Stunting Increases Influenza Virus Shedding Duration in Preschool/School-Aged Children.

The role of undernutrition on influenza virus shedding is unclear. We assessed stunting, an indicator of chronic undernutrition, as a predictor of shedding duration in children in the Household Influenza Cohort Study, in Managua, Nicaragua. Stunted children, aged 3-9 years, shed influenza longer than their nonstunted peers. In sub-group analysis, associations were driven by H3N2 and influenza B (IB) infections. Analysis of cycle threshold (Ct) values showed slower clearance of IB viruses in stunted children. These findings suggest undernutrition may prolong influenza shedding, with implications for transmission dynamics and control strategies in low- and middle-income countries where stunting remains prevalent.