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The environmental deposition of influenza virus from patients infected with influenza A(H1N1)pdm09: Implications for infection prevention and control

The environmental deposition of influenza virus from patients infected with influenza A(H1N1)pdm09: Implications for infection prevention and control
The environmental deposition of influenza virus from patients infected with influenza A(H1N1)pdm09: Implications for infection prevention and control

In a multi-center, prospective, observational study over two influenza seasons, we sought to quantify and correlate the amount of virus recovered from the nares of infected subjects with that recovered from their immediate environment in community and hospital settings. We recorded the symptoms of adults and children with A(H1N1)pdm09 infection, took nasal swabs, and sampled touched surfaces and room air. Forty-two infected subjects were followed up. The mean duration of virus shedding was 6.2 days by PCR (Polymerase Chain Reaction) and 4.2 days by culture. Surface swabs were collected from 39 settings; 16 (41%) subject locations were contaminated with virus. Overall, 33 of the 671 (4.9%) surface swabs were PCR positive for influenza, of which two (0.3%) yielded viable virus. On illness Day 3, subjects yielding positive surface samples had significantly higher nasal viral loads (geometric mean ratio 25.7; 95% CI 1.75, 376.0, p=0.021) and a positive correlation (r=0.47, p=0.006) was observed between subject nasal viral loads and viral loads recovered from the surfaces around them. Room air was sampled in the vicinity of 12 subjects, and PCR positive samples were obtained for five (42%) samples. Influenza virus shed by infected subjects did not detectably contaminate the vast majority of surfaces sampled. We question the relative importance of the indirect contact transmission of influenza via surfaces, though our data support the existence of super-spreaders via this route. The air sampling results add to the accumulating evidence that supports the potential for droplet nuclei (aerosol) transmission of influenza.

Adolescent, Adult, Child, Child, Preschool, Disease Transmission, Infectious, Environmental Microbiology, Female, Humans, Infant, Infant, Newborn, Infection Control, Influenza A Virus, H1N1 Subtype, Influenza, Human, Longitudinal Studies, Male, Middle Aged, Nose, Polymerase Chain Reaction, Prospective Studies, Time Factors, Virus Cultivation, Virus Shedding, Young Adult, Journal Article, Multicenter Study, Observational Study
1876-0341
278-288
Killingley, Benjamin
2b01cff9-9523-4ed2-96d5-a04a7c81a6b4
Greatorex, Jane
91d1e9e8-e113-430b-833b-3458a10d0d13
Digard, Paul
add039be-1a8e-4d49-b6a3-ea350eeec872
Wise, Helen
b54d8058-19de-42fc-b913-64ca1681f32d
Garcia, Fayna
360f510d-2f99-4ee0-a472-55f16a4bc0df
Varsani, Harsha
8979db6d-c5ae-4947-90a9-a01df8cd5ddc
Cauchemez, Simon
5cbca338-0d29-42b9-809c-f0a70396da17
Enstone, Joanne E.
1e6488d9-b4ac-4c9c-9cd8-dd66e663752f
Hayward, Andrew
fbd5098c-bd3d-455d-b09a-4f3b403baecd
Curran, Martin D.
f8d611e4-a2f5-4720-8a0a-b030a13784ab
Read, Robert C.
b5caca7b-0063-438a-b703-7ecbb6fc2b51
Lim, Wei S.
e6bb323c-0cab-44e7-9c03-78d48e3112bf
Nicholson, Karl G.
27948033-015f-4e4f-a8ed-1df896b42b0a
Nguyen-Van-Tam, Jonathan S.
1aac2164-f614-4c82-87f9-e123817bf128
Killingley, Benjamin
2b01cff9-9523-4ed2-96d5-a04a7c81a6b4
Greatorex, Jane
91d1e9e8-e113-430b-833b-3458a10d0d13
Digard, Paul
add039be-1a8e-4d49-b6a3-ea350eeec872
Wise, Helen
b54d8058-19de-42fc-b913-64ca1681f32d
Garcia, Fayna
360f510d-2f99-4ee0-a472-55f16a4bc0df
Varsani, Harsha
8979db6d-c5ae-4947-90a9-a01df8cd5ddc
Cauchemez, Simon
5cbca338-0d29-42b9-809c-f0a70396da17
Enstone, Joanne E.
1e6488d9-b4ac-4c9c-9cd8-dd66e663752f
Hayward, Andrew
fbd5098c-bd3d-455d-b09a-4f3b403baecd
Curran, Martin D.
f8d611e4-a2f5-4720-8a0a-b030a13784ab
Read, Robert C.
b5caca7b-0063-438a-b703-7ecbb6fc2b51
Lim, Wei S.
e6bb323c-0cab-44e7-9c03-78d48e3112bf
Nicholson, Karl G.
27948033-015f-4e4f-a8ed-1df896b42b0a
Nguyen-Van-Tam, Jonathan S.
1aac2164-f614-4c82-87f9-e123817bf128

