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© Research
Publication : The Journal of infectious diseases

Influenza A Virus Shedding and Infectivity in Households

Scientific Fields
Diseases
Organisms
Applications
Technique

Published in The Journal of infectious diseases - 15 Apr 2015

Tsang TK, Cowling BJ, Fang VJ, Chan KH, Ip DK, Leung GM, Peiris JS, Cauchemez S

Link to Pubmed [PMID] – 25883385

J. Infect. Dis. 2015 Nov;212(9):1420-8

BACKGROUND: Viral shedding is often considered to correlate with the infectivity of influenza, but the evidence for this is limited.

METHODS: In a detailed study of influenza virus transmission within households in 2008-2012, index case patients with confirmed influenza were identified in outpatient clinics, and we collected nose and throat swab specimens for testing by reverse-transcription polymerase chain reaction from all household members regardless of illness. We used individual-based hazard models to characterize the relationship between viral load (V) and infectivity.

RESULTS: Assuming that infectivity was proportional to viral load V gave the worst fit, because it strongly overestimated the proportion of transmission occurring at symptom onset. Alternative models assuming that infectivity was proportional to a various functions of V provided better fits, although they all overestimated the proportion of transmission occurring >3 days after symptom onset. The best fitting model assumed that infectivity was proportion to V(γ), with estimates of γ = 0.136 and γ = 0.156 for seasonal influenza A(H1N1) and A(H3N2) respectively.

CONCLUSIONS: All the models we considered that used viral loads to approximate infectivity of a case imperfectly explained the timing of influenza secondary infections in households. Identification of more accurate correlates of infectivity will be important to inform control policies and disease modeling.

https://www.ncbi.nlm.nih.gov/pubmed/25883385