Antibody status to influenza A/Singapore/1/57(H2N2) in Finland during a period of outbreaks caused by H3N2 and H1N1 subtype viruses

The incidence of haemagglutination inhibition (HI) antibody (titre greater than or equal to 12) to influenza A/Singapore/1/57(H2N2) in sera collected from a Finnish population in the summer of 1981 was 58%. Subjects born after 1968 were essentially seronegative, and a comparable low HI antibody status was also recorded among the elderly, the lowest being in people born during the period 1901-10. A small increase in antibody titre to the H2N2 virus was observed in the different age groups after infections with the H3N2, but not the H1N1, subtype influenza A viruses. The heterotypic response, which could be due to HI or NA antibodies, was restricted almost exclusively to subjects already exhibiting this antibody in acute phase sera. Moreover, the anamnestic boosting was not as strong as that described in earlier studies from samples collected at the beginning of the present era of H3N2 viruses. At population level, the HI antibody status to H2N2 was about the same at the beginning and end of the follow-up period which covered eight epidemic seasons. The results are discussed with respect to the doctrine of 'original antigenic sin' and to the threat of re-emergence of the H2N2 viruses.     

Antibody status to influenza A/Singapore/1/57(H2N2) in Finland during a period of outbreaks caused by H3N2 and H1N1 subtype viruses.

The incidence of haemagglutination inhibition (HI) antibody (titre greater than or equal to 12) to influenza A/Singapore/1/57(H2N2) in sera collected from a Finnish population in the summer of 1981 was 58%. Subjects born after 1968 were essentially seronegative, and a comparable low HI antibody status was also recorded among the elderly, the lowest being in people born during the period 1901-10. A small increase in antibody titre to the H2N2 virus was observed in the different age groups after infections with the H3N2, but not the H1N1, subtype influenza A viruses. The heterotypic response, which could be due to HI or NA antibodies, was restricted almost exclusively to subjects already exhibiting this antibody in acute phase sera. Moreover, the anamnestic boosting was not as strong as that described in earlier studies from samples collected at the beginning of the present era of H3N2 viruses. At population level, the HI antibody status to H2N2 was about the same at the beginning and end of the follow-up period which covered eight epidemic seasons. The results are discussed with respect to the doctrine of ''original antigenic sin'' and to the threat of re-emergence of the H2N2 viruses.     

A one-year study of trivalent influenza vaccines in primed and unprimed volunteers: immunogenicity, clinical reactions and protection

Three hundred volunteers were divided into two age groups, 14-30 years and 31-60 years. Each participant was immunized intramuscularly with a subunit, whole virus or absorbed whole virus vaccine, containing A/Bangkok/1/79 (H3N2), A/Brazil/11/78 (H1N1) and B/Singapore/222/79 influenza virus. Serum haemagglutination-inhibition (HI) antibody response, protection, and reactogenicity were studied after one and two doses of the vaccines. Primary immunization induced much higher percentages of HI antibody titres greater than or equal to 100 against all three vaccine viruses and much higher geometric mean titres (GMT) in volunteers with pre-immunization titres greater than or equal to 18 as compared to those with pre-immunization titres less than 18. Secondary immunization did not result in an increase of GMTs or antibody titres greater than or equal to 100 in volunteers with pre-immunization titres less than 18. On the whole, the response to the subunit vaccine was similar to that to the other two vaccines. To influenza B/Singapore/222/79 virus the response was lowest after administration of the whole virus vaccine in the age group 31-60 years. Over 50% of the HI titres greater than or equal to 100 found after immunization in the different vaccine and age groups were still present after one year. Serologically established infections during the winter months following immunization amounted to 15% in the subunit vaccine group, 6% in the whole virus vaccine group, and 10% in the adsorbed whole virus vaccine group. Local and systemic reactions to all three vaccines were mild in nature. Local reactions after primary immunization were much less frequent following administration of the subunit vaccine as compared to the other two vaccines, especially in the younger age group. In comparison to primary immunization, after booster immunization the incidence of local reactions was higher for the subunit vaccine and lower for the adsorbed whole virus vaccine. In the age group 14-30 years the incidence of local reactions after primary as well as booster immunization was much greater in females than in males, especially when the adsorbed whole virus vaccine was used.     

