Predictors of influenza among older adults in the emergency department.
Identifieur interne : 000130 ( Main/Exploration ); précédent : 000129; suivant : 000131Predictors of influenza among older adults in the emergency department.
Auteurs : Po-Po Lam [Canada] ; Brenda L. Coleman [Canada] ; Karen Green [Canada] ; Jeff Powis [Canada] ; David Richardson [Canada] ; Kevin Katz [Canada] ; Bjug Borgundvaag [Canada] ; Telisha Smith-Gorvie [Canada] ; Jeffrey C. Kwong [Canada] ; Susan J. Bondy [Canada] ; Allison Mcgeer [Canada]Source :
- BMC infectious diseases [ 1471-2334 ] ; 2016.
Descripteurs français
- KwdFr :
- Adulte d'âge moyen, Femelle, Fièvre (étiologie), Grippe humaine (épidémiologie), Grippe humaine (étiologie), Humains, Modèles logistiques, Mâle, Ontario, Pharyngite (étiologie), Réaction de polymérisation en chaîne, Service hospitalier d'urgences (), Sous-type H1N1 du virus de la grippe A (pathogénicité), Sous-type H3N2 du virus de la grippe A (pathogénicité), Sujet âgé, Sujet âgé de 80 ans ou plus, Toux (étiologie), Vaccins antigrippaux (usage thérapeutique).
- MESH :
- pathogénicité : Sous-type H1N1 du virus de la grippe A, Sous-type H3N2 du virus de la grippe A.
- usage thérapeutique : Vaccins antigrippaux.
- épidémiologie : Grippe humaine.
- étiologie : Fièvre, Grippe humaine, Pharyngite, Toux.
- Adulte d'âge moyen, Femelle, Humains, Modèles logistiques, Mâle, Ontario, Réaction de polymérisation en chaîne, Service hospitalier d'urgences, Sujet âgé, Sujet âgé de 80 ans ou plus.
English descriptors
- KwdEn :
- Aged, Aged, 80 and over, Cough (etiology), Emergency Service, Hospital (statistics & numerical data), Female, Fever (etiology), Humans, Influenza A Virus, H1N1 Subtype (pathogenicity), Influenza A Virus, H3N2 Subtype (pathogenicity), Influenza Vaccines (therapeutic use), Influenza, Human (epidemiology), Influenza, Human (etiology), Logistic Models, Male, Middle Aged, Ontario, Pharyngitis (etiology), Polymerase Chain Reaction.
- MESH :
- chemical , therapeutic use : Influenza Vaccines.
- geographic : Ontario.
- epidemiology : Influenza, Human.
- etiology : Cough, Fever, Influenza, Human, Pharyngitis.
- pathogenicity : Influenza A Virus, H1N1 Subtype, Influenza A Virus, H3N2 Subtype.
- statistics & numerical data : Emergency Service, Hospital.
- Aged, Aged, 80 and over, Female, Humans, Logistic Models, Male, Middle Aged, Polymerase Chain Reaction.
Abstract
BACKGROUND
Diagnosis of influenza in older adults may be complicated by atypical presentations or when patients present with complications of an underlying illness. We aimed to identify clinical characteristics and epidemiological factors associated with influenza among community-dwelling adults aged ≥60 years presenting to emergency departments.
METHODS
We identified patients with influenza-compatible chief complaints presenting to emergency departments of six acute care hospitals in Ontario, Canada during the 2011/12 and 2012/13 influenza seasons. Clinical characteristics, medical history and demographics were collected by patient interview, chart review and by contacting vaccine providers. Nasopharyngeal swabs were tested for influenza using polymerase chain reaction. We modeled predictors of influenza using multivariable logistic regression models that compared individuals with and without influenza.
RESULTS
Of 1318 participants, 151 (11 %) had influenza (98 A/H3N2, 12 A/H1N1, 4 A [not sub-typed], 37 B). In the multivariable model, clinical symptoms associated with influenza were cough (OR 6.4, 95 % CI 3.2, 13.0), feverishness and/or triage temperature ≥37.2 °C (OR 3.0, 95 % CI 2.0, 4.7), 2-5 days from symptom onset to the emergency department visit (OR 2.2, 95 % CI 1.5, 3.2), and wheezing (OR 2.1, 95 % CI 1.3, 3.3). The effect of cough on influenza increased with older age. Epidemiological factors associated with increased odds for influenza included weeks when ≥10 % influenza tests from provincial laboratories were positive (OR 5.1, 95 % CI 1.2, 21.7) and exposure to a person with influenza-like illness (OR 1.9, 95 % CI 1.3, 2.8). Among participants with influenza, only 47 (31 %) met the U.S. Centers for Disease Control and Prevention criteria for influenza-like illness (temperature ≥37.8 °C and cough and/or sore throat).
