Viral Shedding in Patients Infected with Pandemic Influenza A (H1N1) Virus in Kenya, 2009
Identifieur interne : 002019 ( Pmc/Checkpoint ); précédent : 002018; suivant : 002020Viral Shedding in Patients Infected with Pandemic Influenza A (H1N1) Virus in Kenya, 2009
Auteurs : Lilian W. Waiboci [Kenya] ; Emmaculate Lebo [Kenya] ; John M. Williamson [Kenya] ; William Mwiti [Kenya] ; Gilbert K. Kikwai [Kenya] ; Henry Njuguna [Kenya] ; Beatrice Olack [Kenya] ; Robert F. Breiman [Kenya] ; M. Kariuki Njenga [Kenya] ; Mark A. Katz [Kenya, États-Unis]Source :
- PLoS ONE [ 1932-6203 ] ; 2011.
Abstract
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.
Url:
DOI: 10.1371/journal.pone.0020320
PubMed: 21695203
PubMed Central: 3112167
Affiliations:
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<front><div type="abstract" xml:lang="en"><sec><title>Background</title>
<p>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.</p>
</sec>
<sec><title>Methods</title>
<p>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.</p>
</sec>
<sec><title>Results</title>
<p>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.</p>
</sec>
<sec><title>Conclusions</title>
<p>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.</p>
</sec>
</div>
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</TEI>
<pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">PLoS One</journal-id>
<journal-id journal-id-type="publisher-id">plos</journal-id>
<journal-id journal-id-type="pmc">plosone</journal-id>
<journal-title-group><journal-title>PLoS ONE</journal-title>
</journal-title-group>
<issn pub-type="epub">1932-6203</issn>
<publisher><publisher-name>Public Library of Science</publisher-name>
<publisher-loc>San Francisco, USA</publisher-loc>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">21695203</article-id>
<article-id pub-id-type="pmc">3112167</article-id>
<article-id pub-id-type="publisher-id">PONE-D-11-01940</article-id>
<article-id pub-id-type="doi">10.1371/journal.pone.0020320</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject>
</subj-group>
<subj-group subj-group-type="Discipline-v2"><subject>Biology</subject>
<subj-group><subject>Microbiology</subject>
<subj-group><subject>Microbial Pathogens</subject>
</subj-group>
</subj-group>
</subj-group>
<subj-group subj-group-type="Discipline-v2"><subject>Medicine</subject>
<subj-group><subject>Epidemiology</subject>
<subj-group><subject>Infectious Disease Epidemiology</subject>
</subj-group>
</subj-group>
<subj-group><subject>Infectious Diseases</subject>
<subj-group><subject>Viral Diseases</subject>
<subj-group><subject>Influenza</subject>
</subj-group>
</subj-group>
</subj-group>
</subj-group>
</article-categories>
<title-group><article-title>Viral Shedding in Patients Infected with Pandemic Influenza A (H1N1) Virus in Kenya, 2009</article-title>
<alt-title alt-title-type="running-head">Influenza A 2009 H1N1 Virus Shedding, Kenya</alt-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Waiboci</surname>
<given-names>Lilian W.</given-names>
</name>
<xref ref-type="aff" rid="aff1"><sup>1</sup>
</xref>
<xref ref-type="corresp" rid="cor1"><sup>*</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Lebo</surname>
<given-names>Emmaculate</given-names>
</name>
<xref ref-type="aff" rid="aff1"><sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Williamson</surname>
<given-names>John M.</given-names>
</name>
<xref ref-type="aff" rid="aff1"><sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Mwiti</surname>
<given-names>William</given-names>
</name>
<xref ref-type="aff" rid="aff2"><sup>2</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Kikwai</surname>
<given-names>Gilbert K.</given-names>
</name>
<xref ref-type="aff" rid="aff2"><sup>2</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Njuguna</surname>
<given-names>Henry</given-names>
</name>
<xref ref-type="aff" rid="aff2"><sup>2</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Olack</surname>
<given-names>Beatrice</given-names>
</name>
<xref ref-type="aff" rid="aff2"><sup>2</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Breiman</surname>
<given-names>Robert F.</given-names>
</name>
<xref ref-type="aff" rid="aff1"><sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Njenga</surname>
<given-names>M. Kariuki</given-names>
</name>
<xref ref-type="aff" rid="aff1"><sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Katz</surname>
