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Uno N, Ross TM. Multivalent next generation influenza virus vaccines protect against seasonal and pre-pandemic viruses. Sci Rep 2024; 14:1440. [PMID: 38228649 PMCID: PMC10792005 DOI: 10.1038/s41598-023-51024-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 12/29/2023] [Indexed: 01/18/2024] Open
Abstract
Each year, new influenza virus vaccine formulations are generated to keep up with continuously circulating and mutating viral variants. A next-generation influenza virus vaccine would provide long-lasting, broadly-reactive immune protection against current and future influenza virus strains for both seasonal and pre-pandemic viruses. Next generation immunogens were designed using computationally optimized broadly reactive antigen (COBRA) methodology to protect against a broad range of strains over numerous seasons. Novel HA and NA amino acid sequences were derived from multilayered consensus sequence alignment for multiple subtypes of influenza. This multivalent formulation was hypothesized to elicit broadly protective immune responses against both seasonal and pre-pandemic influenza viruses. Mice were vaccinated with multivalent mixtures of HA and NA (H1, H2, H3, H5, H7, N1, N2) proteins. Multivalent COBRA vaccinations elicited antibodies that recognized a broad panel of strains and vaccinated mice were protected against viruses representing multiple subtypes. This is a promising candidate for a universal influenza vaccine that elicits protective immune responses against seasonal and pre-pandemic strains over multiple seasons.
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Affiliation(s)
- Naoko Uno
- Center for Vaccines and Immunology, University of Georgia, Athens, GA, USA
- Department of Infection Biology, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Ted M Ross
- Center for Vaccines and Immunology, University of Georgia, Athens, GA, USA.
- Department of Infectious Diseases, University of Georgia, Athens, GA, USA.
- Florida Research and Innovation Center, Cleveland Clinic Florida, 9801 SW Discovery Way, Port Saint Lucie, FL, 34986, USA.
- Department of Infection Biology, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA.
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Zolotarova O, Fesenko A, Holubka O, Radchenko L, Bortz E, Budzanivska I, Mironenko A. Genotypic Variants of Pandemic H1N1 Influenza A Viruses Isolated from Severe Acute Respiratory Infections in Ukraine during the 2015/16 Influenza Season. Viruses 2021; 13:2125. [PMID: 34834932 PMCID: PMC8619959 DOI: 10.3390/v13112125] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 10/05/2021] [Accepted: 10/15/2021] [Indexed: 01/15/2023] Open
Abstract
Human type A influenza viruses A(H1N1)pdm09 have caused seasonal epidemics of influenza since the 2009-2010 pandemic. A(H1N1)pdm09 viruses had a leading role in the severe epidemic season of 2015/16 in the Northern Hemisphere and caused a high incidence of acute respiratory infection (ARI) in Ukraine. Serious complications of influenza-associated severe ARI (SARI) were observed in the very young and individuals at increased risk, and 391 fatal cases occurred in the 2015/16 epidemic season. We analyzed the genetic changes in the genomes of A(H1N1)pdm09 influenza viruses isolated from SARI cases in Ukraine during the 2015/16 season. The viral hemagglutinin (HA) fell in H1 group 6B.1 for all but four isolates, with known mutations affecting glycosylation, the Sa antigenic site (S162N in all 6B.1 isolates), or virulence (D222G/N in two isolates). Other mutations occurred in antigenic site Ca (A141P and S236P), and a subgroup of four strains were in group 6B.2, with potential alterations to antigenicity in A(H1N1)pdm09 viruses circulating in 2015/16 in Ukraine. A cluster of Ukrainian isolates exhibited novel D2E and N48S mutations in the RNA binding domain, and E125D in the effector domain, of immune evasion nonstructural protein 1 (NS1). The diverse spectrum of amino-acid substitutions in HA, NS1, and other viral proteins including nucleoprotein (NP) and the polymerase complex suggested the concurrent circulation of multiple lineages of A(H1N1)pdm09 influenza viruses in the human population in Ukraine, a country with low vaccination coverage, complicating public health measures against influenza.
