{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T16:44:28Z","timestamp":1791477868474,"version":"4.3.4"},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"6","funder":[{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["HHSN266200700005C"],"award-info":[{"award-number":["HHSN266200700005C"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["N01-AI-70005"],"award-info":[{"award-number":["N01-AI-70005"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["U54 GM088558"],"award-info":[{"award-number":["U54 GM088558"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000057","name":"National Institute of General Medical Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000057","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Research Grants Council of the Hong Kong Special Administrative Region, China","award":["T11-705\/14N"],"award-info":[{"award-number":["T11-705\/14N"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,3,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background.<\/jats:title>\n                  <jats:p>Influenza virus infections are associated with a wide spectrum of disease. However, few studies have investigated in detail the epidemiological and virological characteristics of asymptomatic and mild illness with influenza virus infections.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods.<\/jats:title>\n                  <jats:p>In a community-based study in Hong Kong from 2008 to 2014, we followed up initially healthy individuals who were household contacts of symptomatic persons with laboratory-confirmed influenza, to identify secondary infections. Information from daily symptom diaries was used to classify infections as symptomatic (\u22652 signs\/symptoms, including fever \u226537.8\u00b0C, headache, myalgia, cough, sore throat, runny nose and sputum), paucisymptomatic (1 symptom only), or asymptomatic (none of these symptoms). We compared the patterns of influenza viral shedding between these groups.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results.<\/jats:title>\n                  <jats:p>We identified 235 virologically confirmed secondary cases of influenza virus infection in the household setting, including 31 (13%) paucisymptomatic and 25 (11%) asymptomatic cases. The duration of viral RNA shedding was shorter and declined more rapidly in paucisymptomatic and asymptomatic than in symptomatic cases. The mean levels of influenza viral RNA shedding in asymptomatic and paucisymptomatic cases were approximately 1\u20132 log10 copies lower than in symptomatic cases.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions.<\/jats:title>\n                  <jats:p>The presence of influenza viral shedding in patients with influenza who have very few or no symptoms reflects their potential for transmitting the virus to close contacts. These findings suggest that further research is needed to investigate the contribution of persons with asymptomatic or clinically mild influenza virus infections to influenza virus transmission in household, institutional, and community settings.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciw841","type":"journal-article","created":{"date-parts":[[2016,12,8]],"date-time":"2016-12-08T20:23:42Z","timestamp":1481228622000},"page":"736-742","source":"Crossref","is-referenced-by-count":138,"title":["Viral Shedding and Transmission Potential of Asymptomatic and Paucisymptomatic Influenza Virus Infections in the Community"],"prefix":"10.1093","volume":"64","author":[{"given":"Dennis K. M.","family":"Ip","sequence":"first","affiliation":[{"name":"WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health 1 ,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lincoln L. H.","family":"Lau","sequence":"additional","affiliation":[{"name":"Dalla Lana School of Public Health, University of Toronto 4 , Ontario , ;","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy H. L.","family":"Leung","sequence":"additional","affiliation":[{"name":"WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health 1 ,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vicky J.","family":"Fang","sequence":"additional","affiliation":[{"name":"WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health 1 ,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kwok-Hung","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Microbiology 2 , and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel K. W.","family":"Chu","sequence":"additional","affiliation":[{"name":"WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health 1 ,"},{"name":"Centre of Influenza Research, Li Ka Shing Faculty of Medicine, University of Hong Kong 3 ;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel M.","family":"Leung","sequence":"additional","affiliation":[{"name":"WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health 1 ,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. S. Malik","family":"Peiris","sequence":"additional","affiliation":[{"name":"WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health 1 ,"},{"name":"Centre of Influenza Research, Li Ka Shing Faculty of Medicine, University of Hong Kong 3 ;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy M.","family":"Uyeki","sequence":"additional","affiliation":[{"name":"Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention 5 , Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin J.","family":"Cowling","sequence":"additional","affiliation":[{"name":"WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health 1 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