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Conference Paper: Influenza virus in human exhaled breath

TitleInfluenza virus in human exhaled breath
Authors
Issue Date2008
PublisherCenters for Disease Control and Prevention.
Citation
The 6th International Conference on Emerging Infectious Diseases, Atlanta, GA, 16-19 March 2008, p. 166 How to Cite?
AbstractBackground: Recent studies suggest that humans exhale fine particles during tidal breathing but little is known about where the particles are generated or their role in infection transmission. We conducted a study of influenza infected patients to characterize particle and influenza virus concentrations in their exhaled breath. Methods: We recruited patients with influenza-like illness presenting for medical care at three clinics in Hong Kong, China. We collected two nasal swabs per subject, one for rapid testing and a second one for analysis via quantitative PCR (qPCR). Patients breathed with a steady regular pattern through a mouthpiece supplied with HEPA filtered air. Exhaled breath flowed through a 22 mm diameter and 40 cm long tube to an Exhalair (Pulmatrix, Inc, Lexington, MA), which monitored flow rate, and counted particles between 0.3 and 5 um in diameter using an optical particle counter. After three minutes of particle counting, we collected exhaled breath particles by sampling for 20 minutes on Teflon filters. We assayed each filter for influenza A and B using qPCR. Results: Thirteen of the 51 screened patients tested positive for influenza using the QuickVue rapid test (7 for influenza B, 6 for influenza A). Twelve rapid test positive patients completed the exhaled breath test (7 influenza B subjects and 5 influenza A subjects) and we recovered influenza virus in the exhaled breath of 4 (25%) subjects. Three (60%) of the five patients with influenza A infection and one (14%) of the seven with influenza B infection had detectable influenza virus in their exhaled breath. Exhaled breath virus concentrations ranged between 21 and 312 virus copies per sample, corresponding to a generation rate between 1 and 16 virus particles per minute. Preliminary particle data analysis indicated that 50% of subjects exhaled more than 500 particles per liter of air, a suggested threshold for identification of high particle producers. Conclusions: We recovered influenza virus from the exhaled breath of 4 out of 12 influenza patients, three of whom tested positive for influenza A. The results provide evidence that influenza virus is contained in fine particles generated during tidal breathing.
Persistent Identifierhttp://hdl.handle.net/10722/98146

 

DC FieldValueLanguage
dc.contributor.authorFabian, MPen_HK
dc.contributor.authorMcDevitt, JJen_HK
dc.contributor.authorDehaan, WHen_HK
dc.contributor.authorFung, ROPen_HK
dc.contributor.authorCowling, BJen_HK
dc.contributor.authorChan, KHen_HK
dc.contributor.authorLeung, GMen_HK
dc.contributor.authorMilton, DKen_HK
dc.date.accessioned2010-09-25T17:36:35Z-
dc.date.available2010-09-25T17:36:35Z-
dc.date.issued2008en_HK
dc.identifier.citationThe 6th International Conference on Emerging Infectious Diseases, Atlanta, GA, 16-19 March 2008, p. 166en_HK
dc.identifier.urihttp://hdl.handle.net/10722/98146-
dc.description.abstractBackground: Recent studies suggest that humans exhale fine particles during tidal breathing but little is known about where the particles are generated or their role in infection transmission. We conducted a study of influenza infected patients to characterize particle and influenza virus concentrations in their exhaled breath. Methods: We recruited patients with influenza-like illness presenting for medical care at three clinics in Hong Kong, China. We collected two nasal swabs per subject, one for rapid testing and a second one for analysis via quantitative PCR (qPCR). Patients breathed with a steady regular pattern through a mouthpiece supplied with HEPA filtered air. Exhaled breath flowed through a 22 mm diameter and 40 cm long tube to an Exhalair (Pulmatrix, Inc, Lexington, MA), which monitored flow rate, and counted particles between 0.3 and 5 um in diameter using an optical particle counter. After three minutes of particle counting, we collected exhaled breath particles by sampling for 20 minutes on Teflon filters. We assayed each filter for influenza A and B using qPCR. Results: Thirteen of the 51 screened patients tested positive for influenza using the QuickVue rapid test (7 for influenza B, 6 for influenza A). Twelve rapid test positive patients completed the exhaled breath test (7 influenza B subjects and 5 influenza A subjects) and we recovered influenza virus in the exhaled breath of 4 (25%) subjects. Three (60%) of the five patients with influenza A infection and one (14%) of the seven with influenza B infection had detectable influenza virus in their exhaled breath. Exhaled breath virus concentrations ranged between 21 and 312 virus copies per sample, corresponding to a generation rate between 1 and 16 virus particles per minute. Preliminary particle data analysis indicated that 50% of subjects exhaled more than 500 particles per liter of air, a suggested threshold for identification of high particle producers. Conclusions: We recovered influenza virus from the exhaled breath of 4 out of 12 influenza patients, three of whom tested positive for influenza A. The results provide evidence that influenza virus is contained in fine particles generated during tidal breathing.-
dc.languageengen_HK
dc.publisherCenters for Disease Control and Prevention.en_HK
dc.relation.ispartofInternational Conference on Emerging Infectious Diseases, ICEID 2008en_HK
dc.titleInfluenza virus in human exhaled breathen_HK
dc.typeConference_Paperen_HK
dc.identifier.emailFung, ROP: flustudy@hku.hken_HK
dc.identifier.emailCowling, BJ: bcowling@hku.hken_HK
dc.identifier.emailChan, KH: chankh2@HKUCC.hku.hken_HK
dc.identifier.emailLeung, GM: gmleung@hku.hken_HK
dc.identifier.authorityLeung, GM=rp00460en_HK
dc.identifier.hkuros141002en_HK
dc.identifier.spage166en_HK

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