Ebell et al reported a clinical decision rule for the diagnosis of influenza. This can help guide testing and management. The authors are from the University of Georgia, University of California at San Francisco and the University of Lausanne.
Parameters:
(1) onset in hours
(2) myalgia
(3) chills and sweats
(4) fever and cough
Parameter
Finding
Points
onset
< 48 hours
1
>= 48 hours
0
myalgias
absent
0
present
2
chills and sweats
absent
0
present
1
fever and cough
absent
0
present
2
total score =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 0
• maximum score: 6
Total Score
Risk Group
0 to 2
low
3
moderate
4 to 6
high
Season (Prevalence)
Risk Group
Action
not flu season (2.5%)
NA
no testing, no therapy
shoulder (10%)
low or moderate
no testing, no therapy
high
order rapid test, treat if positive
flu season (30%)
low
no testing, no therapy
moderate
order rapid test, treat if positive
high
treat empirically
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