<given-names>Mark A.</given-names>
</name>
<xref ref-type="aff" rid="aff1"><sup>1</sup>
</xref>
<xref ref-type="aff" rid="aff3"><sup>3</sup>
</xref>
</contrib>
</contrib-group>
<aff id="aff1"><label>1</label>
<addr-line>US Centers for Disease Control and Prevention-Kenya, Nairobi, Kenya</addr-line>
</aff>
<aff id="aff2"><label>2</label>
<addr-line>Kenya Medical Research Institute/US Centers for Disease Control and Prevention-Kenya, Nairobi, Kenya</addr-line>
</aff>
<aff id="aff3"><label>3</label>
<addr-line>Influenza Division, National Center for Immunization and Respiratory Diseases (NCIRD), Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America</addr-line>
</aff>
<contrib-group><contrib contrib-type="editor"><name><surname>Aguilar</surname>
<given-names>Patricia V.</given-names>
</name>
<role>Editor</role>
<xref ref-type="aff" rid="edit1"></xref>
</contrib>
</contrib-group>
<aff id="edit1">University of Texas Medical Branch, United States of America</aff>
<author-notes><corresp id="cor1">* E-mail: <email>lwaiboci@ke.cdc.gov</email>
</corresp>
<fn fn-type="con"><p>Conceived and designed the experiments: LWW EL MAK MKN HN WM RFB BO. Performed the experiments: GKK LWW MKN. Analyzed the data: JMW EL MAK LWW. Contributed reagents/materials/analysis tools: MAK MKN RFB. Wrote the paper: LWW MAK EL MKN JMW. Collected clinical specimens and managed clinical data: HN WM. Coordinated field activities: BO WM.</p>
</fn>
</author-notes>
<pub-date pub-type="collection"><year>2011</year>
</pub-date>
<pub-date pub-type="epub"><day>10</day>
<month>6</month>
<year>2011</year>
</pub-date>
<volume>6</volume>
<issue>6</issue>
<elocation-id>e20320</elocation-id>
<history><date date-type="received"><day>22</day>
<month>1</month>
<year>2011</year>
</date>
<date date-type="accepted"><day>21</day>
<month>4</month>
<year>2011</year>
</date>
</history>
<permissions><copyright-statement>This is an open-access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.</copyright-statement>
<copyright-year>2011</copyright-year>
</permissions>
<abstract><sec><title>Background</title>
<p>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.</p>
</sec>
<sec><title>Methods</title>
<p>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.</p>
</sec>
<sec><title>Results</title>
<p>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.</p>
</sec>
<sec><title>Conclusions</title>
<p>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.</p>
</sec>
</abstract>
<counts><page-count count="6"></page-count>
</counts>
</article-meta>
</front>
</pmc>
<affiliations><list><country><li>Kenya</li>
<li>États-Unis</li>
</country>
<region><li>Géorgie (États-Unis)</li>
</region>
</list>
<tree><country name="Kenya"><noRegion><name sortKey="Waiboci, Lilian W" sort="Waiboci, Lilian W" uniqKey="Waiboci L" first="Lilian W." last="Waiboci">Lilian W. Waiboci</name>
</noRegion>
<name sortKey="Breiman, Robert F" sort="Breiman, Robert F" uniqKey="Breiman R" first="Robert F." last="Breiman">Robert F. Breiman</name>
<name sortKey="Katz, Mark A" sort="Katz, Mark A" uniqKey="Katz M" first="Mark A." last="Katz">Mark A. Katz</name>
<name sortKey="Kikwai, Gilbert K" sort="Kikwai, Gilbert K" uniqKey="Kikwai G" first="Gilbert K." last="Kikwai">Gilbert K. Kikwai</name>
<name sortKey="Lebo, Emmaculate" sort="Lebo, Emmaculate" uniqKey="Lebo E" first="Emmaculate" last="Lebo">Emmaculate Lebo</name>
<name sortKey="Mwiti, William" sort="Mwiti, William" uniqKey="Mwiti W" first="William" last="Mwiti">William Mwiti</name>
<name sortKey="Njenga, M Kariuki" sort="Njenga, M Kariuki" uniqKey="Njenga M" first="M. Kariuki" last="Njenga">M. Kariuki Njenga</name>
<name sortKey="Njuguna, Henry" sort="Njuguna, Henry" uniqKey="Njuguna H" first="Henry" last="Njuguna">Henry Njuguna</name>
<name sortKey="Olack, Beatrice" sort="Olack, Beatrice" uniqKey="Olack B" first="Beatrice" last="Olack">Beatrice Olack</name>
<name sortKey="Williamson, John M" sort="Williamson, John M" uniqKey="Williamson J" first="John M." last="Williamson">John M. Williamson</name>
</country>
<country name="États-Unis"><region name="Géorgie (États-Unis)"><name sortKey="Katz, Mark A" sort="Katz, Mark A" uniqKey="Katz M" first="Mark A." last="Katz">Mark A. Katz</name>
</region>
</country>
</tree>
</affiliations>
</record>
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