Comparison of Shedding Characteristics of Seasonal Influenza Virus (Sub)Types and Influenza A(H1N1)pdm09; Germany, 2007-2011

被引:94
作者
Suess, Thorsten [1 ]
Remschmidt, Cornelius [1 ]
Schink, Susanne B. [1 ]
Schweiger, Brunhilde [2 ]
Heider, Alla [2 ]
Milde, Jeanette [2 ]
Nitsche, Andreas [3 ]
Schroeder, Kati [3 ]
Doellinger, Joerg [3 ]
Braun, Christian [1 ]
Haas, Walter [1 ]
Krause, Gerard [1 ]
Buchholz, Udo [1 ]
机构
[1] Robert Koch Inst, Dept Infect Dis Epidemiol, Berlin, Germany
[2] Robert Koch Inst, Natl Reference Ctr Influenza, Berlin, Germany
[3] Robert Koch Inst, Ctr Biol Secur, Div Highly Pathogen Viruses ZBS1, Berlin, Germany
来源
PLOS ONE | 2012年 / 7卷 / 12期
关键词
NEURAMINIDASE INHIBITOR OSELTAMIVIR; RANDOMIZED CONTROLLED-TRIAL; H1N1 PANDEMIC INFLUENZA; HOUSEHOLD TRANSMISSION; CLINICAL ILLNESS; HAND HYGIENE; A VIRUS; INFECTIONS; A/H1N1; DURATION;
D O I
10.1371/journal.pone.0051653
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Background: Influenza viral shedding studies provide fundamental information for preventive strategies and modelling exercises. We conducted a prospective household study to investigate viral shedding in seasonal and pandemic influenza between 2007 and 2011 in Berlin and Munich, Germany. Methods: Study physicians recruited index patients and their household members. Serial nasal specimens were obtained from all household members over at least eight days and tested quantitatively by qRT-PCR for the influenza virus (sub) type of the index patient. A subset of samples was also tested by viral culture. Symptoms were recorded daily. Results: We recruited 122 index patients and 320 household contacts, of which 67 became secondary household cases. Among all 189 influenza cases, 12 were infected with seasonal/prepandemic influenza A(H1N1), 19 with A(H3N2), 60 with influenza B, and 98 with A(H1N1)pdm09. Nine (14%) of 65 non-vaccinated secondary cases were asymptomatic/subclinical (0 (0%) of 21 children, 9 (21%) of 44 adults; p = 0.03). Viral load among patients with influenza-like illness (ILI) peaked on illness days 1, 2 or 3 for all (sub) types and declined steadily until days 7-9. Clinical symptom scores roughly paralleled viral shedding dynamics. On the first day prior to symptom onset 30% (12/40) of specimens were positive. Viral load in 6 asymptomatic/subclinical patients was similar to that in ILI-patients. Duration of infectiousness as measured by viral culture lasted approximately until illness days 4-6. Viral load did not seem to be influenced by antiviral therapy, age or vaccination status. Conclusion: Asymptomatic/subclinical infections occur infrequently, but may be associated with substantial amounts of viral shedding. Presymptomatic shedding may arise in one third of cases, and shedding characteristics appear to be independent of (seasonal or pandemic) (sub) type, age, antiviral therapy or vaccination; however the power to find moderate differences was limited.
引用
收藏
页数:11
相关论文
共 37 条
[1]   Breaking the Waves: Modelling the Potential Impact of Public Health Measures to Defer the Epidemic Peak of Novel Influenza A/H1N1 [J].
an der Heiden, Matthias ;
Buchholz, Udo ;
Krause, Gerard ;
Kirchner, Goeran ;
Claus, Hermann ;
Haas, Walter H. .
PLOS ONE, 2009, 4 (12)
[2]   Viral Shedding Duration of Pandemic Influenza A H1N1 Virus during an Elementary School Outbreak-Pennsylvania, May-June 2009 [J].
Bhattarai, Achuyt ;
Villanueva, Julie ;
Palekar, Rakhee S. ;
Fagan, Ryan ;
Sessions, Wendy ;
Winter, Joern ;
Berman, LaShondra ;
Lute, James ;
Leap, Rebecca ;
Marchbanks, Tiffany ;
Sodha, Samir V. ;
Moll, Maria ;
Xu, Xiyan ;
Fry, Alicia ;
Fiore, Anthony ;
Ostroff, Stephen ;
Swerdlow, David L. .
