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Volume 17, Number 11—November 2011

Dispatch

Seasonal Influenza A Virus in Feces of Hospitalized Adults

Martin C.W. Chan1, Nelson Lee1Comments to Author , Paul K.S. Chan, K.F. To, Rity Y.K. Wong, Wing-Shan Ho, Karry L.K. Ngai, and Joseph J.Y. Sung
Author affiliations: The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People’s Republic of China

Main Article

Table 1

Comparisons of baseline clinical and laboratory variables between influenza patients with positive and negative fecal viral RNA detection test results, Hong Kong, 2006–2009*

Patient characteristics Fecal viral RNA–positive, n = 56 Fecal viral RNA–negative, n = 63 p value
Mean age, y (SD) 65.3 (18.6) 69.9 (13.4) 0.12
Age group, y, no. (%) 0.35†
18–49 7 (13) 6 (10)
50–65 18 (32) 14 (22)
>65 31 (55) 43 (68)
Female sex, no. (%) 33 (59) 30 (48) 0.27
Interval from illness onset to sample collection <5 d, no. (%) 52 (93) 53 (84) 0.14
Concurrent condition, no. (%)
Any 36 (64) 43 (68) 0.65
Major‡ 31 (55) 37 (59) 0.72
Virus isolation, nasopharyngeal aspirates 50 (89) 49 (77) 0.06
Signs and symptoms when care was sought, no. (%)
Fever 48 (86) 53 (84) 1.00
Cough and sputum 39 (74) 45 (76) 0.83
Sore throat 15 (28) 18 (31) 0.84
Rhinorrhea 21 (40) 21 (36) 0.70
Shortness of breath 18 (34) 27 (46) 0.25
Vomiting or diarrhea 10 (18) 9 (14) 0.63
Vomiting 7 (13) 8 (13) 1.00
Diarrhea 5 (9) 2 (3) 0.25
Laboratory parameters when care was sought
Total leukocyte count, × 109 cells/L, median (IQR) 7.3 (5.9–8.9) 7.9 (6.1–10.3) 0.18
Neutrophil count, × 109 cells/L, median (IQR) 5.1 (4.2–7.0) 6.0 (4.1–7.7) 0.22
Lymphocyte count, × 109 cells/L, median (IQR) 0.8 (0.6–1.1) 0.9 (0.6–1.2) 0.20
Lymphocyte count <1.0 × 109 cells/L, no. (%) 37 (66) 29 (46) 0.03
Monocyte count, × 109 cells/L, median (IQR) 0.7 (0.5–0.9) 0.7 (0.5–0.9) 0.51
Platelet count, × 109 cells/L, median (IQR) 180 (142–228) 196 (156–248) 0.20
Alanine aminotransferase level, IU/L, median (IQR) 19 (13–32) 22 (15–36) 0.54
Antiviral treatment, no. (%)
Oseltamivir§ 35 (63) 42 (67) 0.70
Zanamivir 6 (11) 5 (8) 0.75
Specimen collected after starting antiviral drugs, no. (%) 39 (70) 42 (67) 0.84
Complication, no. (%)
Any 39 (70) 44 (70) 0.98
Cardiorespiratory¶ 29 (52) 38 (60) 0.36
Clinical outcome, no. (%)
ICU admission 2 (4) 0 (0) 0.22
Death 0 0 NA
Median duration of hospitalization, d (IQR) 6 (4–12) 5 (4–13) 0.50

*Univariate comparisons of categorical and continuous variables were performed by using Fisher exact test and Mann-Whitney U test or Student t test, whenever appropriate. IQR, interquartile range; ICU, intensive care unit; NA, not applicable.
†Fisher 2×3 exact test.
‡Defined as congestive heart failure; cerebrovascular, neoplastic, chronic liver, and renal diseases; diabetes; ischemic heart disease; or use of immunosuppressant drugs (8). Approximately 5% of patients were profoundly immunocompromised.
§Oseltamivir (standard oral regimen, 75 mg 2×/d for 5 d). Amantadine was coadministered to 7 patients during the 2008–09 influenza season.
¶Defined as pneumonia, acute bronchitis, acute exacerbation of chronic respiratory conditions (e.g., chronic obstructive pulmonary disease, asthma); acute coronary syndrome, decompensated heart failure, arrhythmia, or acute cerebrovascular events (8).

Main Article

1These authors contributed equally to this article.

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