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J Clin Microbiol. 1994 January; 32(1): 70–74.
PMCID: PMC262972

Comparison of rapid detection methods for influenza A virus and their value in health-care management of institutionalized geriatric patients.


Respiratory specimens from 160 geriatric patients with suspected influenza illness were used to evaluate the abilities of two enzyme immunoassays (EIAs; Directigen FLU-A [Becton Dickinson Microbiology Systems, Cockeysville, Md.] and Prima EIA [Baxter/Bartels Diagnostics, Inc., Issaquah, Wash.]) and direct immunofluorescence testing (immunofluorescence assay [IFA]) to identify influenza A virus. In comparison with culture isolation, the sensitivities and specificities of the IFA, Directigen FLU-A, and Prima EIA were 92.5 and 97.2%, 86.8 and 99.1%, and 92.5 and 98.1%, respectively. In contrast to EIA, IFA was labor intensive and required a high degree of technical expertise, and the results of IFA were difficult to interpret. These factors may preclude the use of IFA for testing large numbers of specimens. A retrospective epidemiologic survey of influenza infection was done in six geriatric institutions which had used either rapid and culture testing or culture alone. Preventable cases of influenza A virus infection ranged from 9 to 38% of all cases in facilities which used culture testing only and which had not instituted amantadine prophylaxis. The use of direct specimen testing is recommended as an adjunct to culture isolation for the identification of influenza A virus. Use of a combination of these methods permits the timely administration of appropriate antiviral therapy and infection control measures, while it also permits the antigenic surveillance of circulating influenza strains, which is necessary for present vaccine efficacy evaluations and the creation of future effective vaccine formulations.

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Selected References

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  • Arden NH, Patriarca PA, Fasano MB, Lui KJ, Harmon MW, Kendal AP, Rimland D. The roles of vaccination and amantadine prophylaxis in controlling an outbreak of influenza A (H3N2) in a nursing home. Arch Intern Med. 1988 Apr;148(4):865–868. [PubMed]
  • Chomel JJ, Pardon D, Thouvenot D, Allard JP, Aymard M. Comparison between three rapid methods for direct diagnosis of influenza and the conventional isolation procedure. Biologicals. 1991 Oct;19(4):287–292. [PubMed]
  • Falsey AR, Treanor JJ, Betts RF, Walsh EE. Viral respiratory infections in the institutionalized elderly: clinical and epidemiologic findings. J Am Geriatr Soc. 1992 Feb;40(2):115–119. [PubMed]
  • Grandien M, Pettersson CA, Gardner PS, Linde A, Stanton A. Rapid viral diagnosis of acute respiratory infections: comparison of enzyme-linked immunosorbent assay and the immunofluorescence technique for detection of viral antigens in nasopharyngeal secretions. J Clin Microbiol. 1985 Nov;22(5):757–760. [PMC free article] [PubMed]
  • Johnston SL, Bloy H. Evaluation of a rapid enzyme immunoassay for detection of influenza A virus. J Clin Microbiol. 1993 Jan;31(1):142–143. [PMC free article] [PubMed]
  • Lui KJ, Kendal AP. Impact of influenza epidemics on mortality in the United States from October 1972 to May 1985. Am J Public Health. 1987 Jun;77(6):712–716. [PubMed]
  • Matthey S, Nicholson D, Ruhs S, Alden B, Knock M, Schultz K, Schmuecker A. Rapid detection of respiratory viruses by shell vial culture and direct staining by using pooled and individual monoclonal antibodies. J Clin Microbiol. 1992 Mar;30(3):540–544. [PMC free article] [PubMed]
  • McClure CL. Common infections in the elderly. Am Fam Physician. 1992 Jun;45(6):2691–2698. [PubMed]
  • Sorvillo FJ, Huie SF, Strassburg MA, Butsumyo A, Shandera WX, Fannin SL. An outbreak of respiratory syncytial virus pneumonia in a nursing home for the elderly. J Infect. 1984 Nov;9(3):252–256. [PubMed]
  • Spada B, Biehler K, Chegas P, Kaye J, Riepenhoff-Talty M. Comparison of rapid immunofluorescence assay to cell culture isolation for the detection of influenza A and B viruses in nasopharyngeal secretions from infants and children. J Virol Methods. 1991 Aug;33(3):305–310. [PubMed]
  • Waner JL, Todd SJ, Shalaby H, Murphy P, Wall LV. Comparison of Directigen FLU-A with viral isolation and direct immunofluorescence for the rapid detection and identification of influenza A virus. J Clin Microbiol. 1991 Mar;29(3):479–482. [PMC free article] [PubMed]
  • Weingarten S, Riedinger M, Bolton LB, Miles P, Ault M. Barriers to influenza vaccine acceptance. A survey of physicians and nurses. Am J Infect Control. 1989 Aug;17(4):202–207. [PubMed]

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