A one-year study of trivalent influenza vaccines in primed and unprimed volunteers: immunogenicity, clinical reactions and protection.

Three hundred volunteers were divided into two age groups, 14-30 years and 31-60 years. Each participant was immunized intramuscularly with a subunit, whole virus or absorbed whole virus vaccine, containing A/Bangkok/1/79 (H3N2), A/Brazil/11/78 (H1N1) and B/Singapore/222/79 influenza virus. Serum haemagglutination-inhibition (HI) antibody response, protection, and reactogenicity were studied after one and two doses of the vaccines. Primary immunization induced much higher percentages of HI antibody titres greater than or equal to 100 against all three vaccine viruses and much higher geometric mean titres (GMT) in volunteers with pre-immunization titres greater than or equal to 18 as compared to those with pre-immunization titres less than 18. Secondary immunization did not result in an increase of GMTs or antibody titres greater than or equal to 100 in volunteers with pre-immunization titres less than 18. On the whole, the response to the subunit vaccine was similar to that to the other two vaccines. To influenza B/Singapore/222/79 virus the response was lowest after administration of the whole virus vaccine in the age group 31-60 years. Over 50% of the HI titres greater than or equal to 100 found after immunization in the different vaccine and age groups were still present after one year. Serologically established infections during the winter months following immunization amounted to 15% in the subunit vaccine group, 6% in the whole virus vaccine group, and 10% in the adsorbed whole virus vaccine group. Local and systemic reactions to all three vaccines were mild in nature. Local reactions after primary immunization were much less frequent following administration of the subunit vaccine as compared to the other two vaccines, especially in the younger age group. In comparison to primary immunization, after booster immunization the incidence of local reactions was higher for the subunit vaccine and lower for the adsorbed whole virus vaccine. In the age group 14-30 years the incidence of local reactions after primary as well as booster immunization was much greater in females than in males, especially when the adsorbed whole virus vaccine was used.     

Studies with inactivated equine influenza vaccine. 1. Serological responses of ponies to graded doses of vaccine.

Serological responses to three bivalent aqueous equine influenza vaccines of different potency and an adjuvanted bivalent vaccine containing inactivated A/equine/Prague/56 (H7N7) and A/equine/Miami/63 (H3N8) viruses, were examined in seronegative ponies. Potencies of the vaccines, measured by single-radial-diffusion tests, ranged from 4 to 56 micrograms of haemagglutinin (HA) antigen activity/virus strain per dose. Serological responses to vaccination were examined by haemagglutination-inhibition (HI) and single-radial-haemolysis (SRH) tests. Four weeks after a primary dose, HI responses to both vaccine viruses were barely detectable; after a second dose the HI responses to A/Miami/63 virus were low or undetectable but HI responses to A/Prague/56 virus were higher (17/20 ponies with titres greater than or equal to 1:16). In contrast SRH tests revealed dose-related antibody responses to both virus strains after one and two vaccine doses; levels after the second dose were 2- to 5-fold higher than after the primary dose. Highest post-vaccination antibody titres were obtained with the adjuvanted vaccine which contained 2- to 4-fold less antigen (13-23 micrograms HA) than the most potent aqueous vaccine. Post-vaccination antibody reacted well in SRH tests with recent antigenic variants of equine influenza virus. A remarkable finding was the high rate of decline in antibody, detected by HI or SRH tests, following one or two doses of vaccine. Even in animals with the highest post-vaccine antibody levels 2-4 weeks after a booster dose, antibody levels had declined to low or indetectable levels 14 weeks later. The low antibody titres detected at 14-32 weeks after vaccination were nevertheless vaccine dose-related.     

Studies with inactivated equine influenza vaccine. 1. Serological responses of ponies to graded doses of vaccine

