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Wilson JL, Akin E, Zhou R, Jedlicka A, Dziedzic A, Liu H, Fenstermacher KZJ, Rothman RE, Pekosz A. The Influenza B Virus Victoria and Yamagata Lineages Display Distinct Cell Tropism and Infection-Induced Host Gene Expression in Human Nasal Epithelial Cell Cultures. Viruses 2023; 15:1956. [PMID: 37766362 PMCID: PMC10537232 DOI: 10.3390/v15091956] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 09/11/2023] [Accepted: 09/12/2023] [Indexed: 09/29/2023] Open
Abstract
Understanding Influenza B virus infections is of critical importance in our efforts to control severe influenza and influenza-related diseases. Until 2020, two genetic lineages of influenza B virus-Yamagata and Victoria-circulated in the population. These lineages are antigenically distinct, but the differences in virus replication or the induction of host cell responses after infection have not been carefully studied. Recent IBV clinical isolates of both lineages were obtained from influenza surveillance efforts of the Johns Hopkins Center of Excellence in Influenza Research and Response and characterized in vitro. B/Victoria and B/Yamagata clinical isolates were recognized less efficiently by serum from influenza-vaccinated individuals in comparison to the vaccine strains. B/Victoria lineages formed smaller plaques on MDCK cells compared to B/Yamagata, but infectious virus production in primary human nasal epithelial cell (hNEC) cultures showed no differences. While ciliated epithelial cells were the dominant cell type infected by both lineages, B/Victoria lineages had a slight preference for MUC5AC-positive cells, and B/Yamagata lineages infected more basal cells. Finally, while both lineages induced a strong interferon response 48 h after infection of hNEC cultures, the B/Victoria lineages showed a much stronger induction of interferon-related signaling pathways compared to B/Yamagata. This demonstrates that the two influenza B virus lineages differ not only in their antigenic structure but also in their ability to induce host innate immune responses.
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Affiliation(s)
- Jo L. Wilson
- W. Harry Feinstone, Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA; (J.L.W.); (E.A.); (R.Z.); (A.J.); (A.D.); (H.L.)
- Division of Allergy, Immunology, and Rheumatology, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Elgin Akin
- W. Harry Feinstone, Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA; (J.L.W.); (E.A.); (R.Z.); (A.J.); (A.D.); (H.L.)
| | - Ruifeng Zhou
- W. Harry Feinstone, Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA; (J.L.W.); (E.A.); (R.Z.); (A.J.); (A.D.); (H.L.)
| | - Anne Jedlicka
- W. Harry Feinstone, Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA; (J.L.W.); (E.A.); (R.Z.); (A.J.); (A.D.); (H.L.)
| | - Amanda Dziedzic
- W. Harry Feinstone, Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA; (J.L.W.); (E.A.); (R.Z.); (A.J.); (A.D.); (H.L.)
| | - Hsuan Liu
- W. Harry Feinstone, Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA; (J.L.W.); (E.A.); (R.Z.); (A.J.); (A.D.); (H.L.)
| | - Katherine Z. J. Fenstermacher
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA; (K.Z.J.F.); (R.E.R.)
| | - Richard E. Rothman
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA; (K.Z.J.F.); (R.E.R.)
| | - Andrew Pekosz
- W. Harry Feinstone, Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA; (J.L.W.); (E.A.); (R.Z.); (A.J.); (A.D.); (H.L.)
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Wilson JL, Akin E, Zhou R, Jedlicka A, Dziedzic A, Liu H, Fenstermacher KZ, Rothman R, Pekosz A. The Influenza B Virus Victoria and Yamagata Lineages Display Distinct Cell Tropism and Infection Induced Host Gene Expression in Human Nasal Epithelial Cell Cultures. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.08.04.551980. [PMID: 37577630 PMCID: PMC10418153 DOI: 10.1101/2023.08.04.551980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/15/2023]
Abstract
Understanding Influenza B virus infections is of critical importance in our efforts to control severe influenza and influenza-related disease. Until 2020, two genetic lineages of influenza B virus - Yamagata and Victoria - circulated in the population. These lineages are antigenically distinct but differences in virus replication or the induction of host cell responses after infection have not been carefully studied. Recent IBV clinical isolates of both lineages were obtained from influenza surveillance efforts of the Johns Hopkins Center of Excellence in Influenza Research and Response and characterized in vitro . B/Victoria and B/Yamagata clinical isolates were recognized less efficiently by serum from influenza-vaccinated individuals in comparison to the vaccine strains. B/Victoria lineages formed smaller plaques on MDCK cells compared to B/Yamagata, but infectious virus production in primary human nasal epithelial cell (hNEC) cultures showed no differences. While ciliated epithelial cells were the dominant cell type infected by both lineages, B/Victoria lineages had a slight preference for MUC5AC-positive cells, while B/Yamagata lineages infected more basal cells. Finally, while both lineages induced a strong interferon response 48 hours after infection of hNEC cultures, the B/Victoria lineages showed a much stronger induction of interferon related signaling pathways compared to B/Yamagata. This demonstrates that the two influenza B virus lineages differ not only in their antigenic structure but in their ability to induce host innate immune responses.
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Affiliation(s)
- Jo L Wilson
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States
- Department of Pediatric Allergy and Immunology, Johns Hopkins Hospital, Baltimore, MD, United States
| | - Elgin Akin
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States
| | - Ruifeng Zhou
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States
| | - Anne Jedlicka
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States
| | - Amanda Dziedzic
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States
| | - Hsuan Liu
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States
| | | | - Richard Rothman
- Adult Emergency Department, Johns Hopkins Hospital, Baltimore, MD, United States
| | - Andrew Pekosz
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States
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Yang Z, Xu X, Silva CAT, Farnos O, Venereo-Sanchez A, Toussaint C, Dash S, González-Domínguez I, Bernier A, Henry O, Kamen A. Membrane Chromatography-Based Downstream Processing for Cell-Culture Produced Influenza Vaccines. Vaccines (Basel) 2022; 10:vaccines10081310. [PMID: 36016198 PMCID: PMC9414887 DOI: 10.3390/vaccines10081310] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 08/10/2022] [Accepted: 08/11/2022] [Indexed: 11/18/2022] Open
Abstract
New influenza strains are constantly emerging, causing seasonal epidemics and raising concerns to the risk of a new global pandemic. Since vaccination is an effective method to prevent the spread of the disease and reduce its severity, the development of robust bioprocesses for producing pandemic influenza vaccines is exceptionally important. Herein, a membrane chromatography-based downstream processing platform with a demonstrated industrial application potential was established. Cell culture-derived influenza virus H1N1/A/PR/8/34 was harvested from benchtop bioreactor cultures. For the clarification of the cell culture broth, a depth filtration was selected as an alternative to centrifugation. After inactivation, an anion exchange chromatography membrane was used for viral capture and further processing. Additionally, two pandemic influenza virus strains, the H7N9 subtype of the A/Anhui/1/2013 and H3N2/A/Hong Kong/8/64, were successfully processed through similar downstream process steps establishing optimized process parameters. Overall, 41.3–62.5% viral recovery was achieved, with the removal of 86.3–96.5% host cell DNA and 95.5–99.7% of proteins. The proposed membrane chromatography purification is a scalable and generic method for the processing of different influenza strains and is a promising alternative to the current industrial purification of influenza vaccines based on ultracentrifugation methodologies.
