title: Heterogeneity in viral shedding among individuals with medically attended influenza A virus infection.
abstract: Compared with the average transmissibility of human influenza A virus, much less attention has been paid to the potential variability in its transmissibility. We considered viral shedding as a proxy for infectiousness and explored the heterogeneity of infectiousness among patients with medically attended seasonal influenza A virus infection. The analysis revealed that viral shedding is more heterogeneous in children than in adults. The top 20% most infectious children and adults were estimated to be responsible for 89%-96% and 78%-82%, respectively, of the total infectiousness in each age group. Further investigation is required to correlate the substantial variations in viral shedding with heterogeneity in actual transmissibility.
authors: Infectious Disease Epidemiology Group, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong, China.
authors: Lincoln L H
authors: LL
authors: Lau
authors: Dennis K M
authors: DK
authors: Ip
authors: Hiroshi
authors: H
authors: Nishiura
authors: Vicky J
authors: VJ
authors: Fang
authors: Kwok-Hung
authors: KH
authors: Chan
authors: J S Malik
authors: JS
authors: Peiris
authors: Gabriel M
authors: GM
authors: Leung
authors: Benjamin J
authors: BJ
authors: Cowling
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D018076:DNA, Complementary / Q000032:analysis; D005260:Female; D006801:Humans; D053122:Influenza A Virus, H3N2 Subtype / Q000472:pathogenicity; D009980:Influenza A virus / Q000235:genetics / Q000472:pathogenicity*; D007251:Influenza, Human / Q000473:pathology / Q000635:transmission* / Q000821:virology; D016014:Linear Models; D008297:Male; D008954:Models, Biological; D012367:RNA, Viral / Q000032:analysis / Q000235:genetics; D012621:Seasons; D013997:Time Factors; D017201:Virus Shedding; D055815:Young Adult
chemical_list: D018076:DNA, Complementary; D012367:RNA, Viral
references: Int J Infect Dis. 2011 Aug;15(8):e510-3
references: 21737332
references: N Engl J Med. 2010 Jun 10;362(23):2175-2184
references: 20558368
references: Scand J Infect Dis. 2012 Mar;44(3):225-7
references: 22148980
references: Am J Epidemiol. 1979 Jul;110(1):1-6
references: 463858
references: Am J Med. 2002 Apr 22;112 Suppl 6A:4S-12S
references: 11955454
references: Nature. 2005 Nov 17;438(7066):355-9
references: 16292310
references: J Infect Dis. 2012 Oct 1;206(7):1078-84
references: 22837493
references: Emerg Infect Dis. 2003 Jun;9(6):628-33
references: 12781000
references: Ann Intern Med. 2009 Oct 6;151(7):437-46
references: 19652172
references: PLoS Comput Biol. 2009 Aug;5(8):e1000471
references: 19696879
references: Emerg Infect Dis. 2006 Jan;12(1):81-7
references: 16494722
references: Proc Natl Acad Sci U S A. 1997 Jan 7;94(1):338-42
references: 8990210
references: J Infect Dis. 2012 Feb 15;205(4):631-4
references: 22198963
references: J Infect Dis. 2010 May 15;201(10):1509-16
references: 20377412
references: Am J Epidemiol. 2008 Apr 1;167(7):775-85
references: 18230677