Viral load and epidemiological profile of patients infected by pandemic influenza a (H1N1) 2009 and seasonal influenza a virus in Southern Brazil
Identifieur interne : 000921 ( Istex/Corpus ); précédent : 000920; suivant : 000922Viral load and epidemiological profile of patients infected by pandemic influenza a (H1N1) 2009 and seasonal influenza a virus in Southern Brazil
Auteurs : Ana Beatriz Gorini Da Veiga ; Nélson Alexandre Kretzmann ; Laura Trevizan Corrêa ; Alessandra Mari Goshiyama ; Tatiana Baccin ; Patrícia Ardenghi ; Fernanda Matias ; Tatiana Schaffer Gregianini ; Pedro Alves D'AzevedoSource :
- Journal of Medical Virology [ 0146-6615 ] ; 2012-03.
Abstract
Correlation between virologic profile and clinical features of patients infected by influenza virus provides important information for epidemiological control and clinical management of future disease outbreaks. Samples from patients in Southern Brazil, from June to December 2009, were examined and the viral load was correlated with epidemiological data. All samples were analyzed by qRT‐PCR for detection of the 2009‐pandemic Influenza A (H1N1). Relative viral loads were assessed based on the 2−ΔCT method and epidemiological data were obtained for each patient, following ethical policies. A total of 933 samples were positive for pH1N1 (2009) influenza; 172 were positive for seasonal influenza A; 13 were undetermined; 1992 samples were negative for influenza A. Combined molecular and epidemiological data were available for 38 seasonal and 198 pandemic samples. The median viral load was higher in pandemic than in seasonal influenza samples; in patients infected with pH1N1 (2009), viral load associated positively with chills, myalgia and rhinorrhea, and negatively with dyspnea, but no association was observed with other symptoms, nor with clinical conditions such as pregnancy, smoking, immunodepression and co‐morbidities. Regarding patients infected with seasonal influenza, viral loads did not show statistically significant association with any of the symptoms. This is the first study in Brazil that examines epidemiological and molecular data from the 2009 influenza pandemic. The results may serve as a basis for developing strategies to control human‐to‐human infection and viral dissemination, and for implementing effective measures and public health policies against future novel disease outbreaks. J. Med. Virol. 84:371–379, 2012. © 2011 Wiley Periodicals, Inc.
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DOI: 10.1002/jmv.23198
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last="Gregianini">Tatiana Schaffer Gregianini</name><affiliation><mods:affiliation>Institute of Biological Research‐State Foundation in Health Production and Research‐Rio Grande do Sul (IPB‐LACEN/FEPPS‐RS), Porto Alegre‐RS, Brazil</mods:affiliation></affiliation></author><author><name sortKey="Alves D Azevedo, Pedro" sort="Alves D Azevedo, Pedro" uniqKey="Alves D Azevedo P" first="Pedro" last="Alves D'Azevedo">Pedro Alves D'Azevedo</name><affiliation><mods:affiliation>Laboratory of Molecular Microbiology, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre‐RS, Brazil</mods:affiliation></affiliation><affiliation><mods:affiliation>Graduate Program in Pathology, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre‐RS, Brazil</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:50BBA1993741C80AA19243E3370333EE9D047E09</idno><date when="2012" 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of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre‐RS, Brazil</mods:affiliation></affiliation><affiliation><mods:affiliation>Graduate Program in Pathology, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre‐RS, Brazil</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: anabgv@ufcspa.edu.br</mods:affiliation></affiliation><affiliation><mods:affiliation>Correspondence address: R. Sarmento Leite, 245/sala 309 – Centro, Porto Alegre‐RS, CEP 90050‐170, Brazil.===</mods:affiliation></affiliation></author><author><name sortKey="Kretzmann, Nelson Alexandre" sort="Kretzmann, Nelson Alexandre" uniqKey="Kretzmann N" first="Nélson Alexandre" last="Kretzmann">Nélson Alexandre Kretzmann</name><affiliation><mods:affiliation>Laboratory of Molecular Microbiology, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre‐RS, Brazil</mods:affiliation></affiliation><affiliation><mods:affiliation>Graduate Program in Pathology, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre‐RS, Brazil</mods:affiliation></affiliation></author><author><name sortKey="Correa, Laura Trevizan" sort="Correa, Laura Trevizan" uniqKey="Correa L" first="Laura Trevizan" last="Corrêa">Laura Trevizan Corrêa</name><affiliation><mods:affiliation>Laboratory of Molecular Biology, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre‐RS, Brazil</mods:affiliation></affiliation></author><author><name sortKey="Goshiyama, Alessandra Mari" sort="Goshiyama, Alessandra