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Affiliation(s)
- Zeyu Yang
- Viral Vectors and Vaccines Bioprocessing Group, Department of Bioengineering, McGill University, Montreal, QC H3A 0G4, Canada
| | - Xingge Xu
- Viral Vectors and Vaccines Bioprocessing Group, Department of Bioengineering, McGill University, Montreal, QC H3A 0G4, Canada
| | - Cristina A. T. Silva
- Viral Vectors and Vaccines Bioprocessing Group, Department of Bioengineering, McGill University, Montreal, QC H3A 0G4, Canada
- Department of Chemical Engineering, Polytechnique Montreal, Montreal, QC H3T 1J4, Canada
| | - Omar Farnos
- Viral Vectors and Vaccines Bioprocessing Group, Department of Bioengineering, McGill University, Montreal, QC H3A 0G4, Canada
| | - Alina Venereo-Sanchez
- Viral Vectors and Vaccines Bioprocessing Group, Department of Bioengineering, McGill University, Montreal, QC H3A 0G4, Canada
| | - Cécile Toussaint
- Viral Vectors and Vaccines Bioprocessing Group, Department of Bioengineering, McGill University, Montreal, QC H3A 0G4, Canada
| | - Shantoshini Dash
- Viral Vectors and Vaccines Bioprocessing Group, Department of Bioengineering, McGill University, Montreal, QC H3A 0G4, Canada
| | - Irene González-Domínguez
- Viral Vectors and Vaccines Bioprocessing Group, Department of Bioengineering, McGill University, Montreal, QC H3A 0G4, Canada
| | - Alice Bernier
- Viral Vectors and Vaccines Bioprocessing Group, Department of Bioengineering, McGill University, Montreal, QC H3A 0G4, Canada
| | - Olivier Henry
- Department of Chemical Engineering, Polytechnique Montreal, Montreal, QC H3T 1J4, Canada
| | - Amine Kamen
- Viral Vectors and Vaccines Bioprocessing Group, Department of Bioengineering, McGill University, Montreal, QC H3A 0G4, Canada
- Correspondence:
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Tsybalova LM, Stepanova LA, Ramsay ES, Vasin AV. Influenza B: Prospects for the Development of Cross-Protective Vaccines. Viruses 2022; 14:v14061323. [PMID: 35746794 PMCID: PMC9228933 DOI: 10.3390/v14061323] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 06/09/2022] [Accepted: 06/12/2022] [Indexed: 01/04/2023] Open
Abstract
In this review, we analyze the epidemiological and ecological features of influenza B, one of the most common and severe respiratory infections. The review presents various strategies for cross-protective influenza B vaccine development, including recombinant viruses, virus-like particles, and recombinant proteins. We provide an overview of viral proteins as cross-protective vaccine targets, along with other updated broadly protective vaccine strategies. The importance of developing such vaccines lies not only in influenza B prevention, but also in the very attractive prospect of eradicating the influenza B virus in the human population.
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Affiliation(s)
- Liudmila M. Tsybalova
- Smorodintsev Research Institute of Influenza, Prof. Popova Str., 15/17, 197376 St. Petersburg, Russia; (L.A.S.); (E.S.R.); or (A.V.V.)
- Correspondence: or
| | - Liudmila A. Stepanova
- Smorodintsev Research Institute of Influenza, Prof. Popova Str., 15/17, 197376 St. Petersburg, Russia; (L.A.S.); (E.S.R.); or (A.V.V.)
| | - Edward S. Ramsay
- Smorodintsev Research Institute of Influenza, Prof. Popova Str., 15/17, 197376 St. Petersburg, Russia; (L.A.S.); (E.S.R.); or (A.V.V.)
| | - Andrey V. Vasin
- Smorodintsev Research Institute of Influenza, Prof. Popova Str., 15/17, 197376 St. Petersburg, Russia; (L.A.S.); (E.S.R.); or (A.V.V.)
- Research Institute of Influenza named after A.A. Smorodintsev, Peter the Great St. Petersburg Polytechnic University, Polytechnicheskaya, 29, 195251 St. Petersburg, Russia
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Soldevila N, Basile L, Martínez A, Torner N, Marcos MÁ, Mosquera MM, Antón A, Andrés C, Rius C, Pumarola T, Domínguez Á. Surveillance of influenza B severe hospitalized cases during ten seasons in Catalonia. Does the lineage make a difference? J Med Virol 2022; 94:4417-4424. [PMID: 35593301 DOI: 10.1002/jmv.27876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 05/07/2022] [Accepted: 05/17/2022] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Influenza B viruses circulates in two lineages (B/Victoria and B/Yamagata). Although classically affecting children, recently it has shown high rate of infection and increased hospitalization in the elderly. OBJECTIVE To describe and analyze the clinical and epidemiological characteristics of severe hospitalized laboratory confirmed influenza B virus (SHLCI-B) cases in Catalonia associated to mismatch from Influenza B virus strain included in the trivalent influenza vaccine (TIV). METHODS SHLCI-B registered by the influenza sentinel surveillance system of Catalonia (PIDIRAC) during ten surveillance seasons from 2010 to 2020. Variables age, comorbidities, vaccination status were recorded. Vaccine effectiveness was estimated as (1-OR) for intensive care unit (ICU) admission. Statistical significance was established at p <0.05. RESULTS A total of 1159 SHLCI-B were registered, of these 68.2% (791) corresponded to the 2017-18 season; 21.8% (253) were admitted to ICU and 13.8% (160) were exitus; 62.5% (725) cases occurred in those aged > 64 years; most frequent risk factor was cardiovascular disease (35.1%, 407) followed by chronic pulmonary obstructive disease-COPD (24.6%, 285) and diabetes (24.1%, 279). In 4 seasons, the predominant circulating lineage was B/Victoria, in 2 seasons the B/Yamagata lineage and 4 seasons had no IBV activity. Four seasons presented discordance with the strain included within the TIV. Vaccine effectiveness (VE) to prevent ICU admission was 31% (95% CI: 4-51%; p=0.03); being 29% (95%CI: -3%, 51%) in discordant and 43% (95% CI:-43%, 77%) in concordant seasons. Significant differences were observed in the number of affected aged > 64 years (OR=2.5; 95% CI: 1.9-3.4; p <0.001) and in patients with heart disease (OR = 2.40 95% CI: 1.7-3.4; p <0.001), COPD (OR = 1.6 95% CI: 1.1-2.3; p = 0.01) and diabetes (OR = 1.5 95% CI: 1.1-2.1; p = 0.04) between discordant and concordant seasons. CONCLUSIONS The increase in hospitalization rate in people> 64 years of age and those presenting comorbidities in seasons with circulating influenza B virus belonging to a lineage discordant with the strain included in the TIV and the decrease of VE to prevent ICU admissions evidences the vital need to administer the quadrivalent influenza vaccine regardless of the findings of predominant circulation in the previous season. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Núria Soldevila
- Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Luca Basile
- Public Health Agency of Catalonia, Barcelona, Spain
| | - Ana Martínez
- Public Health Agency of Catalonia, Barcelona, Spain.,Ciber Epidemiology and Public Health CIBERESP, Instituto de Salud Carlos III, Madrid
| | - Núria Torner
- Department of Medicine, University of Barcelona, Barcelona, Spain.,Ciber Epidemiology and Public Health CIBERESP, Instituto de Salud Carlos III, Madrid
| | | | - MMar Mosquera
- Department of Microbiology, Hospital Clínic of Barcelona
| | - Andrés Antón
- Respiratory Viruses Unit, Microbiology Department, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid
| | - Cristina Andrés
- Respiratory Viruses Unit, Microbiology Department, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid
| | - Cristina Rius
- Ciber Epidemiology and Public Health CIBERESP, Instituto de Salud Carlos III, Madrid.,Public Health Agency of Barcelona, Barcelona, Spain
| | - Tomàs Pumarola
- Respiratory Viruses Unit, Microbiology Department, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid
| | - Ángela Domínguez
- Department of Medicine, University of Barcelona, Barcelona, Spain.,Ciber Epidemiology and Public Health CIBERESP, Instituto de Salud Carlos III, Madrid
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Kim Y, Hong K, Kim H, Nam J. Influenza vaccines: Past, present, and future. Rev Med Virol 2022; 32:e2243. [PMID: 33949021 PMCID: PMC8209895 DOI: 10.1002/rmv.2243] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Accepted: 04/27/2021] [Indexed: 01/08/2023]
Abstract
Globally, infection by seasonal influenza viruses causes 3-5 million cases of severe illness and 290,000-650,000 respiratory deaths each year. Various influenza vaccines, including inactivated split- and subunit-type, recombinant and live attenuated vaccines, have been developed since the 1930s when it was discovered that influenza viruses could be cultivated in embryonated eggs. However, the protection rate offered by these vaccines is rather low, especially in very young children and the elderly. In this review, we describe the history of influenza vaccine development, the immune responses induced by the vaccines and the adjuvants applied. Further, we suggest future directions for improving the effectiveness of influenza vaccines in all age groups. This includes the development of an influenza vaccine that induces a balanced T helper cell type 1 and type 2 immune responses based on the understanding of the immune system, and the development of a broad-spectrum influenza vaccine that can increase effectiveness despite antigen shifts and drifts, which are characteristics of the influenza virus. A brighter future can be envisaged if the development of an adjuvant that is safe and effective is realized.