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Affiliation(s)
- Oksana Zolotarova
- Educational Scientific Centre “Institute of Biology and Medicine”, Taras Shevchenko National University of Kyiv, 01601 Kyiv, Ukraine;
| | - Anna Fesenko
- Gromashevsky L.V. Institute of Epidemiology and Infectious Diseases, National Academy of Medical Sciences of Ukraine, 03680 Kyiv, Ukraine; (A.F.); (O.H.); (L.R.); (A.M.)
| | - Olga Holubka
- Gromashevsky L.V. Institute of Epidemiology and Infectious Diseases, National Academy of Medical Sciences of Ukraine, 03680 Kyiv, Ukraine; (A.F.); (O.H.); (L.R.); (A.M.)
| | - Larysa Radchenko
- Gromashevsky L.V. Institute of Epidemiology and Infectious Diseases, National Academy of Medical Sciences of Ukraine, 03680 Kyiv, Ukraine; (A.F.); (O.H.); (L.R.); (A.M.)
| | - Eric Bortz
- Department of Biological Sciences, University of Alaska, 3211 Providence Dr., Anchorage, AK 99508, USA;
| | - Iryna Budzanivska
- Educational Scientific Centre “Institute of Biology and Medicine”, Taras Shevchenko National University of Kyiv, 01601 Kyiv, Ukraine;
| | - Alla Mironenko
- Gromashevsky L.V. Institute of Epidemiology and Infectious Diseases, National Academy of Medical Sciences of Ukraine, 03680 Kyiv, Ukraine; (A.F.); (O.H.); (L.R.); (A.M.)
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Abstract
Introduction: As the pathogen that caused the first influenza virus pandemic in this century, the swine-origin A(H1N1) pdm09 influenza virus has caused continuous harm to human public health. The evolution of hemagglutinin protein glycosylation sites, including the increase in number and positional changes, is an important way for influenza viruses to escape host immune pressure. Based on the traditional influenza virus molecular monitoring, special attention should be paid to the influence of glycosylation evolution on the biological characteristics of virus antigenicity, transmission and pathogenicity. The epidemiological significance of glycosylation mutants should be analyzed as a predictive tool for early warning of new outbreaks and pandemics, as well as the design of vaccines and drug targets.Areas covered: We review on the evolutionary characteristics of glycosylation on the HA protein of the A(H1N1)pdm09 influenza virus in the last ten years.Expert opinion: We discuss the crucial impact of evolutionary glycosylation on the biological characteristics of the virus and the host immune responses, summarize studies revealing different roles of glycosylation play during host adaptation. Although these studies show the significance of glycosylation evolution in host-virus interaction, much remains to be discovered about the mechanism.
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Affiliation(s)
- Pan Ge
- Center for Vaccines and Immunology, University of Georgia, Athens, GA, USA
| | - Ted M Ross
- Center for Vaccines and Immunology, University of Georgia, Athens, GA, USA.,Department of Infectious Diseases, University of Georgia, Athens, GA USA
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Liu H, Gong YN, Shaw-Saliba K, Mehoke T, Evans J, Liu ZY, Lewis M, Sauer L, Thielen P, Rothman R, Chen KF, Pekosz A. Differential disease severity and whole-genome sequence analysis for human influenza A/H1N1pdm virus in 2015-2016 influenza season. Virus Evol 2021; 7:veab044. [PMID: 34040796 PMCID: PMC8135377 DOI: 10.1093/ve/veab044] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
During the 2015–16 winter, the US experienced a relatively mild influenza season compared to Taiwan, which had a higher number of total and severe cases. While H1N1pdm viruses dominated global surveillance efforts that season, the global distribution of genetic variants and their contributions to disease severity have not been investigated. Samples collected from influenza A-positive patients by the Johns Hopkins Center of Excellence for Influenza Research and Surveillance active surveillance in the emergency rooms in Baltimore, Maryland, USA, and northern Taiwan between November 2015 and April 2016, were processed for influenza A virus whole-genome sequencing. In Baltimore, the majority of the viruses were the H1N1pdm clade 6B.1 and no H1N1pdm clade 6B.2 viruses were detected. In northern Taiwan, more than half of the H1N1pdm viruses were clade 6B.1 and 38% were clade 6B.2, consistent with the global observation that most 6B.2 viruses circulated in Asia and not North America. Whole virus genome sequence analysis identified two genetic subgroups present in each of the 6B.1 and 6B.2 clades and one 6B.1 interclade reassortant virus. Clinical data showed 6B.2 patients had more disease symptoms including higher crude and inverse probability weighted odds of pneumonia than 6B.1 patients, suggesting 6B.2 circulation may be one of the reasons for the severe flu season in Taiwan. Local surveillance efforts linking H1N1pdm virus sequences to patient clinical and demographic data improve our understanding of influenza circulation and disease potential.
