ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, Abraham J, Adair T, Aggarwal R, Ahn SY, Alvarado M, Anderson HR, Anderson LM, Andrews KG, Atkinson C, Baddour LM, Barker-Collo S, Bartels DH, Bell ML, Benjamin EJ, Bennett D, Bhalla K, Bikbov B, Bin Abdulhak A, Birbeck G, Blyth F, Bolliger I, Boufous S, Bucello C, Burch M, Burney P, Carapetis J, Chen H, Chou D, Chugh SS, Coffeng LE, Colan SD, Colquhoun S, Colson KE, Condon J, Connor MD, Cooper LT, Corriere M, Cortinovis M, de Vaccaro KC, Couser W, Cowie BC, Criqui MH, Cross M, Dabhadkar KC, Dahodwala N, De Leo D, Degenhardt L, Delossantos A, Denenberg J, Des Jarlais DC, Dharmaratne SD, Dorsey ER, Driscoll T, Duber H, Ebel B, Erwin PJ, Espindola P, Ezzati M, Feigin V, Flaxman AD, Forouzanfar MH, Fowkes FG, Franklin R, Fransen M, Freeman MK, Gabriel SE, Gakidou E, Gaspari F, Gillum RF, Gonzalez-Medina D, Halasa YA, Haring D, Harrison JE, Havmoeller R, Hay RJ, Hoen B, Hotez PJ, Hoy D, Jacobsen KH, James SL, Jasrasaria R, Jayaraman S, Johns N, Karthikeyan G, Kassebaum N, Keren A, Khoo JP, Knowlton LM, Kobusingye O, Koranteng A, Krishnamurthi R, Lipnick M, Lipshultz SE, Ohno SL, Mabweijano J, MacIntyre MF, Mallinger L, March L, Marks GB, Marks R, Matsumori A, Matzopoulos R, Mayosi BM, McAnulty JH, McDermott MM, McGrath J, Mensah GA, Merriman TR, Michaud C, Miller M, Miller TR, Mock C, Mocumbi AO, Mokdad AA, Moran A, Mulholland K, Nair MN, Naldi L, Narayan KM, Nasseri K, Norman P, O'Donnell M, Omer SB, Ortblad K, Osborne R, Ozgediz D, Pahari B, Pandian JD, Rivero AP, Padilla RP, Perez-Ruiz F, Perico N, Phillips D, Pierce K, Pope CA 3rd, Porrini E, Pourmalek F, Raju M, Ranganathan D, Rehm JT, Rein DB, Remuzzi G, Rivara FP, Roberts T, De Leon FR, Rosenfeld LC, Rushton L, Sacco RL, Salomon JA, Sampson U, Sanman E, Schwebel DC, Segui-Gomez M, Shepard DS, Singh D, Singleton J, Sliwa K, Smith E, Steer A, Taylor JA, Thomas B, Tleyjeh IM, Towbin JA, Truelsen T, Undurraga EA, Venketasubramanian N, Vijayakumar L, Vos T, Wagner GR, Wang M, Wang W, Watt K, Weinstock MA, Weintraub R, Wilkinson JD, Woolf AD, Wulf S, Yeh PH, Yip P, Zabetian A, Zheng ZJ, Lopez AD, Murray CJ, AlMazroa MA, Memish ZA, 2012. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 380: 2095–2128.
-
2.
Peltola V, Ruuskanen O, 2008. Editorial commentary: respiratory viral infections in developing countries: common, severe, and unrecognized. Clin Infect Dis 46: 58–60.
-
3.
Peasah SK, Azziz-Baumgartner E, Breese J, Meltzer MI, Widdowson MA, 2013. Influenza cost and cost-effectiveness studies globally–a review. Vaccine 31: 5339–5348.
-
4.
World Health Organization, 2008. Influenza. Available at: http://www.who.int/immunization/topics/influenza/en/. Accessed September 23, 2014.
-
5.