Mari" uniqKey="Goshiyama A" first="Alessandra Mari" last="Goshiyama">Alessandra Mari Goshiyama</name><affiliation><mods:affiliation>Laboratory of Molecular Biology, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre‐RS, Brazil</mods:affiliation></affiliation><affiliation><mods:affiliation>Laboratory of Molecular Microbiology, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre‐RS, Brazil</mods:affiliation></affiliation></author><author><name sortKey="Baccin, Tatiana" sort="Baccin, Tatiana" uniqKey="Baccin T" first="Tatiana" last="Baccin">Tatiana Baccin</name><affiliation><mods:affiliation>Institute of Biological Research‐State Foundation in Health Production and Research‐Rio Grande do Sul (IPB‐LACEN/FEPPS‐RS), Porto Alegre‐RS, Brazil</mods:affiliation></affiliation></author><author><name sortKey="Ardenghi, Patricia" sort="Ardenghi, Patricia" uniqKey="Ardenghi P" first="Patrícia" last="Ardenghi">Patrícia Ardenghi</name><affiliation><mods:affiliation>Institute of Biological Research‐State Foundation in Health Production and Research‐Rio Grande do Sul (IPB‐LACEN/FEPPS‐RS), Porto Alegre‐RS, Brazil</mods:affiliation></affiliation></author><author><name sortKey="Matias, Fernanda" sort="Matias, Fernanda" uniqKey="Matias F" first="Fernanda" last="Matias">Fernanda Matias</name><affiliation><mods:affiliation>Laboratory of Molecular Microbiology, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre‐RS, Brazil</mods:affiliation></affiliation><affiliation><mods:affiliation>Graduate Program in Pathology, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre‐RS, Brazil</mods:affiliation></affiliation></author><author><name sortKey="Gregianini, Tatiana Schaffer" sort="Gregianini, Tatiana Schaffer" uniqKey="Gregianini T" first="Tatiana Schaffer" last="Gregianini">Tatiana Schaffer Gregianini</name><affiliation><mods:affiliation>Institute of Biological Research‐State Foundation in Health Production and Research‐Rio Grande do Sul (IPB‐LACEN/FEPPS‐RS), Porto Alegre‐RS, Brazil</mods:affiliation></affiliation></author><author><name sortKey="Alves D Azevedo, Pedro" sort="Alves D Azevedo, Pedro" uniqKey="Alves D Azevedo P" first="Pedro" last="Alves D'Azevedo">Pedro Alves D'Azevedo</name><affiliation><mods:affiliation>Laboratory of Molecular Microbiology, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre‐RS, Brazil</mods:affiliation></affiliation><affiliation><mods:affiliation>Graduate Program in Pathology, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre‐RS, Brazil</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j" type="main">Journal of Medical Virology</title><title level="j" type="alt">JOURNAL OF MEDICAL VIROLOGY</title><idno type="ISSN">0146-6615</idno><idno type="eISSN">1096-9071</idno><imprint><biblScope unit="vol">84</biblScope><biblScope unit="issue">3</biblScope><biblScope unit="page" from="371">371</biblScope><biblScope unit="page" to="379">379</biblScope><biblScope unit="page-count">9</biblScope><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2012-03">2012-03</date></imprint><idno type="ISSN">0146-6615</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0146-6615</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Correlation between virologic profile and clinical features of patients infected by influenza virus provides important information for epidemiological control and clinical management of future disease outbreaks. Samples from patients in Southern Brazil, from June to December 2009, were examined and the viral load was correlated with epidemiological data. All samples were analyzed by qRT‐PCR for detection of the 2009‐pandemic Influenza A (H1N1). Relative viral loads were assessed based on the 2−ΔCT method and epidemiological data were obtained for each patient, following ethical policies. A total of 933 samples were positive for pH1N1 (2009) influenza; 172 were positive for seasonal influenza A; 13 were undetermined; 1992 samples were negative for influenza A. Combined molecular and epidemiological data were available for 38 seasonal and 198 pandemic samples. The median viral load was higher in pandemic than in seasonal influenza samples; in patients infected with pH1N1 (2009), viral load associated positively with chills, myalgia and rhinorrhea, and negatively with dyspnea, but no association was observed with other symptoms, nor with clinical conditions such as pregnancy, smoking, immunodepression and co‐morbidities. Regarding patients infected with seasonal influenza, viral loads did not show statistically significant association with any of the symptoms. This is the first study in Brazil that examines epidemiological and molecular data from the 2009 influenza pandemic. The results may serve as a basis for developing strategies to control human‐to‐human infection and viral dissemination, and for implementing effective measures and public health policies against future novel disease outbreaks. J. Med. 