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Affiliation(s)
- Hsuan Liu
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205, USA
| | - Yu-Nong Gong
- Research Center for Emerging Viral Infections, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Laboratory Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Kathryn Shaw-Saliba
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205, USA.,Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205, USA
| | - Thomas Mehoke
- Research and Exploratory Development Department, Johns Hopkins Applied Physics Laboratory, Laurel, Maryland, 20723, USA
| | - Jared Evans
- Research and Exploratory Development Department, Johns Hopkins Applied Physics Laboratory, Laurel, Maryland, 20723, USA
| | - Zhen-Ying Liu
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Mitra Lewis
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205, USA
| | - Lauren Sauer
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205, USA
| | - Peter Thielen
- Research and Exploratory Development Department, Johns Hopkins Applied Physics Laboratory, Laurel, Maryland, 20723, USA
| | - Richard Rothman
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205, USA
| | - Kuan-Fu Chen
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Keelung, Taiwan.,Clinical Informatics and Medical Statistics Research Center, Chang Gung University, Taoyuan, Taiwan.,Community Medicine Research Center, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Andrew Pekosz
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205, USA.,Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205, USA.,Department of Environmental Health and Engineering, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205, USA
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5
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Chang KW, Leu SW, Lin SW, Liang SJ, Yang KY, Chan MC, Chen WC, Hu HC, Fang WF, Chen YM, Sheu CC, Tsai MJ, Wang HC, Chien YC, Peng CK, Wu CL, Kao KC. Renal Replacement Therapy in Patients with Influenza Pneumonia Related Acute Respiratory Distress Syndrome. J Clin Med 2021; 10:jcm10091837. [PMID: 33922592 PMCID: PMC8122892 DOI: 10.3390/jcm10091837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 04/05/2021] [Accepted: 04/14/2021] [Indexed: 11/16/2022] Open
Abstract
Acute kidney injury (AKI) requiring renal replacement therapy (RRT) increases the mortality of acute respiratory distress syndrome (ARDS) patients. The aim of this study was to investigate the outcomes and predictors of RRT in patients with influenza pneumonia-related ARDS. This retrospective cohort study includes patients from eight tertiary referral centers in Taiwan between January and March 2016, and all 282 patients with influenza pneumonia-related ARDS were enrolled. Thirty-four patients suffered from AKI requiring RRT, while 16 patients had underlying end stage renal disease (ESRD). The 30- and 60-day mortality rates were significantly higher in patients with AKI requiring RRT compared with those not requiring RRT (50.0% vs. 19.8%, p value < 0.001; 58.8% vs. 27.2%, p value = 0.001, respectively), but the patients with ESRD had no significant difference in mortality (12.5% vs. 19.8%, p value = 0.744; 31.3% vs. 27.2%, p value = 0.773, respectively). The predictors for AKI requiring RRT included underlying chronic liver disease and C-reactive protein. The mortality predictors for patients with AKI requiring RRT included the pneumonia severity index, tidal volume, and continuous renal replacement therapy. In this study, patients with influenza pneumonia-related ARDS with AKI requiring RRT had significantly higher mortality compared with other patients.
