Pandemic H1N1 virus transmission and shedding dynamics in index case households of a prospective Vietnamese cohort - 08/05/14
Summary |
Objectives |
Influenza household transmission studies are required to guide prevention strategies but most passively recruit index cases that seek healthcare. We investigated A(H1N1)pdm09 transmission in a household-based cohort during 2009.
Methods |
Health-workers visited 270 households weekly, and collected swabs from influenza-like-illness cases. If A(H1N1)pdm09 was RT-PCR-confirmed, all household members had symptoms assessed and swabs collected daily for 10–15 days. Viral RNA was quantified and sequenced and serology performed on pre-pandemic sera.
Results |
Index cases were detected in 20 households containing 81 people. 98.5% lacked A(H1N1)pdm09 neutralizing antibodies in pre-pandemic sera. Eleven (18.6%, 95% CI 10.7–30.4%) of 59 contacts were infected. Virus genetic diversity within households was negligible and less than between households. Index and secondary cases were distributed between mothers, daughters and sons, and had similar virus-RNA shedding and symptom dynamics. Fathers were rarely infected. Five secondary cases (45%) had no apparent symptoms and three shed virus before symptoms. Secondary infection was associated with index case wet cough (OR 1.56, 95% CI 1.22–1.99).
Conclusions |
In this cohort of A(H1N1)pdm09 susceptible persons, virus sequencing was capable of discriminating household from community transmission. Household transmission involved mothers and children but rarely fathers. Asymptomatic or pre-symptomatic shedding was common.
Le texte complet de cet article est disponible en PDF.Keywords : Influenza, Transmission, Pandemic, Serial interval, Household, Shedding, Symptoms, Index, Secondary, Antibody
Plan
Vol 68 - N° 6
P. 581-590 - juin 2014 Retour au numéro
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