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Sarmento Leite, 245/sala 309 – Centro, Porto Alegre‐RS, CEP 90050‐170, Brazil.===</json:string></affiliations></json:item><json:item><name>Nélson Alexandre Kretzmann</name><affiliations><json:string>Laboratory of Molecular Microbiology, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre‐RS, Brazil</json:string><json:string>Graduate Program in Pathology, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre‐RS, Brazil</json:string></affiliations></json:item><json:item><name>Laura Trevizan Corrêa</name><affiliations><json:string>Laboratory of Molecular Biology, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre‐RS, Brazil</json:string></affiliations></json:item><json:item><name>Alessandra Mari Goshiyama</name><affiliations><json:string>Laboratory of Molecular Biology, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre‐RS, Brazil</json:string><json:string>Laboratory of Molecular Microbiology, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre‐RS, Brazil</json:string></affiliations></json:item><json:item><name>Tatiana Baccin</name><affiliations><json:string>Institute of Biological Research‐State Foundation in Health Production and Research‐Rio Grande do Sul (IPB‐LACEN/FEPPS‐RS), Porto Alegre‐RS, Brazil</json:string></affiliations></json:item><json:item><name>Patrícia Ardenghi</name><affiliations><json:string>Institute of Biological Research‐State Foundation in Health Production and Research‐Rio Grande do Sul (IPB‐LACEN/FEPPS‐RS), Porto Alegre‐RS, Brazil</json:string></affiliations></json:item><json:item><name>Fernanda Matias</name><affiliations><json:string>Laboratory of Molecular Microbiology, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre‐RS, Brazil</json:string><json:string>Graduate Program in Pathology, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre‐RS, Brazil</json:string></affiliations></json:item><json:item><name>Tatiana Schaffer Gregianini</name><affiliations><json:string>Institute of Biological Research‐State Foundation in Health Production and Research‐Rio Grande do Sul (IPB‐LACEN/FEPPS‐RS), Porto Alegre‐RS, Brazil</json:string></affiliations></json:item><json:item><name>Pedro Alves d'Azevedo</name><affiliations><json:string>Laboratory of Molecular Microbiology, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre‐RS, Brazil</json:string><json:string>Graduate Program in Pathology, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre‐RS, Brazil</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>acute respiratory infection</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>influenza‐like symptoms</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>influenza pandemic</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>relative viral load</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>2−ΔCT method</value></json:item></subject><articleId><json:string>JMV23198</json:string></articleId><arkIstex>ark:/67375/WNG-F2Q8GJL1-F</arkIstex><language><json:string>eng</json:string></language><originalGenre><json:string>article</json:string></originalGenre><abstract>Correlation between virologic profile and clinical features of patients infected by influenza virus provides important information for epidemiological control and clinical management of future disease outbreaks. Samples from patients in Southern Brazil, from June to December 2009, were examined and the viral load was correlated with epidemiological data. All samples were analyzed by qRT‐PCR for detection of the 2009‐pandemic Influenza A (H1N1). Relative viral loads were assessed based on the 2−ΔCT method and epidemiological data were obtained for each patient, following ethical policies. A total of 933 samples were positive for pH1N1 (2009) influenza; 172 were positive for seasonal influenza A; 13 were undetermined; 1992 samples were negative for influenza A. Combined molecular and epidemiological data were available for 38 seasonal and 198 pandemic samples. The median viral load was higher in pandemic than in seasonal influenza samples; in patients infected with pH1N1 (2009), viral load associated positively with chills, myalgia and rhinorrhea, and negatively with dyspnea, but no association was observed with other symptoms, nor with clinical conditions such as pregnancy, smoking, immunodepression and co‐morbidities. Regarding patients infected with seasonal influenza, viral loads did not show statistically significant association with any of the symptoms. This is the first study in Brazil that examines epidemiological and molecular data from the 2009 influenza pandemic. The results may serve as a basis for developing strategies to control human‐to‐human infection and viral dissemination, and for implementing effective measures and public health policies against future novel disease outbreaks. J. Med. 