title: Correlation of pandemic (H1N1) 2009 viral load with disease severity and prolonged viral shedding in children.
abstract: Pandemic (H1N1) 2009 virus causes severe illness, including pneumonia, which leads to hospitalization and even death. To characterize the kinetic changes in viral load and identify factors of influence, we analyzed variables that could potentially influence the viral shedding time in a hospital-based cohort of 1,052 patients. Viral load was inversely correlated with number of days after the onset of fever and was maintained at a high level over the first 3 days. Patients with pneumonia had higher viral loads than those with bronchitis or upper respiratory tract infection. Median viral shedding time after the onset of symptoms was 9 days. Patients <13 years of age had a longer median viral shedding time than those >or=13 years of age (11 days vs. 7 days). These results suggest that younger children may require a longer isolation period and that patients with pneumonia may require treatment that is more aggressive than standard therapy for pandemic (H1N1) 2009 virus.
authors.affiliation: Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung, Taiwan; and Chang Gung University College of Medicine, Kaohsiung.
authors.forename: Chung-Chen
authors.initials: CC
authors.lastname: Li
authors.forename: Lin
authors.initials: L
authors.lastname: Wang
authors.forename: Hock-Liew
authors.initials: HL
authors.lastname: Eng
authors.forename: Huey-Ling
authors.initials: HL
authors.lastname: You
authors.forename: Ling-Sai
authors.initials: LS
authors.lastname: Chang
authors.forename: Kuo-Shu
authors.initials: KS
authors.lastname: Tang
authors.forename: Ying-Jui
authors.initials: YJ
authors.lastname: Lin
authors.forename: Hsuan-Chang
authors.initials: HC
authors.lastname: Kuo
authors.forename: Ing-Kit
authors.initials: IK
authors.lastname: Lee
authors.forename: Jien-Wei
authors.initials: JW
authors.lastname: Liu
authors.forename: Eng-Yen
authors.initials: EY
authors.lastname: Huang
authors.forename: Kuender D
authors.initials: KD
authors.lastname: Yang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D058872:Epidemics; D006801:Humans; D007223:Infant; D053118:Influenza A Virus, H1N1 Subtype / Q000235:genetics / Q000302:isolation & purification*; D007251:Influenza, Human / Q000188:drug therapy / Q000453:epidemiology* / Q000821:virology*; D053139:Oseltamivir / Q000627:therapeutic use; D012367:RNA, Viral / Q000737:chemistry / Q000235:genetics; D020133:Reverse Transcriptase Polymerase Chain Reaction; D018709:Statistics, Nonparametric; D013624:Taiwan / Q000453:epidemiology; D017201:Virus Shedding; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; D012367:RNA, Viral; D053139:Oseltamivir