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Affiliation(s)
- Yun‐Hee Kim
- Department of Medical and Biological SciencesThe Catholic University of KoreaBucheonRepublic of Korea
- Department of R&DSK BioscienceBundang‐guRepublic of Korea
| | - Kee‐Jong Hong
- UIC FoundationKonkuk UniversitySeoulRepublic of Korea
| | - Hun Kim
- Department of R&DSK BioscienceBundang‐guRepublic of Korea
| | - Jae‐Hwan Nam
- Department of Medical and Biological SciencesThe Catholic University of KoreaBucheonRepublic of Korea
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Tejus A, Mathur A, Pradhan S, Malik S, Salmani MF. Drug update - Baloxavir marboxil: Latest entrant into the arena of pharmacotherapy of influenza. Med J Armed Forces India 2021; 78:125-130. [PMID: 35463549 PMCID: PMC9023778 DOI: 10.1016/j.mjafi.2021.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 09/21/2021] [Indexed: 11/17/2022] Open
Abstract
Influenza is a frequent cause of clinically significant human disease, with seasonal epidemics and occasional pandemics. Uncomplicated influenza in healthy individuals is managed symptomatically. Vaccination against influenza plays a vital role in the control of infection in humans. The currently available antivirals include adamantanes, neuraminidase inhibitors, and ribavirin. Baloxavir marboxil, the prodrug of baloxavir, is the latest addition to the family of anti-influenza drugs, and it received US-FDA approval on October 24, 2018. Baloxavir acts through a novel mechanism of inhibiting Cap-dependent endonuclease (CEN), the vital step in the transcription of viral RNA, and prevents further spread of the virus.
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Affiliation(s)
- A. Tejus
- Classified Specialist (Pharmacology), Medical Officer, HQ IMTRAT, C/o 99 APO, India
- Corresponding author.
| | | | - Sapna Pradhan
- Professor (Pharmacology), Army College of Medical Sciences, Delhi Cantt, India
| | - Salma Malik
- Demonstrator (Pharmacology), Army College of Medical Sciences, Delhi Cantt, India
| | - Md Fadil Salmani
- Demonstrator (Pharmacology), Army College of Medical Sciences, Delhi Cantt, India
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Burden of Seasonal Influenza A and B in Panama from 2011 to 2017: An Observational Retrospective Database Study. Infect Dis Ther 2021; 10:2465-2478. [PMID: 34424506 PMCID: PMC8381717 DOI: 10.1007/s40121-021-00501-y] [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: 03/29/2021] [Accepted: 07/07/2021] [Indexed: 11/20/2022] Open
Abstract
Introduction Influenza A and B viruses constantly evolve and cause seasonal epidemics and sporadic outbreaks. Therefore, epidemiological surveillance is critical for monitoring their circulation pattern. Trivalent and quadrivalent vaccine formulations are available in Panama (until and since 2016, respectively). Herein, we analysed influenza A and B epidemiological patterns in Panama. Methods This was a retrospective descriptive analysis of all laboratory-confirmed influenza nasopharyngeal samples recorded between 2011 and 2017 in the nationwide surveillance database of Gorgas Memorial Institute for Health Studies. The analysis involved data relative to demographic information, virus type, subtype and lineage, geographic region, treatment and outcomes. The percentage level of mismatch between circulating and vaccine-recommended B lineage was assessed for each May–October influenza season. Results Among 1839 influenza cases, 79.6% were type A and 20.4% were type B. Most of them were observed in Panama City (54.7%) followed by the West (23.2%) and Central (16.7%) regions; across all regions, influenza A and B cases were distributed in a 4:1 ratio. Overall, approximately half were hospitalized (52.0% for type A; 45.5% for type B) and 11 (0.6%) died. Treatment, usually antimicrobial, was administered in 15.1% of cases. Children less than 2 years old were the most affected by this disease. Influenza type A circulated every year, while influenza B only circulated in 2012, 2014 and 2017. In the 2012 May–October influenza B season, the predominant lineage was B/Victoria and a switch to B/Yamagata was observed in 2014. Both lineages co-circulated in 2017, leading to a 38.9% B-lineage-level vaccine mismatch. Conclusion Influenza A was predominant among all ages and children less than 2 years and inhabitants of Panama City reported the highest circulation rate. In 2017, co-circulation of both B lineages led to a vaccine mismatch. Continuous monitoring of seasonal influenza is critical to establish immunization recommendations. Supplementary Information The online version contains supplementary material available at 10.1007/s40121-021-00501-y. Influenza or “flu” is caused by influenza viruses A and B and its symptoms range from mild to severe. This virus is constantly evolving; thus, careful monitoring of influenza is important to update immunization and vaccine recommendations yearly. This study used data from surveillance centres in Panama from 2011 to 2017 and evaluated the number of flu cases by age, gender, region, virus type, symptoms, comorbidities, treatment, coinfections with other viruses, and the circulating influenza subtype and the vaccine recommended each year. We found several points: almost 80% of cases were influenza A; most of the positive samples were found in children less than 2 years old and the Panama city region; more than 50% of influenza cases needed hospitalization; and in 2017 a mismatch was detected between the circulating influenza subtype and the recommended vaccine. This study helped to better characterize influenza circulation patterns and the burden of the disease during 2011–2017. We concluded that continuous monitoring of the influenza cases is necessary to establish future vaccination recommendations.
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Yechezkel M, Ndeffo Mbah ML, Yamin D. Optimizing antiviral treatment for seasonal influenza in the USA: a mathematical modeling analysis. BMC Med 2021; 19:54. [PMID: 33641677 PMCID: PMC7917004 DOI: 10.1186/s12916-021-01926-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 01/22/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Seasonal influenza remains a major cause of morbidity and mortality in the USA. Despite the US Centers for Disease Control and Prevention recommendation promoting the early antiviral treatment of high-risk patients, treatment coverage remains low. METHODS To evaluate the population-level impact of increasing antiviral treatment timeliness and coverage among high-risk patients in the USA, we developed an influenza transmission model that incorporates data on infectious viral load, social contact, and healthcare-seeking behavior. We modeled the reduction in transmissibility in treated individuals based on their reduced daily viral load. The reduction in hospitalizations following treatment was based on estimates from clinical trials. We calibrated the model to weekly influenza data from Texas, California, Connecticut, and Virginia between 2014 and 2019. We considered in the baseline scenario that 2.7-4.8% are treated within 48 h of symptom onset while an additional 7.3-12.8% are treated after 48 h of symptom onset. We evaluated the impact of improving the timeliness and uptake of antiviral treatment on influenza cases and hospitalizations. RESULTS Model projections suggest that treating high-risk individuals as early as 48 h after symptom onset while maintaining the current treatment coverage level would avert 2.9-4.5% of all symptomatic cases and 5.5-7.1% of all hospitalizations. Geographic variability in the effectiveness of earlier treatment arises primarily from variabilities in vaccination coverage and population demographics. Regardless of these variabilities, we found that when 20% of the high-risk individuals were treated within 48 h, the reduction in hospitalizations doubled. We found that treatment of the elderly population (> 65 years old) had the highest impact on reducing hospitalizations, whereas treating high-risk individuals aged 5-19 years old had the highest impact on reducing transmission. Furthermore, the population-level benefit per treated individual is enhanced under conditions of high vaccination coverage and a low attack rate during an influenza season. CONCLUSIONS Increased timeliness and coverage of antiviral treatment among high-risk patients have the potential to substantially reduce the burden of seasonal influenza in the USA, regardless of influenza vaccination coverage and the severity of the influenza season.
