Purpose: The evaluation of four post-pandemic influenza seasons 2009-2013 in the Faculty hospital Hradec Králové and comparison of used rapid antigen tests (RATs) with real time RT-PCR. Material and methods: Between November 2009 and June 2013 were examined 3845 samples from patients with respiratory tract infections by RATs (Influenza A/B 2 Panel Test (GECKO(R) Pharma, Germany), Rapid VIDITEST Influenza A+B Card (VIDIA(R), Czech Republic) and BinaxNOW Influenza A&B Test (ALERE(R), USA) or real time RT-PCR (RTR InfA/H1N1 Detection Set (Roche(R)), RealStar(R) Influenza S and T RT-PCR Kit 3.0 (Altona (R), Germany).
Results:A totally 1059 samples were examined simultaneously by RAT and real time RT-PCR. The overall sensitivity and specificity of RATs compared with real time RT-PCR were 32.2% and 98.1% for influenza A and 17.6% and 99.4% for influenza B.
Higher sensitivity of RATs were in children (66.6%) compared with adults (14.3 - 40.0 %). In the first three post-pandemic seasons were continuously decrease of positive samples from 23.5% in season 2009-2010 to 3.3% in season 2011-2012. but in season 2012-2013 were rapidly increase of positive results. to 31.5%, with high share of influenza A/ H1N1/ 2009 (79.6%).
Conclusion: Our results shown insufficient sensitivity of all used RATs and necessity of having other confirmatory test, like RT-PCR. It was also shown unexplained increase of case and influenza severity in season 2012-13.