CONCLUSIONS
As in younger adults, cough and feverishness are the two symptoms most predictive of influenza in the elderly. Current influenza-like illness definitions did not adequately capture influenza in older adults.
DOI: 10.1186/s12879-016-1966-4
PubMed: 27793117
Affiliations:
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Kwong</name><affiliation wicri:level="1"><nlm:affiliation>Institute for Clinical Evaluative Sciences, Toronto, ON, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Institute for Clinical Evaluative Sciences, Toronto, ON</wicri:regionArea><wicri:noRegion>ON</wicri:noRegion></affiliation></author><author><name sortKey="Bondy, Susan J" sort="Bondy, Susan J" uniqKey="Bondy S" first="Susan J" last="Bondy">Susan J. Bondy</name><affiliation wicri:level="4"><nlm:affiliation>Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Dalla Lana School of Public Health, University of Toronto, Toronto, ON</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Mcgeer, Allison" sort="Mcgeer, Allison" uniqKey="Mcgeer A" first="Allison" last="Mcgeer">Allison Mcgeer</name><affiliation wicri:level="4"><nlm:affiliation>Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Dalla Lana School of Public Health, University of Toronto, Toronto, ON</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation><affiliation wicri:level="1"><nlm:affiliation>Department of Microbiology, Mount Sinai Hospital, Toronto, ON, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Microbiology, Mount Sinai Hospital, Toronto, ON</wicri:regionArea><wicri:noRegion>ON</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:affiliation>Toronto Invasive Bacterial Diseases Network, Toronto, ON, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Toronto Invasive Bacterial Diseases Network, Toronto, ON</wicri:regionArea><wicri:noRegion>ON</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2016">2016</date><idno type="RBID">pubmed:27793117</idno><idno type="pmid">27793117</idno><idno type="doi">10.1186/s12879-016-1966-4</idno><idno type="wicri:Area/Main/Corpus">000122</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000122</idno><idno type="wicri:Area/Main/Curation">000122</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Curation">000122</idno><idno type="wicri:Area/Main/Exploration">000122</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Predictors of influenza among older adults in the emergency department.</title><author><name sortKey="Lam, Po Po" sort="Lam, Po Po" uniqKey="Lam P" first="Po-Po" last="Lam">Po-Po Lam</name><affiliation wicri:level="4"><nlm:affiliation>Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada. popo.lam@utoronto.ca.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Dalla Lana School of Public Health, University of Toronto, Toronto, ON</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation><affiliation wicri:level="1"><nlm:affiliation>Department of Microbiology, Mount Sinai Hospital, Toronto, ON, Canada. popo.lam@utoronto.ca.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Microbiology, Mount Sinai Hospital, Toronto, ON</wicri:regionArea><wicri:noRegion>ON</wicri:noRegion></affiliation></author><author><name sortKey="Coleman, Brenda L" sort="Coleman, Brenda L" uniqKey="Coleman B" first="Brenda L" last="Coleman">Brenda L. Coleman</name><affiliation wicri:level="4"><nlm:affiliation>Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Dalla Lana School of Public Health, University of Toronto, Toronto, ON</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation><affiliation wicri:level="1"><nlm:affiliation>Department of Microbiology, Mount Sinai Hospital, Toronto, ON, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Microbiology, Mount Sinai Hospital, Toronto, ON</wicri:regionArea><wicri:noRegion>ON</wicri:noRegion></affiliation></author><author><name sortKey="Green, Karen" sort="Green, Karen" uniqKey="Green K" first="Karen" last="Green">Karen Green</name><affiliation wicri:level="1"><nlm:affiliation>Department of Microbiology, Mount Sinai Hospital, Toronto, ON, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Microbiology, Mount Sinai Hospital, Toronto, ON</wicri:regionArea><wicri:noRegion>ON</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:affiliation>Toronto Invasive Bacterial Diseases Network, Toronto, ON, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Toronto Invasive Bacterial Diseases Network, Toronto, ON</wicri:regionArea><wicri:noRegion>ON</wicri:noRegion></affiliation></author><author><name sortKey="Powis, Jeff" sort="Powis, Jeff" uniqKey="Powis J" first="Jeff" last="Powis">Jeff Powis</name><affiliation wicri:level="1"><nlm:affiliation>Toronto East