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Evaluation of ECDC Influenza-like illness (ILI) case definition to detect respiratory syncytial virus (RSV) infection through the Influenza Surveillance System in Portugal, 2010-2018
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Advisor(s)
Abstract(s)
Background: One of the main problems to implement a global Respiratory syncytial virus (RSV) surveillance system is the lack of a suitable case definition for RSV disease. In Portugal, RSV cases are detected through the Influenza Surveillance System (ISS) using the ECDC Influenza-like illness (ILI) case definition. The aim of this study was to evaluate the suitability of this case definition to detect RSV infections in Portugal.
Methods: We conducted a retrospective and observational cross-sectional study of 4,711 cases with individual clinical symptoms and laboratory-confirmed result for respiratory virus between October 2010 and May 2017. Association between clinical characteristics and RSV detection using bivariate and multinomial logistic regression was carried out. The ILI case definition accuracy was assessed by its sensitivity, specificity, and area under the receiver operating characteristic curve (AUC). A 0.05 significance level was accepted.
Results: A total of 141 (3%) samples were laboratory-confirmed RSV positive cases, being highly significant among children less than 5 years old (8.5%) and among adults ≥ 65 years old (23%). Cough (OR=2.71; 95CI 1.19-6.18) and difficulty breathing (OR=2.16; 95CI 1.53-3.06) were the best predictors for RSV infections. However, fever or feverishness (OR=0.4; 95CI 0.27-0.59), headache (OR=0.65; 95CI0.46-0.93) and myalgia (OR=0.34; 95CI 0.23-0.5) were negative associated with RSV disease although were significantly associated with influenza positive cases. The ILI case definition was not significant and showed a sensitivity of 80.9% (73.4-87), specificity of 19.7% (18.6-20.9) and an AUC of 0.623.
Conclusions: We showed that ILI case definition was not accurate for RSV detection in Portugal. Therefore, the case definition should be adapted within the ISS or a specific RSV surveillance system should be implemented in Portugal.
Description
INSA-DDI em colaboração com Emma Sáez-López (programa EUPHEM) e INSA-DEP.
Poster abstract publicado em: ESCAIDE 2018: Abstract book, pp. 87-88. Disponível em: https://www.escaide.eu/sites/escaide/files/documents/book_escaide2018_updated-dec-2018.pdf
Poster abstract publicado em: ESCAIDE 2018: Abstract book, pp. 87-88. Disponível em: https://www.escaide.eu/sites/escaide/files/documents/book_escaide2018_updated-dec-2018.pdf
Keywords
RSV Influenza Surveillance ILI Surveillance Respiratory Syncytial Virus Influenza-like illness Case Definition Surveillance Infecções Respiratórias Estados de Saúde e de Doença