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Affiliation(s)
- Ko-Wei Chang
- Department of Thoracic Medicine, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan; (K.-W.C.); (S.-W.L.); (S.-W.L.); (H.-C.H.)
| | - Shaw-Woei Leu
- Department of Thoracic Medicine, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan; (K.-W.C.); (S.-W.L.); (S.-W.L.); (H.-C.H.)
| | - Shih-Wei Lin
- Department of Thoracic Medicine, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan; (K.-W.C.); (S.-W.L.); (S.-W.L.); (H.-C.H.)
| | - Shinn-Jye Liang
- Division of Pulmonary and Critical Care, Department of Internal Medicine, China Medical University Hospital, Taichung 404, Taiwan;
| | - Kuang-Yao Yang
- Department of Chest Medicine, Taipei Veterans General Hospital, Taipei 122, Taiwan; (K.-Y.Y.); (W.-C.C.)
- Institute of Emergency and Critical Care Medicine, School of Medicine, National Yang-Ming University, Taipei 122, Taiwan
| | - Ming-Cheng Chan
- Division of Critical Care and Respiratory Therapy, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung 407, Taiwan;
- College of Science, Tunghai University, Taichung 407, Taiwan
| | - Wei-Chih Chen
- Department of Chest Medicine, Taipei Veterans General Hospital, Taipei 122, Taiwan; (K.-Y.Y.); (W.-C.C.)
- Institute of Emergency and Critical Care Medicine, School of Medicine, National Yang-Ming University, Taipei 122, Taiwan
| | - Han-Chung Hu
- Department of Thoracic Medicine, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan; (K.-W.C.); (S.-W.L.); (S.-W.L.); (H.-C.H.)
- Department of Respiratory Therapy, College of Medicine, Chang-Gung University, Taoyuan 333, Taiwan
| | - Wen-Feng Fang
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan; (W.-F.F.); (Y.-M.C.)
- Department of Respiratory Care, Chang Gung University of Science and Technology, Chiayi 613, Taiwan
| | - Yu-Mu Chen
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan; (W.-F.F.); (Y.-M.C.)
| | - Chau-Chyun Sheu
- Division of Pulmonary and Critical Care Medicine, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan; (C.-C.S.); (M.-J.T.)
- Department of Internal Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Ming-Ju Tsai
- Division of Pulmonary and Critical Care Medicine, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan; (C.-C.S.); (M.-J.T.)
- Department of Internal Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Hao-Chien Wang
- Division of Chest Medicine, Department of Internal Medicine, National Taiwan University Hospital, Taipei 100, Taiwan; (H.-C.W.); (Y.-C.C.)
| | - Ying-Chun Chien
- Division of Chest Medicine, Department of Internal Medicine, National Taiwan University Hospital, Taipei 100, Taiwan; (H.-C.W.); (Y.-C.C.)
| | - Chung-Kan Peng
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan;
| | - Chieh-Liang Wu
- Center for Quality Management, Taichung Veterans General Hospital, Taichung 407, Taiwan;
- Office of Medical Administration, Taichung Veterans General Hospital, Taichung 407, Taiwan
| | - Kuo-Chin Kao
- Department of Thoracic Medicine, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan; (K.-W.C.); (S.-W.L.); (S.-W.L.); (H.-C.H.)