General Hospital, Toronto, ON, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Toronto East General Hospital, Toronto, ON</wicri:regionArea><wicri:noRegion>ON</wicri:noRegion></affiliation></author><author><name sortKey="Richardson, David" sort="Richardson, David" uniqKey="Richardson D" first="David" last="Richardson">David Richardson</name><affiliation wicri:level="1"><nlm:affiliation>William Osler Health System, Toronto, ON, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>William Osler Health System, Toronto, ON</wicri:regionArea><wicri:noRegion>ON</wicri:noRegion></affiliation></author><author><name sortKey="Katz, Kevin" sort="Katz, Kevin" uniqKey="Katz K" first="Kevin" last="Katz">Kevin Katz</name><affiliation wicri:level="1"><nlm:affiliation>North York General Hospital, Toronto, ON, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>North York General Hospital, Toronto, ON</wicri:regionArea><wicri:noRegion>ON</wicri:noRegion></affiliation></author><author><name sortKey="Borgundvaag, Bjug" sort="Borgundvaag, Bjug" uniqKey="Borgundvaag B" first="Bjug" last="Borgundvaag">Bjug Borgundvaag</name><affiliation wicri:level="1"><nlm:affiliation>Schwartz/Reisman Emergency Medicine Institute, Mount Sinai Hospital, Toronto, ON, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Schwartz/Reisman Emergency Medicine Institute, Mount Sinai Hospital, Toronto, ON</wicri:regionArea><wicri:noRegion>ON</wicri:noRegion></affiliation></author><author><name sortKey="Smith Gorvie, Telisha" sort="Smith Gorvie, Telisha" uniqKey="Smith Gorvie T" first="Telisha" last="Smith-Gorvie">Telisha Smith-Gorvie</name><affiliation wicri:level="1"><nlm:affiliation>Department of Emergency Medicine, University Health Network, Toronto, ON, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Emergency Medicine, University Health Network, Toronto, ON</wicri:regionArea><wicri:noRegion>ON</wicri:noRegion></affiliation></author><author><name sortKey="Kwong, Jeffrey C" sort="Kwong, Jeffrey C" uniqKey="Kwong J" first="Jeffrey C" last="Kwong">Jeffrey C. Kwong</name><affiliation wicri:level="1"><nlm:affiliation>Institute for Clinical Evaluative Sciences, Toronto, ON, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Institute for Clinical Evaluative Sciences, Toronto, ON</wicri:regionArea><wicri:noRegion>ON</wicri:noRegion></affiliation></author><author><name sortKey="Bondy, Susan J" sort="Bondy, Susan J" uniqKey="Bondy S" first="Susan J" last="Bondy">Susan J. Bondy</name><affiliation wicri:level="4"><nlm:affiliation>Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Dalla Lana School of Public Health, University of Toronto, Toronto, ON</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Mcgeer, Allison" sort="Mcgeer, Allison" uniqKey="Mcgeer A" first="Allison" last="Mcgeer">Allison Mcgeer</name><affiliation wicri:level="4"><nlm:affiliation>Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Dalla Lana School of Public Health, University of Toronto, Toronto, ON</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation><affiliation wicri:level="1"><nlm:affiliation>Department of Microbiology, Mount Sinai Hospital, Toronto, ON, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Microbiology, Mount Sinai Hospital, Toronto, ON</wicri:regionArea><wicri:noRegion>ON</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:affiliation>Toronto Invasive Bacterial Diseases Network, Toronto, ON, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Toronto Invasive Bacterial Diseases Network, Toronto, ON</wicri:regionArea><wicri:noRegion>ON</wicri:noRegion></affiliation></author></analytic><series><title level="j">BMC infectious diseases</title><idno type="eISSN">1471-2334</idno><imprint><date when="2016" type="published">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term><term>Aged, 80 and over</term><term>Cough (etiology)</term><term>Emergency Service, Hospital (statistics & numerical data)</term><term>Female</term><term>Fever (etiology)</term><term>Humans</term><term>Influenza A Virus, H1N1 Subtype (pathogenicity)</term><term>Influenza A Virus, H3N2 Subtype (pathogenicity)</term><term>Influenza Vaccines (therapeutic use)</term><term>Influenza, Human (epidemiology)</term><term>Influenza, Human (etiology)</term><term>Logistic Models</term><term>Male</term><term>Middle Aged</term><term>Ontario</term><term>Pharyngitis (etiology)</term><term>Polymerase Chain Reaction</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte d'âge moyen</term><term>Femelle</term><term>Fièvre (étiologie)</term><term>Grippe humaine (épidémiologie)</term><term>Grippe humaine (étiologie)</term><term>Humains</term><term>Modèles