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Article: Viral shedding and clinical illness in naturally acquired influenza virus infections

TitleViral shedding and clinical illness in naturally acquired influenza virus infections
Authors
Issue Date2010
PublisherOxford University Press. The Journal's web site is located at http://jid.oxfordjournals.org
Citation
Journal Of Infectious Diseases, 2010, v. 201 n. 10, p. 1509-1516 How to Cite?
AbstractBackground. Volunteer challenge studies have provided detailed data on viral shedding from the respiratory tract before and through the course of experimental influenza virus infection. There are no comparable quantitative data to our knowledge on naturally acquired infections. Methods. In a community-based study in Hong Kong in 2008, we followed up initially healthy individuals to quantify trends in viral shedding on the basis of cultures and reverse-transcription polymerase chain reaction (RT-PCR) through the course of illness associated with seasonal influenza A and B virus infection. Results. Trends in symptom scores more closely matched changes in molecular viral loads measured with RT-PCR for influenza A than for influenza B. For influenza A virus infections, the replicating viral loads determined with cultures decreased to undetectable levels earlier after illness onset than did molecular viral loads. Most viral shedding occurred during the first 2-3 days after illness onset, and we estimated that 1%-8% of infectiousness occurs prior to illness onset. Only 14% of infections with detectable shedding at RT-PCR were asymptomatic, and viral shedding was low in these cases. Conclusions. Our results suggest that "silent spreaders" (ie, individuals who are infectious while asymptomatic or presymptomatic) may be less important in the spread of influenza epidemics than previously thought. © 2010 by the Infectious Diseases Society of America. All rights reserved.
Persistent Identifierhttp://hdl.handle.net/10722/86713
ISSN
2015 Impact Factor: 6.344
2015 SCImago Journal Rankings: 4.000
PubMed Central ID
ISI Accession Number ID
Funding AgencyGrant Number
US Centers for Disease Control and Prevention1 U01 CI000439-02
Research Fund for the Control of Infectious Disease, Food and Health Bureau, Government of the Hong Kong SAR08070632
Harvard Center for Communicable Disease Dynamics from the US National Institutes of Health Models of Infectious Disease Agent Study1 U54 GM088558
Area of Excellence Scheme of the Hong Kong University Grants CommitteeAoE/M-12/06
Funding Information:

US Centers for Disease Control and Prevention (grant 1 U01 CI000439-02), the Research Fund for the Control of Infectious Disease, Food and Health Bureau, Government of the Hong Kong SAR (grant 08070632), the Harvard Center for Communicable Disease Dynamics from the US National Institutes of Health Models of Infectious Disease Agent Study program (grant 1 U54 GM088558), and the Area of Excellence Scheme of the Hong Kong University Grants Committee (grant AoE/M-12/06). The funding agencies had no role in data collection and analysis, or the decision to publish, but the CDC was involved in study design and preparation of the manuscript. This work represents the views of the authors and not their institutions, including the Centers for Disease Control and Prevention. Reprints or correspondence: Dr Benjamin J Cowling, School of Public Health,

References
Grants

 

