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Fever Alone Unreliable Indicator of H1N1 Infection

Coughing or other respiratory symptoms may be more accurate indicators of H1N1 infection

MONDAY, Aug. 2 (HealthDay News) -- Standard diagnostic criteria used for the diagnosis of 2009 H1N1 influenza infection, based on the presence of fever, may fail to identify patients with the disease, and respiratory symptoms may be more reliable indicators, according to research published in the August issue of the American Journal of Infection Control.

In a retrospective review, Ina Jeong, M.D., of Seoul National University College of Medicine in South Korea, and colleagues evaluated the medical records of 44 patients who were hospitalized and quarantined and had tested positive for the 2009 H1N1 virus between May 29 and July 28, 2009. Oseltamivir was started in all patients after the onset of initial symptoms.

The researchers found that common symptoms among patients included cough (77.3 percent), subjective fever (52.3 percent), rhinorrhea or nasal congestion (50 percent), sore throat (43.2 percent), and diarrhea (15.9 percent). Objective fever was documented in 45.5 percent of patients. In addition, laboratory tests revealed common markers among patients included leucopenia (52.3 percent) and mildly elevated C-reactive protein (59.1 percent).

"Although findings were generally nonspecific, cough, mild leukopenia, and mildly elevated C-reactive protein were relatively common clinical manifestations," the authors write. "Considering this clinical observation, we conclude that case-based surveillance for the index cluster of pandemic influenza is not an effective method for infection control in communities and hospital settings."

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