Azziz Baumgartner E, Dao CN, Nasreen S, Bhuiyan MU, Mah EMS, Al Mamun A, Sharker MA, Zaman RU, Cheng PY, Klimov AI, Widdowson MA, Uyeki TM, Luby SP, Mounts A, Bresee J, 2012. Seasonality, timing, and climate drivers of influenza activity worldwide. J Infect Dis 206: 838–846.
-
6.
Bhavnani D, Phatinawin L, Chantra S, Olsen SJ, Simmerman JM, 2007. The influence of rapid influenza diagnostic testing on antibiotic prescribing patterns in rural Thailand. Int J Infect Dis 11: 355–359.
-
7.
Perera KV, Chan KH, Ma E, Peiris JS, 2010. Influenza virus infections among a sample of hospital attendees in Ragama, Sri Lanka. Ceylon Med J 55: 40–44.
-
8.
World Health Organization, 2012. WHO Interim Global Epidemiological Surveillance Standards for Influenza. Geneva, Switzerland: World Health Organization. 1–61.
-
9.
Hassan F, Nguyen A, Formanek A, Bell JJ, Selvarangan R, 2014. Comparison of the BD Veritor System for Flu A+B with the Alere BinaxNOW influenza A&B card for detection of influenza A and B viruses in respiratory specimens from pediatric patients. J Clin Microbiol 52: 906–910.
-
10.
Lee VJ, Yap J, Cook AR, Tan CH, Loh JP, Koh WH, Lim EA, Liaw JC, Chew JS, Hossain I, Chan KW, Ting PJ, Ng SH, Gao Q, Kelly PM, Chen MI, Tambyah PA, Tan BH, 2011. A clinical diagnostic model for predicting influenza among young adult military personnel with febrile respiratory illness in Singapore. PLoS ONE 6: e17468.
-
11.
Central Bank of Sri Lanka, 2014. Current Economic Indicators. Available at: http://www.cbsl.gov.lk/htm/english/_cei/er/e_1.asp. Accessed September 17, 2014.
-
12.
Centers for Disease Control and Prevention, 2013. Overview of Influenza Surveillance in the United States. Available at: http://www.cdc.gov/flu/weekly/overview.htm. Accessed September 10, 2014.
-
13.
Fowlkes A, Giorgi A, Erdman D, Temte J, Goodin K, Di Lonardo S, Sun Y, Martin K, Feist M, Linz R, Boulton R, Bancroft E, McHugh L, Lojo J, Filbert K, Finelli L, 2014. Viruses associated with acute respiratory infections and influenza-like illness among outpatients from the Influenza Incidence Surveillance Project, 2010–2011. J Infect Dis 209: 1715–1725.
-
14.
Unit E, Sri Lanka Ministry of Health, 2013. Epidemiological Bulletin-Sri Lanka-First Quarter 2013. Available at: http://www.epid.gov.lk/web/images/pdf/bulletin/2013/1st_qeb_2013.pdf. Accessed January 9, 2015.
-
15.
Unit E, Sri Lanka Ministry of Health, 2013. Epidemiological Bulletin-Sri Lanka-Second Quarter 2013. Available at: http://www.epid.gov.lk/web/images/pdf/bulletin/2013/2nd_qeb_2013.pdf. Accessed January 9, 2015.
-
16.
Unit E, Sri Lanka Ministry of Health, 2013. Epidemiological Bulletin-Sri Lanka-Third Quarter 2013. Available at: http://www.epid.gov.lk/web/images/pdf/bulletin/2013/3rd_qeb_2013.pdf. Accessed January 9, 2015.
-
17.
Bilcke J, Coenen S, Beutels P, 2014. Influenza-like-illness and clinically diagnosed flu: disease burden, costs and quality of life for patients seeking ambulatory care or no professional care at all. PLoS ONE 9: e102634.
-
18.
