期刊
JOURNAL OF INFECTIOUS DISEASES
卷 201, 期 10, 页码 1509-1516出版社
OXFORD UNIV PRESS INC
DOI: 10.1086/652241
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资金
- US Centers for Disease Control and Prevention [1 U01 CI000439-02]
- Research Fund for the Control of Infectious Disease, Food and Health Bureau, Government of the Hong Kong SAR [08070632]
- Harvard Center for Communicable Disease Dynamics from the US National Institutes of Health Models of Infectious Disease Agent Study [1 U54 GM088558]
- Area of Excellence Scheme of the Hong Kong University Grants Committee [AoE/M-12/06]
Background. 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.
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