- Department of Respiratory Therapy, College of Medicine, Chang-Gung University, Taoyuan 333, Taiwan
- Correspondence:
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P S, Dhandapani N SK. Evaluation of Pregnancy, Younger Age, and Old Age as Independent Risk Factors for Poor Hospitalization Outcomes in Influenza A (H1N1)pdm09 Virus a Decade After the Pandemic. Cureus 2020; 12:e11762. [PMID: 33274169 PMCID: PMC7707136 DOI: 10.7759/cureus.11762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Introduction The influenza A (H1N1)pdm09 virus infection was first reported in Mexico in 2009 and quickly became the first flu pandemic of the 21st century. Statistics show that the prevalence of H1N1 infection was higher among young adults during the pandemic while the elderly were at more risk of death. However; many studies have shown a gradual change over the years, with attack rates increasing in older adults as compared to young adults. The other significant vulnerable group for this infection seems to be pregnant women. Over the years, many authors have found that pregnancy may not be a significant risk factor for increased hospitalization and poorer outcomes. This study aims to perform a comparative analysis and thereby assess pregnancy, younger age, and old age as independent risk factors for poor hospitalization outcomes. Materials and methods The hospital records of all patients with H1N1 infection admitted between January 1, 2018, to December 31, 2018, were screened. The patients included in the study were young adults (18-31 years), pregnant women, and the elderly (≥65 years). Comparative analysis was done between them. Nominal variables were compared using the chi-square test. Results A total of 379 patients were admitted to our hospital with H1N1 infection from January 1, 2018, to December 31, 2018. There were 75 elderly (19.7%), 224 (59%) middle-aged adults, 55 (14.5%) young adults, and 25 (6.5%) pregnant women. Fever (90%, 84%, and 96%) and cough with expectoration (72%, 67.3%, and 40%) were the most prevalent symptoms. The elderly reported more dyspnoea (28% vs. 5.5%, 4 %). Diabetes mellitus was found in 73.3 % of the elderly, 3.6% of the young adults, and 12% of pregnant women. Hypertension was present in 45% of the elderly, 1.8% of young adults, and 4% of pregnant women. Coronary artery disease was seen in 22.7% of the elderly and 1.8% of young adults. Chronic kidney disease (5.3%) and chronic obstructive pulmonary disease (13.3%) were seen only in the elderly group. Relative lymphopenia was prevalent in all groups and was more in pregnant women (76% vs. 61.8% and 41.8%) as compared to other groups. Serum creatinine was elevated in 38% of the elderly, 2% of young adults, and 0% of pregnant women. Abnormal chest radiograph was reported for 48% of the elderly, 30.9% of young adults, and 12% of pregnant women. Twenty-six point seven percent (26.7%) of the elderly needed more than a weeks' stay as compared to 7.3% of young adults and 20% of pregnant women. Thirty-two percent (32%) of the elderly required intensive care as compared to 1.5% of young adults and none of the pregnant women. More of the elderly (26.7%) required ventilator support than other groups (7.3% and 4%). About 25.3% of the elderly had a superinfection. Eight percent (8%) of the elderly died in the study while none died in the other groups. Conclusion Age representation and poor hospitalization outcomes due to H1N1 seem to have shifted from young adults to older age groups. The elderly are at more risk for a prolonged stay, intensive care, ventilator support, and death as compared to young adults and pregnant women. Pregnancy may not be associated with poor hospitalization outcomes for H1N1 as has been earlier thought.