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Affiliation(s)
- Matan Yechezkel
- Department of Industrial Engineering, Tel Aviv University, 55 Haim Levanon St, Tel Aviv, Israel
| | - Martial L Ndeffo Mbah
- Department of Veterinary Integrative Biosciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, Texas, 77843, USA.
- Department of Epidemiology and Biostatistics, School of Public Health, Texas A&M University, Texas, 77843, USA.
| | - Dan Yamin
- Department of Industrial Engineering, Tel Aviv University, 55 Haim Levanon St, Tel Aviv, Israel.
- Department of Epidemiology and Biostatistics, School of Public Health, Texas A&M University, Texas, 77843, USA.
- Center for Combatting Pandemic, sTel Aviv University, 55 Haim Levanon St, Tel Aviv, Israel.
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The Israel National Sera Bank: Methods, Representativeness, and Challenges. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052280. [PMID: 33668988 PMCID: PMC7956577 DOI: 10.3390/ijerph18052280] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 02/17/2021] [Accepted: 02/21/2021] [Indexed: 12/03/2022]
Abstract
The Israel National Sera Bank (INSB) was established in 1997 in the Israel Center for Disease Control. The purpose of the INSB was to provide policymakers with data on the immunity status of the Israeli population against vaccine-preventable diseases, and on the extent and characteristics of exposure to emerging and re-emerging infectious diseases. The aim of this paper is to describe the methods, representativeness, and challenges in maintaining the INSB. The INSB comprises residual sera collected in six laboratories. By the end of 2019, 138,898 samples had been deposited in the INSB. These include samples from four community laboratories: 30.7% from the National Blood Service, 22.2% from Haifa and the Western Galilee, 21.7% from Soroka, and 0.7% from Jerusalem; and from two medical center laboratories: 18.6% from Schneider and 6.1% from Mayanei Hayeshua. The demographic characteristics of the sample at the end of 2019 closely resembled those of the general population. The main challenges addressed in maintaining the INSB relate to its representativeness, the possibility of repeated donors, costs, stability of antibody levels after long-term storage, ethical aspects, and the data available for each sample. The INSB is a unique, powerful, and necessary tool for assessing population immunity levels, based on serum samples collected over a long period of time.
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11
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Yin H, Jiang N, Shi W, Chi X, Liu S, Chen JL, Wang S. Development and Effects of Influenza Antiviral Drugs. Molecules 2021; 26:molecules26040810. [PMID: 33557246 PMCID: PMC7913928 DOI: 10.3390/molecules26040810] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 01/28/2021] [Accepted: 02/01/2021] [Indexed: 12/15/2022] Open
Abstract
Influenza virus is a highly contagious zoonotic respiratory disease that causes seasonal outbreaks each year and unpredictable pandemics occasionally with high morbidity and mortality rates, posing a great threat to public health worldwide. Besides the limited effect of vaccines, the problem is exacerbated by the lack of drugs with strong antiviral activity against all flu strains. Currently, there are two classes of antiviral drugs available that are chemosynthetic and approved against influenza A virus for prophylactic and therapeutic treatment, but the appearance of drug-resistant virus strains is a serious issue that strikes at the core of influenza control. There is therefore an urgent need to develop new antiviral drugs. Many reports have shown that the development of novel bioactive plant extracts and microbial extracts has significant advantages in influenza treatment. This paper comprehensively reviews the development and effects of chemosynthetic drugs, plant extracts, and microbial extracts with influenza antiviral activity, hoping to provide some references for novel antiviral drug design and promising alternative candidates for further anti-influenza drug development.
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12
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Nisar N, Aamir UB, Badar N, Mahmood MR, Yaqoob A, Tripathy JP, Laxmeshwar C, Tenzin K, Zaidi SSZ, Salman M, Ikram A. Epidemiology of Influenza among patients with influenza-like illness and severe acute respiratory illness in Pakistan: A 10-year surveillance study 2008-17. J Med Virol 2020; 92:3028-3037. [PMID: 32314812 DOI: 10.1002/jmv.25913] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 04/17/2020] [Indexed: 02/03/2023]
Abstract
In Pakistan, the burden of influenza was largely unknown, as no formal surveillance system was in place. In 2008, an influenza surveillance system was set up in eight sentinel sites. This study describes the epidemiology of influenza virus using a 10-year surveillance data from 2008 to 2017. Nasopharyngeal/throat swabs were collected from patients with influenza-like illness (ILI) and severe acute respiratory illness (SARI) along with relevant epidemiological information. The samples were tested using real-time reverse transcriptase-polymerase chain reaction for the detection and characterization of influenza viruses. A total of 17 209 samples were tested for influenza, out of which 3552 (20.6%) were positive; 2151/11 239 (19.1%) were patients with ILI, whereas 1401/5970 (23.5%) were patients with SARI. Influenza A/H1N1pdm09 was the predominant strain with 40.6% (n = 1442) followed by influenza B (936, 26.4%). Influenza A/H1N1pdm09 was predominant among the children (5-14 years) and adults (15-64 years). Influenza B strain was predominantly found in the elderly age group (≥ 65 years) accounting for 48% of cases followed by children (2-4 years) accounting for 37% of cases. This 10-year surveillance data provides evidence of influenza activity in the country throughout the year with seasonal winter peaks. The results could be used to strengthen the epidemic preparedness and response plan.
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Affiliation(s)
- Nadia Nisar
- Department of Virology, Public Health Laboratories Division, National Institute of Health, Islamabad, Pakistan
| | - Uzma Bashir Aamir
- Department of Virology, Public Health Laboratories Division, National Institute of Health, Islamabad, Pakistan
| | - Nazish Badar
- Department of Virology, Public Health Laboratories Division, National Institute of Health, Islamabad, Pakistan
| | - Muhammad Rashid Mahmood
- Department of Virology, Public Health Laboratories Division, National Institute of Health, Islamabad, Pakistan
| | - Aashifa Yaqoob
- Research Unit, Common Management Unit (HIV/AIDS, TB & Malaria), Islamabad, Pakistan
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Jaya Prasad Tripathy
- Department of Community Medicine, All India Institute of Medical Sciences, Nagpur, India
- Center of Operational Research, International Union Against Tuberculosis and Lung Disease, Paris, France
| | | | - Karma Tenzin
- Faculty of Postgraduate Medicine, Khesar Gyalpo University of Medical Sciences of Bhutan, Thimphu, Bhutan
| | - Syed Sohail Zahoor Zaidi
- Department of Virology, Public Health Laboratories Division, National Institute of Health, Islamabad, Pakistan
| | - Muhammad Salman
- Department of Virology, Public Health Laboratories Division, National Institute of Health, Islamabad, Pakistan
| | - Aamer Ikram
- Department of Virology, Public Health Laboratories Division, National Institute of Health, Islamabad, Pakistan
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13
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Jung SW, Kim YJ, Han SB, Lee KY, Kang JH. Differences in the age distribution of influenza B virus infection according to influenza B virus lineages in the Korean population. Postgrad Med 2020; 133:82-88. [PMID: 32945235 DOI: 10.1080/00325481.2020.1825295] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Since the 2000s, two lineages of the influenza B virus (influenza B/Victoria and influenza B/Yamagata) have been co-circulating. Information on the age distribution of patients infected by each influenza B virus lineage may be helpful for establishing differentiated influenza prevention and control strategies for each age group. METHODS Age distributions were compared between patients infected by influenza A and B viruses and between those infected by the influenza B virus when B/Victoria and B/Yamagata lineages circulated dominantly. RESULTS Between the 2014-2015 and 2018-2019 influenza seasons, 2,718 and 1,397 patients were diagnosed with influenza A and B virus infections, respectively. The median age of patients infected by the influenza B virus was lower than that of patients infected by the influenza A virus (8 vs 12 years, p < 0.001). In the Yamagata season, the median ages of patients infected by influenza A and B viruses were similar (12 vs 11 years, p = 0.732); however, in the Victoria season, the median age of patients infected by the influenza B virus was lower than that of patients infected by the influenza A virus (6 vs 10 years, p < 0.001). In patients infected by the influenza B virus, patients aged <6 years and those aged ≥6 years were more likely to be infected during the Victoria and Yamagata seasons, respectively (p < 0.001). CONCLUSION The age distribution of patients infected by the influenza virus was different between the Yamagata and Victoria seasons. Different influenza prevention and control strategies should be considered on the basis of the predominantly circulating virus and the affected age group.
