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Updated: Feb 23, 2026
Rapid Molecular Detection and Differentiation of Influenza Viruses A and B
Published on: January 30, 2017
Diagnostic Accuracy of Novel and Traditional Rapid Tests for Influenza Infection Compared With Reverse Transcriptase
Joanna Merckx1, Rehab Wali1, Ian Schiller1
1From McGill University, McGill University Health Centre, and Centre Hospitalier Universitaire Sainte-Justine, Université de Montréal, Montreal, Quebec, Canada, and Royal College of Surgeons in Ireland, Dublin, Ireland.
Newer digital immunoassays (DIAs) and rapid nucleic acid amplification tests (NAATs) offer significantly higher accuracy for diagnosing influenza in children and adults compared to traditional rapid influenza diagnostic tests (RIDTs). These advanced tests provide improved sensitivity while maintaining high specificity for influenza A and B detection.
Area of Science:
- Medical Diagnostics
- Virology
- Public Health
Background:
- Accurate and rapid influenza diagnostics are crucial for effective patient management and public health strategies.
- Traditional rapid influenza diagnostic tests (RIDTs) have limitations in sensitivity, impacting their clinical utility.
- Advancements in diagnostic technologies aim to improve the speed and accuracy of influenza detection.
Purpose of the Study:
- To systematically review and compare the diagnostic accuracy of traditional RIDTs, digital immunoassays (DIAs), and rapid nucleic acid amplification tests (NAATs).
- To evaluate the performance of these influenza diagnostic methods in both pediatric and adult populations.
- To identify the most accurate rapid diagnostic tools for influenza detection in clinical settings.
Main Methods:
- A comprehensive literature search was conducted across 6 databases from inception through May 2017.
- Included studies compared commercialized rapid influenza tests (results <30 minutes) against reverse transcriptase polymerase chain reaction (RT-PCR) reference standards.
- Data extraction and quality assessment were performed using standardized forms and QUADAS-2 criteria, respectively.
Main Results:
- A total of 162 studies were analyzed, encompassing 130 RIDT, 19 DIA, and 13 NAAT studies.
- Pooled sensitivities for influenza A were 54.4% for RIDTs, 80.0% for DIAs, and 91.6% for NAATs; for influenza B, sensitivities were 53.2% (RIDTs), 76.8% (DIAs), and 95.4% (NAATs).
- Specificities for all test types were uniformly high (>98%). Pediatric populations showed higher sensitivities for DIAs and RIDTs compared to adults, while NAATs showed comparable performance across age groups.
Conclusions:
- Novel DIAs and rapid NAATs demonstrate markedly superior sensitivity for detecting influenza A and B in both children and adults compared to traditional RIDTs.
- The high specificity observed across all rapid test categories ensures reliable negative results.
- Limitations include underreporting of clinical variables, limited adult-specific data for NAATs, and frequent unclear risk of bias in study methodologies.