Serological responses to three bivalent aqueous equine influenza vaccines of different potency and an adjuvanted bivalent vaccine containing inactivated A/equine/Prague/56 (H7N7) and A/equine/Miami/63 (H3N8) viruses, were examined in seronegative ponies. Potencies of the vaccines, measured by single-radial-diffusion tests, ranged from 4 to 56 micrograms of haemagglutinin (HA) antigen activity/virus strain per dose. Serological responses to vaccination were examined by haemagglutination-inhibition (HI) and single-radial-haemolysis (SRH) tests. Four weeks after a primary dose, HI responses to both vaccine viruses were barely detectable; after a second dose the HI responses to A/Miami/63 virus were low or undetectable but HI responses to A/Prague/56 virus were higher (17/20 ponies with titres greater than or equal to 1:16). In contrast SRH tests revealed dose-related antibody responses to both virus strains after one and two vaccine doses; levels after the second dose were 2- to 5-fold higher than after the primary dose. Highest post-vaccination antibody titres were obtained with the adjuvanted vaccine which contained 2- to 4-fold less antigen (13-23 micrograms HA) than the most potent aqueous vaccine. Post-vaccination antibody reacted well in SRH tests with recent antigenic variants of equine influenza virus. A remarkable finding was the high rate of decline in antibody, detected by HI or SRH tests, following one or two doses of vaccine. Even in animals with the highest post-vaccine antibody levels 2-4 weeks after a booster dose, antibody levels had declined to low or indetectable levels 14 weeks later. The low antibody titres detected at 14-32 weeks after vaccination were nevertheless vaccine dose-related.     

Serological evaluation of an influenza A virus cold-adapted reassortant live vaccine, CR-37 (H1N1), in Japanese adult volunteers

A cold-adapted influenza A virus, CR-37 (H1N1), derived from genetic reassortment between A/Ann Arbor/6/60 (H2N2) cold-adapted variant virus and A/California/10/78 (H1N1) wild-type virus, was tested in Japanese adult volunteer. The CR-37 live virus preparation induced only low-grade clinical reactions in volunteers for the first 3-4 days after inoculation. Two vaccinees who did not show any antibody changes became febrile (over 38.0 degrees C). Skin tests using the vaccine preparation and uninfected allantoic fluid were performed, and indicated that one of these two vaccines was positive for the CR-37 vaccine preparation. A high proportion of the vaccinees whose sera had a haemagglutination-inhibition (HI) antibody titre against the vaccine strain of less than or equal to 64 before inoculation, seroconverted in both HI and neuraminidase-inhibition (NAI) antibody titrations, and only a few seroconverted in the titration of antibody against type-specific internal antigens. The serological examinations against heterotypic H1N1 variants indicated that the cold-adapted live influenza virus vaccine could induce a broad spectrum of HI antibody reactivity and immunity of long duration.     

Serological evaluation of an influenza A virus cold-adapted reassortant live vaccine, CR-37 (H1N1), in Japanese adult volunteers.

A cold-adapted influenza A virus, CR-37 (H1N1), derived from genetic reassortment between A/Ann Arbor/6/60 (H2N2) cold-adapted variant virus and A/California/10/78 (H1N1) wild-type virus, was tested in Japanese adult volunteer. The CR-37 live virus preparation induced only low-grade clinical reactions in volunteers for the first 3-4 days after inoculation. Two vaccinees who did not show any antibody changes became febrile (over 38.0 degrees C). Skin tests using the vaccine preparation and uninfected allantoic fluid were performed, and indicated that one of these two vaccines was positive for the CR-37 vaccine preparation. A high proportion of the vaccinees whose sera had a haemagglutination-inhibition (HI) antibody titre against the vaccine strain of less than or equal to 64 before inoculation, seroconverted in both HI and neuraminidase-inhibition (NAI) antibody titrations, and only a few seroconverted in the titration of antibody against type-specific internal antigens. The serological examinations against heterotypic H1N1 variants indicated that the cold-adapted live influenza virus vaccine could induce a broad spectrum of HI antibody reactivity and immunity of long duration.     

Antibody responses after repeated influenza A virus immunizations among schoolchildren in Japan.

Antibody responses to influenza virus immunizations were examined among junior high school students. The students received two doses of a commercial split-product vaccine containing influenza A H1N1 during a 2-year period following the first appearance of H1N1 virus in the winter of 1977-78. In haemagglutination-inhibition (HI) tests, the students who had been infected with H1N1 virus in 1977-78 showed a better response and wider cross-reactivity to the drift strain than the students who had not experienced earlier H1N1 influenza infection. Neuraminidase-inhibition (NAI) antibody titres after immunization depended upon a history of natural infection with H1N1 virus, since students not previously infected showed no significant NAI antibody rise after immunization.     