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Affiliation(s)
- Sathyamurthy P
- Internal Medicine, Sri Ramachandra Institue of Higher Education and Research, Chennai, IND
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Chu SE, Seak CJ, Su TH, Chaou CH, Tseng HJ, Li CH. Prognostic accuracy of SIRS criteria and qSOFA score for in-hospital mortality among influenza patients in the emergency department. BMC Infect Dis 2020; 20:385. [PMID: 32471385 PMCID: PMC7256917 DOI: 10.1186/s12879-020-05102-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Accepted: 05/17/2020] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND The seasonal influenza epidemic is an important public health issue worldwide. Early predictive identification of patients with potentially worse outcome is important in the emergency department (ED). Similarly as with bacterial infection, influenza can cause sepsis. This study was conducted to investigate the effectiveness of the Systemic Inflammatory Response Syndrome (SIRS) criteria and the quick Sequential Organ Failure Assessment (qSOFA) score as prognostic predictors for ED patients with influenza. METHODS This single-center, retrospective cohort study investigated data that was retrieved from a hospital-based research database. Adult ED patients (age ≥ 18 at admission) with laboratory-proven influenza from 2010 to 2016 were included for data analysis. The initial SIRS and qSOFA scores were both collected. The primary outcome was the utility of each score in the prediction of in-hospital mortality. RESULTS For the study period, 3561 patients met the study inclusion criteria. The overall in-hospital mortality was 2.7% (95 patients). When the qSOFA scores were 0, 1, 2, and 3, the percentages of in-hospital mortality were 0.6, 7.2, 15.9, and 25%, respectively. Accordingly, the odds ratios (ORs) were 7.72, 11.92, and 22.46, respectively. The sensitivity and specificity was 24 and 96.2%, respectively, when the qSOFA score was ≥2. However, the SIRS criteria showed no significant associations with the primary outcome. The area under the receiver operating characteristic curve (AUC) was 0.864, which is significantly higher than that with SIRS, where the AUC was 0.786 (P < 0.01). CONCLUSIONS The qSOFA score potentially is a useful prognostic predictor for influenza and could be applied in the ED as a risk stratification tool. However, qSOFA may not be a good screening tool for triage because of its poor sensitivity. The SIRS criteria showed poor predictive performance in influenza for mortality as an outcome. Further research is needed to determine the role of these predictive tools in influenza and in other viral infections.
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Affiliation(s)
- Sheng-En Chu
- Department of Emergency Medicine, Linkou Medical Center, Chang-Gung Memorial Hospital, Taoyuan, Taiwan.,Department of Emergency Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan.,College of Medicine, Chang-Gung University, Taoyuan, Taiwan
| | - Chen-June Seak
- Department of Emergency Medicine, Linkou Medical Center, Chang-Gung Memorial Hospital, Taoyuan, Taiwan.,College of Medicine, Chang-Gung University, Taoyuan, Taiwan
| | - Tse-Hsuan Su
- Department of Emergency Medicine, Linkou Medical Center, Chang-Gung Memorial Hospital, Taoyuan, Taiwan.,College of Medicine, Chang-Gung University, Taoyuan, Taiwan
| | - Chung-Hsien Chaou
- Department of Emergency Medicine, Linkou Medical Center, Chang-Gung Memorial Hospital, Taoyuan, Taiwan.,College of Medicine, Chang-Gung University, Taoyuan, Taiwan.,Chang Gung Medical Education Research Centre, Chang-Gung Memorial Hospital, Taoyuan, Taiwan
| | - Hsiao-Jung Tseng
- Clinical Trial Center, Chang-Gung Memorial Hospital, Taoyuan, Taiwan
| | - Chih-Huang Li
- Department of Emergency Medicine, Linkou Medical Center, Chang-Gung Memorial Hospital, Taoyuan, Taiwan. .,College of Medicine, Chang-Gung University, Taoyuan, Taiwan. .,Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang-Gung University, Taoyuan, Taiwan.