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[2009]</json:string><json:string>WHO, 2009</json:string><json:string>To et al. [2010]</json:string><json:string>Capelozzi et al., 2010</json:string><json:string>Oliveira et al., 2009</json:string></ref_bibl><bibl></bibl></unitex></namedEntities><ark><json:string>ark:/67375/WNG-F2Q8GJL1-F</json:string></ark><categories><wos><json:string>1 - science</json:string><json:string>2 - virology</json:string></wos><scienceMetrix><json:string>1 - health sciences</json:string><json:string>2 - biomedical research</json:string><json:string>3 - virology</json:string></scienceMetrix><scopus><json:string>1 - Health Sciences</json:string><json:string>2 - Medicine</json:string><json:string>3 - Infectious Diseases</json:string><json:string>1 - Life Sciences</json:string><json:string>2 - Immunology and Microbiology</json:string><json:string>3 - Virology</json:string></scopus><inist><json:string>1 - sciences appliquees, technologies et medecines</json:string><json:string>2 - sciences biologiques et medicales</json:string><json:string>3 - sciences 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Relative viral loads were assessed based on the 2<sup>−ΔCT</sup> method and epidemiological data were obtained for each patient, following ethical policies. A total of 933 samples were positive for pH1N1 (2009) influenza; 172 were positive for seasonal influenza A; 13 were undetermined; 1992 samples were negative for influenza A. Combined molecular and epidemiological data were available for 38 seasonal and 198 pandemic samples. The median viral load was higher in pandemic than in seasonal influenza samples; in patients infected with pH1N1 (2009), viral load associated positively with chills, myalgia and rhinorrhea, and negatively with dyspnea, but no association was observed with other symptoms, nor with clinical conditions such as pregnancy, smoking, immunodepression and co‐morbidities. Regarding patients infected with seasonal influenza, viral loads did not show statistically significant association with any of the symptoms. This is the first study in Brazil that examines epidemiological and molecular data from the 2009 influenza pandemic. The results may serve as a basis for developing strategies to control human‐to‐human infection and viral dissemination, and for implementing effective measures and public health policies against future novel disease outbreaks. J. Med. Virol. 84:371–379, 2012. © 2011 Wiley Periodicals, Inc.</p></abstract></abstractGroup></contentMeta><noteGroup><note xml:id="fn1"><p>Ana Beatriz Gorini da Veiga and Nélson Alexandre Kretzmann contributed equally to this work.</p></note><note xml:id="fn2"><p>The authors of this study declare they do not have any kind of conflict of interest.</p></note></noteGroup></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Viral load and epidemiological profile of patients infected by pandemic influenza a (H1N1) 2009 and seasonal influenza a virus in Southern Brazil</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Influenza A in Southern Brazil, 2009</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Viral load and epidemiological profile of patients infected by pandemic influenza a (H1N1) 2009 and seasonal influenza a virus in Southern Brazil</title></titleInfo><name type="personal"><namePart type="given">Ana Beatriz</namePart><namePart type="family">Gorini da Veiga</namePart><affiliation>Laboratory of Molecular Biology, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre‐RS, Brazil</affiliation><affiliation>Laboratory of Molecular Microbiology, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre‐RS, Brazil</affiliation><affiliation>Graduate Program in Pathology, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre‐RS, Brazil</affiliation><affiliation>E-mail: anabgv@ufcspa.edu.br</affiliation><affiliation>Correspondence address: R. Sarmento Leite, 245/sala 309 – Centro, Porto Alegre‐RS, CEP 90050‐170, Brazil.===</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Nélson Alexandre</namePart><namePart type="family">Kretzmann</namePart><affiliation>Laboratory of Molecular Microbiology, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre‐RS, Brazil</affiliation><affiliation>Graduate Program in Pathology, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre‐RS, Brazil</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Laura Trevizan</namePart><namePart type="family">Corrêa</namePart><affiliation>Laboratory of Molecular Biology, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre‐RS, Brazil</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Alessandra Mari</namePart><namePart type="family">Goshiyama</namePart><affiliation>Laboratory of Molecular Biology, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre‐RS, Brazil</affiliation><affiliation>Laboratory of Molecular Microbiology, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre‐RS, Brazil</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Tatiana</namePart><namePart type="family">Baccin</namePart><affiliation>Institute