Viral shedding in patients infected with pandemic influenza A (H1N1) virus in Kenya, 2009

Lilian W Waiboci; Emmaculate Lebo; John M Williamson; William Mwiti; Gilbert K Kikwai; Henry Njuguna; Beatrice Olack; Robert F Breiman; M Kariuki Njenga; Mark A Katz

doi:10.1371/journal.pone.0020320

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Viral shedding in patients infected with pandemic influenza A (H1N1) virus in Kenya, 2009

Journal article

Open access

Viral shedding in patients infected with pandemic influenza A (H1N1) virus in Kenya, 2009

Lilian W Waiboci, Emmaculate Lebo, John M Williamson, William Mwiti, Gilbert K Kikwai, Henry Njuguna, Beatrice Olack, Robert F Breiman, M Kariuki Njenga and Mark A Katz

PloS one, Vol.6(6), pp.e20320-e20320

2011

DOI: https://doi.org/10.1371/journal.pone.0020320

Handle:

https://hdl.handle.net/2376/107729

PMCID: PMC3112167

PMID: 21695203

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Abstract

Virus Shedding - physiology

Demography

Pandemics

Kenya - epidemiology

Humans

Influenza A Virus, H1N1 Subtype - physiology

Kaplan-Meier Estimate

Child, Preschool

Influenza, Human - epidemiology

Male

Reverse Transcriptase Polymerase Chain Reaction

Influenza A Virus, H1N1 Subtype - isolation & purification

Adolescent

Female

Influenza, Human - virology

Child

Influenza A Virus, H1N1 Subtype - genetics

Understanding shedding patterns of 2009 pandemic influenza A (H1N1) (pH1N1) can inform recommendations about infection control measures. We evaluated the duration of pH1N1 virus shedding in patients in Nairobi, Kenya. Nasopharyngeal (NP) and oropharyngeal (OP) specimens were collected from consenting laboratory-confirmed pH1N1 cases every 2 days during October 14-November 25, 2009, and tested at the Centers for Diseases Control and Prevention-Kenya by real time reverse transcriptase polymerase chain reaction (rRT-PCR). A subset of rRT-PCR-positive samples was cultured. Of 285 NP/OP specimens from patients with acute respiratory illness, 140 (49%) tested positive for pH1N1 by rRT-PCR; 106 (76%) patients consented and were enrolled. The median age was 6 years (Range: 4 months-41 years); only two patients, both asthmatic, received oseltamivir. The median duration of pH1N1 detection after illness onset was 8 days (95% CI: 7-10 days) for rRT-PCR and 3 days (Range: 0-13 days) for viral isolation. Viable pH1N1 virus was isolated from 132/162 (81%) of rRT-PCR-positive specimens, which included 118/125 (94%) rRT-PCR-positive specimens collected on day 0-7 after symptoms onset. Viral RNA was detectable in 18 (17%) and virus isolated in 7/18 (39%) of specimens collected from patients after all their symptoms had resolved. In this cohort, pH1N1 was detected by rRT-PCR for a median of 8 days. There was a strong correlation between rRT-PCR results and virus isolation in the first week of illness. In some patients, pH1N1 virus was detectable after all their symptoms had resolved.

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Title: Viral shedding in patients infected with pandemic influenza A (H1N1) virus in Kenya, 2009
Creators: Lilian W Waiboci - US Centers for Disease Control and Prevention-Kenya, Nairobi, Kenya. lwaiboci@ke.cdc.gov
Emmaculate Lebo
John M Williamson
William Mwiti
Gilbert K Kikwai
Henry Njuguna
Beatrice Olack
Robert F Breiman
M Kariuki Njenga
Mark A Katz
Publication Details: PloS one, Vol.6(6), pp.e20320-e20320
Academic Unit: Paul G. Allen School for Global Animal Health
Publisher: United States
Identifiers: 99900547044401842
Language: English
Resource Type: Journal article