title: Predictors of influenza a molecular viral shedding in Hutterite communities.
abstract: Patterns of influenza molecular viral shedding following influenza infection have been well established; predictors of viral shedding however remain uncertain.
  
  
  
  We sought to determine factors associated with peak molecular viral load, duration of shedding, and viral area under the curve (AUC) in children and adult Hutterite colony members with laboratory-confirmed influenza.
  
  
  
  A cohort study was conducted in Hutterite colonies in Alberta, Canada. Flocked nasal swabs were collected during three influenza seasons (2007-2008 to 2009-2010) from both symptomatic and asymptomatic individuals infected with influenza. Samples were tested by real-time reverse-transcription polymerase chain reaction for influenza A and influenza B, and the viral load was determined for influenza A-positive samples.
  
  
  
  For seasonal H1N1, younger age was associated with a larger AUC, female sex was associated with decreased peak viral load and reduced viral shedding duration, while the presence of comorbidity was associated with increased peak viral load. For H3N2, younger age was associated with increased peak viral load and increased AUC. For pandemic H1N1, younger age was associated with increased peak viral load and increased viral AUC, female sex was associated with reduced peak viral load, while inapparent infection was associated with reduced peak viral load, reduced viral shedding duration, and reduced viral AUC.
  
  
  
  Patterns of molecular viral shedding vary by age, sex, comorbidity, and the presence of symptoms. Predictor variables vary by influenza A subtype.
authors.affiliation: Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada.
authors.forename: Biao
authors.initials: B
authors.lastname: Wang
authors.affiliation: Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
authors.forename: Margaret L
authors.initials: ML
authors.lastname: Russell
authors.affiliation: Department of Microbiology and Infectious Diseases and Provincial Laboratory for Public Health, University of Calgary, Calgary, AB, Canada.
authors.forename: Kevin
authors.initials: K
authors.lastname: Fonseca
authors.affiliation: Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada.|Michael G. De- Groote Institute for Infectious Disease Research, McMaster University, Hamilton, ON, Canada.|Department of Mathematics and Statistics, McMaster University, Hamilton, ON, Canada.
authors.forename: David J D
authors.initials: DJD
authors.lastname: Earn
authors.affiliation: Saskatchewan Disease Control Laboratory, Regina, SK, Canada.
authors.forename: Gregory
authors.initials: G
authors.lastname: Horsman
authors.affiliation: Cadham Provincial Laboratory, Winnipeg, MB, Canada.
authors.forename: Paul
authors.initials: P
authors.lastname: Van Caeseele
authors.affiliation: Saskatchewan Health, Prince Albert Parkland Health Region, Prince Albert, SK, Canada.
authors.forename: Khami
authors.initials: K
authors.lastname: Chokani
authors.affiliation: Saskatchewan Health, Five Hills Health Region, Moose Jaw, SK, Canada.
authors.forename: Mark
authors.initials: M
authors.lastname: Vooght
authors.affiliation: University of Alberta, Edmonton, AB, Canada.
authors.forename: Lorne
authors.initials: L
authors.lastname: Babiuk
authors.affiliation: Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada.
authors.forename: Stephen D
authors.initials: SD
authors.lastname: Walter
authors.affiliation: Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada.|Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada.|Michael G. De- Groote Institute for Infectious Disease Research, McMaster University, Hamilton, ON, Canada.|Department of Medicine, McMaster University, Hamilton, ON, Canada.
authors.forename: Mark
authors.identifier: 0000-0003-2315-5390
authors.initials: M
authors.lastname: Loeb
mesh_terms: D000293:Adolescent; D000328:Adult; D000416:Alberta / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007223:Infant; D053118:Influenza A Virus, H1N1 Subtype / Q000235:genetics / Q000302:isolation & purification / Q000502:physiology; D053122:Influenza A Virus, H3N2 Subtype / Q000235:genetics / Q000502:physiology; D007251:Influenza, Human / Q000453:epidemiology / Q000821:virology*; D008297:Male; D008875:Middle Aged; D009975:Orthomyxoviridae / Q000145:classification / Q000235:genetics / Q000302:isolation & purification / Q000502:physiology*; D012621:Seasons; D019562:Viral Load; D017201:Virus Shedding; D055815:Young Adult
keywords: influenza viral shedding; predictors; viral AUC; viral load; viral shedding duration