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Pandemic (H1N1) 2009 transmission during presymptomatic phase, Japan.

Yoshiaki Gu, Nobuhiro Komiya, Hajime Kamiya, Yoshinori Yasui, Kiyosu Taniguchi, Nobuhiko Okabe
Emerging Infectious Diseases 2011 September
During an epidemiologic investigation of pandemic influenza (H1N1) 2009 virus infection in May 2009 in Osaka, Japan, we found 3 clusters in which virus transmission occurred during the presymptomatic phase. This finding has public health implications because it indicates that viral transmission in communities cannot be prevented solely by isolating symptomatic case-patients.

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