Prolonged shedding of pandemic influenza A (H1N1) 2009 virus in a pancreas-after-kidney transplant recipient

The virologist and the flu

“…It is known that comorbidities and immunosuppression can be associated with longer influenza virus shedding and slower viral clearance [7]. Previous reports have described shedding of influenza A in immunocompromised patients for up to 18 months [8][9][10][11][12][13][14][15]. However, our virologist has been otherwise healthy.…”

“…Thus, the observations in this case are sufficiently unique to warrant further study of influenza shedding more extensively using PCR. The clinical relevance of the laboratory results for influenza virus in this case are uncertain, because it is not clear whether an individual with detection of viral nucleic acid is still infectious and if, there might be a difference between immunocompetent and immunocompromised patients [9]. Despite using a standardised throat swab procedure, quite variable Ct-values (ranging from 40 to 27.9 [on day 18]) were noted after the acute infection period.…”

A family cluster of diagnosed coronavirus disease 2019 (COVID‐19) kidney transplant recipient in Thailand

“…We assumed that sustained viral shedding beyond 14 days had been reported in several respiratory viral infections in immunocompromised patients such as influenza and lower respiratory tract specimens have high yield for late detection and monitoring of patients with severe COVID-19 pneumonia. 30,53 However, tested clinical samples were done from different sites and onset times. In addition, these tested qualitatively; the exact viral copy numbers cannot be determined.…”

“…Repeated testing was done for all cases, and persistent positive RT‐PCR from lower respiratory tract specimens was found in KT recipient who had severe pneumonia. We assumed that sustained viral shedding beyond 14 days had been reported in several respiratory viral infections in immunocompromised patients such as influenza and lower respiratory tract specimens have high yield for late detection and monitoring of patients with severe COVID‐19 pneumonia 30,53 . However, tested clinical samples were done from different sites and onset times.…”

Persistent Infection of Drug-resistant Influenza A Virus during Chemotherapy for Malignant Lymphoma

“…In the healthy adult population, the average duration of viral shedding is reported to be 4.8 days (1). Prolonged shedding, defined as seven days or more (2), can sometimes occur in childhood, elderly people and immunocompromised hosts, including patients with hematologic malignancy (3)(4)(5)(6)(7)(8)(9). Systemic glucocorticoid administration, diabetes or chronic lung disease can also impede viral clearance (4).…”