Heterogeneity in viral shedding among individuals with medically attended influenza A virus infection.

Compared with the average transmissibility of human influenza A virus, much less attention has been paid to the potential variability in its transmissibility. We considered viral shedding as a proxy for infectiousness and explored the heterogeneity of infectiousness among patients with medically attended seasonal influenza A virus infection. The analysis revealed that viral shedding is more heterogeneous in children than in adults. The top 20% most infectious children and adults were estimated to be responsible for 89%-96% and 78%-82%, respectively, of the total infectiousness in each age group. Further investigation is required to correlate the substantial variations in viral shedding with heterogeneity in actual transmissibility.