2017-2019年呼和浩特市甲型A(H1N1)pdm09流感病毒基因特征分析

目的 了解呼和浩特市甲型A(H1N1)pdm09流感病毒遗传进化特征及抗原位点、糖基化位点和耐药位点的变异情况,为流感防控提供科学依据。方法 采集2017-2019年呼和浩特市3家哨点医院的流感样病例(ILI)咽拭子标本进行核酸检测,阳性样本通过MDCK细胞和鸡胚进行病毒分离。随机抽取15株甲型A(H1N1)pdm09流感毒株进行基因测序分析。采用MEGA7.0.14软件、DNASTAR7.0.1软件和NetNGlyc1.0软件进行基因进化树分析、核苷酸同源性分析和糖基化位点分析。结果 呼和浩特市2017-2019年15株甲型A(H1N1)pdm09分离株与疫苗株A/Brisbane/02/2018和A/Michigan/45/2015共同属于6B.1分支。各年度分离株与疫苗株A/Brisbane/02/2018的组间遗传距离分别为0.004、0.011和0.013。相较于疫苗株A/California/07/2009和A/Michigan/45/2015,2017年起甲型A(H1N1)pdm09病毒抗原位点变异较大,但与疫苗株A/Brisbane/02/2018相比并未发生抗原漂移现...     

2016-2020年福建省A(H1N1)pdm09流感病毒HA基因特征分析

目的 分析2016-2020年福建省A(H1N1)pdm09亚型流感病毒的血凝素(Hemagglutinin, HA)基因特征,了解与其他省份和全球范围内时间和空间上的分布差异。方法 选取2016-2020年福建省流感监测网络实验室分离A(H1N1)pdm09流感毒株基因序列测定。基因序列用MEGA、Net NGlyc 1.0 Server分析基因特征。结果 2016-2020年福建省A(H1N1)pdm09亚型流感病毒HA基因进化树分析与其他省份及国外大部分一致,但仍有少部分不同。HA分支由6B转化为6B.1并演化至6B.1A5A。HA基因变异主要在抗原性决定簇Sa、Ca、Sb。对于不同地区疫苗株匹配度也会有差异。结论 福建省A(H₁N₁)pdm09病毒流行株具有遗传多样性。     

2019-2020年山东省A(H1N1)pdm09亚型流感病毒抗原性及血凝素基因特征分析北大核心CSCD

目的了解山东省2019-2020年分离株A(H1N1)pdm09亚型流感病毒的抗原性及血凝素(hemagglutinin, HA)基因变异情况。方法采用单向红细胞凝集抑制试验对2019-2020监测年分离的15株A(H1N1)pdm09亚型流感病毒进行抗原性分析;PCR扩增病毒的HA基因并测序,进行进化分析,以及糖基化位点、抗原变异位点、受体结合位点的变异分析。结果 2019-2020年流行株A(H1N1)pdm09亚型流感病毒均为疫苗株A/Brisbane/02/2018的类似株。HA基因均属于6B.1分支,毒株HA基因核苷酸序列与当季疫苗株A/Brisbane/02/2018的同源性为98.5%~99.0%,与最新疫苗株A/Guangdong-Maonan/SWL1536/2019的核苷酸同源性为99.3%~99.8%。所有毒株与当季疫苗株相比均出现了T185I位点变异。结论 2019-2020监测年度山东省流行的A(H1N1)pdm09亚型流感病毒与WHO推荐的疫苗组分匹配性良好,疫苗株推荐存在滞后性。HA基因与其编码的氨基酸持续变异,因此应加强对病毒变异的监测,为疫苗筛选及流感防控措施的制定提供参考。     

