Influenza and influenza-like illness in general practice: drawing lessons for surveillance from a pilot study in Paris, France

摘要: BACKGROUND: There are two types of inflenza surveillance techniques: qualitative laboratory-based and quantitative medical practice-based surveillance. The former is great importance in isolating new strains the virus, which helps decision-making process concerning composition vaccine, latter provides estimates morbidity, mortality or economic impact as a result infection from influenza virus. Rapid methods such immunoflourescence (IF) immunocapture assays (ICA) now available for diagnosis infections. However, little known about use these purposes. AIMS: To evaluate feasibility rapid ambulatory conditions, to investigate therapeutical outcomes patients suffering influenza-like illness (ILI) relation virological diagnoses. METHOD: During 1994-1995 season, 130 presenting with ILI symptoms (< 36 hours) 33 general practitioners (GPs) were included prospective study. Two nasal swabs one throat swab per patient collected sent laboratory within 12 hours. Information was recorded during examination. Specimens analysed using immunofluorescence method antigen assay (ICA). RESULTS: Sixteen A (12%) 19 B (15%) infections diagnosed. overall rate positive specimens 17% pre-epidemic period 31% epidemic (P = 0.1). rates usable IF assay, ICA 46%, 100% 99% respectively. combination three collections ensured highly sensitive diagnosis. no differences between negative cases. GPs prescribed antibiotics 60% cases mean duration 7 days (+/- 1.2). sick leave 3.4 1.6). Twelve (four positive, eight negative) had been vaccinated at beginning winter. practitioner's intuition 'which should be tested virus' did not prove useful improving aptness diagnoses field CONCLUSION: only way estimate true carry out systematic sampling based on clinical definition methods.