Diagnosis of influenza following the first wave of pandemic (H1N1) 2009 influenza

Abstract

Aetiological confirmation of respiratory tract infections in individual patients facilitates appropriate antimicrobial use and infection control procedures. From a public health perspective, influenza confirmation allows assessment of community attack rates and the efficacy of vaccination programs, while assisting in modelling for pandemic preparedness planning. Rapid antigen and immunofluorescent antigen tests are relatively insensitive in detecting pandemic (H1N1) 2009 influenza, and influenza subtype-specific nucleic acid amplification tests should be used as the ‘gold standard’ for diagnosis. Pathogen-specific serological testing aids the retrospective diagnosis of infection. Although some challenges surrounding diagnostic testing during the first pandemic wave have been resolved, others remain; this may test laboratories again in the second and subsequent pandemic waves.