logistiques</term><term>Mâle</term><term>Ontario</term><term>Pharyngite (étiologie)</term><term>Réaction de polymérisation en chaîne</term><term>Service hospitalier d'urgences ()</term><term>Sous-type H1N1 du virus de la grippe A (pathogénicité)</term><term>Sous-type H3N2 du virus de la grippe A (pathogénicité)</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Toux (étiologie)</term><term>Vaccins antigrippaux (usage thérapeutique)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Influenza Vaccines</term></keywords><keywords scheme="MESH" type="geographic" xml:lang="en"><term>Ontario</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Influenza, Human</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Cough</term><term>Fever</term><term>Influenza, Human</term><term>Pharyngitis</term></keywords><keywords scheme="MESH" qualifier="pathogenicity" xml:lang="en"><term>Influenza A Virus, H1N1 Subtype</term><term>Influenza A Virus, H3N2 Subtype</term></keywords><keywords scheme="MESH" qualifier="pathogénicité" xml:lang="fr"><term>Sous-type H1N1 du virus de la grippe A</term><term>Sous-type H3N2 du virus de la grippe A</term></keywords><keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Emergency Service, Hospital</term></keywords><keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr"><term>Vaccins antigrippaux</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Grippe humaine</term></keywords><keywords scheme="MESH" qualifier="étiologie" xml:lang="fr"><term>Fièvre</term><term>Grippe humaine</term><term>Pharyngite</term><term>Toux</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Aged, 80 and over</term><term>Female</term><term>Humans</term><term>Logistic Models</term><term>Male</term><term>Middle Aged</term><term>Polymerase Chain Reaction</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte d'âge moyen</term><term>Femelle</term><term>Humains</term><term>Modèles logistiques</term><term>Mâle</term><term>Ontario</term><term>Réaction de polymérisation en chaîne</term><term>Service hospitalier d'urgences</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>Diagnosis of influenza in older adults may be complicated by atypical presentations or when patients present with complications of an underlying illness. We aimed to identify clinical characteristics and epidemiological factors associated with influenza among community-dwelling adults aged ≥60 years presenting to emergency departments.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>We identified patients with influenza-compatible chief complaints presenting to emergency departments of six acute care hospitals in Ontario, Canada during the 2011/12 and 2012/13 influenza seasons. Clinical characteristics, medical history and demographics were collected by patient interview, chart review and by contacting vaccine providers. Nasopharyngeal swabs were tested for influenza using polymerase chain reaction. We modeled predictors of influenza using multivariable logistic regression models that compared individuals with and without influenza.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>Of 1318 participants, 151 (11 %) had influenza (98 A/H3N2, 12 A/H1N1, 4 A [not sub-typed], 37 B). In the multivariable model, clinical symptoms associated with influenza were cough (OR 6.4, 95 % CI 3.2, 13.0), feverishness and/or triage temperature ≥37.2 °C (OR 3.0, 95 % CI 2.0, 4.7), 2-5 days from symptom onset to the emergency department visit (OR 2.2, 95 % CI 1.5, 3.2), and wheezing (OR 2.1, 95 % CI 1.3, 3.3). The effect of cough on influenza increased with older age. Epidemiological factors associated with increased odds for influenza included weeks when ≥10 % influenza tests from provincial laboratories were positive (OR 5.1, 95 % CI 1.2, 21.7) and exposure to a person with influenza-like illness (OR 1.9, 95 % CI 1.3, 2.8). Among participants with influenza, only 47 (31 %) met the U.S. Centers for Disease Control and Prevention criteria for influenza-like illness (temperature ≥37.8 °C and cough and/or sore throat).</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>As in younger adults, cough and feverishness are the two symptoms most predictive of influenza in the elderly. Current influenza-like illness definitions did not adequately capture influenza in older adults.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">27793117</PMID><DateCompleted><Year>2017</Year><Month>06</Month><Day>12</Day></DateCompleted><DateRevised><Year>2019</Year><Month>03</Month><Day>20</Day></DateRevised><Article PubModel="Electronic"><Journal><ISSN IssnType="Electronic">1471-2334</ISSN><JournalIssue CitedMedium="Internet"><Volume>16</Volume><Issue>1</Issue><PubDate><Year>2016</Year><Month>Oct</Month><Day>28</Day></PubDate></JournalIssue><Title>BMC infectious diseases</Title><ISOAbbreviation>BMC Infect. Dis.