Shiley KT, Nadolski G, Mickus T, Fishman NO, Lautenbach E, 2010. Differences in the epidemiological characteristics and clinical outcomes of pandemic (H1N1) 2009 influenza, compared with seasonal influenza. Infect Control Hosp Epidemiol 31: 676–682.
-
19.
Friedman MJ, Attia MW, 2004. Clinical predictors of influenza in children. Arch Pediatr Adolesc Med 158: 391–394.
-
20.
Stein J, Louie J, Flanders S, Maselli J, Hacker JK, Drew WL, Gonzales R, 2005. Performance characteristics of clinical diagnosis, a clinical decision rule, and a rapid influenza test in the detection of influenza infection in a community sample of adults. Ann Emerg Med 46: 412–419.
-
21.
Gill JM, Fleischut P, Haas S, Pellini B, Crawford A, Nash DB, 2006. Use of antibiotics for adult upper respiratory infections in outpatient settings: a national ambulatory network study. Fam Med 38: 349–354.
-
22.
Grijalva CG, Nuorti JP, Griffin MR, 2009. Antibiotic prescription rates for acute respiratory tract infections in US ambulatory settings. JAMA 302: 758–766.
-
23.
Little P, Moore M, Kelly J, Williamson I, Leydon G, McDermott L, Mullee M, Stuart B, 2014. Delayed antibiotic prescribing strategies for respiratory tract infections in primary care: pragmatic, factorial, randomised controlled trial. BMJ 348: g1606.
-
24.
Michiels B, Thomas I, Van Royen P, Coenen S, 2011. Clinical prediction rules combining signs, symptoms and epidemiological context to distinguish influenza from influenza-like illnesses in primary care: a cross sectional study. BMC Fam Pract 12: 4.
-
25.
Montalto NJ, 2003. An office-based approach to influenza: clinical diagnosis and laboratory testing. Am Fam Physician 67: 111–118.
| Past two years | Past Year | Past 30 Days | |
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| Abstract Views | 563 | 506 | 27 |
| Full Text Views | 304 | 20 | 1 |
| PDF Downloads | 93 | 9 | 1 |
An Under-Recognized Influenza Epidemic Identified by Rapid Influenza Testing, Southern Sri Lanka, 2013
L. Gayani Tillekeratne
L. Gayani Tillekeratne
Duke Global Health Institute, Durham, North Carolina; Departments of Medicine, Microbiology, and Pediatrics, Faculty of Medicine, Ruhuna University, Galle, Sri Lanka; Teaching Hospital Karapitiya, Galle, Sri Lanka; Genetech Research Institute, Colombo, Sri Lanka; Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Medicine, Duke University, Durham, North Carolina
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Champica K. Bodinayake
Champica K. Bodinayake
Duke Global Health Institute, Durham, North Carolina; Departments of Medicine, Microbiology, and Pediatrics, Faculty of Medicine, Ruhuna University, Galle, Sri Lanka; Teaching Hospital Karapitiya, Galle, Sri Lanka; Genetech Research Institute, Colombo, Sri Lanka; Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Medicine, Duke University, Durham, North Carolina
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Ajith Nagahawatte
Ajith Nagahawatte
Duke Global Health Institute, Durham, North Carolina; Departments of Medicine, Microbiology, and Pediatrics, Faculty of Medicine, Ruhuna University, Galle, Sri Lanka; Teaching Hospital Karapitiya, Galle, Sri Lanka; Genetech Research Institute, Colombo, Sri Lanka; Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Medicine, Duke University, Durham, North Carolina
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Dhammika Vidanagama
Dhammika Vidanagama
Duke Global Health Institute, Durham, North Carolina; Departments of Medicine, Microbiology, and Pediatrics, Faculty of Medicine, Ruhuna University, Galle, Sri Lanka; Teaching Hospital Karapitiya, Galle, Sri Lanka; Genetech Research Institute, Colombo, Sri Lanka; Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Medicine, Duke University, Durham, North Carolina
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Vasantha Devasiri
Vasantha Devasiri
Duke Global Health Institute, Durham, North Carolina; Departments of Medicine, Microbiology, and Pediatrics, Faculty of Medicine, Ruhuna University, Galle, Sri Lanka; Teaching Hospital Karapitiya, Galle, Sri Lanka; Genetech Research Institute, Colombo, Sri Lanka; Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Medicine, Duke University, Durham, North Carolina
