tetano
Editor, Senior Moderator
American Journal of Epidemiology Advance Access originally published online on May 3, 2010
American Journal of Epidemiology 2010 171(11):1157-1164; doi:10.1093/aje/kwq071
American Journal of Epidemiology © The Author 2010. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.
ORIGINAL CONTRIBUTIONS
Shedding and Transmission of Novel Influenza Virus A/H1N1 Infection in Households—Germany, 2009
Thorsten Suess*, Udo Buchholz, Susann Dupke, Roland Grunow, Matthias an der Heiden, Alla Heider, Barbara Biere, Brunhilde Schweiger, Walter Haas, Gérard Krause and on Behalf of the Robert Koch Institute Shedding Investigation Group
* Correspondence to Dr. Thorsten Suess, Department of Infectious Disease Epidemiology, Robert Koch Institute, FG 36, DGZ – Ring 1, 13386 Berlin, Germany (e-mail: SuessT{at}rki.de).
Received for publication December 16, 2009. Accepted for publication March 11, 2010.
Essential epidemiologic and virologic parameters must be measured to provide evidence for policy/public health recommendations and mathematical modeling concerning novel influenza A/H1N1 virus (NIV) infections. Therefore, from April through August of 2009, the authors collected nasopharyngeal specimens and information on antiviral medication and symptoms from households with NIV infection on a daily basis in Germany. Specimens were analyzed quantitatively by using reverse transcriptase-polymerase chain reaction. In 36 households with 83 household contacts, 15 household contacts became laboratory-confirmed secondary cases of NIV. Among 47 contacts without antiviral prophylaxis, 12 became cases (secondary attack rate of 26%), and 1 (8%) of these was asymptomatic. The mean and median serial interval were 2.6 and 3 days, respectively (range: 1–3 days). On average, the authors detected viral RNA copies for 6.6 illness days (treated in time = 5.7 days, not treated in time = 7.1 days; P = 0.06), but they estimated that most patients cease to excrete viable virus by the fifth illness day. Shedding profiles were consistent with the number and severity of symptoms. Compared with other nasopharyngeal specimen types, nasal wash was the most sensitive. These results support the notion that epidemiologic and virologic characteristics of NIV are in many aspects similar to those of seasonal influenza.
http://aje.oxfordjournals.org/cgi/content/short/171/11/1157?rss=1
American Journal of Epidemiology 2010 171(11):1157-1164; doi:10.1093/aje/kwq071
American Journal of Epidemiology © The Author 2010. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.
ORIGINAL CONTRIBUTIONS
Shedding and Transmission of Novel Influenza Virus A/H1N1 Infection in Households—Germany, 2009
Thorsten Suess*, Udo Buchholz, Susann Dupke, Roland Grunow, Matthias an der Heiden, Alla Heider, Barbara Biere, Brunhilde Schweiger, Walter Haas, Gérard Krause and on Behalf of the Robert Koch Institute Shedding Investigation Group
* Correspondence to Dr. Thorsten Suess, Department of Infectious Disease Epidemiology, Robert Koch Institute, FG 36, DGZ – Ring 1, 13386 Berlin, Germany (e-mail: SuessT{at}rki.de).
Received for publication December 16, 2009. Accepted for publication March 11, 2010.
Essential epidemiologic and virologic parameters must be measured to provide evidence for policy/public health recommendations and mathematical modeling concerning novel influenza A/H1N1 virus (NIV) infections. Therefore, from April through August of 2009, the authors collected nasopharyngeal specimens and information on antiviral medication and symptoms from households with NIV infection on a daily basis in Germany. Specimens were analyzed quantitatively by using reverse transcriptase-polymerase chain reaction. In 36 households with 83 household contacts, 15 household contacts became laboratory-confirmed secondary cases of NIV. Among 47 contacts without antiviral prophylaxis, 12 became cases (secondary attack rate of 26%), and 1 (8%) of these was asymptomatic. The mean and median serial interval were 2.6 and 3 days, respectively (range: 1–3 days). On average, the authors detected viral RNA copies for 6.6 illness days (treated in time = 5.7 days, not treated in time = 7.1 days; P = 0.06), but they estimated that most patients cease to excrete viable virus by the fifth illness day. Shedding profiles were consistent with the number and severity of symptoms. Compared with other nasopharyngeal specimen types, nasal wash was the most sensitive. These results support the notion that epidemiologic and virologic characteristics of NIV are in many aspects similar to those of seasonal influenza.
http://aje.oxfordjournals.org/cgi/content/short/171/11/1157?rss=1