Killingley, Benjamin, Greatorex, Jane, Digard, Paul, Wise, Helen, Garcia, Fayna, Varsani, Harsha, Cauchemez, Simon, Enstone, Joanne E., Hayward, Andrew, Curran, Martin D., Read, Robert C., Lim, Wei S., Nicholson, Karl G. and Nguyen-Van-Tam, Jonathan S. (2015) The environmental deposition of influenza virus from patients infected with influenza A(H1N1)pdm09: Implications for infection prevention and control. Journal of Infection and Public Health, 9 (3), 278-288. (doi:10.1016/j.jiph.2015.10.009).

Record type: Article

Abstract

In a multi-center, prospective, observational study over two influenza seasons, we sought to quantify and correlate the amount of virus recovered from the nares of infected subjects with that recovered from their immediate environment in community and hospital settings. We recorded the symptoms of adults and children with A(H1N1)pdm09 infection, took nasal swabs, and sampled touched surfaces and room air. Forty-two infected subjects were followed up. The mean duration of virus shedding was 6.2 days by PCR (Polymerase Chain Reaction) and 4.2 days by culture. Surface swabs were collected from 39 settings; 16 (41%) subject locations were contaminated with virus. Overall, 33 of the 671 (4.9%) surface swabs were PCR positive for influenza, of which two (0.3%) yielded viable virus. On illness Day 3, subjects yielding positive surface samples had significantly higher nasal viral loads (geometric mean ratio 25.7; 95% CI 1.75, 376.0, p=0.021) and a positive correlation (r=0.47, p=0.006) was observed between subject nasal viral loads and viral loads recovered from the surfaces around them. Room air was sampled in the vicinity of 12 subjects, and PCR positive samples were obtained for five (42%) samples. Influenza virus shed by infected subjects did not detectably contaminate the vast majority of surfaces sampled. We question the relative importance of the indirect contact transmission of influenza via surfaces, though our data support the existence of super-spreaders via this route. The air sampling results add to the accumulating evidence that supports the potential for droplet nuclei (aerosol) transmission of influenza.

Full text not available from this repository.

More information

Accepted/In Press date: 7 October 2015
e-pub ahead of print date: 2 December 2015
Published date: 15 December 2015
Additional Information: Copyright © 2015 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.
Keywords: Adolescent, Adult, Child, Child, Preschool, Disease Transmission, Infectious, Environmental Microbiology, Female, Humans, Infant, Infant, Newborn, Infection Control, Influenza A Virus, H1N1 Subtype, Influenza, Human, Longitudinal Studies, Male, Middle Aged, Nose, Polymerase Chain Reaction, Prospective Studies, Time Factors, Virus Cultivation, Virus Shedding, Young Adult, Journal Article, Multicenter Study, Observational Study

Identifiers

Local EPrints ID: 417518
URI: https://eprints.soton.ac.uk/id/eprint/417518
ISSN: 1876-0341
PURE UUID: a0ce3900-ecdb-4c1d-9a01-fd72293e56e0
ORCID for Robert C. Read: ORCID iD orcid.org/0000-0002-4297-6728

Catalogue record

Date deposited: 01 Feb 2018 17:31
Last modified: 17 Jul 2019 17:42

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