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Updated: May 19, 2026
Rapid Molecular Detection and Differentiation of Influenza Viruses A and B
Published on: January 30, 2017
Early detection of influenza A and B infection in infants and children using conventional and fluorescence-based
Barbara Rath1, Franziska Tief, Patrick Obermeier
1Department of Paediatrics, Division of Pneumonology-Immunology, Charité University Medical Centre, Augustenburger Platz 1, Berlin, Germany. Barbara.Rath@gmail.com
Insights
Accurate influenza diagnosis in children is crucial for management. Fluorescence-based rapid antigen testing offers a sensitive and specific point-of-care tool, particularly for infants and young children.
Area of Science:
- Pediatric Infectious Diseases
- Diagnostic Microbiology
- Public Health Surveillance
Background:
- Effective management of pediatric influenza relies on accurate, timely point-of-care (POC) diagnosis.
- Rapid diagnostic tests are essential for prompt clinical decision-making in children with influenza-like illness (ILI).
Purpose of the Study:
- To evaluate QuickVue™ rapid test strips for simultaneous RSV/influenza detection.
- To assess a novel fluorescence-based rapid influenza antigen test (SOFIA™) for pediatric ILI.
Main Methods:
- Real-time surveillance study (ChILD Cohort) at Charité Department of Pediatrics, Germany.
- Comparison of POC rapid tests (QuickVue™) and SOFIA™ against RT-PCR.
- Evaluation of SOFIA™ using frozen samples and at POC in pediatric patients.
Main Results:
- QuickVue™ showed sensitivities of 62.7% for influenza and 67.8% for RSV, higher in infants (<1 year).
- SOFIA™ demonstrated high sensitivities (up to 97.7%) in laboratory samples and 78.9% at POC.
- POC SOFIA™ testing showed high specificity (99.7%) and NPV (97.3%), with highest sensitivity in infants and children <2 years.
Conclusions:
- Fluorescence-based rapid antigen testing (SOFIA™) is a highly sensitive and specific POC tool for pediatric influenza.
- This method is particularly valuable for diagnosing influenza in infants and young children (<2 years) with high viral loads.
Background:
The appropriate management of infants and children with influenza depends on the accurate and timely diagnosis, ideally at the point of care (POC).
Objectives:
To evaluate the use of simultaneous RSV/influenza rapid testing with QuickVue™ test strips as well as (the use of) novel, fluorescence-based, rapid influenza antigen testing (SOFIA™) in infants and children with influenza-like illness (ILI).
Study Design:
The Study was conducted in a real-time surveillance program at the Charité Department of Pediatrics in collaboration with the National Reference Centre for Influenza at the Robert Koch Institute (RKI) in Berlin, Germany (Charité Influenza-Like Disease=ChILD Cohort).
Results:
During the 2010/2011 influenza season, 395 infants and children were simultaneously tested using QuickVue™ FluA&B and RSV10 rapid tests at POC compared to independent RT-PCR. Sensitivities were 62.7/67.8% for Influenza/RSV overall, but highest in infants <1 year with 76.0/76.2%. The evaluation of the fluorescence-based rapid test SOFIA™ with frozen laboratory samples (derived from the 2008/2009 and 2010/2011 national surveillance) yielded sensitivities of 97.7/86.7/86.7/81.7% for influenza A(H1N1)pdm09/A(H3N2)/B-Victoria/B-Yamagata in samples with CT values <34, and 80.2/79.8/67.5/62.5% for all CT values combined. The same method used at POC with 649 consecutive ChILD patients in 2011-2012 yielded sensitivity/specificity/PPV/NPV values of 78.9/99.7/96.6/97.3%. Again, sensitivities were highest in infants (85.7%) and small children <2 years (88%).
Conclusions:
Fluorescence-based rapid antigen testing provides a highly sensitive and specific tool for POC diagnostics of acute influenza in the paediatric age group, especially in infants and small children <2 years, when viral loads are at their peak and treatment decisions are imminent.