甲型流感病毒株H1N1(09pdm)的分离及HA和NA基因分析北大核心CSCD

目的对成都某部人感染甲型流感病毒进行分离鉴定和基因突变分析。方法采集甲型流感患者咽拭子标本,通过MDCK细胞分离病毒毒株;采用免疫荧光法鉴定其感染细胞能力,采用基因分型特异性引物鉴定病毒亚型,PCR扩增血凝素基因(HA)和神经氨酸酶基因(NA)后测序,与NCBI数据库在线比对并利用MEGA软件构建系统发育进化树,分析突变位点。结果从甲型流感患者咽拭子标本中分离出1株流感病毒,经型特异性引物PCR鉴定为H1N1(09pdm)亚型,该毒株在37℃时对细胞致病力较强。免疫荧光检测到分离毒株感染细胞内甲型流感病毒核蛋白(NP)高表达,甲型流感病毒NP蛋白在细胞核和细胞质中均有大量分布。利用反转录PCR和测序获得该毒株HA和NA全长基因序列。在线比对及系统发育树分析显示,该毒株HA和NA序列与2017-2018流感季其他国家流行株同源性均>99%。对HA氨基酸突变位点进行分析,其序列的155位点存在组氨酸-酪氨酸(H-Y)点突变,该点突变也发生Influenza A/Hawaii/24/2018(H1N1)(MH245873)、Influenza A/North Carolina/19/2018(H1N1)(MH245873)和In-fluenza A/Missouri/51/2017(H1N1)(MH083792)毒株上。NA氨基酸序列与近期流行的毒株均相同。结论本起流感病毒株H1N1(09pdm)的HA、NA基因序列与同期其他国家流行株高度相似,但在HA氨基酸序列的155位点存在一个组氨酸-酪氨酸的点突变,其意义尚不清楚。     

2009-2013年无锡地区新甲型H1N1流感病毒基因变异分析

目的了解2009～2013年无锡地区新甲型H1N1流感病毒血凝素（HA）和神经氨酸酶（NA）的基因变异情况。方法选取2009～2013年哨点医院分离的新甲型H1N1流感病毒，进行HA和NA核苷酸序列测定，用Bioedit和MEGA version4．0分析软件进行基因种系进化特性分析。结果无锡地区2009～2013年种型H1N1流感病毒HA基因序列的同源性为98．9％～99．5％；氨基酸序列分析显示，无锡地区分离株第203位与国内、国际代表株比较发生氨基酸替换：S→T；第83位和321位与国内代表株相同，而与国际代表株不同，分别为S→P、V→I。NA基因序列与国内、国际代表株同源性为99．2％～99．8％；第87位和349位与国内代表株相同，而与国际代表株不同，分别为R→Q、D→G。结论通过对HA和NA基因序列的比对分析，2009-2013年无锡地区新甲型H1N1流感病毒流行株基因序列与国内、国际代表株高度同源。表明该地区近期不会发生新甲型H1N1流感大流行。     

2019—2020年山东省H3N2流感病毒抗原性及血凝素基因特征分析

目的 了解2019—2020年流感监测年度山东省分离的H3N2亚型流感病毒抗原性及血凝素(hemagglutinin,HA)基因遗传进化规律与氨基酸变异情况。方法 用免疫雪貂后的抗血清进行红细胞凝集抑制试验,对2019年4月至2020年3月山东省分离的40株H3N2亚型流感毒株进行抗原性分析,并对其中19株待检病毒的HA基因进行序列测定及分析。结果 抗原性分析结果显示检测的H3N2亚型流感病毒中仅仅35%(14/40)与疫苗株A/Kansas/14/2017抗原性类似。系统进化树显示,19株H3N2亚型流感病毒分离株血凝素基因在进化树上全部属于3C.2a分支,与处于3C.3a分支的疫苗株A/Kansas/14/2017亲缘关系较远;与疫苗株相比,所有待检毒株A抗原决定簇有3个位点,B抗原决定簇有2个位点发生改变;受体结合位点均发生T135K位和S137F位变异;19株分离株全部发生133位糖基化位点缺失。结论 抗原性分析及HA基因序列分析结果显示,WHO推荐的 2019—2020 年疫苗株保护效果有可能不理想。应继续密切关注 H3N2 亚型流感病毒的流行与基因变异情况,为流感病毒疫苗株推荐及防控提供科学依据。     

2009年广东省新型甲型H1N1流行性感冒病毒神经氨酸酶基因进化分析

目的 探讨2009年广东省新型甲型H1N1流行性感冒(流感)病毒神经氨酸酶(NA)基因的进化及NA基因编码蛋白抗原性、酶活性位点、糖基化位点变异情况.方法 从2009年广东省新型甲型H1N1流感患者中分离到病毒毒株共69株,提取病毒总RNA,RT-PCR扩增NA基因,并测序分析;同时从美国国立生物技术信息中心基因库检索获得 52株不同年代、不同地域甲型流感病毒NA基因序列,用MEGA 4.0软件进行基因进化分析和氨基酸序列分析.结果 2009年广东省新型甲型H1N1流感病毒NA基因与禽H5N1流感病毒同源性较高,为87.1%,潜在抗原位点氨基酸分布相同;所有毒株的酶活性中心位点高度保守;具有8个糖基化位点,其中5个位点有不同程度的氨基酸替换,但与2001年禽H5N1毒株的糖基化位点的氨基酸相同.结论 2009年广东省新型甲型H1N1流感病毒NA基因与禽H5N1流感病毒高度同源,与NA抑制剂的特异性结合位点未发生变化.     

