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  • Title: Identification of influenza A virus by shell vial culture and two commercially available antigen detection methods.
    Author: Steed LL, Salmon VC, Overall JC.
    Journal: Clin Diagn Virol; 1994 Aug; 2(4-5):261-9. PubMed ID: 15566771.
    Abstract:
    BACKGROUND: Effective use of amantidine and rimantidine for treating patients and for reducing transmission requires rapid diagnosis of influenza A. Rapid culture methods require 1-2 days to detect influenza A virus. Direct fluorescent antibody (DFA) staining and enzyme immunoassay (EIA) can detect influenza A antigen within 1-4 h. OBJECTIVES: We compared DFA staining using the Bartels viral respiratory panel and the Directigen FLU-A EIA with shell vial centrifugation culture. STUDY DESIGN: Ninety-seven fresh specimens from a variety of respiratory sources and transported from hospitals throughout the USA to our national referral laboratory were tested. A true positive was defined as culture positive or both antigen tests positive. RESULTS: Fifteen specimens were true positive. Sensitivity with culture was 93%, EIA 67%, and DFA 47%. Specificity was excellent with all three methods: 100%, 98%, 99%. Culture detected additional viruses that can cause respiratory tract disease: herpes simplex, cytomegalovirus, respiratory syncytial, influenza B, and adenovirus. Fourteen (70%) of 20 frozen specimens previously positive for influenza A were positive on retest by EIA. Overall sensitivity of EIA compared with culture using 35 positive specimens was 69%. CONCLUSIONS: These results suggest that the rapid EIA is useful to screen for influenza A, but that critical antigen-negative specimens should be submitted to a virology laboratory for culture for optimal sensitivity and for recovery of other viruses.
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