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Wasantha Kodikara Arachchi
Wasantha Kodikara Arachchi
Duke Global Health Institute, Durham, North Carolina; Departments of Medicine, Microbiology, and Pediatrics, Faculty of Medicine, Ruhuna University, Galle, Sri Lanka; Teaching Hospital Karapitiya, Galle, Sri Lanka; Genetech Research Institute, Colombo, Sri Lanka; Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Medicine, Duke University, Durham, North Carolina
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Ruvini Kurukulasooriya
Ruvini Kurukulasooriya
Duke Global Health Institute, Durham, North Carolina; Departments of Medicine, Microbiology, and Pediatrics, Faculty of Medicine, Ruhuna University, Galle, Sri Lanka; Teaching Hospital Karapitiya, Galle, Sri Lanka; Genetech Research Institute, Colombo, Sri Lanka; Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Medicine, Duke University, Durham, North Carolina
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Aruna Dharshan De Silva
Aruna Dharshan De Silva
Duke Global Health Institute, Durham, North Carolina; Departments of Medicine, Microbiology, and Pediatrics, Faculty of Medicine, Ruhuna University, Galle, Sri Lanka; Teaching Hospital Karapitiya, Galle, Sri Lanka; Genetech Research Institute, Colombo, Sri Lanka; Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Medicine, Duke University, Durham, North Carolina
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Truls Østybe
Truls Østybe
Duke Global Health Institute, Durham, North Carolina; Departments of Medicine, Microbiology, and Pediatrics, Faculty of Medicine, Ruhuna University, Galle, Sri Lanka; Teaching Hospital Karapitiya, Galle, Sri Lanka; Genetech Research Institute, Colombo, Sri Lanka; Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Medicine, Duke University, Durham, North Carolina
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Megan E. Reller
Megan E. Reller
Duke Global Health Institute, Durham, North Carolina; Departments of Medicine, Microbiology, and Pediatrics, Faculty of Medicine, Ruhuna University, Galle, Sri Lanka; Teaching Hospital Karapitiya, Galle, Sri Lanka; Genetech Research Institute, Colombo, Sri Lanka; Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Medicine, Duke University, Durham, North Carolina
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Christopher W. Woods
Christopher W. Woods
Duke Global Health Institute, Durham, North Carolina; Departments of Medicine, Microbiology, and Pediatrics, Faculty of Medicine, Ruhuna University, Galle, Sri Lanka; Teaching Hospital Karapitiya, Galle, Sri Lanka; Genetech Research Institute, Colombo, Sri Lanka; Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Medicine, Duke University, Durham, North Carolina
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Influenza accounts for a large burden of acute respiratory tract infections in high-income countries; data from lower-income settings are limited due to lack of confirmatory testing. Consecutive outpatients presenting to the largest tertiary care hospital in southern Sri Lanka were surveyed for influenza-like illness (ILI), defined as acute onset of fever ≥ 38.0°C and cough. Patients were administered a questionnaire and nasal/nasopharyngeal sampling for rapid influenza A/B testing. We enrolled 311 patients with ILI from March to November 2013: 170 (54.7%) children and 172 (55.3%) males. Approximately half (147, 47.3%) tested positive for influenza, but 253 (81.4%) were prescribed antibiotics. On bivariable analysis, symptoms associated with influenza included pain with breathing (P < 0.001), headache (P = 0.005), fatigue (P = 0.003), arthralgias (P = 0.003), and myalgias (P = 0.006) in children and pain with breathing (P = 0.01), vomiting (P = 0.03), and arthralgias (P = 0.03) in adults. Our final clinical predictive models had low sensitivity and fair specificity—50.0% (95% CI: 38.6–61.4%) and 83.2% (95% CI: 73.4–90.0%), respectively, in children and 52.2% (95% CI: 39.9–64.2%) and 81.4% (95% CI: 70.0–89.4%), respectively, in adults. Our study confirms the ability of rapid influenza testing to identify an influenza epidemic in a setting in which testing is not routinely available.