of Biological Research‐State Foundation in Health Production and Research‐Rio Grande do Sul (IPB‐LACEN/FEPPS‐RS), Porto Alegre‐RS, Brazil</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Patrícia</namePart><namePart type="family">Ardenghi</namePart><affiliation>Institute of Biological Research‐State Foundation in Health Production and Research‐Rio Grande do Sul (IPB‐LACEN/FEPPS‐RS), Porto Alegre‐RS, Brazil</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Fernanda</namePart><namePart type="family">Matias</namePart><affiliation>Laboratory of Molecular Microbiology, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre‐RS, Brazil</affiliation><affiliation>Graduate Program in Pathology, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre‐RS, Brazil</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Tatiana Schaffer</namePart><namePart type="family">Gregianini</namePart><affiliation>Institute of Biological Research‐State Foundation in Health Production and Research‐Rio Grande do Sul (IPB‐LACEN/FEPPS‐RS), Porto Alegre‐RS, Brazil</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Pedro</namePart><namePart type="family">Alves d'Azevedo</namePart><affiliation>Laboratory of Molecular Microbiology, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre‐RS, Brazil</affiliation><affiliation>Graduate Program in Pathology, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre‐RS, Brazil</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article" authority="ISTEX" authorityURI="https://content-type.data.istex.fr" valueURI="https://content-type.data.istex.fr/ark:/67375/XTP-6N5SZHKN-D">article</genre><originInfo><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><place><placeTerm type="text">Hoboken</placeTerm></place><dateIssued encoding="w3cdtf">2012-03</dateIssued><dateValid encoding="w3cdtf">2011-11-09</dateValid><copyrightDate encoding="w3cdtf">2012</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><extent unit="figures">2</extent><extent unit="tables">6</extent><extent unit="references">20</extent><extent unit="words">6400</extent></physicalDescription><abstract lang="en">Correlation between virologic profile and clinical features of patients infected by influenza virus provides important information for epidemiological control and clinical management of future disease outbreaks. Samples from patients in Southern Brazil, from June to December 2009, were examined and the viral load was correlated with epidemiological data. All samples were analyzed by qRT‐PCR for detection of the 2009‐pandemic Influenza A (H1N1). Relative viral loads were assessed based on the 2−ΔCT method and epidemiological data were obtained for each patient, following ethical policies. A total of 933 samples were positive for pH1N1 (2009) influenza; 172 were positive for seasonal influenza A; 13 were undetermined; 1992 samples were negative for influenza A. Combined molecular and epidemiological data were available for 38 seasonal and 198 pandemic samples. The median viral load was higher in pandemic than in seasonal influenza samples; in patients infected with pH1N1 (2009), viral load associated positively with chills, myalgia and rhinorrhea, and negatively with dyspnea, but no association was observed with other symptoms, nor with clinical conditions such as pregnancy, smoking, immunodepression and co‐morbidities. Regarding patients infected with seasonal influenza, viral loads did not show statistically significant association with any of the symptoms. This is the first study in Brazil that examines epidemiological and molecular data from the 2009 influenza pandemic. The results may serve as a basis for developing strategies to control human‐to‐human infection and viral dissemination, and for implementing effective measures and public health policies against future novel disease outbreaks. J. Med. Virol. 84:371–379, 2012. © 2011 Wiley Periodicals, Inc.</abstract><note type="content">*Ana Beatriz Gorini da Veiga and Nélson Alexandre Kretzmann contributed equally to this work.</note><note type="content">*The authors of this study declare they do not have any kind of conflict of interest.</note><note type="funding">Research Foundation of the State of Rio Grande do Sul (FAPERGS) P.A. d'Azevedo and A.B.G. Veiga - No. FAPERGS 007/2009‐PPIR; </note><note type="funding">Pathology Graduate Program of UFCSPA</note><note type="funding">CAPES, CNPq and FINEP–Federative Republic of Brazil N.A. Kretzmann and F. Matias - No. MEC/CAPES and MCT/CNPq/FINEP n° 28/2010; </note><subject lang="en"><genre>keywords</genre><topic>acute respiratory infection</topic><topic>influenza‐like symptoms</topic><topic>influenza pandemic</topic><topic>relative viral load</topic><topic>2−ΔCT method</topic></subject><relatedItem type="host"><titleInfo><title>Journal of Medical Virology</title></titleInfo><titleInfo type="abbreviated"><title>J. Med. 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