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8
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Opanda S, Bulimo W, Gachara G, Ekuttan C, Amukoye E. Assessing antigenic drift and phylogeny of influenza A (H1N1) pdm09 virus in Kenya using HA1 sub-unit of the hemagglutinin gene. PLoS One 2020; 15:e0228029. [PMID: 32045419 PMCID: PMC7012450 DOI: 10.1371/journal.pone.0228029] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 01/06/2020] [Indexed: 02/07/2023] Open
Abstract
Influenza A (H1N1) pdm09 virus emerged in North America in 2009 and has been established as a seasonal strain in humans. After an antigenic stasis of about six years, new antigenically distinct variants of the virus emerged globally in 2016 necessitating a change in the vaccine formulation for the first time in 2017. Herein, we analyzed thirty-eight HA sequences of influenza A (H1N1) pdm09 strains isolated in Kenya during 2015-2018 seasons, to evaluate their antigenic and molecular properties based on the HA1 sub-unit. Our analyses revealed that the A (H1N1) pdm09 strains that circulated in Kenya during this period belonged to genetic clade 6B, subclade 6B.1 and 6B.2. The Kenyan 2015 and 2016 isolates differed from the vaccine strain A/California/07/2009 at nine and fourteen antigenic sites in the HA1 respectively. Further, those isolated in 2017 and 2018 correspondingly varied from A/Michigan/45/2015 vaccine strain at three and fifteen antigenic sites. The predicted vaccine efficacy of A/California/07/2009 against Kenyan 2015/2016 was estimated to be 32.4% while A/Michigan/45/2015 showed estimated vaccine efficacies of 39.6% - 41.8% and 32.4% - 42.1% against Kenyan 2017 and 2018 strains, respectively. Hemagglutination-inhibition (HAI) assay using ferret post-infection reference antiserum showed that the titers for the Kenyan 2015/2016 isolates were 2-8-fold lower compared to the vaccine strain. Overall, our results suggest the A (H1N1) pdm09 viruses that circulated in Kenya during 2015/2016 influenza seasons were antigenic variants of the recommended vaccine strains, denoting sub-optimal vaccine efficacy. Additionally, data generated point to a swiftly evolving influenza A (H1N1) pdm09 virus in recent post pandemic era, underscoring the need for sustained surveillance coupled with molecular and antigenic analyses, to inform appropriate and timely influenza vaccine update.
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Affiliation(s)
- Silvanos Opanda
- Department of Emerging Infectious Diseases (DEID), United States Army Medical Research Directorate–Africa (USAMRD-A), Nairobi, Kenya
| | - Wallace Bulimo
- Department of Emerging Infectious Diseases (DEID), United States Army Medical Research Directorate–Africa (USAMRD-A), Nairobi, Kenya
- Department of Biochemistry, University of Nairobi (UoN), Nairobi, Kenya
| | - George Gachara
- Department of Medical Laboratory Science, Kenyatta University (KU), Nairobi, Kenya
| | - Christopher Ekuttan
- Defense Forces Memorial Hospital, Kenya Defense Forces (KDF), Nairobi, Kenya
| | - Evans Amukoye
- Center for Respiratory Diseases Research, Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
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Huang KYA, Huang YC, Chiu CH, Tsao KC, Lin TY. Impaired Vaccine-Induced Antibody Response Against Clade 6B H1N1 Viruses in Individuals Before Viral Emergence. Open Forum Infect Dis 2020; 7:ofz513. [PMID: 31950072 PMCID: PMC6954487 DOI: 10.1093/ofid/ofz513] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 01/06/2020] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Clade 6B H1N1 pdm09 influenza viruses cause substantial morbidity and mortality worldwide. Human antibody profiles elicited upon vaccination against the clade 6B virus are largely unclear before viral emergence. METHODS Healthy volunteers, including children aged 3-8 years, adolescents aged 9-17 years, and adults, were enrolled before the clade 6B H1N1 outbreak and received the 2013-2014 inactivated influenza vaccine. We determined antibody responses before and after vaccination. Vaccine-induced plasmablast-derived antibodies were tested against H1N1 pdm09 reference and clade 6B viruses. RESULTS The majority of the subjects generated robust hemagglutination inhibition and neutralizing antibody responses upon vaccination across the different age groups. Nevertheless, a subset of young adults preferentially produced antibodies that failed to neutralize clade 6B viruses that emerged and circulated in 2014-2016. The hemagglutinin K163Q change at the Sa antigenic site, one of the substitutions that define clade 6B viruses, was responsible for resistance to neutralization by both postvaccination sera and vaccine-induced plasmablast-derived antibodies. CONCLUSIONS Vaccine-induced antibody immunity is compromised by the antigenic change of H1N1 pdm09 virus in a subset of adults, and this may warrant the incorporation of human serology in the antigenic characterization of virus and vaccine strain selection.
