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Related Experiment Video

Updated: Feb 25, 2026

Rapid Molecular Detection and Differentiation of Influenza Viruses A and B
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Suspected Pediatric Influenza Risk-Stratification Algorithm: A Clinical Decision Tool.

Patrick D Evers1, Michelle Starr2, Michael J McNeil2

  • 1From the Divisions of Cardiology.

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Summary

This study developed the Suspected Pediatric Influenza Risk-Stratification Algorithm (SPIRA) to help clinicians identify children with influenza-like illness who truly need treatment, reducing unnecessary testing and medication.

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Area of Science:

  • Pediatric infectious diseases
  • Clinical decision support systems
  • Epidemiology

Background:

  • Influenza poses a significant annual health burden on children.
  • Current guidelines often lead to overtreatment or expensive viral testing for children with influenza-like illness (ILI).
  • A need exists for better tools to differentiate children who require empiric treatment from those who need further testing.

Purpose of the Study:

  • To develop and validate a risk-stratification algorithm for children presenting with ILI.
  • To assist clinicians in determining the likelihood of influenza infection in pediatric patients.
  • To optimize the use of empiric antiviral treatment and viral diagnostic testing.

Main Methods:

  • Retrospective analysis of 818 children with ILI presenting to the emergency department.
  • Review of medical records for symptoms, influenza risk factors, and viral assay results.
  • Classification and regression tree analyses were conducted separately for children younger and older than 2 years.

Main Results:

  • For children <2 years, influenza likelihood was associated with influenza-positive contact, lack of immunization, and high-incidence periods.
  • For children ≥2 years, high-risk factors included lack of immunization, high-incidence periods, myalgia, and absence of diarrhea.
  • Specific factors identified low risk for influenza in younger children (immunization, low-incidence season, absence of cough).

Conclusions:

  • The Suspected Pediatric Influenza Risk-Stratification Algorithm (SPIRA) was developed based on these findings.
  • SPIRA can guide clinicians in deciding between empiric treatment and viral testing for children with ILI.
  • The algorithm aims to reduce unnecessary antiviral exposure and costly diagnostic procedures.