Efficacy of Rapid Diagnostic Testing for Influenza in Reducing Laboratory Tests and Improving Patient Management in the Pediatric Emergency Department

Objective: To determine the influence of rapid diagnosis of influenza on patient management and laboratory tests as well as the length of the stay in the emergency department of children presenting with influenza-like illness (ILI) without signs of focal infection. Material and Method: A cross-sectional study was conducted in the pediatric emergency department of Vakif Gureba Hospital, Istanbul, between December 2008 and March 2009, including patients aged 8 months to 11 years presenting with fever and cough, coryza, myalgias, and /or malaise. After obtaining informed consent, patients were allocated into two groups. Group 1: physician informed about the rapid influenza test result; or Group 2; physician not informed of the rapid influenza test result. Nasopharyngeal swabs obtained from all patients were immediately tested with Influenza A/B Rapid Test (R) for influenza A and B. Laboratory tests ordered and length of stay in the emergency department were compared between the resultant influenza- positive groups (informed and not informed). After initial presentation, a control visit check was carried out 1 month later. Results: One hundred and fifty children were enrolled, (mean age 4.2 +/- 3.8 years years, male/female ratio1.2) among whom 72 (48%) tested positive for influenza. Comparison of the groups revealed that the number of tests ordered and length of stay in the emergency department were significantly lower in the first group (12 versus 35 cases, and 62 versus 145 minutes respectively, (p<.0001). Clinical presentation symptoms were not significantly different between two groups. Conclusion: During the influenza season, rapid diagnosis of influenza may allow a reduction of additional laboratory tests and decreased length of time to discharge in a pediatric emergency department.