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Affiliation(s)
- Kuan-Ying A Huang
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Molecular Infectious Disease Research Centre, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Research Center for Emerging Viral Infections, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yhu-Chering Huang
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Cheng-Hsun Chiu
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Molecular Infectious Disease Research Centre, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Kuo-Chien Tsao
- Department of Laboratory Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Tzou-Yien Lin
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
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Gong YN, Tsao KC, Chen GW, Wu CJ, Chen YH, Liu YC, Yang SL, Huang YC, Shih SR. Population dynamics at neuraminidase position 151 of influenza A (H1N1)pdm09 virus in clinical specimens. J Gen Virol 2019; 100:752-759. [PMID: 30994443 DOI: 10.1099/jgv.0.001258] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Influenza A virus mutates rapidly, allowing it to escape natural and vaccine-induced immunity. Neuraminidase (NA) is a surface protein capable of cleaving the glycosidic linkages of neuraminic acids to release newly formed virions from infected cells. Genetic variants within a viral population can influence the emergence of pandemic viruses as well as drug susceptibility and vaccine effectiveness. In the present study, 55 clinical specimens from patients infected with the 2009 pandemic influenza A/H1N1 virus, abbreviated as A(H1N1)pdm09, during the 2015-2016 outbreak season in Taiwan were collected. Whole genomes were obtained through next-generation sequencing. Based on the published sequences from A(H1N1)pdm09 strains worldwide, a mixed population of two distinct variants at NA position 151 was revealed. We initially reasoned that such a mixed population may have emerged during cell culture. However, additional investigations confirmed that these mixed variants were detectable in the specimens of patients. To further investigate the role of the two NA-151 variants in a dynamic population, a reverse genetics system was employed to generate recombinant A(H1N1)pdm09 viruses. It was observed that the mixture of the two distinct variants was characterized by a higher replication rate compared to the recombinant viruses harbouring a single variant. Moreover, an NA inhibition assay revealed that a high frequency of the minor NA-151 variant in A(H1N1)pdm09 was associated with a reduced susceptibility to NA inhibitors. We conclude that two distinct NA-151 variants can be identified in patient specimens and that such variants may increase viral replication and NA activity.
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Affiliation(s)
- Yu-Nong Gong
- 1Research Center for Emerging Viral Infections, College of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC.,2Department of Laboratory Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, ROC
| | - Kuo-Chien Tsao
- 1Research Center for Emerging Viral Infections, College of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC.,3Department of Medical Biotechnology and Laboratory Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC.,2Department of Laboratory Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, ROC
| | - Guang-Wu Chen
- 1Research Center for Emerging Viral Infections, College of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC.,2Department of Laboratory Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, ROC.,4Department of Computer Science and Information Engineering, School of Electrical and Computer Engineering, College of Engineering, Chang Gung University, Taoyuan, Taiwan, ROC
| | - Chung-Jung Wu
- 1Research Center for Emerging Viral Infections, College of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC
| | - Yi-Hsiang Chen
- 1Research Center for Emerging Viral Infections, College of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC
| | - Yi-Chun Liu
- 2Department of Laboratory Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, ROC
| | - Shu-Li Yang
- 2Department of Laboratory Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, ROC.,3Department of Medical Biotechnology and Laboratory Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC
| | - Yhu-Chering Huang
- 5Department of Pediatrics, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, ROC.,6College of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC
| | - Shin-Ru Shih
- 2Department of Laboratory Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, ROC.,7Research Center for Chinese Herbal Medicine, Research Center for Food and Cosmetic Safety and Graduate Institute of Health Industry Technology, College of Human Ecology, Chang Gung University of Science and Technology, Taoyuan, Taiwan, ROC.,1Research Center for Emerging Viral Infections, College of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC.,3Department of Medical Biotechnology and Laboratory Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC
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