Inactivated influenza virus vaccines in man: a comparative study of subunit and split vaccines using two methods for assessment of antibody responses

The serum antibody responses and reactions of volunteers to a trivalent subunit influenza virus vaccine prepared using cetyl trimethyl ammonium bromide (CTAB) or trivalent split vaccine prepared by ether-extraction, were essentially similar, although the antibody levels to the A/Brazil/78 (H1N1) components of the vaccine were greater in volunteers receiving the subunit preparation. Antibody responses to the vaccines were assessed using both the haemagglutination-inhibition (HI) and single radial haemolysis (SRH) tests. Although good correlation was found between the tests with respect to both antibody titres in individual sera and antibody responses in serum pairs to both A(H3N2 and H1N1) and B influenza viruses, the greater reliability of SRH, indicates this test should supplant the HI test for the routine measurement of antibody responses to influenza viruses.     

Comparison of influenza viruses isolated from man and from whales.

Four isolates of influenza virus strains from Moscow and Habarovsk that caused outbreaks of influenza in November and December 1977 in several cities of the USSR were studied and their haemagglutinins and neuraminidases were compared with those of other human and animal influenza viruses including A/whale/Pacific Ocean/76. In H1 tests these isolates, designated A/USSR/77, reacted with immune serum against A/FM/1/47 (H1N1) to the homologous titre, and with antiserum against A/whale/PO/19/76 virus to 1/8 of the homologous titre. In neuraminidase inhibition tests all A/USSR/77 isolates showed the presence of human N1 type neuraminidase, more closely related to A/sw/New Jersey/76 (Hsw1N1) than to A/FM/1/47 (H1N1) virus. The haemagglutinin of A/whale/Pacific Ocean/19/76 virus occupies an intermediate position between H0 and H1, but its neuraminidase is close to Nav2. The virus from whales multiplies better at low (28°C) and at high (40°C) temperatures than do the viruses of human origin that were tested.     

Evaluation of age-related differences in the immunogenicity of a G9 H9N2 influenza vaccine

Avian influenza A/H9N2 viruses can infect people and are viruses considered to be a potential pandemic threat. Prior studies with an inactivated G1 clade H9N2 vaccine reported that persons born before 1968 were more likely to have an immune response than younger subjects. We performed a randomized, double-blind trial to evaluate whether immune responses following immunization with an inactivated, unadjuvanted influenza G9 H9N2 vaccine prepared from A/chicken/Hong Kong/G9/97 virus were more frequent in persons born in 1964 or earlier (44-59 years) than in those born in 1970 or later (18-38 years). One hundred twenty one persons were randomized to receive two doses of either 7.5- or 30-mcg of hemagglutinin intramuscularly. Post-vaccination serum antibody responses as measured by hemagglutination inhibition and microneutralization were either similar in the two age cohorts or greater in the younger age group. Persons born before 1968 were not more likely to respond to a G9 H9N2 influenza vaccine than persons born in 1970 or later.     

Antigenicity in hamsters of inactivated vaccines prepared from recombinant influenza viruses.

Inactivated vaccines prepared form influenza virus strains obtained by the recombination of A/PR/8/34 (H1N1) or A/FM/1/47 (H1N1) viruses with A/Victoria/3/75 (H3N2) virus, were tested for their antigenicity in hamsters. The parental origin of the genes of each cloned recombinant virus was determined by polyacrylamide gel electrophoresis, and vaccines prepared from each strain by concentration, purification on sucrose density gradients and inactivation with formalin. All the recombinant strains used in these studies possessed surface haemagglutinin and neuraminidase antigens derived from the A/Victoria/75 parent strain. On inoculation into hamsters, at equivalent concentrations, these vaccines varied in their ability to induce haemagglutination-inhibiting (HI) antibodies in the serum. This variation was not dependent on concentration and was observed using neutralization and single radial haemolysis, as well as HI. The possible reasons for the findings are discussed.     