</ISOAbbreviation></Journal><ArticleTitle>Predictors of influenza among older adults in the emergency department.</ArticleTitle><Pagination><MedlinePgn>615</MedlinePgn></Pagination><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Diagnosis of influenza in older adults may be complicated by atypical presentations or when patients present with complications of an underlying illness. We aimed to identify clinical characteristics and epidemiological factors associated with influenza among community-dwelling adults aged ≥60 years presenting to emergency departments.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">We identified patients with influenza-compatible chief complaints presenting to emergency departments of six acute care hospitals in Ontario, Canada during the 2011/12 and 2012/13 influenza seasons. Clinical characteristics, medical history and demographics were collected by patient interview, chart review and by contacting vaccine providers. Nasopharyngeal swabs were tested for influenza using polymerase chain reaction. We modeled predictors of influenza using multivariable logistic regression models that compared individuals with and without influenza.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">Of 1318 participants, 151 (11 %) had influenza (98 A/H3N2, 12 A/H1N1, 4 A [not sub-typed], 37 B). In the multivariable model, clinical symptoms associated with influenza were cough (OR 6.4, 95 % CI 3.2, 13.0), feverishness and/or triage temperature ≥37.2 °C (OR 3.0, 95 % CI 2.0, 4.7), 2-5 days from symptom onset to the emergency department visit (OR 2.2, 95 % CI 1.5, 3.2), and wheezing (OR 2.1, 95 % CI 1.3, 3.3). The effect of cough on influenza increased with older age. Epidemiological factors associated with increased odds for influenza included weeks when ≥10 % influenza tests from provincial laboratories were positive (OR 5.1, 95 % CI 1.2, 21.7) and exposure to a person with influenza-like illness (OR 1.9, 95 % CI 1.3, 2.8). Among participants with influenza, only 47 (31 %) met the U.S. Centers for Disease Control and Prevention criteria for influenza-like illness (temperature ≥37.8 °C and cough and/or sore throat).</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">As in younger adults, cough and feverishness are the two symptoms most predictive of influenza in the elderly. Current influenza-like illness definitions did not adequately capture influenza in older adults.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Lam</LastName><ForeName>Po-Po</ForeName><Initials>PP</Initials><Identifier Source="ORCID">http://orcid.org/0000-0003-3125-9958</Identifier><AffiliationInfo><Affiliation>Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada. popo.lam@utoronto.ca.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Microbiology, Mount Sinai Hospital, Toronto, ON, Canada. popo.lam@utoronto.ca.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Coleman</LastName><ForeName>Brenda L</ForeName><Initials>BL</Initials><AffiliationInfo><Affiliation>Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Microbiology, Mount Sinai Hospital, Toronto, ON, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Green</LastName><ForeName>Karen</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>Department of Microbiology, Mount Sinai Hospital, Toronto, ON, Canada.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Toronto Invasive Bacterial Diseases Network, Toronto, ON, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Powis</LastName><ForeName>Jeff</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Toronto East General Hospital, Toronto, ON, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Richardson</LastName><ForeName>David</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>William Osler Health System, Toronto, ON, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Katz</LastName><ForeName>Kevin</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>North York General Hospital, Toronto, ON, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Borgundvaag</LastName><ForeName>Bjug</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>Schwartz/Reisman Emergency Medicine Institute, Mount Sinai Hospital, Toronto, ON, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Smith-Gorvie</LastName><ForeName>Telisha</ForeName><Initials>T</Initials><AffiliationInfo><Affiliation>Department of Emergency Medicine, University Health Network, Toronto, ON, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kwong</LastName><ForeName>Jeffrey C</ForeName><Initials>JC</Initials><AffiliationInfo><Affiliation>Institute for Clinical Evaluative Sciences, Toronto, ON, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bondy</LastName><ForeName>Susan J</ForeName><Initials>SJ</Initials><AffiliationInfo><Affiliation>Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>McGeer</LastName><ForeName>Allison</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Microbiology, Mount Sinai Hospital, Toronto, ON, Canada.