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Updated: Aug 20, 2026
High-throughput Detection Method for Influenza Virus
Published on: February 4, 2012
Identification of influenza A virus by shell vial culture and two commercially available antigen detection methods
L L Steed1, V C Salmon, J C Overall
1Diagnostic Virology Laboratory, Associated Regional and University Pathologists, Inc., Salt Lake City, UT 84108, USA.
Background:
Influenza continues to be a major cause of morbidity and mortality especially in the elderly and persons with underlying disease. Shell vial cell culture and antigen detection techniques may speed up diagnosis and enable better patient treatment and management.
Objectives:
To compare shell vial centrifugation culture with commercially available direct fluorescence and enzyme immunoassay kits using a variety of respiratory specimens.
Study Design:
To detect influenza A virus, we compared direct fluorescent antibody (DFA) staining using the Bartels Viral Respiratory Panel and the Directigen FLU-A enzyme immunoassay (EIA) with shell vial centrifugation culture. Ninety-seven fresh specimens from a variety of respiratory sources, and transported from hospitals throughout the U.S. to our national referral laboratory, were tested.
Results:
Fifteen specimens were true positives: culture positive or both antigen tests 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:
The rapid EIA is useful to screen for influenza A, but critical antigen-negative specimens should be submitted to a virology laboratory for culture. Shell vial cultures can provide a sensitive and universal diagnostic system for influenza A and a variety of other viruses.
Insights
Shell vial culture offers superior sensitivity for detecting influenza A virus compared to antigen tests. While enzyme immunoassay (EIA) is useful for initial screening, shell vial culture provides a more comprehensive diagnostic system for various respiratory viruses.
Area of Science:
- Virology
- Clinical Diagnostics
Background:
- Influenza remains a significant cause of illness and death, particularly in vulnerable populations.
- Rapid diagnostic methods are crucial for timely patient management.
Purpose of the Study:
- To compare the diagnostic performance of shell vial centrifugation culture with direct fluorescence antibody (DFA) staining and enzyme immunoassay (EIA) kits for influenza A detection.
- To evaluate the utility of these methods in diagnosing respiratory viral infections.
Main Methods:
- Ninety-seven respiratory specimens were tested using shell vial culture, DFA, and EIA for influenza A detection.
- Specimens were sourced from hospitals across the U.S. and transported to a national referral laboratory.
Main Results:
- Shell vial culture demonstrated the highest sensitivity (93%) for influenza A detection, followed by EIA (67%) and DFA (47%).
- All methods exhibited excellent specificity (98-100%).
- Shell vial culture also identified other respiratory viruses, including influenza B, RSV, adenovirus, HSV, and CMV.
Conclusions:
- Enzyme immunoassay (EIA) serves as a valuable rapid screening tool for influenza A.
- Specimens negative by EIA should be further tested by shell vial culture for definitive diagnosis.
- Shell vial culture provides a sensitive and versatile diagnostic platform for a broad range of respiratory viruses.
