The role of asymptomatic infections in influenza transmission: what do we really know

Martha P Montgomery; Sinead E Morris; Melissa A Rolfes; Wanitchaya Kittikraisak; Aaron M Samuels; Matthew Biggerstaff; William W Davis; Carrie Reed; Sonja J Olsen

doi:10.1016/S1473-3099(23)00619-9

The role of asymptomatic infections in influenza transmission: what do we really know

Lancet Infect Dis. 2023 Dec 18:S1473-3099(23)00619-9. doi: 10.1016/S1473-3099(23)00619-9. Online ahead of print.

Authors

Martha P Montgomery¹, Sinead E Morris², Melissa A Rolfes², Wanitchaya Kittikraisak³, Aaron M Samuels², Matthew Biggerstaff², William W Davis³, Carrie Reed², Sonja J Olsen²

Affiliations

¹ Influenza Division, National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and Prevention, Atlanta, GA, USA; Thailand Ministry of Public Health-US Centers for Disease Control and Prevention Collaboration, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand. Electronic address: lwx6@cdc.gov.
² Influenza Division, National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and Prevention, Atlanta, GA, USA.
³ Influenza Division, National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and Prevention, Atlanta, GA, USA; Thailand Ministry of Public Health-US Centers for Disease Control and Prevention Collaboration, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand.

PMID: 38128563
DOI: 10.1016/S1473-3099(23)00619-9

Abstract

Before the COVID-19 pandemic, the role of asymptomatic influenza virus infections in influenza transmission was uncertain. However, the importance of asymptomatic infection with SARS-CoV-2 for onward transmission of COVID-19 has led experts to question whether the role of asymptomatic influenza virus infections in transmission had been underappreciated. We discuss the existing evidence on the frequency of asymptomatic influenza virus infections, the extent to which they contribute to infection transmission, and remaining knowledge gaps. We propose priority areas for further evaluation, study designs, and case definitions to address existing knowledge gaps.

Publication types

Review