Viral Shedding and Transmission Potential of Asymptomatic and Paucisymptomatic Influenza Virus Infections in the Community

Clinical Infectious Diseases

Volumn 64, Issue 6, 2017, Pages 736-742

  Ip, Dennis K M ^a   Lau, Lincoln L H ^d   Leung, Nancy H L ^a   Fang, Vicky J ^a   Chan, Kwok Hung ^b   Chu, Daniel K W ^a,c   Leung, Gabriel M ^a   Peiris, J S Malik ^a,c   Uyeki, Timothy M ^e   Cowling, Benjamin J ^a  

^a School of Public Health   (Hong Kong)

^b Department of Microbiology ^*  (Hong Kong)

^c UNIVERSITY OF HONG KONG   (Hong Kong)

^d UNIVERSITY OF TORONTO   (Canada)

^e NATIONAL CENTER FOR IMMUNIZATION AND RESPIRATORY DISEASES   (United States)

Author keywords

asymptomatic; epidemiology; influenza virus; public health; viral shedding

Indexed keywords

ADOLESCENT; ADULT; ASYMPTOMATIC DISEASE; CHILD; CLASSIFICATION; COMMUNITY ACQUIRED INFECTION; FEMALE; FOLLOW UP; GENETICS; HONG KONG; HUMAN; INFANT; INFLUENZA; INFLUENZA A VIRUS; MALE; MIDDLE AGED; NEWBORN; PRESCHOOL CHILD; RISK FACTOR; TRANSMISSION; VIROLOGY; VIRUS LOAD; VIRUS SHEDDING; YOUNG ADULT;

ADOLESCENT; ADULT; ASYMPTOMATIC DISEASES; CHILD; CHILD, PRESCHOOL; COMMUNITY-ACQUIRED INFECTIONS; FEMALE; FOLLOW-UP STUDIES; HONG KONG; HUMANS; INFANT; INFANT, NEWBORN; INFLUENZA A VIRUS; INFLUENZA, HUMAN; MALE; MIDDLE AGED; RISK FACTORS; VIRAL LOAD; VIRUS SHEDDING; YOUNG ADULT;

EID: 85025597453     PISSN: 10584838     EISSN: 15376591     Source Type: Journal    
DOI: 10.1093/cid/ciw841     Document Type: Article

References (25)

1. Patrozou E, Mermel LA. Does influenza transmission occur from asymptomatic infection or prior to symptom onset? Public Health Rep 2009; 124:193–6.
2. Carrat F, Vergu E, Ferguson NM, et al. Time lines of infection and disease in human influenza: a review of volunteer challenge studies. Am J Epidemiol 2008; 167:775–85.
3. Alford RH, Kasel JA, Gerone PJ, Knight V. Human influenza resulting from aerosol inhalation. Proc Soc Exp Biol Med 1966; 122: 800–4.
4. Leung NH, Xu C, Ip DK, Cowling BJ. Review article: the fraction of influenza virus infections that are asymptomatic: a systematic review and meta-analysis. Epidemiology 2015; 26:862–72.
5. Hayward AC, Fragaszy EB, Bermingham A, et al; Flu Watch Group. Comparative community burden and severity of seasonal and pandemic influenza: results of the Flu Watch cohort study. Lancet Respir Med 2014; 2:445–54.
6. Wang TE, Lin CY, King CC, Lee WC. Estimating pathogen-specific asymptomatic ratios. Epidemiology 2010; 21:726–8.
7. Loeb M, Singh PK, Fox J, et al. Longitudinal study of influenza molecular viral shedding in Hutterite communities. J Infect Dis 2012; 206:1078–84.
8. Cowling BJ, Chan KH, Fang VJ, et al. Facemasks and hand hygiene to prevent influenza transmission in households: a cluster randomized trial. Ann Intern Med 2009; 151:437–46.
9. Cowling BJ, Chan KH, Fang VJ, et al. Comparative epidemiology of pandemic and seasonal influenza A in households. N Engl J Med 2010; 362:2175–84.
10. Peiris JS, Tang WH, Chan KH, et al. Children with respiratory disease associated with metapneumovirus in Hong Kong. Emerg Infect Dis 2003; 9:628–33.
11. Chan KH, Peiris JS, Lim W, Nicholls JM, Chiu SS. Comparison of nasopharyngeal flocked swabs and aspirates for rapid diagnosis of respiratory viruses in children. J Clin Virol 2008; 42:65–9.
12. Lau LL, Cowling BJ, Fang VJ, et al. Viral shedding and clinical illness in naturally acquired influenza virus infections. J Infect Dis 2010; 201:1509–16.
13. Tsou TP, Shao PL, Lu CY, et al. Viral load and clinical features in children infected with seasonal influenza B in 2006/2007. J Formos Med Assoc 2012; 111: 83–7.
14. Cheng SM, Vainionpaa R, Zhao P, et al. Detection of influenza B in clinical specimens: comparison of high throughput RT-PCR and culture confirmation. Virus Res 2004; 103:85–90.
15. Tsang TK, Cowling BJ, Fang VJ, et al. Influenza a virus shedding and infectivity in households. J Infect Dis 2015; 212:1420–8.
16. Ip DK, Lau EH, Tam YH, So HC, Cowling BJ, Kwok HK. Increases in absenteeism among health care workers in Hong Kong during influenza epidemics, 2004–2009. BMC Infect Dis 2015; 15: 586.
17. Cheung DH, Tsang TK, Fang VJ, et al. Association of oseltamivir treatment with virus shedding, illness, and household transmission of influenza viruses. J Infect Dis 2015; 212:391–6.
18. Bischoff WE, Swett K, Leng I, Peters TR. Exposure to influenza virus aerosols during routine patient care. J Infect Dis 2013; 207:1037–46.
19. Thai PQ, Mai le Q, Welkers MR, et al. Pandemic H1N1 virus transmission and shedding dynamics in index case households of a prospective Vietnamese cohort. J Infect 2014; 68:581–90.
20. Ip DK, Lau LL, Chan KH, et al. The dynamic relationship between clinical symptomatology and viral shedding in naturally acquired seasonal and pandemic influenza virus infections. Clin Infect Dis 2016; 62:431–7.
21. Suess T, Remschmidt C, Schink SB, et al. Comparison of shedding characteristics of seasonal influenza virus (sub)types and influenza A(H1N1)pdm09; Germany, 2007–2011. PLoS One 2012; 7: e51653.
22. Cowling BJ, Ip DK, Fang VJ, et al. Aerosol transmission is an important mode of influenza A virus spread. Nat Commun 2013; 4:1935.
23. Hayden FG, Belshe R, Villanueva C, et al. Management of influenza in households: a prospective, randomized comparison of oseltamivir treatment with or without postexposure prophylaxis. J Infect Dis 2004; 189:440–9.
24. + T cells correlate with disease protection against influenza challenge in humans. Nat Med 2012; 18:274–80.
25. Poon LL, Chan KH, Chu DK, et al. Viral genetic sequence variations in pandemic H1N1/2009 and seasonal H3N2 influenza viruses within an individual, a household and a community. J Clin Virol 2011; 52: 146–50.