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風邪でマスクをつけて咳をする男
風邪でマスクをつけて咳をする男

インフルエンザ検査で陰性であっても、油断してはいけないその理由

インフルエンザの男

インフルエンザの季節になりました。この時期はウイルスが活発に動きまわる時期でもあり、インフルエンザ以外にも様々な病気にかかりやすくなっています。

高熱がでて体の節々が痛くなっても、風邪かもしれないし、違う病気かもしれない。インフルエンザは症状の上では他の病気と類似症状が多い病気ですので、インフルエンザかどうかを確認するにはインフルエンザの検査が必要になるでしょう。

しかしながら、インフルエンザかどうかを確認するインフルエンザ検査は100%の的中率を誇るというわけでもありません。陽性の場合にはインフルエンザである可能性が非常に高いのですが、陰性の場合はインフルエンザではない可能性も考えられます。

この記事では、インフルエンザ検査で陰性であっても完全には信じられないその理由についてご説明いたします。

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インフルエンザの検査について

インフルエンザの女性

インフルエンザの検査は投薬治療のためにも必要です。インフルエンザの治療薬の中には48時間以内に投与しなければならない薬品も多く、一刻も早い検査が必要になります。かつては血液検査で一日以上かかっていましたが、現在では鼻の粘膜や口内の粘膜からすぐに検査が可能です。

ところがこの検査は稀にインフルエンザに罹患していても陰性と判断されてしまうことがあるのです。検査で陰性と出たとしても、最終的な判断は主治医の判断に委ねられることになっています。

学校などでは、検査が陰性とでた場合インフルエンザとは認められないといったケースもあるそうですが、ナンセンスの極みといえるでしょう。いずれの場合も、医師の判断に従うようにしましょう。

インフルエンザの感度と特異度

インフルエンザ迅速検査で検査ミスが起こるのは、陽性/陰性的中率が100%ではないからですが、これらには「感度」と「特異度」といったパラメーターが影響しています。

  • 感度は、インフルエンザの人が検査で陽性になる割合
  • 特異度は、インフルエンザではない人が検査で陰性になる割合

感度と特異度同じもののように見えますが、異なります。両方のパラメータはようするに「通常の検査結果が問題なく出る人」で100%であるほどよいとされます。ところが、感度と特異度は、時期や人の健康状態や体力、ウイルスの体内における分布状況など様々な要因に影響されてしまいます。なかでも

平均的には、感度70%、特異度は90%前後と言われていますが、インフルエンザの流行状況によって大幅に異なります。詳しいインフルエンザ検査の的中率を計算するアルゴリズムもあるのですが、今ははしょります。

ごくごく簡単に言ってしまえば、流行時には検査陰性でもインフルエンザである可能性が高いが、非流行時には検査陰性ならインフルエンザの可能性は低いということです。

インフルエンザ検査で陰性であった場合におこなうこと

このように万全ではないインフルエンザ検査ですが、陰性と判断された場合にはどうしたらよいでしょうか。医師の判断に従うのが無難ですが、インフルエンザ時には使ってはいけない解熱剤などもあり、陰性であっても高熱や関節痛、疲労などがある場合には注意が必要です。

自覚症状や経過などからインフルエンザの疑いが抜けない場合には、注意が必要です。

アセトアミノフェン配合の解熱剤を使う

インフルエンザではないとなれば強力な解熱剤を使うこともできますが、インフルエンザの時にはインフルエンザ脳症等の併発リスクがあるため、アスピリン等は使えません。インフルエンザの疑いが消えない場合にはアセトアミノフェン配合の緩やかな作用の解熱剤を利用しましょう。

手洗い、うがい、マスクをして感染を防ぐ

インフルエンザはアルコール消毒にきわめて弱く、アルコール消毒を擦ることはすすめられます。
手洗いなども有効です。また、看病してくれる人の前では、マスクを欠かさずにつけて、二次感染を防ぎましょう。

安静にしてゆっくりと休む

インフルエンザでなかったとしても、高熱がある場合にはライノウイルス他様々なウイルスによる病気である可能性があります。高熱がでている間、鼻水や咳がでている間はしっかりゆっくり休むことを心がけましょう。

一生インフルエンザにかからない体質の作り方
村上 一裕
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まとめ:インフルエンザの検査は万全ではない。体調管理は万全に

インフルエンザの検査は、一定数の誤診が起こります。流行数によってその数は大きくかわりますので、大流行している時にはインフルエンザの検査で陰性がでたとしても注意が必要です。医師の診断にしたがうことが重要ですが、自分の体調を万全にするようにしましょう。

自分の体調が万全ではない場合には、インフルエンザの時と同じように安静にしていましょう。インフルエンザの疑いがある場合は解熱後4日は休みたいところですね。

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Check Also

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