Contagious period for pandemic (H1N1) 2009

Abstract

We estimated the proportion of persons with pandemic (H1N1) 2009 who were shedding infectious virus at diagnosis and on day 8 of illness. In households with confirmed cases, nasopharyngeal swabs were collected on all members and tested by PCR and virus culture. Of 47 cases confirmed by PCR at &lt7 days of illness, virus culture was positive in 92% (11/12) of febrile and 63% (22/35) of afebrile persons. Of 43 persons with PCR-confirmed pandemic (H1N1) 2009 from whom a second specimen was collected on day 8, 74% remained PCR positive and 19% were culture positive. If the 73 symptomatic household members without PCR-confirmed illness are assumed to have pandemic (H1N1) 2009, a minimum of 8% (6/73) of case-patients shed replicating virus on day 8. Self-isolation only until fever abates appears insufficient to limit transmission. Self-isolation for a week may be more effective, although some case-patients still would shed infectious virus.

Figure 1

Flowchart of characteristics of 173 participants in study of shedding of pandemic (H1N1) 2009 virus, Quebec City, Quebec, Canada, May 27–July 10, 2009.

Figure 2

Positive results by PCR and culture for influenza A and pandemic (H1N1) 2009 virus (pH1N1) in 47 household contacts with laboratory-confirmed influenza, by delay between day of symptom onset and day of first swab collection, Quebec City, Quebec, Canada, May 27–July 10, 2009.