Pathogenesis and Transmission of Swine-Origin 2009 A(H1N1) Influenza Virus in Ferrets

Munster, Vincent J.; Wit, Emmie de; Brand, Judith M. A. van den; Herfst, Sander; Schrauwen, Eefje J. A.; Bestebroer, Theo M.; Vijver, David van de; Boucher, Charles A.; Koopmans, Marion; Rimmelzwaan, Guus F.; Kuiken, Thijs; Osterhaus, Albert D. M. E.; Fouchier, Ron A. M.

doi:10.1126/science.1177127

Cited by 551 publications

(590 citation statements)

References 17 publications

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“…Both type I and type II pneumocytes were infected. Ferrets inoculated with pandemic H1N1/09 virus displayed more severe symptoms, involving the entire respiratory tract, compared with ferrets inoculated with seasonal influenza A (H1N1) which displayed symptoms of necrotising rhinitis only (17). The detection of pandemic H1N1/09 virus in the intestinal tract of some infected ferrets is consistent with the gastrointestinal complaints from several human patients with pandemic H1N1/09 infection (16).…”

Section: Pathogenesissupporting

confidence: 60%

“…Pandemic H1N1/09 virus pathogenicity and transmissibility studies conducted in ferrets, mice and cynomolgus macaques proved that the pandemic strain is more pathogenic than seasonal H1N1 influenza, as the virus replicated more efficiently in the lungs of all three animal models (15)(16)(17). Macaque lungs demonstrated severe thickening of the alveolar walls, and the alveolar spaces were filled with inflammatory infiltrates and oedematous exudates.…”

Section: Pathogenesismentioning

confidence: 99%

“…Two of the studies found that it spreads as efficiently as seasonal influenza A (H1N1) via aerosols and respiratory droplets (15,17). However, one study found that pandemic H1N1/09 virus is transmitted less efficiently via respiratory droplets (16).…”

Section: Pathogenesismentioning

confidence: 99%

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Pandemic influenza A (H1N1) 2009: the experience of the first six months

Maritz

Maree²,

Preiser³

2009

Clinical Chemistry and Laboratory Medicine

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After a break of 41 years, 2009 saw the first influenza pandemic of the 21st century caused by a triple-reassortant influenza A (H1N1) virus. The current estimated case fatality rate is lower than that of previous influenza pandemics, but this may change as the pandemic evolves. Illness frequently occurs in previously healthy, young adults with a wide range of clinical presentations. The majority of circulating pandemic viruses remain susceptible to neuraminidase inhibitors, although all strains are intrinsically resistant to the adamantanes. Monovalent vaccines against the pandemic strain are available in both live attenuated and inactivated forms. This review aims to summarise important virological, epidemiological and clinical aspects of the pandemic influenza A (H1N1) virus for physicians and other clinical personnel. Clin Chem Lab Med 2010;48:11-21.

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Section: Pathogenesissupporting

confidence: 60%

Section: Pathogenesismentioning

confidence: 99%

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Pandemic influenza A (H1N1) 2009: the experience of the first six months

Maritz

Maree²,

Preiser³

2009

Clinical Chemistry and Laboratory Medicine

View full text Add to dashboard Cite

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“…A substantial number of previously healthy patients have been reported to complain of dyspnea sensations or to have pneumonia (2, 3). The novel influenza A (H1N1) virus has an affinity to airway epithelial cells, thus it could cause bronchitis and bronchiolitis (12,13). Pulmonary emphysema in smokers includes such a large portion in the general population that this alone could not account for the frequency of the non-obvious risk population among those who require hospitalization.…”

Section: Discussionmentioning

confidence: 99%

Severe Pneumonia Caused by a Novel Influenza A (H1N1) Virus in an Asymptomatic Emphysematous Smoker

et al. 2010

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A 49-year-old female presented with diarrhea and a high fever followed by progressive dyspnea. Until this presentation, she had been healthy except for chronic dyspepsia and diarrhea. She had a smoking habit of 15 pack-years. Laboratory tests revealed lymphopenia, hypoalbuminemia and hypogammaglobulinemia. A rapid influenza test in combination with an RT-PCR assay revealed the presence of the novel influenza A (H1N1) virus. Chest computed tomography revealed centrilobular emphysema. This report suggests that regular smoking may become a risk for severe pneumonia in patients presenting with the novel influenza A (H1N1) virus, when accompanying asymptomatic emphysema is combined with other problems such as hypoalbuminemia and hypogammaglobulinemia.

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“…With regard to the 2009 H1N1 influenza strain, the World Health Organization (WHO) has recommended that patients receive 5 days of treatment with antiviral agents 4. However, animal models show that the 2009 H1N1 virus replicates more efficiently than seasonal influenza viruses in the respiratory tract 5, 6, 7. In addition, several studies have shown that the 2009 H1N1 virus can still be present for 8 days or more 8, 9, 10, 11, 12.…”

Section: Introductionmentioning

confidence: 99%

Factors promoting the prolonged shedding of the pandemic (H1N1) 2009 influenza virus in patients treated with oseltamivir for 5 days

Ryoo

Kim

Sohn

et al. 2012

Influenza Resp Viruses

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BackgroundThe duration of viral shedding is an important determinant of infectivity and transmissibility and provides vital information for effective infection prevention and control. However, few studies have evaluated viral shedding in patients admitted to hospital with 2009 H1N1 influenza and treated with oseltamivir.ObjectiveTo determine the incidence of prolonged 2009 H1N1 influenza viral shedding in patients treated for 5 days with oseltamivir and to identify factors that promote prolonged viral shedding.MethodsThis was a prospective, observational cohort study of 173 patients infected with 2009 H1N1 influenza (confirmed by RT‐PCR) who were admitted to isolation rooms in the emergency department of our hospital between August 25, 2009 and December 31, 2009. All of the patients were treated according to institutional protocols and received routine follow‐up RT‐PCR testing after 5 days of oseltamivir therapy. Prolonged viral shedding was defined as a positive follow‐up RT‐PCR result.ResultOf the 173 patients in our cohort, 88 (50·8%) showed persistent viral shedding after oseltamivir treatment. Viral shedding was significantly prolonged if antiviral therapy was started ≥2 days after symptom onset (OR 2·74, 95% CI 1·29–5·82), if there were major comorbidities (OR 3·07, 95% CI 1·29–7·32), and/or if respiratory symptoms were still present on the day 5 of antiviral treatment (OR 4·13, 95% CI 2·10–8·11).ConclusionsThe presence of major comorbidities, a delay in initiating antiviral treatment, and continuing respiratory symptoms after 5 days of antiviral treatment are associated with prolonged shedding of the 2009 H1N1 influenza virus.

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Pathogenesis and Transmission of Swine-Origin 2009 A(H1N1) Influenza Virus in Ferrets

Cited by 551 publications

References 17 publications

Pandemic influenza A (H1N1) 2009: the experience of the first six months

Pandemic influenza A (H1N1) 2009: the experience of the first six months

Severe Pneumonia Caused by a Novel Influenza A (H1N1) Virus in an Asymptomatic Emphysematous Smoker

Factors promoting the prolonged shedding of the pandemic (H1N1) 2009 influenza virus in patients treated with oseltamivir for 5 days

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