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Influensa: Diagnosen

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Influensasymptomene er typiske, og det er spesielt feber kombinert med smerter i muskler og ledd, samt lengre varighet, som skiller sykdommen fra mer uskyldige forkjølelser. Hos de aller fleste vil derfor diagnosen kunne stilles uten tilleggsprøver.

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Om nødvendig kan diagnosen bekreftes ved å ta virusprøve fra svelget, eller ved å ta blodprøver for påvisning av antistoffer. Blodprøve for å påvise antistoffer må tas tidlig under sykdommen, og gjentas noen uker etter sykdom for å påvise forandring av antistoffinnhold. Både halsprøve og blodprøve tas vanligvis kun når det er usikkerhet om diagnosen, eller dersom det er nødvendig for å fastslå om en epidemi er i gang.

Hurtigtester til undersøkelse på influensa er under utvikling, men de er fortsatt unøyaktige. Problemet er at de har lav sensitivitet, det vil si at testen bare fanger opp en andel av de som er syke.

Vil du vite mer

Dette dokumentet er basert på det profesjonelle dokumentet Influensa . Referanselisten for dette dokumentet vises nedenfor

  1. Nicholson KG, Wood JM, Zambon M. Influenza. Lancet 2003; 362: 1733-45. PubMed
  2. Hayward AC, Fragaszy EB, Bermingham A, et al. Comparative community burden and severity of seasonal and pandemic influenza: results of the Flu Watch cohort study. Lancet Respiratory Medicine 2014. doi:10.1016/S2213-2600(14)70034-7 DOI
  3. Jefferson T. How to deal with influenza?. BMJ 2004; 329: 634-5. PubMed
  4. World Health Organization. Fifty-Sixth World Health Assembly. Prevention and control of influenza pandemics and annual epidemics (agenda item 14.14). Geneva: WHO, 26 May 2003.
  5. Turner D, Wailoo A, Nicholson K, Cooper N, Sutton A, Abrams K. Systematic review and economic decision modeling for the prevention and treatment of influenza A and B. http://www.nice.org.uk/pdf/ influenzaassrep.pdf (accessed Oct 15, 2003).
  6. Gaitonde DY, Moore FC, Morgan MMK. Influenza: Diagnosis and Treatment. Am Fam Physician. 2019 Dec 15;100(12):751-758 . PubMed
  7. Taubenberger JK, Morens DM. Influenza: the once and future pandemic. Public Health Rep. 2010;125(suppl 3):16–26.
  8. Yan J, Grantham M, Pantelic J, et al. Infectious virus in exhaled breath of symptomatic seasonal influenza cases from a college community. Proc Natl Acad Sci USA; 2018. pmid:29348203 PubMed
  9. Moscona A. Neuraminidase inhibitors for influenza. N Engl J Med 2005; 353: 1363-73. PubMed
  10. Ebell MH, White LL, Casault T. A systematic review of the history and physical examination to diagnose influenza. J Am Board Fam Pract 2004; 17:1-5. PubMed
  11. Peteranderl C, Herold S, Schmoldt C. Human influenza virus infections. Semin Respir Crit Care Med. 2016;37(4):487–500.
  12. Dugas AF, Valsamakis A, Atreya MR, et al. Clinical diagnosis of influenza in the ED. Am J Emerg Med 2015 Jun; 33:770. PMID: 25827595 PubMed
  13. Jefferson T, Jones MA, Doshi P, et al. Neuraminidase inhibitors for preventing and treating influenza in healthy adults and children. Cochrane Database of Systematic Reviews 2014, Issue 4. Art. No.: CD008965. DOI: 10.1002/14651858.CD008965.pub4 DOI
