Evidence map›Paper›PMID 42669676›Full record

ArticleNature communications2026

The roles of pre-season immunity, age, viral shedding, and community exposures in shaping influenza household transmission dynamics.

Molly K Sauter, Jackie Kleynhans, Jocelyn Moyes, Meredith L McMorrow, Florette K Treurnicht, Orienka Hellferscee, Anne von Gottberg, Nicole Wolter, Amelia Buys, Lorens Maake and 11 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Nature communications, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors.

Molly K SauterDivision of International Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, Bethesda, MD, USA.ORCID 0009-0004-3580-0187
Jackie KleynhansCentre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa.ORCID 0000-0001-7081-6273
Jocelyn MoyesCentre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa.
Meredith L McMorrowInfluenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA.ORCID 0000-0001-6363-4033
Florette K TreurnichtCentre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa.
Orienka HellfersceeCentre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa.
Anne von GottbergCentre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa.ORCID 0000-0002-0243-7455
Nicole WolterCentre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa.ORCID 0000-0002-9526-0133
Amelia BuysCentre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa.
Lorens MaakeCentre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa.
Neil A MartinsonPerinatal HIV Research Unit, MRC Soweto Matlosana Collaborating Centre for HIV/AIDS and TB, University of the Witwatersrand, Johannesburg, South Africa.
Kathleen KahnMRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.ORCID 0000-0003-3339-3931
Limakatso LebinaPerinatal HIV Research Unit, MRC Soweto Matlosana Collaborating Centre for HIV/AIDS and TB, University of the Witwatersrand, Johannesburg, South Africa.
Katlego MotlhaolengPerinatal HIV Research Unit, MRC Soweto Matlosana Collaborating Centre for HIV/AIDS and TB, University of the Witwatersrand, Johannesburg, South Africa.
Floidy WafawanakaMRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Francesc Xavier Gómez-OlivéMRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.ORCID 0000-0002-4876-0848
Stefano TempiaSchool of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.ORCID 0000-0003-4395-347X
Bryan GrenfellDepartment of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, USA.ORCID 0000-0003-3227-5909
Cécile ViboudDivision of International Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, Bethesda, MD, USA.ORCID 0000-0003-3243-4711
Kaiyuan Sun *Division of International Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, Bethesda, MD, USA. sunkaiyuan@westlake.edu.cn.ORCID 0000-0002-1753-9884
Cheryl Cohen *Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa. cherylc@nicd.ac.za.ORCID 0000-0003-0376-2302

Funding

NCIRD CDC HHS U51 IP000155
6 · The paper itself

Abstract

Protective immunity against influenza transmission remains poorly understood due to the high prevalence of undetected asymptomatic infections. To address this, we analyze 1518 individuals and 623 infection episodes from a three-year, rural and urban, South African household cohort study that combines pre-season serum collection with twice-weekly virological testing regardless of symptoms. By developing a subtype/lineage-specific household transmission model and incorporating time-resolved viral shedding kinetics for all observed infections, we disentangle household and community exposure, pre-season immunity, and age effects. After adjusting for exposure intensity, pre-season hemagglutination inhibition (HAI) titers ≥1:40 are associated with a reduced infection risk for A(H1N1)pdm09, A(H3N2), and B/Victoria, but not B/Yamagata. However, children exhibit higher susceptibility and longer viral shedding durations than adults across all subtypes/lineages, even after accounting for pre-season HAI titers. Here, we show persistent age-related effects on influenza susceptibility and viral shedding, underscoring the need to explore immune mechanisms beyond HAI-based correlates of protection.

Indexed as

Influenza, HumanVirus SheddingAdolescentAdultAge FactorsAntibodies, ViralChildChild, PreschoolCohort StudiesFamily CharacteristicsFemaleHemagglutination Inhibition TestsHumansInfantInfluenza A Virus, H1N1 SubtypeInfluenza A Virus, H3N2 SubtypeAntibodies, Viral

Identifiers

PMID42669676
PMCPMC13526887

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.