DC FieldValueLanguage
dc.contributor.authorLau, LLHen_HK
dc.contributor.authorCowling, BJen_HK
dc.contributor.authorFang, VJen_HK
dc.contributor.authorChan, KHen_HK
dc.contributor.authorLau, EHYen_HK
dc.contributor.authorLipsitch, Men_HK
dc.contributor.authorCheng, CKYen_HK
dc.contributor.authorHouck, PMen_HK
dc.contributor.authorUyeki, TMen_HK
dc.contributor.authorMalik Peiris, JSen_HK
dc.contributor.authorLeung, GMen_HK
dc.date.accessioned2010-09-06T09:20:25Z-
dc.date.available2010-09-06T09:20:25Z-
dc.date.issued2010en_HK
dc.identifier.citationJournal Of Infectious Diseases, 2010, v. 201 n. 10, p. 1509-1516en_HK
dc.identifier.issn0022-1899en_HK
dc.identifier.urihttp://hdl.handle.net/10722/86713-
dc.description.abstractBackground. Volunteer challenge studies have provided detailed data on viral shedding from the respiratory tract before and through the course of experimental influenza virus infection. There are no comparable quantitative data to our knowledge on naturally acquired infections. Methods. In a community-based study in Hong Kong in 2008, we followed up initially healthy individuals to quantify trends in viral shedding on the basis of cultures and reverse-transcription polymerase chain reaction (RT-PCR) through the course of illness associated with seasonal influenza A and B virus infection. Results. Trends in symptom scores more closely matched changes in molecular viral loads measured with RT-PCR for influenza A than for influenza B. For influenza A virus infections, the replicating viral loads determined with cultures decreased to undetectable levels earlier after illness onset than did molecular viral loads. Most viral shedding occurred during the first 2-3 days after illness onset, and we estimated that 1%-8% of infectiousness occurs prior to illness onset. Only 14% of infections with detectable shedding at RT-PCR were asymptomatic, and viral shedding was low in these cases. Conclusions. Our results suggest that "silent spreaders" (ie, individuals who are infectious while asymptomatic or presymptomatic) may be less important in the spread of influenza epidemics than previously thought. © 2010 by the Infectious Diseases Society of America. All rights reserved.en_HK
dc.languageengen_HK
dc.publisherOxford University Press. The Journal's web site is located at http://jid.oxfordjournals.orgen_HK
dc.relation.ispartofJournal of Infectious Diseasesen_HK
dc.subject.meshInfluenza A virus - physiology-
dc.subject.meshInfluenza B virus - physiology-
dc.subject.meshInfluenza, Human - pathology - virology-
dc.subject.meshVirus Shedding-
dc.subject.meshCommunity-Acquired Infections-
dc.titleViral shedding and clinical illness in naturally acquired influenza virus infectionsen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0022-1899&volume=201&issue=10&spage=1509&epage=1516&date=2010&atitle=Viral+shedding+and+clinical+illness+in+naturally+acquired+influenza+virus+infectionsen_HK
dc.identifier.emailCowling, BJ: bcowling@hku.hken_HK
dc.identifier.emailLau, EHY: ehylau@hku.hken_HK
dc.identifier.emailMalik Peiris, JS: malik@hkucc.hku.hken_HK
dc.identifier.emailLeung, GM: gmleung@hku.hken_HK
dc.identifier.authorityCowling, BJ=rp01326en_HK
dc.identifier.authorityLau, EHY=rp01349en_HK
dc.identifier.authorityMalik Peiris, JS=rp00410en_HK
dc.identifier.authorityLeung, GM=rp00460en_HK
dc.description.naturelink_to_OA_fulltext-
dc.identifier.doi10.1086/652241en_HK
dc.identifier.pmid20377412-
dc.identifier.pmcidPMC3060408-
dc.identifier.scopuseid_2-s2.0-77951883726en_HK
dc.identifier.hkuros169732en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-77951883726&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume201en_HK
dc.identifier.issue10en_HK
dc.identifier.spage1509en_HK
dc.identifier.epage1516en_HK
dc.identifier.isiWOS:000276767600010-
dc.publisher.placeUnited Statesen_HK
dc.relation.projectViral shedding, natural clinical history and transmissibility of influenza-
dc.relation.projectControl of Pandemic and Inter-pandemic Influenza-
dc.identifier.scopusauthoridLau, LLH=36010688600en_HK
dc.identifier.scopusauthoridCowling, BJ=8644765500en_HK
dc.identifier.scopusauthoridFang, VJ=24474130400en_HK
dc.identifier.scopusauthoridChan, KH=7406034307en_HK
dc.identifier.scopusauthoridLau, EHY=7103086074en_HK
dc.identifier.scopusauthoridLipsitch, M=7006236353en_HK
dc.identifier.scopusauthoridCheng, CKY=24474272100en_HK
dc.identifier.scopusauthoridHouck, PM=7004317844en_HK
dc.identifier.scopusauthoridUyeki, TM=6603544967en_HK
dc.identifier.scopusauthoridMalik Peiris, JS=7005486823en_HK
dc.identifier.scopusauthoridLeung, GM=7007159841en_HK
dc.identifier.citeulike7016499-

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