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Toronto Invasive Bacterial Diseases Network, Toronto, ON, Canada.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2016</Year><Month>10</Month><Day>28</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>BMC Infect Dis</MedlineTA><NlmUniqueID>100968551</NlmUniqueID><ISSNLinking>1471-2334</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D007252">Influenza Vaccines</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000369" MajorTopicYN="N">Aged, 80 and over</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D003371" MajorTopicYN="N">Cough</DescriptorName><QualifierName UI="Q000209" MajorTopicYN="N">etiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D004636" MajorTopicYN="N">Emergency Service, Hospital</DescriptorName><QualifierName UI="Q000706" MajorTopicYN="N">statistics & numerical data</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005334" MajorTopicYN="N">Fever</DescriptorName><QualifierName UI="Q000209" MajorTopicYN="N">etiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D053118" MajorTopicYN="N">Influenza A Virus, H1N1 Subtype</DescriptorName><QualifierName UI="Q000472" MajorTopicYN="N">pathogenicity</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D053122" MajorTopicYN="N">Influenza A Virus, H3N2 Subtype</DescriptorName><QualifierName UI="Q000472" MajorTopicYN="N">pathogenicity</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D007252" MajorTopicYN="N">Influenza Vaccines</DescriptorName><QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D007251" MajorTopicYN="N">Influenza, Human</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="Y">epidemiology</QualifierName><QualifierName UI="Q000209" MajorTopicYN="Y">etiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D016015" MajorTopicYN="N">Logistic Models</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D009864" MajorTopicYN="N" Type="Geographic">Ontario</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D010612" MajorTopicYN="N">Pharyngitis</DescriptorName><QualifierName UI="Q000209" MajorTopicYN="N">etiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D016133" MajorTopicYN="N">Polymerase Chain Reaction</DescriptorName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Clinical symptoms</Keyword><Keyword MajorTopicYN="N">Elderly</Keyword><Keyword 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Bondy</name><name sortKey="Borgundvaag, Bjug" sort="Borgundvaag, Bjug" uniqKey="Borgundvaag B" first="Bjug" last="Borgundvaag">Bjug Borgundvaag</name><name sortKey="Coleman, Brenda L" sort="Coleman, Brenda L" uniqKey="Coleman B" first="Brenda L" last="Coleman">Brenda L. Coleman</name><name sortKey="Coleman, Brenda L" sort="Coleman, Brenda L" uniqKey="Coleman B" first="Brenda L" last="Coleman">Brenda L. Coleman</name><name sortKey="Green, Karen" sort="Green, Karen" uniqKey="Green K" first="Karen" last="Green">Karen Green</name><name sortKey="Green, Karen" sort="Green, Karen" uniqKey="Green K" first="Karen" last="Green">Karen Green</name><name sortKey="Katz, Kevin" sort="Katz, Kevin" uniqKey="Katz K" first="Kevin" last="Katz">Kevin Katz</name><name sortKey="Kwong, Jeffrey C" sort="Kwong, Jeffrey C" uniqKey="Kwong J" first="Jeffrey C" last="Kwong">Jeffrey C. Kwong</name><name sortKey="Lam, Po Po" sort="Lam, Po Po" uniqKey="Lam P" first="Po-Po" last="Lam">Po-Po Lam</name><name sortKey="Mcgeer, Allison" sort="Mcgeer, Allison" uniqKey="Mcgeer A" first="Allison" last="Mcgeer">Allison Mcgeer</name><name sortKey="Mcgeer, Allison" sort="Mcgeer, Allison" uniqKey="Mcgeer A" first="Allison" last="Mcgeer">Allison Mcgeer</name><name sortKey="Mcgeer, Allison" sort="Mcgeer, Allison" uniqKey="Mcgeer A" first="Allison" last="Mcgeer">Allison Mcgeer</name><name sortKey="Powis, Jeff" sort="Powis, Jeff" uniqKey="Powis J" first="Jeff" last="Powis">Jeff Powis</name><name sortKey="Richardson, David" sort="Richardson, David" uniqKey="Richardson D" first="David" last="Richardson">David Richardson</name><name sortKey="Smith Gorvie, Telisha" sort="Smith Gorvie, Telisha" uniqKey="Smith Gorvie T" first="Telisha" last="Smith-Gorvie">Telisha Smith-Gorvie</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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