Asymptomatic Shedding of Respiratory Virus Among an Ambulatory Population Across Seasons
Journal Article - Open Access
Columbia University New York United States
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Most observation of human respiratory virus carriage is derived from medical surveillance however, the infections documented by this surveillance represent only a symptomatic fraction of the total infected population. As the role of asymptomatic infection in respiratory virus transmission is still largely unknown and rates of asymptomatic shedding are not well constrained, it is important to obtain more-precise estimates through alternative sampling methods. We actively recruited participants from among visitors to a New York City tourist attraction. Nasopharyngeal swabs, demographics, and survey information on symptoms, medical history, and recent travel were obtained from 2,685 adults over two seasonal arms. We used multiplex PCR to test swab specimens for a selection of common respiratory viruses. A total of 6.2 of samples 168 individuals tested positive for at least one virus, with 5.6 testing positive in the summer arm and 7.0 testing positive in the winter arm. Of these, 85 50.6 were positive for human rhinovirus HRV, 65 38.7 for coronavirus CoV, and 18 10.2 for other viruses including adenovirus, human metapneumovirus, influenza virus, and parainfluenza virus. Depending on the definition of symptomatic infection, 65 to 97 of infections were classified as asymptomatic. The best-fit model for prediction of positivity across all viruses included a symptom severity score, Hispanic ethnicity data, and age category, though there were slight differences across the seasonal arms. Though having symptoms is predictive of virus positivity, there are high levels of asymptomatic respiratory virus shedding among the members of an ambulatory population in New York City.
- Medicine and Medical Research