The Journal of Pediatrics
Volume 154, Issue 1 , Pages 91-95 , January 2009

A Randomized, Controlled Trial of the Impact of Early and Rapid Diagnosis of Viral Infections in Children Brought to an Emergency Department with Febrile Respiratory Tract Illnesses

  • Quynh H. Doan, MDCM, MHSc

      Affiliations

    • Pediatric Emergency Department, BC Children's Hospital, Vancouver, British Columbia, Canada
    • Corresponding Author InformationReprint requests: Dr Quynh Doan, University of British Columbia Children's Hospital, Room K4-105, 4480 Oak Street, Vancouver, British Columbia V6H 3V4, Canada
    • ,
  • Niranjan Kissoon, MD

      Affiliations

    • Acute and Critical Care Programs, Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
    • ,
  • Simon Dobson, MD

      Affiliations

    • Vaccine Evaluation Centre, Children's and Women's Health Centre, Vancouver, British Columbia, Canada
    • ,
  • Sandy Whitehouse, MD

      Affiliations

    • Pediatric Emergency Department, BC Children's Hospital, Vancouver, British Columbia, Canada
    • ,
  • Doug Cochrane, MD

      Affiliations

    • Medical Affairs and Quality Assurance, Neurosurgery, BC Children's Hospital, Vancouver, British Columbia, Canada
    • ,
  • Brian Schmidt, OD, MSc

      Affiliations

    • Provincial Health Services Authority, Vancouver, British Columbia, Canada
    • ,
  • Eva Thomas, MD, PhD

      Affiliations

    • Division of Microbiology/Virology, Children's and Women's Health Centre, Vancouver, British Columbia, Canada

Received 28 February 2008 ,Revised 30 June 2008 ,Accepted 21 July 2008.

References 

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  2. Rosenstein N, Phillips W, Gerber M, Marcy M, Schwartz B, Dowell S. The common cold: principles of judicious use of antimicrobial agents. Pediatrics. 1998;101:181
  3. Menec VH, Black C, MacWilliam L, Aoki FY. The impact of influenza-associated respiratory illnesses on hospitalizations, physician visits, emergency room visits, and mortality. Can J Public Health Revue Canadienne de Sante Publique. 2003;94:59–63
  4. Neuzil KM, Mellen BG, Wright PF, Mitchel EF, Griffin MR. The effect of influenza on hospitalizations, outpatient visits, and courses of antibiotics in children. N Engl J Med. 2000;342:225–231
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  6. Weigl JAI, Puppe W, Gröndahl B, Schmitt HJ. Epidemiological investigation of nine respiratory pathogens in hospitalized children in Germany using multiplex reverse-transcriptase polymerase chain reaction. Eur J Clin Microbiol Infect Dis. 2000;19:336
  7. Wang E, Einarson T, Kellner J, Conly J. Antibiotic prescribing for preschool children: evidence of overprescribing for viral infections. Clin Infect Dis. 1999;29:155–160
  8. Greenes DS, Harper MB. Low risk of bacteremia in febrile children with recognizable viral syndromes. Pediatr Infect Dis J. 1999;18:258
  9. Thomas E, Krajden M, Anderson B, DeKleer R, Gagan V, Hunt M, et al. VIRAP: a quality focused rapid respiratory viral testing program. 2005;Paper presented at Clinical Virology Annual Symposium. Proceedings of the 22nd Symposium. May, Clearwater, Florida
  10. Vega R. Rapid viral testing in the evaluation of the febrile infant and child. Curr Opin Pediatr. 2005;17:363–367
  11. Landry ML, Ferguson D. SimulFluor respiratory screen for rapid detection of multiple respiratory viruses in clinical specimens by immunofluorescence staining. J Clin Microbiol. 2000;38:708–711
  12. Smitherman HF, Caviness AC, Macias CG. Retrospective review of serious bacterial infections in infants who are 0 to 36 months of age and have influenza A infection. Pediatrics. 2005;115:710–718
  13. Bonner AB, Monroe KW, Talley LI, Klasner AE, Kimberlin DW. Impact of the rapid diagnosis of influenza on physician decision-making and patient management in the pediatric emergency department: results of a randomized, prospective, controlled trial. Pediatrics. 2003;112:363–367
  14. Esposito S, Marchisio P, Morelli P, Crovari P, Principi N. Effect of a rapid influenza diagnosis. Arch Dis Child. 2003;88:525–526
  15. Abanses JC, Dowd MD, Simon SD, Sharma V. Impact of rapid influenza testing at triage on management of febrile infants and young children. Pediatr Emerg Care. 2006;22:145–149
  16. Benito-Fernandez J, Vazquez-Ronco M, Morteruel-Aizkuren E, Mintegui-Raso S, Sanchez-Etxaniz J, Fernandez-Landaluce A. Impact of rapid viral testing for influenza A and B viruses on management of febrile infants without signs of focal infection. Pediatr Infect Dis J. 2006;25:1153–1157
  17. Iyer SB, Gerber MA, Pomerantz WJ, Mortensen JE, Ruddy RM. Effect of point-of-care influenza testing on management of febrile children. Acad Emerg Med. 2006;13:1259–1268

 Supported by the Michael Smith Foundation for Health Research.

 The authors declare no conflicts of interest.

PII: S0022-3476(08)00624-0

doi: 10.1016/j.jpeds.2008.07.043

The Journal of Pediatrics
Volume 154, Issue 1 , Pages 91-95 , January 2009

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