上海市人群甲型流感病毒H1、H3、H5、H9抗体血清学监测

[目的 ]　了解上海市人群对甲 3型、甲 1型流感病毒和禽流感病毒H9、H5的抗体 ,探讨甲 3型、甲 1型流感流行的趋势和禽流感病毒H9、H5抗体存在情况。　 [方法 ]　应用常规血凝抑制试验微量半加敏法对上海市不同年龄组人群进行甲型流感抗体血清学监测。　 [结果 ]　对A/SH/1/98(H3N2 )毒株的抗体阳性率为 96.2 0 % ;对A/SH /7/99(H1N1)毒株的抗体阳性率为 72 .60 % ;对H9毒株的抗体阳性率为 7.5 6% ;对H5毒株的抗体阳性率仅 0 .75 %。　 [结论 ]　A/SH/1/98(H3N2 )类毒株已不可能在上海再度引起流行 ;A/SH/7/99(H1N1)类毒株今后在人群中 ,特别在 0～ 4岁年龄组中可能存在散在性发生或局限性小爆发 ;本市人群曾受到禽流感H 9病毒的感染 ,不能排除由本市禽类中的H9病毒感染及人的可能 ;受禽流感H5毒株感染只是个别现象。禽流感病毒在本市禽类中的感染状况及对人的影响需进一步研究     

Age distribution of patients with medically-attended illnesses caused by sequential variants of influenza A/H1N1: comparison to age-specific infection rates, 1978-1989

Since influenza A/H1N1 viruses reappeared during the 1977-1978 season, this subtype has contributed 27% of 6,609 documented influenza infections of persons with acute respiratory disease presenting to clinics serving as surveillance sites of the Influenza Research Center in Houston for the 12-year period ending June 1989. Wide differences in the distribution of H1N1 viruses occurred by age group: more than 50% of H1N1 infections were detected among persons aged 10-34 years, compared with 28% for influenza A/H3N2 and 35% for influenza B. Over age 35 years, the contribution of H1N1 viruses dropped to only 4%, compared with 20% and 16% for influenza A/H3N2 and influenza B, respectively. When birth dates of persons with positive cultures were examined, it was found that most of the H1N1-positive persons were born after 1950. Concurrently, longitudinal studies of families and other adults under intensive surveillance for infection, including cultures of all respiratory illnesses and tests for serum antibody rise over the respiratory disease season, revealed appreciable infection rates for adults born before 1950. Furthermore, the annual peak of hospitalization of older persons with pneumonia and other acute respiratory illnesses was significantly correlated with the peak of H1N1 virus activity in 1978-1979, a year when H1N1 viruses were the only influenza viruses prevalent. These observations indicate that many persons infected with influenza A/H1N1 viruses that circulated from 1946 through 1953 have immunity which has persisted for more than 25 years but this immunity is not complete. Reinfection that may result in serious illness in older vulnerable adults does occur but with lower frequency than with influenza A/H3N2 infection. Currently prevalent H1N1 variants are antigenically different from those that circulated in the 1950s; however, older adults readily acquire immunity to these new variants--perhaps as a result of immunologic priming that occurred in childhood.     

Efficacy of an AS03A-adjuvanted split H5N1 influenza vaccine against an antigenically distinct low pathogenic H5N1 virus in pigs

We used the pig model of influenza to examine the efficacy of an AS03(A)-adjuvanted split H5N1 (A/Indonesia/05/2005) vaccine against challenge with a low pathogenic (LP) H5N1 avian influenza (AI) virus (duck/Minnesota/1525/1981) with only 85% amino acid homology in its HA1. Influenza seronegative pigs were vaccinated twice intramuscularly with adjuvanted vaccine at 3 antigen doses, unadjuvanted vaccine or placebo. All pigs were challenged 4 weeks after the second vaccination and euthanized 2 days later. After 2 vaccinations, all pigs in the adjuvanted vaccine groups had high hemagglutination inhibiting (HI) antibody titers to the vaccine strain (160-640), and lower antibody titers to the A/Vietnam/1194/04 H5N1 strain and to 2 LP H5 viruses with 90-91% amino acid homology to the vaccine strain (20-160). Eight out of 12 pigs had HI titers (10-20) to the challenge virus immediately before challenge. Neuraminidase inhibiting antibodies to the challenge virus were detected in most pigs (7/12) and virus neutralizing antibodies in all pigs. There was no antigen-dose dependent effect on the antibody response among the pigs immunized with adjuvanted H5N1 vaccines. After challenge, these pigs showed a complete clinical protection, reduced lung lesions and a significant protection against virus replication in the respiratory tract. Though the challenge virus showed only moderate replication efficiency in pigs, our study suggests that AS03(A)-adjuvanted H5N1 vaccine may confer a broader protection than generally assumed. The pros and cons of the pig as an H5N1 challenge model are also discussed.     

