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Test Characteristics of the Respiratory Syncytial Virus Enzyme-Linked Immunoabsorbent Assay in Febrile Infants?60 Days of Age

Faiz Ahmad, MD

Jacqueline Urtecho, MD

Michael Novick, BS

Patricia Dixon, MD

Children's Hospital of New York, Columbia University College of Physicians and Surgeons, New York

Debbie Levine, MD

New York University School of Medicine, Bellvue Hospital Center

Steven Miller, MD

Children's Hospital of New York, Columbia University College of Physicians and Surgeons, New York

The test characteristics of rapid tests for respiratory syncytial virus (RSV) in infants may differ from older children secondary to a lower likelihood of previous illness with RSV. Our main goal was to establish the test characteristics of the RSV Abbott Testpack (TP) enzyme-linked immunoabsorbent assay (EIA) ® in febrile infants < 60 days of age. Our secondary goal was to determine the likelihood of RSV given a particular clinical syndrome and a negative or positive EIA. A prospective sample of infants with a temperature > 38.0⁰C was evaluated during 2 successive RSV seasons. Conventional tissue and shell vial viral cultures were utilized as the reference standard. The RSV Abbott Testpack EJA® had a sensitivity of 75% (95% CI 60-90%), a specificity of 98% (95% CI 96-100%), a positive predictive value of 89% (95% CI 77-100%), a negative predictive value of 95% (95% CI 91-98%), a likelihood ratio for a positive test of 35.5 (95% CI 11.4-110.7), and a likelihood ratio for a negative test of 0.26 (95% CI 0.14-0.47). Even with a negative EIA, patients with lower and upper respiratory tract illness still had a 22.3% and 5.5% chance of harboring RSV, respectively. The RSV Abbott Testpack® is a useful diagnostic tool in the detection of RSV in febrile infants but has limitations. During months typically associated with RSV disease, a positive RSV TP indicates a high likelihood of illness, but clinicians should be wary of false negatives.

Clinical Pediatrics, Vol. 41, No. 6, 415-418 (2002)
DOI: 10.1177/000992280204100606


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