{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T04:48:41Z","timestamp":1791348521926,"version":"4.3.1"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"4","funder":[{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"crossref","award":["HHSN266200700005C"],"award-info":[{"award-number":["HHSN266200700005C"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"crossref","award":["N01-AI-70005"],"award-info":[{"award-number":["N01-AI-70005"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000060","name":"NIAID","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Centers for Excellence in Influenza Research and Surveillance"},{"name":"Hong Kong Special Administrative Region","award":["T11-705\/14N"],"award-info":[{"award-number":["T11-705\/14N"]}]},{"name":"Harvard Center for Communicable Disease Dynamics"},{"DOI":"10.13039\/100000057","name":"National Institute of General Medical Sciences","doi-asserted-by":"publisher","award":["U54 GM088558"],"award-info":[{"award-number":["U54 GM088558"]}],"id":[{"id":"10.13039\/100000057","id-type":"DOI","asserted-by":"publisher"}]},{"name":"government of the Hong Kong Special Administrative Region"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2016,2,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Background. \u2003Although the pattern of viral shedding over time has been documented in volunteer challenge studies, understanding of the relationship between clinical symptomatology and viral shedding in naturally acquired influenza infections in humans remains limited.<\/jats:p>\n                  <jats:p>Methods. \u2003In a community-based study in Hong Kong from 2008 to 2014, we followed up initially healthy individuals and identified 224 secondary cases of natural influenza virus infection in the household setting. We examined the dynamic relationship between patterns of clinical symptomatology and viral shedding as quantified using reverse transcription polymerase chain reaction and viral culture in 127 cases with a clinical picture of acute respiratory infection.<\/jats:p>\n                  <jats:p>Results. \u2003Viral shedding in influenza A virus infections peaked on the first 1\u20132 days of clinical illness, and decreased gradually to undetectable levels by day 6\u20137, matching closely with the dynamics of clinical illness. Viral shedding in influenza B virus infections rose up to 2 days prior to symptom onset and persisted for 6\u20137 days after onset with a bimodal pattern.<\/jats:p>\n                  <jats:p>Conclusions. \u2003Our results suggest that while clinical illness profiles may serve as a proxy for clinical infectiousness in influenza A virus infections, patients may potentially be infectious even before symptom onset or after clinical improvement in influenza B virus infections.<\/jats:p>","DOI":"10.1093\/cid\/civ909","type":"journal-article","created":{"date-parts":[[2015,10,30]],"date-time":"2015-10-30T21:19:19Z","timestamp":1446239959000},"page":"431-437","source":"Crossref","is-referenced-by-count":68,"title":["The Dynamic Relationship Between Clinical Symptomatology and Viral Shedding in Naturally Acquired Seasonal and Pandemic Influenza Virus Infections"],"prefix":"10.1093","volume":"62","author":[{"given":"Dennis K. M.","family":"Ip","sequence":"first","affiliation":[{"name":"University of Hong Kong 1 World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine , , Hong Kong Special Administrative Region ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lincoln L. H.","family":"Lau","sequence":"additional","affiliation":[{"name":"University of Toronto 2 Dalla Lana School of Public Health , ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kwok-Hung","family":"Chan","sequence":"additional","affiliation":[{"name":"3 Department of Microbiology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vicky J.","family":"Fang","sequence":"additional","affiliation":[{"name":"University of Hong Kong 1 World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine , , Hong Kong Special Administrative Region ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel M.","family":"Leung","sequence":"additional","affiliation":[{"name":"University of Hong Kong 1 World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine , , Hong Kong Special Administrative Region ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malik J. S.","family":"Peiris","sequence":"additional","affiliation":[{"name":"University of Hong Kong 1 World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine , , Hong Kong Special Administrative Region ,","place":["China"]},{"name":"University of Hong Kong 4 Centre of Influenza Research, Li Ka Shing Faculty of Medicine , , Hong Kong Special Administrative Region ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin J.","family":"Cowling","sequence":"additional","affiliation":[{"name":"University of Hong Kong 1 World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine , , Hong Kong Special Administrative Region 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