Interpretation of responses and protective levels of antibody against attenuated influenza A viruses using single radial haemolysis.

Antibody determinations against H3N2 and H1N1 type A influenza viruses were carried out on paired sera obtained from volunteers taking part in influenza virus vaccine studies, using both the haemagglutination-inhibition (HI) and single radial haemolysis (SRH) test. Good correlation between the HI and SRH test was found for both H3N2 and H1N1 antibody and the zone area increases corresponding to significant SRH antibody rises determined for both virus strains. In both H3N2 and H1N1 vaccine studies, intranasal infection of the volunteers with live attenuated viruses was involved and by the measurement of HI and SRH antibodies prior to and following infection, levels of antibody equating with protection against the infecting viruses could be estimated. For the HI test the antibody titres associated with 50% protection were 42 for H1N1, and 44 for H3N2 viruses; for the SRH test, 50% protection was associated with zone areas of 20.0-25.0 mm2 for both H1N1 and H3N2 viruses.     

Interpretation of responses and protective levels of antibody against attenuated influenza A viruses using single radial haemolysis

Antibody determinations against H3N2 and H1N1 type A influenza viruses were carried out on paired sera obtained from volunteers taking part in influenza virus vaccine studies, using both the haemagglutination-inhibition (HI) and single radial haemolysis (SRH) test. Good correlation between the HI and SRH test was found for both H3N2 and H1N1 antibody and the zone area increases corresponding to significant SRH antibody rises determined for both virus strains. In both H3N2 and H1N1 vaccine studies, intranasal infection of the volunteers with live attenuated viruses was involved and by the measurement of HI and SRH antibodies prior to and following infection, levels of antibody equating with protection against the infecting viruses could be estimated. For the HI test the antibody titres associated with 50% protection were 42 for H1N1, and 44 for H3N2 viruses; for the SRH test, 50% protection was associated with zone areas of 20.0-25.0 mm2 for both H1N1 and H3N2 viruses.     

太原地区2005-2006年儿童流行性感冒病毒感染调查

目的了解太原地区2005—2006年流行性感冒（流感）在儿童急性呼吸道感染中的分布并确定当年的流感病毒优势株。方法采集山西省人民医院门诊急性呼吸道感染患儿的标本87份，分别经传代犬肾（MDCK）细胞分离病毒和血凝抑制试验（HI）鉴定流感病毒型别；并于2005年10月和2006年3月（流感流行前、后期）采集415份非呼吸道疾病的儿童及部分成年人血清标本进行了流感HI抗体检测。结果从87份流感样患儿血清标本中分离出甲1型流感病毒7株，阳性率8．04％。415份血清标本中0～岁、3～岁及7～18岁组甲1型流感HI抗体阳性率及几何平均滴度流感流行后期均明显高于流行前期，差异有统计学意义（P〈0．01）。结论2005—2006年冬春太原地区儿童流感流行以甲1型为主。     

Protective efficacy of an inactivated Eurasian avian-like H1N1 swine influenza vaccine against homologous H1N1 and heterologous H1N1 and H1N2 viruses in mice

Eurasian avian-like H1N1 (EA H1N1) swine influenza viruses are prevalent in pigs in Europe and Asia, but occasionally cause human infection, which raises concern about their pandemic potential. Here, we produced a whole-virus inactivated vaccine with an EA H1N1 strain (A/swine/Guangxi/18/2011, SW/GX/18/11) and evaluated its efficacy against homologous H1N1 and heterologous H1N1 and H1N2 influenza viruses in mice. A strong humoral immune response, which we measured by hemagglutination inhibition (HI) and virus neutralization (VN), was induced in the vaccine-inoculated mice upon challenge. The inactivated SW/GX/18/11 vaccine provided complete protection against challenge with homologous SW/GX/18/11 virus in mice and provided effective protection against challenge with heterologous H1N1 and H1N2 viruses with distinctive genomic combinations. Our findings suggest that this EA H1N1 vaccine can provide protection against both homologous H1N1 and heterologous H1N1 or H1N2 virus infection. As such, it is an excellent vaccine candidate to prevent H1N1 swine influenza.