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Affiliation(s)
- Seung Won Jung
- Department of Pediatrics, College of Medicine, The Catholic University of Korea , Seoul, Republic of Korea.,The Vaccine Bio Research Institute, College of Medicine, The Catholic University of Korea , Seoul, Republic of Korea
| | - Ye Jin Kim
- Department of Pediatrics, College of Medicine, The Catholic University of Korea , Seoul, Republic of Korea
| | - Seung Beom Han
- Department of Pediatrics, College of Medicine, The Catholic University of Korea , Seoul, Republic of Korea.,The Vaccine Bio Research Institute, College of Medicine, The Catholic University of Korea , Seoul, Republic of Korea
| | - Kyung-Yil Lee
- Department of Pediatrics, College of Medicine, The Catholic University of Korea , Seoul, Republic of Korea
| | - Jin Han Kang
- Department of Pediatrics, College of Medicine, The Catholic University of Korea , Seoul, Republic of Korea.,The Vaccine Bio Research Institute, College of Medicine, The Catholic University of Korea , Seoul, Republic of Korea
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14
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Clinical Characteristics and Prognosis of Influenza B Virus-Related Hospitalizations in Northern China during the 2017-18 Influenza Season: A Multicenter Case Series. BIOMED RESEARCH INTERNATIONAL 2019; 2019:8756563. [PMID: 31828141 PMCID: PMC6885173 DOI: 10.1155/2019/8756563] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 08/16/2019] [Accepted: 10/11/2019] [Indexed: 01/20/2023]
Abstract
Background By weekly monitoring of China's influenza situation, Chinese National Influenza Center observed that the 2017-18 season was predominated by influenza B virus (IBV)/Yamagata. No studies regarding hospitalizations in adults with IBV infections have been performed. We aimed to describe the clinical characteristics of hospitalized patients with IBV infection in northern China. Methods In this multicenter and retrospective study, we reviewed all consecutive adult patients with confirmed IBV infections at two level A tertiary teaching hospitals in northern China during the 2017-18 influenza season. Patients' clinical and diagnostic findings, as well as administered treatments and mortality data, were analyzed. Results A total of 573 patients with a confirmed diagnosis of IBV infection were identified, of whom 22 cases were analyzed because of IBV-related hospitalization. Most patients were admitted to the intensive care unit (ICU) and had at least one underlying disease. The total in-hospital mortality was 27.3%. An elevated initial pneumonia severity index score, elevated direct bilirubin values, and lower platelet levels were associated with mortality (p=0.020, 0.013, and 0.049, respectively). The quick development of bilateral diffuse alveolar infiltrates was the most common imaging characteristics, following consolidation and pleural effusion(s). Risk factors such as HIV infection, pregnancy, underlying medical conditions, coinfections, and treatment delays were not associated with mortality. Conclusions IBV should not be neglected because of its significant mortality. The elderly and patients with comorbidities, such as hypertension, diabetes, and connective tissue diseases, are more likely to have severe IBV-related pneumonia. Higher heart rates, direct bilirubin levels, initial PSI scores, and lower platelet levels are correlated with hospital mortality. Increased uptake in tetravalent influenza vaccine should be very helpful in preventing future cases of IBV hospitalizations.
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15
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He G, Yang P, Yan Q, Xiong C. Debate on the compositions of influenza B in northern hemisphere seasonal influenza vaccines. Antimicrob Resist Infect Control 2019; 8:164. [PMID: 31673353 PMCID: PMC6819444 DOI: 10.1186/s13756-019-0631-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Accepted: 10/17/2019] [Indexed: 11/24/2022] Open
Abstract
Background Annual influenza vaccination is the most effective way to prevent influenza. Influenza vaccines have traditionally included the hemagglutinins (HA) and neuraminidases (NA) from the two A viruses (H1N1 and H3N2) and either B Yamagata or B Victoria. Mismatches between circulating isolates of influenza B and the vaccines are very common. Taking 2017/2018 winter in northern hemisphere as an example, this study was designed to find out the reasons for mismatch between the trivalent influenza vaccine (TIV) and most of the epidemic isolates at that time, and to discuss if there are some optimized programs for seasonal influenza vaccines. Methods HA and NA sequences of the seasonal isolates circulating from December 1, 2017 to February 28, 2018, and in the previously other 7 winters in northern hemisphere from Global Initiative on Sharing All Influenza Data (GISAID) and the influenza database of National Center for Biotechnology Information (NCBI). Phylogenetic trees and genetic distances were constructed or calculated by using MAFFT and MEGA 6.0 software. Results Influenza B composition in the TIV recommendation mismatched most of circulating viruses in 2017/2018 winter; the vaccine strain was from the B/Victoria lineage, while most of epidemic isolates were from the B/Yamagata lineage. The epidemic lineage of influenza B reached its peak a little late in the previous winter might be responsible for this mismatch. During 2010-2018, the mean genetic distances between epidemic isolates of influenza A (H1N1 and H3N2) and the vaccines were no higher than 0.02375 ± 0.00341 in both HA and NA. However, concerning influenza B virus, when forecasting done well, the mean genetic distances between epidemic isolates and the vaccines were no higher than 0.02368 ± 0.00272; otherwise, the distances could reach 0.13695 ± 0.00238. Conclusion When applying quadrivalent influenza vaccines (QIVs) for vaccination, the recommendations of compositions for influenza B could be altered and assessed once in 3 or 4 years; when economic burden was considered intensively and TIVs were utilized, the recommended compositions for influenza B could be announced in April or May, rather than in February or March as now.
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Affiliation(s)
- Guozhong He
- Institute of Health, Kunming Medical University, Kunming, 650031 China
| | - Pengfei Yang
- Huai’an Center for Disease Control and Prevention, Huai’an, 223005 China
| | - Qingli Yan
- Huai’an Center for Disease Control and Prevention, Huai’an, 223005 China
| | - Chenglong Xiong
- Department of Public Health Microbiology, School of Public Health, Fudan University, Shanghai, 200032 China
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, 200032 China
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16
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Yaron-Yakoby H, Sefty H, Pando R, Dichtiar R, Katz MA, Stein Y, Mandelboim M, Mendelson E, Shohat T, Glatman-Freedman A. Effectiveness of influenza vaccine in preventing medically-attended influenza virus infection in primary care, Israel, influenza seasons 2014/15 and 2015/16. ACTA ACUST UNITED AC 2019; 23. [PMID: 29471622 PMCID: PMC5824129 DOI: 10.2807/1560-7917.es.2018.23.7.17-00026] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Influenza vaccine is recommended for the entire population in Israel. We assessed influenza vaccine effectiveness (VE) for the 2014/15 and 2015/16 seasons in Israel, for the first time. Methods: Combined nose and throat swab specimens were collected from patients with influenza-like illness (ILI) presenting to sentinel primary care clinics and tested for influenza virus by RT-PCR. VE of the trivalent inactivated vaccine (TIV) was assessed using test-negative case–control design. Results: During the 2014/15 season 1,142 samples were collected; 327 (28.6%) were positive for influenza, 83.8% A(H3N2), 5.8% A(H1N1)pdm09, 9.2% B and 1.2% A un-subtyped. Adjusted VE against all influenza viruses for this influenza season was −4.8% (95% confidence interval (CI): −54.8 to 29.0) and against influenza A(H3N2), it was −15.8% (95% CI: −72.8 to 22.4). For the 2015/16 season, 1,919 samples were collected; 853 (44.4%) were positive for influenza, 43.5% A(H1N1)pdm09, 57% B, 0.7% A(H3N2) and 11 samples positive for both A(H1N1)pdm09 and B. Adjusted VE against all influenza viruses for this influenza season was 8.8% (95% CI: −25.1 to 33.5), against influenza A(H1N1)pdm09, it was 32.3% (95% CI: (−4.3 to 56.1) and against influenza B, it was −2.2% (95% CI: (−47.0 to 29.0). Conclusions: Using samples from patients with ILI visiting sentinel clinics in Israel, we demonstrated the feasibility of influenza VE estimation in Israel.