CLINICAL INFECTIOUS DISEASES, 2011, 52 :S102-S108
[3]   Transmission parameters of the A/H1N1 (2009) influenza virus pandemic: a review [J].
Boelle, Pierre-Yves ;
Ansart, Severine ;
Cori, Anne ;
Valleron, Alain-Jacques .
INFLUENZA AND OTHER RESPIRATORY VIRUSES, 2011, 5 (05) :306-316
[4]   Time lines of infection and disease in human influenza: A review of volunteer challenge studies [J].
Carrat, Fabrice ;
Vergu, Elisabeta ;
Ferguson, Neil M. ;
Lemaitre, Magali ;
Cauchemez, Simon ;
Leach, Steve ;
Valleron, Alain-Jacques .
AMERICAN JOURNAL OF EPIDEMIOLOGY, 2008, 167 (07) :775-785
[5]   Role of social networks in shaping disease transmission during a community outbreak of 2009 H1N1 pandemic influenza [J].
Cauchemez, Simon ;
Bhattarai, Achuyt ;
Marchbanks, Tiffany L. ;
Fagan, Ryan P. ;
Ostroff, Stephen ;
Ferguson, Neil M. ;
Swerdlow, David .
PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA, 2011, 108 (07) :2825-2830
[6]   Fecal detection of influenza A virus in patients with concurrent respiratory and gastrointestinal symptoms [J].
Chan, Martin C. W. ;
Lee, Nelson ;
Chan, Paul K. S. ;
Leung, T. F. ;
Sung, Joseph J. Y. .
JOURNAL OF CLINICAL VIROLOGY, 2009, 45 (03) :208-211
[7]   Factors affecting QuickVue Influenza A plus B rapid test performance in the community setting [J].
Cheng, Calvin K. Y. ;
Cowling, Benjamin J. ;
Chan, Kwok Hung ;
Fang, Vicky J. ;
Seto, Wing Hong ;
Yung, Raymond ;
Uyeki, Timothy M. ;
Houck, Peter M. ;
Peiris, J. S. Malik ;
Leung, Gabriel M. .
DIAGNOSTIC MICROBIOLOGY AND INFECTIOUS DISEASE, 2009, 65 (01) :35-41
[8]   CORRELATED STUDIES OF A RECOMBINANT INFLUENZA-VIRUS VACCINE .3. PROTECTION AGAINST EXPERIMENTAL INFLUENZA IN MAN [J].
COUCH, RB ;
DOUGLAS, RG ;
FEDSON, DS ;
KASEL, JA .
JOURNAL OF INFECTIOUS DISEASES, 1971, 124 (05) :473-&
[9]   Comparative Epidemiology of Pandemic and Seasonal Influenza A in Households. [J].
Cowling, Benjamin J. ;
Chan, Kwok Hung ;
Fang, Vicky J. ;
Lau, Lincoln L. H. ;
So, Hau Chi ;
Fung, Rita O. P. ;
Ma, Edward S. K. ;
Kwong, Alfred S. K. ;
Chan, Chi-Wai ;
Tsui, Wendy W. S. ;
Ngai, Ho-Yin ;
Chu, Daniel W. S. ;
Lee, Paco W. Y. ;
Chiu, Ming-Chee ;
Leung, Gabriel M. ;
Peiris, Joseph S. M. .
NEW ENGLAND JOURNAL OF MEDICINE, 2010, 362 (23) :2175-2184
[10]   Facemasks and Hand Hygiene to Prevent Influenza Transmission in Households A Cluster Randomized Trial [J].
Cowling, Benjamin J. ;
Chan, Kwok-Hung ;
Fang, Vicky J. ;
Cheng, Calvin K. Y. ;
Fung, Rita O. P. ;
Wai, Winnie ;
Sin, Joey ;
Seto, Wing Hong ;
Yung, Raymond ;
Chu, Daniel W. S. ;
Chiu, Billy C. F. ;
Lee, Paco W. Y. ;
Chiu, Ming Chi ;
Lee, Hoi Che ;
Uyeki, Timothy M. ;
Houck, Peter M. ;
Peiris, J. S. Malik ;
Leung, Gabriel M. .
ANNALS OF INTERNAL MEDICINE, 2009, 151 (07) :437-W144