2013.

Materials and methods: All hospitals and their associated laboratories participating in the Influenza Hospitalization Surveillance Network (FluSurv-NET) were included in this evaluation. The network covers more than 80 counties in 15 states, CA, CO, CT, GA, MD, MN, NM, NY, OR, TN, IA, MI, OH, RI, and UT, with a catchment population of ~28 million people. We administered a standardized questionnaire to key personnel, including infection control practitioners and laboratory departments, at each hospital through telephone interviews.

Results: Of the 240 participating laboratories, 67% relied only on commercially available rapid influenza diagnostic tests to diagnose influenza. Few reported the availability of molecular diagnostic assays for detection of influenza (26%) and other viral pathogens (≤20%) in hospitals and commercial laboratories.

Conclusion: Reliance on insensitive assays to detect influenza may detract from optimal clinical management of influenza infections in hospitals.

Keywords: EIP; FluSurv-NET; influenza; laboratory capacity; respiratory viruses.

Published 2015. This article is a U.S. Government work and is in the public domain in the USA.

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Figures

**Figure 1**
Comparison of types of influenza diagnostic tests performed in clinical laboratories serving hospitals during the 2006–2007 and 2012–2013 influenza season.

**Figure 2**
Description of influenza testing practices in hospital laboratories, 2012–2013. Note: Hospitals with missing data are excluded. Confirmatory testing could be performed at the hospital laboratory or at public health laboratories. Participating hospital laboratories were asked to send influenza A specimens to state public health laboratories for subtyping. Some network sites asked laboratories to send RIDT‐negative specimens to public health laboratories.

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References

1. Silvennoinen H, Peltola V, Lehtinen P, Vainionpaa R, Heikkinen T. Clinical presentation of influenza in unselected children treated as outpatients. Pediatr Infect Dis J 2009; 28:372–375. - PubMed
1. Bender JM, Ampofo K, Gesteland P et al Influenza virus infection in infants less than three months of age. Pediatr Infect Dis J 2010; 29:6–9. - PubMed
1. Bonner AB, Monroe KW, Talley LI, Klasner AE, Kimberlin DW. Impact of the rapid diagnosis of influenza on physician decision‐making and patient management in the pediatric emergency department: results of a randomized, prospective, controlled trial. Pediatrics 2003; 112:363–367. - PubMed
1. Jennings LC, Skopnik H, Burckhardt I, Hribar I, Del Piero L, Deichmann KA. Effect of rapid influenza testing on the clinical management of paediatric influenza. Influenza Other Respir Viruses 2009; 3:91–98. - PMC - PubMed
1. Centers for Disease Control and Prevention . Clinical Description and Lab Diagnosis of Influenza. Available at http://www.cdc.gov/flu/professionals/diagnosis/index.htm (Accessed 25 June 2015).

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[1] Silvennoinen H, Peltola V, Lehtinen P, Vainionpaa R, Heikkinen T. Clinical presentation of influenza in unselected children treated as outpatients. Pediatr Infect Dis J 2009; 28:372–375. - PubMed

[2] Silvennoinen H, Peltola V, Lehtinen P, Vainionpaa R, Heikkinen T. Clinical presentation of influenza in unselected children treated as outpatients. Pediatr Infect Dis J 2009; 28:372–375. - PubMed

[3] Bender JM, Ampofo K, Gesteland P et al Influenza virus infection in infants less than three months of age. Pediatr Infect Dis J 2010; 29:6–9. - PubMed

[4] Bender JM, Ampofo K, Gesteland P et al Influenza virus infection in infants less than three months of age. Pediatr Infect Dis J 2010; 29:6–9. - PubMed

[5] Bonner AB, Monroe KW, Talley LI, Klasner AE, Kimberlin DW. Impact of the rapid diagnosis of influenza on physician decision‐making and patient management in the pediatric emergency department: results of a randomized, prospective, controlled trial. Pediatrics 2003; 112:363–367. - PubMed

[6] Bonner AB, Monroe KW, Talley LI, Klasner AE, Kimberlin DW. Impact of the rapid diagnosis of influenza on physician decision‐making and patient management in the pediatric emergency department: results of a randomized, prospective, controlled trial. Pediatrics 2003; 112:363–367. - PubMed

[7] Jennings LC, Skopnik H, Burckhardt I, Hribar I, Del Piero L, Deichmann KA. Effect of rapid influenza testing on the clinical management of paediatric influenza. Influenza Other Respir Viruses 2009; 3:91–98. - PMC - PubMed

[8] Jennings LC, Skopnik H, Burckhardt I, Hribar I, Del Piero L, Deichmann KA. Effect of rapid influenza testing on the clinical management of paediatric influenza. Influenza Other Respir Viruses 2009; 3:91–98. - PMC - PubMed

[9] Centers for Disease Control and Prevention . Clinical Description and Lab Diagnosis of Influenza. Available at http://www.cdc.gov/flu/professionals/diagnosis/index.htm (Accessed 25 June 2015).

[10] Centers for Disease Control and Prevention . Clinical Description and Lab Diagnosis of Influenza. Available at http://www.cdc.gov/flu/professionals/diagnosis/index.htm (Accessed 25 June 2015).

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Survey of influenza and other respiratory viruses diagnostic testing in US hospitals, 2012-2013

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Survey of influenza and other respiratory viruses diagnostic testing in US hospitals, 2012-2013

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