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Affiliation(s)
- Hamutal Yaron-Yakoby
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine Tel Aviv University, Tel Aviv, Israel
| | - Hanna Sefty
- Israel Center for Disease Control, Israel Ministry of Health, Tel Hashomer, Ramat Gan, Israel
| | - Rakefet Pando
- Central Virology Laboratory, Israel Ministry of Health, Chaim Sheba Medical Center, Ramat Gan, Israel.,Israel Center for Disease Control, Israel Ministry of Health, Tel Hashomer, Ramat Gan, Israel
| | - Rita Dichtiar
- Israel Center for Disease Control, Israel Ministry of Health, Tel Hashomer, Ramat Gan, Israel
| | - Mark A Katz
- School of Public Health, University of Michigan, Ann Arbor, Michigan, United States.,Ben Gurion University, Beer Sheva, Israel
| | - Yaniv Stein
- Israel Center for Disease Control, Israel Ministry of Health, Tel Hashomer, Ramat Gan, Israel
| | - Michal Mandelboim
- Central Virology Laboratory, Israel Ministry of Health, Chaim Sheba Medical Center, Ramat Gan, Israel.,Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine Tel Aviv University, Tel Aviv, Israel
| | - Ella Mendelson
- Central Virology Laboratory, Israel Ministry of Health, Chaim Sheba Medical Center, Ramat Gan, Israel.,Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine Tel Aviv University, Tel Aviv, Israel
| | - Tamy Shohat
- Israel Center for Disease Control, Israel Ministry of Health, Tel Hashomer, Ramat Gan, Israel.,Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine Tel Aviv University, Tel Aviv, Israel
| | - Aharona Glatman-Freedman
- Departments of Pediatrics and Family and Community Medicine, New York Medical College, Valhalla, New York, United States.,Israel Center for Disease Control, Israel Ministry of Health, Tel Hashomer, Ramat Gan, Israel.,Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine Tel Aviv University, Tel Aviv, Israel
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- The members of the group are listed at the end of the paper
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17
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Cohen R, Babushkin F, Geller K, Finn T. Characteristics of hospitalized adult patients with laboratory documented Influenza A, B and Respiratory Syncytial Virus - A single center retrospective observational study. PLoS One 2019; 14:e0214517. [PMID: 30921408 PMCID: PMC6438521 DOI: 10.1371/journal.pone.0214517] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Accepted: 03/15/2019] [Indexed: 01/20/2023] Open
Abstract
Introduction The epidemiology, clinical features and outcomes of hospitalized adult patients with Influenza A (FluA), Influenza B (FluB) and Respiratory Syncytial Virus (RSV) have not been thoroughly compared. The aim of this study was to describe the differences between these viruses during 3 winter seasons. Methods A retrospective observational study was conducted consisting of all the polymerase chain reaction (PCR)-based diagnoses of FluA, FluB and RSV among adults during 2015–2018, in one regional hospital. Epidemiology, clinical symptoms and outcome-related data were comparatively analyzed. Results Between November 2015 and April 2018, 759 patients were diagnosed with FluA, FluB or RSV. Study cohort included 539 adult patients (306 FluA, 148 FluB and 85 RSV). FluB was predominant during the winter of 2017–18. RSV caused 15.7% of hospitalizations with diagnosed viral infection and in comparison to influenza, had distinct epidemiological, clinical features and outcomes, including older age (74.2 vs 66.2, p = 0.001) and higher rates of co-morbidities; complications including bacterial pneumonia (31 vs 18%, p = 0.02), mechanical ventilation (20 vs 7%, p = 0.001), and viral-related death (13 vs 6.6%, p = 0.04). FluA and FluB had similar epidemiology, clinical symptoms and outcomes, but vaccinated patients were less prone to be hospitalized with FluB as compared with FluA (3 vs 14%, p = 0.001). Paroxysmal atrial fibrillation and falls were common (8.7 and 8.5% respectively). Conclusions FluA and FluB had similar epidemiological, clinical features and contributed equally to hospitalization burden and complications. RSV had a major impact on hospitalizations, occurring among the more elderly and sick populations and causing significantly worse outcomes, when compared to influenza patients. Vaccination appeared as a protective factor against hospitalizations with FluB as compared with FluA.
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Affiliation(s)
- Regev Cohen
- Infectious Diseases Unit, Sanz Medical Center, Laniado Hospital, Neytanya, Israel
- Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel
- * E-mail: ,
| | - Frida Babushkin
- Infectious Diseases Unit, Sanz Medical Center, Laniado Hospital, Neytanya, Israel
| | - Keren Geller
- Infectious Diseases Unit, Sanz Medical Center, Laniado Hospital, Neytanya, Israel
| | - Talya Finn
- Infectious Diseases Unit, Sanz Medical Center, Laniado Hospital, Neytanya, Israel
- Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel
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Korsun NS, Angelova SG, Trifonova IT, Georgieva IL, Tzotcheva IS, Mileva SD, Voleva SE, Kurchatova AM, Perenovska PI. Predominance of influenza B/Yamagata lineage viruses in Bulgaria during the 2017/2018 season. Epidemiol Infect 2019; 147:e76. [PMID: 30869003 PMCID: PMC6518837 DOI: 10.1017/s0950268818003588] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 11/18/2018] [Accepted: 12/12/2018] [Indexed: 12/14/2022] Open
Abstract
In this study, we investigated the antigenic and genetic characteristics of influenza viruses circulating in Bulgaria during the 2017/2018 season. The detection and typing/subtyping of influenza viruses were performed using real-time RT-PCR. Results of antigenic characterisation, phylogenetic and amino acid sequence analyses of representative influenza strains are presented. The season was characterised by the predominance of B/Yamagata viruses, accounting for 77% of detected influenza viruses, followed by A(H1N1)pdm09 (17%), B/Victoria (3.7%) and A(H3N2) (2.4%). The sequenced B/Yamagata, B/Victoria, A(H1N1)pdm09 and A(H3N2) viruses belonged to the genetic groups 3, 1A, 6B.1 and 3C.2a1, respectively. Amino acid analysis of B/Yamagata isolates revealed the presence of three changes in haemagglutinin (HA), eight changes in neuraminidase (NA) and a number of substitutions in internal proteins compared with the B/Phucket/3073/2013 vaccine virus. Despite the amino acid changes, B/Yamagata viruses remained antigenically related to the vaccine strain. B/Victoria isolates fell into a group of viruses with double deletion (Δ162-163) in HA1. Substitutions in HA and NA sequences of B/Victoria, A(H1N1)pdm09 and A(H3N2) viruses were also identified compared with the vaccine strains, including in antigenic sites. The results of this study confirm the genetic variability of circulating influenza viruses and the need for continual antigenic and molecular surveillance.