Author Notes
Financial support: This work was supported by the NIH Research Training Grant #R25 TW009337 funded by the Fogarty International Center and the National Institute of Mental Health.
Authors' addresses: L. Gayani Tillekeratne and Truls Østybe, Global Health Institute, Duke University, Durham, NC, E-mails: gayani.tillekeratne@dm.duke.edu and truls.ostbye@dm.duke.edu. Champica K. Bodinayake, Ajith Nagahawatte, and Vasantha Devasiri, Departments of Medicine, Microbiology and Pediatrics, Ruhuna University, Galle, Sri Lanka, E-mails: bodinayake@yahoo.co.uk, ajithnagahawatte@yahoo.co.uk, and vdevasiri@gmail.com. Dhammika Vidanagama and Wasantha Kodikara Arachchi, Teaching Hospital Karapitiya, Galle, Sri Lanka, E-mails: dhammikasv@yahoo.com and kody@sltnet.lk. Ruvini Kurukulasooriya, Duke-Ruhuna Collaborative Research Center, Ruhuna University, Galle, Sri Lanka, E-mail: ruhunasearch@gmail.com. Aruna Dharshan De Silva, Genetech, Research Institute, Colombo, Sri Lanka, E-mail: dslv90@yahoo.com. Megan E. Reller, Department of Pathology, Johns Hopkins University, Baltimore, MD, E-mail: mreller1@jhmi.edu. Christopher W. Woods, Department of Medicine, Duke University, Durham, NC, and Global Health Institute, Duke University, Durham, NC, E-mail: chris.woods@duke.edu.
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1.
Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, Abraham J, Adair T, Aggarwal R, Ahn SY, Alvarado M, Anderson HR, Anderson LM, Andrews KG, Atkinson C, Baddour LM, Barker-Collo S, Bartels DH, Bell ML, Benjamin EJ, Bennett D, Bhalla K, Bikbov B, Bin Abdulhak A, Birbeck G, Blyth F, Bolliger I, Boufous S, Bucello C, Burch M, Burney P, Carapetis J, Chen H, Chou D, Chugh SS, Coffeng LE, Colan SD, Colquhoun S, Colson KE, Condon J, Connor MD, Cooper LT, Corriere M, Cortinovis M, de Vaccaro KC, Couser W, Cowie BC, Criqui MH, Cross M, Dabhadkar KC, Dahodwala N, De Leo D, Degenhardt L, Delossantos A, Denenberg J, Des Jarlais DC, Dharmaratne SD, Dorsey ER, Driscoll T, Duber H, Ebel B, Erwin PJ, Espindola P, Ezzati M, Feigin V, Flaxman AD, Forouzanfar MH, Fowkes FG, Franklin R, Fransen M, Freeman MK, Gabriel SE, Gakidou E, Gaspari F, Gillum RF, Gonzalez-Medina D, Halasa YA, Haring D, Harrison JE, Havmoeller R, Hay RJ, Hoen B, Hotez PJ, Hoy D, Jacobsen KH, James SL, Jasrasaria R, Jayaraman S, Johns N, Karthikeyan G, Kassebaum N, Keren A, Khoo JP, Knowlton LM, Kobusingye O, Koranteng A, Krishnamurthi R, Lipnick M, Lipshultz SE, Ohno SL, Mabweijano J, MacIntyre MF, Mallinger L, March L, Marks GB, Marks R, Matsumori A, Matzopoulos R, Mayosi BM, McAnulty JH, McDermott MM, McGrath J, Mensah GA, Merriman TR, Michaud C, Miller M, Miller TR, Mock C, Mocumbi AO, Mokdad AA, Moran A, Mulholland K, Nair MN, Naldi L, Narayan KM, Nasseri K, Norman P, O'Donnell M, Omer SB, Ortblad