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J Infect Dis . Stunting Increases Influenza Virus Shedding Duration in Preschool/School-Aged Children

tetano

Editor, Senior Moderator
J Infect Dis


. 2025 Dec 18:jiaf641.
doi: 10.1093/infdis/jiaf641. Online ahead of print. Stunting Increases Influenza Virus Shedding Duration in Preschool/School-Aged Children

Mia Q Zhu[SUP] 1 [/SUP], Guillermina Kuan[SUP] 2 3 [/SUP], Hannah E Maier[SUP] 1 [/SUP], Roger Lopez[SUP] 2 4 [/SUP], Abigail Shotwell[SUP] 1 [/SUP], Miguel Plazaola[SUP] 2 [/SUP], Sergio Ojeda[SUP] 2 3 [/SUP], Nery Sanchez[SUP] 2 3 [/SUP], Angel Balmaseda[SUP] 2 4 [/SUP], Aubree Gordon[SUP] 1 [/SUP]



Affiliations
Abstract

The role of under-nutrition on influenza virus shedding is unclear. We assessed stunting, an indicator of chronic under-nutrition, as a predictor of shedding duration in children in the Household Influenza Cohort Study, in Managua, Nicaragua. Stunted children, aged 3-9 years, shed influenza longer than their non-stunted peers. In sub-group analysis, associations were driven by H3N2 and influenza B (IB) infections. Analysis of cycle threshold (Ct) values showed slower clearance of IB viruses in stunted children. These findings suggest under-nutrition may prolong influenza shedding, with implications for transmission dynamics and control strategies in low- and middle-income countries where stunting remains prevalent.

Keywords: Influenza; height; nutrition; shedding duration; stunting; undernutrition.

 
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