Viral shedding patterns of children with influenza B infection.

During an epidemic of influenza B, 43 ambulatory children were prospectively followed to determine the quantitative shedding patterns of influenza B viral infection, because these have not been previously described. The spectrum of illness included 74% with a typical influenzalike illness, 7% with an afebrile infection of the upper respiratory tract, and 19% with croup. Mild myositis occurred in 21%. For the first three days of illness, greater than or equal to 93% of the children shed virus, and 74% shed on day 4. The average peak quantity of virus shed in the nasal wash was 4.0 log10 50% tissue culture infective doses/ml(range, 1.5-6.0), which gradually declined over four days to 2.4 log10 50% tissue culture infective doses/ml. The quantities of virus shed correlated significantly with severity of illness and fever score, but not with sex, type of illness, or occurrence of myositis. These results suggest that the degree of clinical illness may be directly related to the cytotoxic effects of the virus and to the transmissibility of the disease.