AI Article Synopsis
- A study on A(H1N1)pdm09 influenza transmission was conducted in 270 households, gathering data through weekly health-worker visits and swabs to assess infections.
- Among 81 people, 18.6% of contacts were infected, and virus genetic diversity was lower within households compared to between them.
- The findings revealed that while mothers and children were commonly infected, fathers were rarely affected, and many cases involved asymptomatic or pre-symptomatic virus shedding.
Article Abstract
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.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4031397 | PMC |
| http://dx.doi.org/10.1016/j.jinf.2014.01.008 | DOI Listing |
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