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Influenza RNA found in nonrespiratory sites in immunocompetent children
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A report of viremia in an immunocompetent child with influenza A/H1N1 infection — which may be the first of its kind to be documented — demonstrates that the virus can spread to other sites, according to a study published online.
"In this study, we detected viral RNA in respiratory and non-respiratory sites among immunocompetent children," Susan H. Wootton, MD, of the division of infectious diseases at the University of Texas Health Sciences Center in Houston, told Infectious Disease News. "The finding of viremia in an immunocompetent child raises questions about the natural cycle of influenza infection in children and outcome."
Susan H. Wootton
Wootton and colleagues included in their study 20 children aged younger than 17 years who were admitted to Children’s Memorial Hermann Hospital, Houston, with laboratory-confirmed influenza between January 2009 and April 2011.
The investigators collected nasopharyngeal wash specimens, stool specimens and a blood sample from each patient and detected influenza in both non-respiratory sites studied.
The authors said that viral shedding profiles may be useful for understanding virulence, cell tropism and transmission dynamics to help design improved management policies.
There were some common traits among the children, notably that only three had received the recommended influenza vaccinations for their age group. Wootton and colleagues also reported some common symptoms, including respiratory distress, fever and gastrointestinal symptoms. Most of the children — 14 of 20 — were treated with oseltamivir (Tamiflu, Genentech) within the recommended 2 days of symptom onset.
The researchers wrote that “cultivable influenza viruses were not detected in stool, however the presence of viral RNA raises infection control concerns.”
Susan H. Wootton, MD, can be reached at susan.h.wootton@uth.tmc.edu.
Disclosure: Wootton reports no relevant financial disclosures. The study was funded by the NIH.
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