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Affiliation(s)
- N. S. Korsun
- Department of Virology, National Centre of Infectious and Parasitic Diseases (NCIPD), Sofia, Bulgaria
| | - S. G. Angelova
- Department of Virology, National Centre of Infectious and Parasitic Diseases (NCIPD), Sofia, Bulgaria
| | - I. T. Trifonova
- Department of Virology, National Centre of Infectious and Parasitic Diseases (NCIPD), Sofia, Bulgaria
| | - I. L. Georgieva
- Department of Virology, National Centre of Infectious and Parasitic Diseases (NCIPD), Sofia, Bulgaria
| | - I. S. Tzotcheva
- Paediatric Clinic, University Hospital Alexandrovska, Sofia Medical University, Sofia, Bulgaria
| | - S. D. Mileva
- Paediatric Clinic, University Hospital Alexandrovska, Sofia Medical University, Sofia, Bulgaria
| | - S. E. Voleva
- Department of Virology, National Centre of Infectious and Parasitic Diseases (NCIPD), Sofia, Bulgaria
| | - A. M. Kurchatova
- Department of Epidemiology, National Centre of Infectious and Parasitic Diseases (NCIPD), Sofia, Bulgaria
| | - P. I. Perenovska
- Paediatric Clinic, University Hospital Alexandrovska, Sofia Medical University, Sofia, Bulgaria
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Ye F, Chen XJ, Guan WD, Pan SH, Yang ZF, Chen RC. Analysis of influenza B virus lineages and the HA1 domain of its hemagglutinin gene in Guangzhou, southern China, during 2016. Virol J 2018; 15:175. [PMID: 30428893 PMCID: PMC6236879 DOI: 10.1186/s12985-018-1085-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Accepted: 10/21/2018] [Indexed: 02/05/2023] Open
Abstract
Background Few studies have analyzed influenza B virus lineages based on hemagglutinin A (HA) gene sequences in southern China. The present study analyzed the HA gene and the lineages of influenza B virus isolates from Guangzhou during 2016, and compared our results with the WHO-recommended vaccine strain. Methods Ninety patients with influenza B were recruited from the First Hospital of Guangzhou Medical University. Throat swab specimens of 72 patients had high viral loads. Among these 72 isolates, the HA1 domain of the HA gene in 43 randomly selected isolates was sequenced using reverse transcription-polymerase chain reaction (RT-PCR), and analyzed using MEGA 5.05. Results Eight of the 90 patients (8.9%) also had influenza A virus infections. Analysis of the 43 influenza B virus isolates indicated that 34 (79.1%) were from the Victoria lineage and 9 (20.9%) were from the Yamagata lineage. A comparison isolates in our Victoria lineage with the B/Brisbane/60/2008 strain indicated 12 mutation sites in the HA1 domain, 4 of which (I132V, N144D, C196S, and E198D) were in antigenic epitopes. A comparison of isolates in our Yamagata lineage with the B/Phuket/3073/2013 stain indicated 5 mutation sites in the HA1 domain, none of which was in an antigenic epitope. None of the isolates had a mutation in regions of the neuraminidase gene (NA) that are known to confer resistance to NA inhibitors. Conclusion In Guangzhou during 2016, most influenza B virus isolates were from the Victoria lineage, in contrast to the vaccine strain recommended by the WHO for this period. Electronic supplementary material The online version of this article (10.1186/s12985-018-1085-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Feng Ye
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease; Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, 151 Yan Jiang Road, Guangzhou, Guangdong, 510120, People's Republic of China.
| | - Xiao-Juan Chen
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease; Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, 151 Yan Jiang Road, Guangzhou, Guangdong, 510120, People's Republic of China
| | - Wen-da Guan
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease; Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, 151 Yan Jiang Road, Guangzhou, Guangdong, 510120, People's Republic of China
| | - Si-Hua Pan
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease; Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, 151 Yan Jiang Road, Guangzhou, Guangdong, 510120, People's Republic of China
| | - Zi-Feng Yang
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease; Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, 151 Yan Jiang Road, Guangzhou, Guangdong, 510120, People's Republic of China
| | - Rong-Chang Chen
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease; Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, 151 Yan Jiang Road, Guangzhou, Guangdong, 510120, People's Republic of China
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20
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Pando R, Sharabi S, Mandelboim M. Exceptional influenza morbidity in summer season of 2017 in Israel may predict the vaccine efficiency in the coming winter. Vaccine 2018; 36:1326-1329. [PMID: 29429813 DOI: 10.1016/j.vaccine.2018.01.085] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 01/17/2018] [Accepted: 01/28/2018] [Indexed: 10/18/2022]
Abstract
Influenza infections are the leading cause of respiratory viral infections worldwide, and are mostly common in the winter season. The seasonal influenza vaccine is currently the most effective preventive modality against influenza infection. Immediately following each winter season the World Health Organization (WHO) announces the vaccine composition for the following winter. Unexpectedly, during the summer of 2017, in Israel, we observed in hospitalized patients, an exceptionally high numbers of Influenza positive cases. The majority of the influenza B infections were caused by influenza B/Yamagata lineage, which did not circulate in Israel in the previous winter, and most of the influenza A infections were caused by influenza A/H3N2, a strain similar to the strain that circulated in Israel in the previous winter. We therefore predict that these two viruses will circulate in the coming winter of 2017/18 and that the trivalent vaccine, which includes antigenically different viruses will be inefficient.
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Affiliation(s)
- Rakefet Pando
- The Israel Center for Disease Control, Israel Ministry of Health, Tel-Hashomer, Israel; Central Virology Laboratory, Ministry of Health, Chaim Sheba Medical Center, Ramat-Gan, Israel
| | - Sivan Sharabi
- Central Virology Laboratory, Ministry of Health, Chaim Sheba Medical Center, Ramat-Gan, Israel; Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Michal Mandelboim
- Central Virology Laboratory, Ministry of Health, Chaim Sheba Medical Center, Ramat-Gan, Israel; Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
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21
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Sansone M, Wiman Å, Karlberg ML, Brytting M, Bohlin L, Andersson LM, Westin J, Nordén R. Molecular characterization of a nosocomial outbreak of influenza B virus in an acute care hospital setting. J Hosp Infect 2018; 101:30-37. [PMID: 29909095 PMCID: PMC7114871 DOI: 10.1016/j.jhin.2018.06.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 06/04/2018] [Indexed: 01/21/2023]
Abstract
Aim To describe a hospital outbreak of influenza B virus (InfB) infection during season 2015/2016 by combining clinical and epidemiological data with molecular methods. Methods Twenty patients diagnosed with InfB from a hospital outbreak over a four-week-period were included. Nasopharyngeal samples (NPS) positive for InfB by multiplex real-time polymerase chain reaction were sent for lineage typing and whole genome sequencing (WGS). Medical records were reviewed retrospectively for data regarding patient characteristics, localization, exposure and outcome, and assembled into a timeline. In order to find possible connections to the hospital outbreak, all patients with a positive NPS for influenza from the region over an extended time period were also reviewed. Findings All 20 cases of InfB were of subtype B/Yamagata, and 17 of 20 patients could be linked to each other by either shared room or shared ward. WGS was successful or partially successful for 15 of the 17 viral isolates, and corroborated the epidemiological link supporting a close relationship. In the main affected ward, 19 of 75 inpatients were infected with InfB during the outbreak period, resulting in an attack rate of 25%. One probable case of influenza-related death was identified. Conclusion InfB may spread within an acute care hospital, and advanced molecular methods may facilitate assessment of the source and extent of the outbreak. A multi-faceted approach, including rapid diagnosis, early recognition of outbreak situations, simple rules for patient management and the use of regular infection control measures, may prevent nosocomial transmission of influenza virus.
