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Ann Epidemiol. 2019 Jul 31. pii: S1047-2797(19)30040-7. doi: 10.1016/j.annepidem.2019.07.013. [Epub ahead of print]
The respiratory microbiota: associations with influenza symptomatology and viral shedding.
Lee KH1, Foxman B2, Kuan G3, L?pez R4, Shedden K5, Ng S6, Balmaseda A7, Gordon A8.
Author information
1 Center for Molecular and Clinical Epidemiology of Infectious Diseases, Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor; Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD. 2 Center for Molecular and Clinical Epidemiology of Infectious Diseases, Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor. 3 Centro de Salud S?crates Flores Vivas, Ministry of Health, Managua, Nicaragua; Sustainable Sciences Institute, Managua, Nicaragua. 4 National Virology Laboratory, Centro Nacional de Diagn?stico y Referencia, Ministry of Health, Managua, Nicaragua. 5 Department of Statistics, University of Michigan, Ann Arbor; Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor. 6 Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor. 7 Sustainable Sciences Institute, Managua, Nicaragua; National Virology Laboratory, Centro Nacional de Diagn?stico y Referencia, Ministry of Health, Managua, Nicaragua. 8 Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor. Electronic address: gordonal@umich.edu.
Abstract
PURPOSE:
Manifestations of infection and the degree of influenza virus vary. We hypothesized that the nose/throat microbiota modifies the duration of influenza symptoms and viral shedding. Exploring these relationships may help identify additional methods for reducing influenza severity and transmission.
METHODS:
Using a household transmission study in Nicaragua, we identified secondary cases of influenza virus infection, defined as contacts with detectable virus or a greater than 4-fold change in hemagglutinin inhibition antibody titer. We characterized the nose/throat microbiota of secondary cases before infection and explored whether the duration of symptoms and shedding differed by bacterial community characteristics.
RESULTS:
Among 124 secondary cases of influenza, higher bacterial community diversity before infection was associated with longer shedding duration (Shannon acceleration factor [AF]: 1.61, 95% confidence interval [CI]: 1.24, 2.10) and earlier time to infection (Shannon AF: 0.72, 95% CI: 0.53, 0.97; Chao1 AF: 0.992, 95% CI: 0.986, 0.998). Neisseria and multiple other oligotypes were significantly associated with symptom and shedding durations and time to infection.
CONCLUSIONS:
The nose/throat microbiota before influenza virus infection was associated with influenza symptoms and shedding durations. Further studies are needed to determine if the nose/throat microbiota is a viable target for reducing influenza symptoms and transmission.
Copyright ? 2019 Elsevier Inc. All rights reserved.
KEYWORDS:
Influenza; Microbiota; Signs and symptoms; Virus shedding
PMID: 31451313 DOI: 10.1016/j.annepidem.2019.07.013
The respiratory microbiota: associations with influenza symptomatology and viral shedding.
Lee KH1, Foxman B2, Kuan G3, L?pez R4, Shedden K5, Ng S6, Balmaseda A7, Gordon A8.
Author information
1 Center for Molecular and Clinical Epidemiology of Infectious Diseases, Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor; Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD. 2 Center for Molecular and Clinical Epidemiology of Infectious Diseases, Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor. 3 Centro de Salud S?crates Flores Vivas, Ministry of Health, Managua, Nicaragua; Sustainable Sciences Institute, Managua, Nicaragua. 4 National Virology Laboratory, Centro Nacional de Diagn?stico y Referencia, Ministry of Health, Managua, Nicaragua. 5 Department of Statistics, University of Michigan, Ann Arbor; Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor. 6 Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor. 7 Sustainable Sciences Institute, Managua, Nicaragua; National Virology Laboratory, Centro Nacional de Diagn?stico y Referencia, Ministry of Health, Managua, Nicaragua. 8 Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor. Electronic address: gordonal@umich.edu.
Abstract
PURPOSE:
Manifestations of infection and the degree of influenza virus vary. We hypothesized that the nose/throat microbiota modifies the duration of influenza symptoms and viral shedding. Exploring these relationships may help identify additional methods for reducing influenza severity and transmission.
METHODS:
Using a household transmission study in Nicaragua, we identified secondary cases of influenza virus infection, defined as contacts with detectable virus or a greater than 4-fold change in hemagglutinin inhibition antibody titer. We characterized the nose/throat microbiota of secondary cases before infection and explored whether the duration of symptoms and shedding differed by bacterial community characteristics.
RESULTS:
Among 124 secondary cases of influenza, higher bacterial community diversity before infection was associated with longer shedding duration (Shannon acceleration factor [AF]: 1.61, 95% confidence interval [CI]: 1.24, 2.10) and earlier time to infection (Shannon AF: 0.72, 95% CI: 0.53, 0.97; Chao1 AF: 0.992, 95% CI: 0.986, 0.998). Neisseria and multiple other oligotypes were significantly associated with symptom and shedding durations and time to infection.
CONCLUSIONS:
The nose/throat microbiota before influenza virus infection was associated with influenza symptoms and shedding durations. Further studies are needed to determine if the nose/throat microbiota is a viable target for reducing influenza symptoms and transmission.
Copyright ? 2019 Elsevier Inc. All rights reserved.
KEYWORDS:
Influenza; Microbiota; Signs and symptoms; Virus shedding
PMID: 31451313 DOI: 10.1016/j.annepidem.2019.07.013