K, Osborne R, Ozgediz D, Pahari B, Pandian JD, Rivero AP, Padilla RP, Perez-Ruiz F, Perico N, Phillips D, Pierce K, Pope CA 3rd, Porrini E, Pourmalek F, Raju M, Ranganathan D, Rehm JT, Rein DB, Remuzzi G, Rivara FP, Roberts T, De Leon FR, Rosenfeld LC, Rushton L, Sacco RL, Salomon JA, Sampson U, Sanman E, Schwebel DC, Segui-Gomez M, Shepard DS, Singh D, Singleton J, Sliwa K, Smith E, Steer A, Taylor JA, Thomas B, Tleyjeh IM, Towbin JA, Truelsen T, Undurraga EA, Venketasubramanian N, Vijayakumar L, Vos T, Wagner GR, Wang M, Wang W, Watt K, Weinstock MA, Weintraub R, Wilkinson JD, Woolf AD, Wulf S, Yeh PH, Yip P, Zabetian A, Zheng ZJ, Lopez AD, Murray CJ, AlMazroa MA, Memish ZA, 2012. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 380: 2095–2128.
-
2.
Peltola V, Ruuskanen O, 2008. Editorial commentary: respiratory viral infections in developing countries: common, severe, and unrecognized. Clin Infect Dis 46: 58–60.
-
3.
Peasah SK, Azziz-Baumgartner E, Breese J, Meltzer MI, Widdowson MA, 2013. Influenza cost and cost-effectiveness studies globally–a review. Vaccine 31: 5339–5348.
-
4.
World Health Organization, 2008. Influenza. Available at: http://www.who.int/immunization/topics/influenza/en/. Accessed September 23, 2014.
-
5.
Azziz Baumgartner E, Dao CN, Nasreen S, Bhuiyan MU, Mah EMS, Al Mamun A, Sharker MA, Zaman RU, Cheng PY, Klimov AI, Widdowson MA, Uyeki TM, Luby SP, Mounts A, Bresee J, 2012. Seasonality, timing, and climate drivers of influenza activity worldwide. J Infect Dis 206: 838–846.
-
6.
Bhavnani D, Phatinawin L, Chantra S, Olsen SJ, Simmerman JM, 2007. The influence of rapid influenza diagnostic testing on antibiotic prescribing patterns in rural Thailand. Int J Infect Dis 11: 355–359.
-
7.
Perera KV, Chan KH, Ma E, Peiris JS, 2010. Influenza virus infections among a sample of hospital attendees in Ragama, Sri Lanka. Ceylon Med J 55: 40–44.
-
8.
World Health Organization, 2012. WHO Interim Global Epidemiological Surveillance Standards for Influenza. Geneva, Switzerland: World Health Organization. 1–61.
-
9.
Hassan F, Nguyen A, Formanek A, Bell JJ, Selvarangan R, 2014. Comparison of the BD Veritor System for Flu A+B with the Alere BinaxNOW influenza A&B card for detection of influenza A and B viruses in respiratory specimens from pediatric patients. J Clin Microbiol 52: 906–910.
-
10.
Lee VJ, Yap J, Cook AR, Tan CH, Loh JP, Koh WH, Lim EA, Liaw JC, Chew JS, Hossain I, Chan KW, Ting PJ, Ng SH, Gao Q, Kelly PM, Chen MI, Tambyah PA, Tan BH, 2011. A clinical diagnostic model for predicting influenza among young adult military personnel with febrile respiratory illness in Singapore. PLoS ONE 6: e17468.
-
11.
Central Bank of Sri Lanka, 2014. Current Economic Indicators. Available at: http://www.cbsl.gov.lk/htm/english/_cei/er/e_1.asp. Accessed September 17, 2014.
