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Viral load in patients infected with pandemic H1N1 2009 influenza A virus.
J Med Virol 2010; 82(1):1-7JM

Abstract

Viral shedding profile of infections caused by the pandemic H1N1 2009 influenza A virus has not been reported. The aim of this study was to determine the viral load in different body sites. Viral loads of pandemic H1N1 virus in respiratory specimens, stool, urine, and serum were determined by quantitative reverse transcriptase-polymerase chain reaction (RT-PCR). Respiratory specimens from patients with seasonal influenza were used as historical controls. Initial pre-treatment viral load were compared between these two groups. Serial respiratory specimens from patients with pandemic H1N1 virus infection were obtained for analysis of viral dynamics. Twenty-two pandemic H1N1 cases and 44 seasonal influenza historical controls were included. The mean initial viral load before oseltamivir therapy was 1.84 x 10(8) copies/ml for pandemic H1N1 virus compared with 3.28 x 10(8) copies/ml in seasonal influenza historical controls (P = 0.085). Among patients with pandemic H1N1 virus infection, peak viral load occurred on the day of onset of symptoms, and declined gradually afterwards, with no virus being detectable in respiratory specimens by RT-PCR 8 days and by culture 5 days after the onset of symptoms respectively, except in one patient. Pandemic H1N1 virus was detected in stool and in urine from 4/9 and 1/14 patients, respectively. Viral culture was also positive from the stool sample with the highest viral load. Younger age was associated with prolonged shedding in the respiratory tract and higher viral load in the stool. Data from this quantitative analysis of viral shedding may have implications for formulating infection control measures.

Authors+Show Affiliations

Department of Microbiology, Queen Mary Hospital, The University of Hong Kong, Hong Kong Special Administrative Region, China.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19950247

Citation

To, Kelvin K W., et al. "Viral Load in Patients Infected With Pandemic H1N1 2009 Influenza a Virus." Journal of Medical Virology, vol. 82, no. 1, 2010, pp. 1-7.
To KK, Chan KH, Li IW, et al. Viral load in patients infected with pandemic H1N1 2009 influenza A virus. J Med Virol. 2010;82(1):1-7.
To, K. K., Chan, K. H., Li, I. W., Tsang, T. Y., Tse, H., Chan, J. F., ... Yuen, K. Y. (2010). Viral load in patients infected with pandemic H1N1 2009 influenza A virus. Journal of Medical Virology, 82(1), pp. 1-7. doi:10.1002/jmv.21664.
To KK, et al. Viral Load in Patients Infected With Pandemic H1N1 2009 Influenza a Virus. J Med Virol. 2010;82(1):1-7. PubMed PMID: 19950247.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Viral load in patients infected with pandemic H1N1 2009 influenza A virus. AU - To,Kelvin K W, AU - Chan,Kwok-Hung, AU - Li,Iris W S, AU - Tsang,Tak-Yin, AU - Tse,Herman, AU - Chan,Jasper F W, AU - Hung,Ivan F N, AU - Lai,Sik-To, AU - Leung,Chi-Wai, AU - Kwan,Yat-Wah, AU - Lau,Yu-Lung, AU - Ng,Tak-Keung, AU - Cheng,Vincent C C, AU - Peiris,Joseph S M, AU - Yuen,Kwok-Yung, PY - 2009/12/2/entrez PY - 2009/12/2/pubmed PY - 2010/2/27/medline SP - 1 EP - 7 JF - Journal of medical virology JO - J. Med. Virol. VL - 82 IS - 1 N2 - Viral shedding profile of infections caused by the pandemic H1N1 2009 influenza A virus has not been reported. The aim of this study was to determine the viral load in different body sites. Viral loads of pandemic H1N1 virus in respiratory specimens, stool, urine, and serum were determined by quantitative reverse transcriptase-polymerase chain reaction (RT-PCR). Respiratory specimens from patients with seasonal influenza were used as historical controls. Initial pre-treatment viral load were compared between these two groups. Serial respiratory specimens from patients with pandemic H1N1 virus infection were obtained for analysis of viral dynamics. Twenty-two pandemic H1N1 cases and 44 seasonal influenza historical controls were included. The mean initial viral load before oseltamivir therapy was 1.84 x 10(8) copies/ml for pandemic H1N1 virus compared with 3.28 x 10(8) copies/ml in seasonal influenza historical controls (P = 0.085). Among patients with pandemic H1N1 virus infection, peak viral load occurred on the day of onset of symptoms, and declined gradually afterwards, with no virus being detectable in respiratory specimens by RT-PCR 8 days and by culture 5 days after the onset of symptoms respectively, except in one patient. Pandemic H1N1 virus was detected in stool and in urine from 4/9 and 1/14 patients, respectively. Viral culture was also positive from the stool sample with the highest viral load. Younger age was associated with prolonged shedding in the respiratory tract and higher viral load in the stool. Data from this quantitative analysis of viral shedding may have implications for formulating infection control measures. SN - 1096-9071 UR - https://www.unboundmedicine.com/medline/citation/19950247/Viral_load_in_patients_infected_with_pandemic_H1N1_2009_influenza_A_virus_ L2 - https://doi.org/10.1002/jmv.21664 DB - PRIME DP - Unbound Medicine ER -