Influenza virus infection among pediatric patients reporting diarrhea and influenza-like illness

Abstract

BackgroundInfluenza is a major cause of morbidity and hospitalization among children. While less often reported in adults, gastrointestinal symptoms have been associated with influenza in children, including abdominal pain, nausea, vomiting, and diarrhea.MethodsFrom September 2005 and April 2008, pediatric patients in Indonesia presenting with concurrent diarrhea and influenza-like illness were enrolled in a study to determine the frequency of influenza virus infection in young patients presenting with symptoms less commonly associated with an upper respiratory tract infection (URTI). Stool specimens and upper respiratory swabs were assayed for the presence of influenza virus.ResultsSeasonal influenza A or influenza B viral RNA was detected in 85 (11.6%) upper respiratory specimens and 21 (2.9%) of stool specimens. Viable influenza B virus was isolated from the stool specimen of one case. During the time of this study, human infections with highly pathogenic avian influenza A (H5N1) virus were common in the survey area. However, among 733 enrolled subjects, none had evidence of H5N1 virus infection.ConclusionsThe detection of influenza viral RNA and viable influenza virus from stool suggests that influenza virus may be localized in the gastrointestinal tract of children, may be associated with pediatric diarrhea and may serve as a potential mode of transmission during seasonal and epidemic influenza outbreaks.

Fecal Influenza in Mammals: Selection of Novel Variants

“…Influenza viruses that cause seasonal or pandemic influenza in humans and epidemics in pigs and horses are ultimately derived from the aquatic bird reservoir (1) and replicate primarily in the upper and lower respiratory tract. However, the literature contains several reports of fecal shedding of influenza viruses from mammals after natural or experimental infection with influenza viruses of avian, swine, equine, or human origin (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22).…”

Viral and bacterial infection among hospitalized-suspected influenza A/H5N1 patients in Indonesia, 2008-2009

“…13,15 Ever since both H5N1 and SARS originated in Asia, such epidemiology data on etiologic of ARI are beneficial to identify any emerging causes of ARI that potential to become serious public health problem in Indonesia. Furthermore, the availability of other etiologies of ARI can provide valuable information for development of guidance of disease management and for further appropriate health intervention such as diagnostic assay and drugs development.…”

Is there an association between wheezing and constipation in preschool children? Explanations from a longitudinal birth cohort

“…First, respiratory infections are risk factors for wheezing and asthma26 but gastro-intestinal infections are also associated with constipation 37. For example, during a flu-like illness, both respiratory and gastrointestinal symptoms may coexist,38 39 and this may clarify that our association between wheezing and constipation is explained by a history of infections as defined by fever accompanied by diarrhoea or respiratory symptoms. Second, from animal studies it is known that very early exposure to micro-organisms, for example, by crowding or infections earlier in life, is required for proper maturation of the immune system in and outside the gut, which may have a protective effect on allergic disease 40.…”