-
12.
Centers for Disease Control and Prevention, 2013. Overview of Influenza Surveillance in the United States. Available at: http://www.cdc.gov/flu/weekly/overview.htm. Accessed September 10, 2014.
-
13.
Fowlkes A, Giorgi A, Erdman D, Temte J, Goodin K, Di Lonardo S, Sun Y, Martin K, Feist M, Linz R, Boulton R, Bancroft E, McHugh L, Lojo J, Filbert K, Finelli L, 2014. Viruses associated with acute respiratory infections and influenza-like illness among outpatients from the Influenza Incidence Surveillance Project, 2010–2011. J Infect Dis 209: 1715–1725.
-
14.
Unit E, Sri Lanka Ministry of Health, 2013. Epidemiological Bulletin-Sri Lanka-First Quarter 2013. Available at: http://www.epid.gov.lk/web/images/pdf/bulletin/2013/1st_qeb_2013.pdf. Accessed January 9, 2015.
-
15.
Unit E, Sri Lanka Ministry of Health, 2013. Epidemiological Bulletin-Sri Lanka-Second Quarter 2013. Available at: http://www.epid.gov.lk/web/images/pdf/bulletin/2013/2nd_qeb_2013.pdf. Accessed January 9, 2015.
-
16.
Unit E, Sri Lanka Ministry of Health, 2013. Epidemiological Bulletin-Sri Lanka-Third Quarter 2013. Available at: http://www.epid.gov.lk/web/images/pdf/bulletin/2013/3rd_qeb_2013.pdf. Accessed January 9, 2015.
-
17.
Bilcke J, Coenen S, Beutels P, 2014. Influenza-like-illness and clinically diagnosed flu: disease burden, costs and quality of life for patients seeking ambulatory care or no professional care at all. PLoS ONE 9: e102634.
-
18.
Shiley KT, Nadolski G, Mickus T, Fishman NO, Lautenbach E, 2010. Differences in the epidemiological characteristics and clinical outcomes of pandemic (H1N1) 2009 influenza, compared with seasonal influenza. Infect Control Hosp Epidemiol 31: 676–682.
-
19.
Friedman MJ, Attia MW, 2004. Clinical predictors of influenza in children. Arch Pediatr Adolesc Med 158: 391–394.
-
20.
Stein J, Louie J, Flanders S, Maselli J, Hacker JK, Drew WL, Gonzales R, 2005. Performance characteristics of clinical diagnosis, a clinical decision rule, and a rapid influenza test in the detection of influenza infection in a community sample of adults. Ann Emerg Med 46: 412–419.
-
21.
Gill JM, Fleischut P, Haas S, Pellini B, Crawford A, Nash DB, 2006. Use of antibiotics for adult upper respiratory infections in outpatient settings: a national ambulatory network study. Fam Med 38: 349–354.
-
22.
Grijalva CG, Nuorti JP, Griffin MR, 2009. Antibiotic prescription rates for acute respiratory tract infections in US ambulatory settings. JAMA 302: 758–766.
-
23.
Little P, Moore M, Kelly J, Williamson I, Leydon G, McDermott L, Mullee M, Stuart B, 2014. Delayed antibiotic prescribing strategies for respiratory tract infections in primary care: pragmatic, factorial, randomised controlled trial. BMJ 348: g1606.
-
24.
Michiels B, Thomas I, Van Royen P, Coenen S, 2011. Clinical prediction rules combining signs, symptoms and epidemiological context to distinguish influenza from influenza-like illnesses in primary care: a cross sectional study. BMC Fam Pract 12: 4.
-
25.
Montalto NJ, 2003. An office-based approach to influenza: clinical diagnosis and laboratory testing. Am Fam Physician 67: 111–118.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 563 | 506 | 27 |
| Full Text Views | 304 | 20 | 1 |
| PDF Downloads | 93 | 9 | 1 |