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Affiliation(s)
- M Sansone
- Institute of Biomedicine, Department of Infectious Diseases, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | - Å Wiman
- Public Health Agency of Sweden, Solna, Sweden
| | | | - M Brytting
- Public Health Agency of Sweden, Solna, Sweden
| | - L Bohlin
- Department of Internal Medicine, Kungalv Hospital, Kungalv, Sweden
| | - L-M Andersson
- Institute of Biomedicine, Department of Infectious Diseases, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - J Westin
- Institute of Biomedicine, Department of Infectious Diseases, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - R Nordén
- Institute of Biomedicine, Department of Infectious Diseases, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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22
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Cortes-Alcala R, Dos Santos G, DeAntonio R, Devadiga R, Ruiz-Matus C, Jimenez-Corona ME, Diaz-Quinonez JA, Romano-Mazzotti L, Cervantes-Apolinar MY, Kuri-Morales P. The burden of influenza A and B in Mexico from the year 2010 to 2013: An observational, retrospective, database study, on records from the Directorate General of Epidemiology database. Hum Vaccin Immunother 2018; 14:1890-1898. [PMID: 29746798 PMCID: PMC6149840 DOI: 10.1080/21645515.2018.1456281] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Accepted: 03/09/2018] [Indexed: 11/01/2022] Open
Abstract
Despite vaccination programs, influenza still represents a significant disease burden in Mexico. We conducted an observational, retrospective analysis to better understand the epidemiological situation of the influenza virus in Mexico. Analysis of the seasonal patterns of influenza A and B were based on the Directorate General of Epidemiology dataset of influenza-like illness(ILI), and severe acute respiratory infection(SARI) that were recorded between January 2010 and December 2013. Our objectives were 1) to describe influenza A and B activity, by age group, and subtype and, 2) to analyze the number of laboratory-confirmed cases presenting with ILI by influenza type, the regional distribution of influenza, and its clinical features. Three periods of influenza activity were captured: August 2010-January 2011, December 2011-March 2012, and October 2012-March 2013. Cases were reported throughout Mexico, with 50.3% (n = 10,320) of cases found in 18-49 year olds. Over the entire capture period, a total of 76,085 ILI/SARI episodes had swab samples analyzed for influenza, 27% were positive. During the same period, influenza A cases were higher in the 18-49 years old, and influenza B cases in both 5-17 and 18-49 age groups. Peak activity occurred in January 2012 (n = 4,159) and December 2012 (n = 348) for influenza A and B respectively. This analysis confirms that influenza is an important respiratory pathogen for children and adults in Mexico despite vaccination recommendations. School-age children and adolescents were more prone to influenza B infection; while younger adults were susceptible to both influenza A and B viruses. Over the seasons, influenza A and B co-circulated.
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Affiliation(s)
| | | | - Rodrigo DeAntonio
- GSK, Urbanización Industrial Juan Díaz Entre Calles A y B, Apartado Postal 6-1697, Panama City, Panama
| | - Raghavendra Devadiga
- GSK, 5, Embassy Links, SRT Road, Opp to Accenture, Cunningham Road, Vasanth Nagar, Bengaluru, Karnataka, India
| | - Cuitlahuac Ruiz-Matus
- Director General of Epidemiology, Ministry of Health, Francisco de P. Miranda 177 Lomas de Plateros, Ciudad de México, México
| | - Maria E. Jimenez-Corona
- Deputy Director General of Epidemiology, Ministry of Health, Francisco de P. Miranda 177 Lomas de Plateros, Ciudad de México, México
| | - Jose A. Diaz-Quinonez
- Deputy Director General of the Institute for Epidemic Diagnose and Reference, Ministry of Health, Francisco de P. Miranda 177 Lomas de Plateros, Ciudad de México, México
- Faculty of Medicine, National Autonomous University of Mexico, Division of Graduate Studies, Avenida Universidad 3000, Copilco El Bajo, Coyoacan, CDMX, Ciudad de México, México
| | | | | | - Pablo Kuri-Morales
- Faculty of Medicine, National Autonomous University of Mexico, Division of Graduate Studies, Avenida Universidad 3000, Copilco El Bajo, Coyoacan, CDMX, Ciudad de México, México
- Assistant Secretary for Health Promotion and Disease Prevention, Lieja No. 7, Col. Juarez, Ciudad de México, México
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23
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Sesay S, Brzostek J, Meyer I, Donazzolo Y, Leroux-Roels G, Rouzier R, Astruc B, Szymanski H, Toursarkissian N, Vandermeulen C, Kowalska E, Van Damme P, Salamand C, Pepin S. Safety, immunogenicity, and lot-to-lot consistency of a split-virion quadrivalent influenza vaccine in younger and older adults: A phase III randomized, double-blind clinical trial. Hum Vaccin Immunother 2017; 14:596-608. [PMID: 28968138 PMCID: PMC5861783 DOI: 10.1080/21645515.2017.1384106] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Here, we report a randomized multicenter phase III trial assessing the lot-to-lot consistency of the 2014–2015 Northern Hemisphere quadrivalent split-virion inactivated influenza vaccine (IIV4; Sanofi Pasteur) and comparing its immunogenicity and safety with that of trivalent inactivated influenza vaccine (IIV3) in younger and older adults (EudraCT no. 2014-000785-21). Younger (18–60 y, n = 1114) and older (>60 y, n = 1111) adults were randomized 2:2:2:1:1 to receive a single dose of one of three lots of IIV4, the licensed IIV3 containing the B Yamagata lineage strain, or an investigational IIV3 containing the B Victoria lineage strain. Post-vaccination (day 21) hemagglutination inhibition antibody titers were equivalent for the three IIV4 lots. For the pooled IIV4s vs. IIV3, hemagglutination inhibition antibody titers were also non-inferior for the A strains, non-inferior for the B strain when present in the comparator IIV3, and superior for the B strain lineage when absent from the comparator IIV3. For all vaccine strains, seroprotection rates were ≥98% in younger adults and ≥90% in older adults. IIV4 also increased seroneutralizing antibody titers against all three vaccine strains of influenza. All vaccines were well tolerated, with no safety concerns identified. Solicited injection-site reactions were similar for IIV4 and IIV3 and mostly grade 1 and transient. This study showed that in younger and older adults, IIV4 had a similar safety profile as the licensed IIV3 and that including a second B strain lineage in IIV4 provided superior immunogenicity for the added B strain without affecting the immunogenicity of the three IIV3 strains.
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Affiliation(s)
| | - Jerzy Brzostek
- b Clinic of Infectious Diseases Health Care Team , Dębica , Poland
| | - Ingo Meyer
- c CRS Clinical Research Services Kiel GmbH , Lübeck , Germany
| | | | - Geert Leroux-Roels
- e Center for Vaccinology, Ghent University and University Hospital , Gent , Belgium
| | - Régine Rouzier
- f Centre CAP, Centre Médical Odysseum , Montpellier , France
| | | | - Henryk Szymanski
- h St Hedwig of Silesia Hospital , Department of Paediatrics , Prusicka , Trzebnica , Poland
| | | | | | | | - Pierre Van Damme
- l Centre for the Evaluation of Vaccination, Vaccine & Infectious Disease Institute , Antwerpen (Wilrijk) , Belgium
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24
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Skowronski DM, Chambers C, De Serres G, Sabaiduc S, Winter AL, Dickinson JA, Gubbay JB, Fonseca K, Drews SJ, Charest H, Martineau C, Krajden M, Petric M, Bastien N, Li Y. Age-Related Differences in Influenza B Infection by Lineage in a Community-Based Sentinel System, 2010-2011 to 2015-2016, Canada. J Infect Dis 2017; 216:697-702. [PMID: 28934439 PMCID: PMC5853978 DOI: 10.1093/infdis/jix393] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 08/03/2017] [Indexed: 11/29/2022] Open
Abstract
Age-related differences in influenza B lineage detection were explored in the community-based Canadian Sentinel Practitioner Surveillance Network (SPSN) from 2010–2011 to 2015–2016. Whereas >80% of B(Victoria) cases were <40 years old, B(Yamagata) cases showed a bimodal age distribution with 27% who were <20 years old and 61% who were 30–64 years old, but with a notable gap in cases between 20 and 29 years old (4%). Overall, the median age was 20 years lower for B(Victoria) vs B(Yamagata) cases (20 vs 40 years; P < .01). Additional phylodynamic and immuno-epidemiological research is needed to understand age-related variation in influenza B risk by lineage, with potential implications for prevention and control across the lifespan.
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Affiliation(s)
- Danuta M Skowronski
- British Columbia Centre for Disease Control.,University of British Columbia, Vancouver
| | | | - Gaston De Serres
- Institut National de Santé Publique du Québec.,Laval University.,Centre Hospitalier Universitaire de Québec, Québec City
| | | | | | | | | | - Kevin Fonseca
- University of Calgary, Alberta.,Alberta Provincial Laboratory, Calgary
| | - Steven J Drews
- Alberta Provincial Laboratory, Edmonton.,University of Alberta, Edmonton
| | | | | | - Mel Krajden
- British Columbia Centre for Disease Control.,University of British Columbia, Vancouver
| | | | - Nathalie Bastien
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Yan Li
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
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25
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Knuf M, Kunze A. Influenza. Monatsschr Kinderheilkd 2016. [DOI: 10.1007/s00112-016-0182-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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