@article{57c84a96ab354d38b945c6b640da6a57,
title = "The respiratory microbiota: associations with influenza symptomatology and viral shedding",
abstract = "Purpose: Manifestations of infection and the degree of influenza virus vary. We hypothesized that the nose/throat microbiota modifies the duration of influenza symptoms and viral shedding. Exploring these relationships may help identify additional methods for reducing influenza severity and transmission. Methods: Using a household transmission study in Nicaragua, we identified secondary cases of influenza virus infection, defined as contacts with detectable virus or a greater than 4-fold change in hemagglutinin inhibition antibody titer. We characterized the nose/throat microbiota of secondary cases before infection and explored whether the duration of symptoms and shedding differed by bacterial community characteristics. Results: Among 124 secondary cases of influenza, higher bacterial community diversity before infection was associated with longer shedding duration (Shannon acceleration factor [AF]: 1.61, 95% confidence interval [CI]: 1.24, 2.10) and earlier time to infection (Shannon AF: 0.72, 95% CI: 0.53, 0.97; Chao1 AF: 0.992, 95% CI: 0.986, 0.998). Neisseria and multiple other oligotypes were significantly associated with symptom and shedding durations and time to infection. Conclusions: The nose/throat microbiota before influenza virus infection was associated with influenza symptoms and shedding durations. Further studies are needed to determine if the nose/throat microbiota is a viable target for reducing influenza symptoms and transmission.",
keywords = "Influenza, Microbiota, Signs and symptoms, Virus shedding",
author = "Lee, {Kyu Han} and Betsy Foxman and Guillermina Kuan and Roger L{\'o}pez and Kerby Shedden and Sophia Ng and Angel Balmaseda and Aubree Gordon",
note = "Funding Information: This work was supported by NIH NIAID (grant no. R21 AI119463). Data collection was supported by NIH (grant no. U01 AI088654), the Fogarty International Center (grant no. K02 TW009483) and National Institutes of Health Department of Health and Human Services under the contract number HHSN272201400031C. Additional funding came from the Tinker Foundation, University of Michigan Center for Latin America and Caribbean Studies, University of Michigan International Institute, and University of Michigan Rackham Graduate School. The authors are grateful to the participants of the Nicaraguan Household Transmission Study and our collaborators at the Nicaraguan Ministry of Health and Sustainable Sciences Institute. The authors thank the University of Michigan Microbial Systems Laboratories for 16S rRNA sequencing. The authors also thank Dr. Marie Griffin for reviewing an earlier draft of this manuscript. Funding Information: This work was supported by NIH NIAID (grant no. R21 AI119463 ). Data collection was supported by NIH (grant no. U01 AI088654 ), the Fogarty International Center (grant no. K02 TW009483 ) and National Institutes of Health Department of Health and Human Services under the contract number HHSN272201400031C . Additional funding came from the Tinker Foundation, University of Michigan Center for Latin America and Caribbean Studies, University of Michigan International Institute, and University of Michigan Rackham Graduate School. The authors are grateful to the participants of the Nicaraguan Household Transmission Study and our collaborators at the Nicaraguan Ministry of Health and Sustainable Sciences Institute. The authors thank the University of Michigan Microbial Systems Laboratories for 16S rRNA sequencing. The authors also thank Dr. Marie Griffin for reviewing an earlier draft of this manuscript. Publisher Copyright: {\textcopyright} 2019 Elsevier Inc.",
year = "2019",
month = sep,
doi = "10.1016/j.annepidem.2019.07.013",
language = "English (US)",
volume = "37",
pages = "51--56.e6",
journal = "Annals of epidemiology",
issn = "1047-2797",
publisher = "Elsevier Inc.",
}