Heterogeneity in viral shedding among individuals with medically attended influenza A virus infection

J Infect Dis. 2013 Apr 15;207(8):1281-5. doi: 10.1093/infdis/jit034. Epub 2013 Feb 4.


Compared with the average transmissibility of human influenza A virus, much less attention has been paid to the potential variability in its transmissibility. We considered viral shedding as a proxy for infectiousness and explored the heterogeneity of infectiousness among patients with medically attended seasonal influenza A virus infection. The analysis revealed that viral shedding is more heterogeneous in children than in adults. The top 20% most infectious children and adults were estimated to be responsible for 89%-96% and 78%-82%, respectively, of the total infectiousness in each age group. Further investigation is required to correlate the substantial variations in viral shedding with heterogeneity in actual transmissibility.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Child
  • DNA, Complementary / analysis
  • Female
  • Humans
  • Influenza A Virus, H3N2 Subtype / pathogenicity
  • Influenza A virus / genetics
  • Influenza A virus / pathogenicity*
  • Influenza, Human / pathology
  • Influenza, Human / transmission*
  • Influenza, Human / virology
  • Linear Models
  • Male
  • Models, Biological
  • RNA, Viral / analysis
  • RNA, Viral / genetics
  • Seasons
  • Time Factors
  • Virus Shedding*
  • Young Adult


  • DNA, Complementary
  • RNA, Viral