[Viremia in influenza: detection by polymerase chain reaction]

Gastroenteritis, arthralgia and myalgia are frequently associated with influenza virus infections in humans. One explanation for these symptoms may be that they are due to extra respiratory transmission of virus by viremia. We tried to detect genomic viral RNA of the nucleoprotein (NP) and H3 subtype hemagglutinin (HA) genes by method of RT-PCR in peripheral blood mononuclear cells (PBMC) of 18 children aged 1-14 who suffered from an influenza outbreak in the Kansai district of Japan between December 1992 and February 1993. Three of the 18 samples were RT-PCR positive. The NP gene sequence observed in one patient's PBMC was identical to that obtained from his throat swab fluid. The HA gene sequences observed in the two other PBMC differed from those of RT-PCR amplified DNA from throat swabs by an order of 3-9 nucleotides. Moreover we tried to isolate virus by co-culture with MDCK cells and RBC or WBC of the patients from an influenza outbreak between December 1993 and March 1994. No virus was isolated from 9 patients suffering from H3 subtype but virus was isolated from 5 of 17 patients suffering from type B influenza virus. We believe these results suggest that the viremia on influenza infection is not so rare.