  14. Uyeki TM, Bernstein HH, Bradley JS, et al. Clinical Practice Guidelines by the Infectious Diseases Society of America: 2018 Update on Diagnosis, Treatment, Chemoprophylaxis, and Institutional Outbreak Management of Seasonal Influenza. Clin Infect Dis 2018. pmid:30566567 PubMed
  15. Rodriguez WJ, Schwartz RH, Thorne MM. Evalaution of diagnostic tests for influenza in a pediatric practice. Pediatr Infect Dis J 2002; 21: 193-96. PubMed
  16. Storch GA. Rapid diagnostic tests for influenza. Curr Opin Pediatr 2003; 15: 77-84. PubMed
  17. Merckx J, Wali R, Schiller I, et al. Diagnostic Accuracy of Novel and Traditional Rapid Tests for Influenza Infection Compared With Reverse Transcriptase Polymerase Chain Reaction: A Systematic Review and Meta-analysis . Ann Intern Med 2017. pmid:28869986 PubMed
  18. Butler CC, van der Velden AW, Bongard E, et al. Oseltamivir plus usual care versus usual care for influenza-like illness in primary care: an open-label, pragmatic, randomised controlled trial. Lancet. 2019. PMID: 31839279 PubMed
  19. Center for Disease Control and Prevention. Maternal and infant outcomes among severely ill pregnant and postpartum women with 2009 pandemic influenza A (H1N1). MMWR 2011; 60: 1193-6. PubMed
  20. Louie JK, Lampiris H. Treating Influenza With Neuraminidase Inhibitors: What Is the Evidence? JAMA Intern Med. 2015 Dec;175(12):1899-900. PubMed
  21. Heneghan CJ, Onakpoya I, Joes MA, et al. Neuraminidase inhibitors for influenza: a systematic review and meta-analysis of regulatory and mortality data. Health Technol Assess 2016. PMID: 27246259 PubMed
  22. Dobson J, Whitley RJ, Pocock S, et al. Oseltamivir treatment for influenza in adults: a meta-analysis of randomised controlled trials. Lancet 2015. 385;1729-37. PMID: 25640810 PubMed
  23. Jefferson T, Jones M, Doshi P, et al. Oseltamivir for influenza in adults and children: systematic review of clinical study reports and summary of regulatory comments. BMJ. 2014 9;348:g2545. doi: 10.1136/bmj.g2545. DOI
  24. Nakano T, Ishiwada N, Sumitani T, et al. Inhaled Laninamivir Octanoate as Prophylaxis for Influenza in Children. Pediatrics. 2016; 138(6). PMID: 27940664 PubMed
  25. Lee J, Park JH, Jwa H, Kim YH. Comparison of Efficacy of Intravenous Peramivir and Oral Oseltamivir for the Treatment of Influenza: Systematic Review and Meta-Analysis. Yonsei Med J 2017; 58: 778-85. pmid:28540991 PubMed
  26. Graner S, Smith T, Beau en pike-Michel C, et al. Neuraminidase inhibitors during pregnancy and risk of adverse neonatal outcomes and congenital malformations: population based European register study. BMJ 2017. doi: 10,1136 / bmj.j629
  27. Hung IFN, To KKW, Chan JFW, et al. Efficacy of clarithromycin-naproxen-oseltamivir combination in the treatment of patients hospitalized for influenza A(H3N2) infection: An open-label randomized, controlled, phase IIb/III trial. Chest 2017 May; 151:1069. PMID: 27884765 PubMed
  28. Hayden FG, Sugaya N, Hirotsu N, et al. Baloxavir Marboxil for Uncomplicated Influenza in Adults and Adolescents. N Engl J Med 2018; 379: 913-23. pmid:30184455 PubMed
  29. Ikematsu H, Hayden FG, Kawaguchi K, et al. Baloxavir Marboxil for Prophylaxis against Influenza in Household Contacts. N Engl J Med 2020; 383: 2020. doi:10.1056/NEJMoa1915341 DOI
  30. Jefferson T, Del Mar C, Dooley L, et al. Physical interventions to interrupt or reduce the spread of respiratory viruses: systematic review. BMJ 2009; 339: b3675. PubMed
