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Duration of Influenza A Virus Shedding in Hospitalized Patients and Implications for Infection Control

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  • Duration of Influenza A Virus Shedding in Hospitalized Patients and Implications for Infection Control



    Duration of Influenza A Virus Shedding in Hospitalized Patients and Implications for Infection Control
    <table border="0" cellpadding="0" cellspacing="0" width="450"> <tbody> <tr><td class="contentAuthor"><author><fname>Surbhi </fname><surname>Leekha</surname>
    , MBBS, MPH</postnom></author>, <author><fname>Nicole L. </fname><surname>Zitterkopf</surname>
    , PhD</postnom></author>, <author><fname>Mark J. </fname><surname>Espy</surname>
    , MS</postnom></author>, <author><fname>Thomas F. </fname><surname>Smith</surname>
    , PhD</postnom></author>, <author><fname>Rodney L. </fname><surname>Thompson</surname>
    , MD</postnom></author>, and <author><fname>Priya </fname><surname>Sampathkumar</surname>
    , MD</postnom></author></td></tr> <tr><td>
    </td></tr> <tr><td>Volume 28(2007), pages 000 - 000
    DOI: 10.1086/520101</td></tr> </tbody> </table> <table border="0" cellpadding="0" cellspacing="0"><tbody><tr><td>Abstract</td></tr> <tr><td>Objective. To assess the duration of shedding of influenza A virus detected by polymerase chain reaction (PCR) and cell culture among patients hospitalized with influenza A virus infection.
    Setting. Mayo Clinic (Rochester, Minnesota) hospitals that cater to both the community and referral populations.
    Methods. Patients 18 years old and older who were hospitalized between December 1, 2004, and March 15, 2005, with a laboratory-confirmed (ie, PCR-based) diagnosis of influenza A virus infection were consecutively enrolled. Additional throat swab specimens were collected at 2, 3, 5, and 7 days after the initial specimen (if the patient was still hospitalized). All specimens were tested by PCR and culture (both conventional tube culture and shell vial assay). Information on demographic characteristics, date of symptom onset, comorbidities, immunosuppression, influenza vaccination status, and receipt of antiviral treatment was obtained by interview and medical record review. Patients were excluded if informed consent could not be obtained or if the date of symptom onset could not be ascertained.
    Results. Of 149 patients hospitalized with influenza A virus infection, 50 patients were enrolled in the study. Most patients were older (median age, 76 years), and almost all (96%) had underlying chronic medical conditions. Of 41 patients included in the final analysis, influenza A virus was detected in 22 (54%) by PCR and in 12 (29%) by culture methods at or beyond 7 days after symptom onset. All 12 patients identified by culture also had PCR results positive for influenza A virus.
    Conclusion. Hospitalized patients with influenza A virus infection can shed detectable virus beyond the 5- to 7-day period traditionally considered the duration of infectivity. Additional research is needed to assess whether prolonging the duration of patient isolation is warranted to prevent nosocomial outbreaks during the influenza season.
    </td></tr></tbody></table>

  • #2
    Re: Duration of Influenza A Virus Shedding in Hospitalized Patients

    good information, Anne! Thank you. This is well beyond what we were taught as the infective period. I wonder if this will trickle down to Hospital Infection control and Employee Health programns, so that they dont bring flu positive staff back to work too quickly? I hope so.
    Upon this gifted age, in its dark hour,
    Rains from the sky a meteoric shower
    Of facts....They lie unquestioned, uncombined.
    Wisdom enough to leech us of our ill
    Is daily spun, but there exists no loom
    To weave it into fabric..
    Edna St. Vincent Millay "Huntsman, What Quarry"
    All my posts to this forum are for fair use and educational purposes only.

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    • #3
      Re: Duration of Influenza A Virus Shedding in Hospitalized Patients

      2,3,5,7

      why did they stop there then ?
      So, let's wait for the next study which does 9,11,13 ...

      that might take some years...
      I'm interested in expert panflu damage estimates
      my current links: http://bit.ly/hFI7H ILI-charts: http://bit.ly/CcRgT

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