  31. Radonovich LJ Jr, Simberkoff MS, Bessesen MT, et al. N95 Respirators vs Medical Masks for Preventing Influenza Among Health Care Personnel: A Randomized Clinical Trial. JAMA. 2019 Sep 3;322(9):824-833. doi: 10.1001/jama.2019.11645. Pmid 31479137
  32. Folkehelseinstituttet. Vaksinasjonsveilederen. Effekt av influensavaksine. Informasjon om kunnskapsgrunnlaget. Sist oppdatert 18.05.2017. Siden besøkt 31.08.2020. www.fhi.no
  33. Treanor JJ, Talbot HK, Ohmit SE, et al. Effectiveness of seasonal influenza vaccines in the United States during a season with circulation of all three vaccine strains. Clin Infect Dis 2012; 55: 951-9. PubMed
  34. Jefferson T, Di Pietrantonj C, Al-Ansary LA, Ferroni E, Thorning S, Thomas RE. Vaccine for preventing influenza in the elderly. Cochrane Database of Systematic Reviews 2010, Issue 2. Art. No.: CD004876. DOI:10.1002/14651858.CD004876.pub3. DOI
  35. Thomas RE, Jefferson T, Lasserson TJ. Influenza vaccination for healthcare workers who care for people aged 60 or older living in long‐term care institutions. Cochrane Database of Systematic Reviews 2016, Issue 6. Art. No.: CD005187. DOI: 10.1002/14651858.CD005187.pub5. Accessed 11 January 2021. The Cochrane Library
  36. Ahmed F, Lindley MC, Allred N, et al. Effect of influenza vaccination of healthcare personnel on morbidity and mortality among patients: Systematic review and grading of evidence. Clin Infect Dis 2014 Jan 1; 58:50. doi.org/10.1093/cid/cit580
  37. AAP News room. AAP recommends mandatory flu vaccine for all health care workers. ; : .
  38. Demicheli V, Jefferson T, Al-Ansary LA, et al. Vaccines for preventing influenza in healthy adults. Cochrane Database Syst Rev 2014, 3: CD001269. PMID: 24623315 PubMed
  39. Jefferson T, Rivetti A, Di Pietrantonj C, Demicheli V, Ferroni E. Vaccines for preventing influenza in healthy children. Cochrane Database of Systematic Reviews 2012, Issue 8. Art. No.: CD004879. DOI: 10.1002/14651858.CD004879.pub4. DOI
  40. Håberg SE, Trogstad L, Gunnes N, et al. Risk of fetal death after pandemic influenza virus infection og vaccination. N Engl J Med 2013. doi: 10.1056/NEJMoa1207210 DOI
  41. Scuffham PA, West PA. Economic evaluation of strategies for the control and management of influenza in Europe. Vaccine 2002;20: 2562-78. PubMed
  42. Peters PH Jr, Gravenstein S, Norwood P, et al. Long-term use of oseltamivir for the prophylaxis of influenza in a vaccinated frail older population. J Am Geriatr Soc 2001; 49: 1025-31. PubMed
  43. Wang GF, Li W, Li K. Acute encephalopathy and encephalitis caused by influenza virus infection. Curr Opin Neurol. 2010;23(3):305-311. PMID: 20455276 PubMed
  44. Estabragh ZR, Mamas MA. The cardiovascular manifestations of influenza: a systematic review. Int J Cardiol. 2013 ;167(6):2397-403. doi: 10.1016/j.ijcard.2013.01.274. DOI
  45. Jefferson T, Demicheli V, Di Pietrantonj C, Rivetti D. Amantadine and rimantadine for influenza A in adults. Cochrane Database of Systematic Reviews 2006, Issue 2. Art. No.: CD001169. DOI: 10.1002/14651858.CD001169.pub3 DOI
  46. Sheffield JS, Greer LG, Rogers VL, et al. Effect of influenza vaccination in the first trimester of pregnancy. Obstet Gynecol 2012; 120: 532-7. PubMed
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