2018-2019年克拉玛依市新甲型H1N1流感病毒NA基因分析

目的 分析新疆克拉玛依市新甲型H1N1流感病毒NA基因特征及变异情况.方法 采集2018年1月-2019年12月哨点医院流感样病例咽拭子,经MDCK细胞完成流感病毒分离后,随机抽取26株分离株测定其NA基因序列,并与疫苗株进行序列比对和分析.结果 与疫苗株A/Michigan/45/2015 NA基因核苷酸相比,2018年分离株与其同源性为98.56％～99.28％,2019年分离株与其同源性为98.35％～98.71％;26株分离株与同期国内其他地区代表株和疫苗株A/Michigan/45/2015在同一进化分支;分离株T180699较疫苗株A/Michigan/45/2015少1个糖基化位点(42～44位),分离株T190041发生了I223V位点变异.结论 相对于疫苗株A/Michigan/45/2015,2018-2019年克拉玛依市新甲型H1N1流感病毒NA基因抗原决定簇、糖基化位点和耐药相关位点已有改变;应继续加强流感监测,密切关注其基因变异情况.     

2014-2015年商洛市流感病毒H3N2亚型血凝素(HA1)基因进化研究

目的分析2014-2015年度商洛市流感监测病毒血凝素(HA)基因变异情况并研究与推荐疫苗的匹配性。方法收集2014-2015年商洛市流感监测平台用狗肾传代细胞(MDCK)培养分离的H3N2亚型毒株,利用RT-PCR方法扩增分离HA片段,进行核苷酸序列测定,应用clustax2.1软件进行序列比对后,用Mega6.0软件构建系统发育进化树,系统进化树采用Neighboring-joining方法进行分析。结果 2014-2015年度分离的流感H3N2毒株同源性在97.2%~99.9%,与推荐疫苗株A/Texas/50/2012同源性为97.3%~98.5%;将分离毒株的HA1基因氨基酸与疫苗株比较,发现2014年毒株主要抗原决定簇氨基酸变异点有B区Y159F、S198P;2015年主要抗原决定簇氨基酸变异点有A区G142R,B区S159F、S198P。结论2014-2015年度商洛市流感H3N2亚型毒株关键抗原决定簇已经出现改变,A/Texas/50/2012作为疫苗组分已经不是最佳,亟需对我国流感H3N2亚型疫苗组分进行更新,应密切关注流感H3N2基因进化趋势。     

2018-2020年山东省甲型H1N1流感病毒NA基因变异和耐药分析北大核心CSCD

目的监测山东省甲型H1N1流感病毒神经氨酸酶(NA)基因变化及其对神经氨酸酶抑制剂(NAIs)的耐药情况。方法从山东省2018-2020流感监测年度中选取20株甲型H1N1流感病毒,提取病毒核酸后对NA基因进行测序,利用生物信息学软件分析NA基因上与耐药有关的氨基酸位点及其基因变异情况。利用荧光法对选取的流感病毒进行生物学耐药试验,检测病毒对奥司他韦和扎那米韦的敏感性。结果选取的20株甲型H1N1流感病毒中有1株奥司他韦耐药(IC50值为233.8nmol/L),其余19株流感病毒对奥司他韦均敏感,IC50平均数为0.34nmol/L(0.14~0.81 nmol/L)。20株甲型H1N1流感病毒均对扎那米韦敏感,对扎那米韦IC50平均数为0.31nmol/L(0.13~0.69nmol/L)。NA基因测序显示奥司他韦耐药株存在H275Y基因变异。山东省近两个监测年度甲型H1N1流感病毒同源性较高,在进化树上交叉分布,与疫苗株亲缘关系较近,且未出现处于NA蛋白抗原决定簇区域内的变异。结论山东地区甲型H1N1流感病毒对NAIs耐药比例较低,临床上可继续使用此类药物,并需加强耐药性监测。     

2019年广州市甲型H1N1流感病毒全基因组序列的遗传特征分析

目的 对甲型H1N1流感病毒进行基因组全序列遗传特征分析,为流感的科学防控提供新数据.方法 选取7株2019年广州市甲型H1N1流感病毒进行全基因组序列测定,分析其遗传特征.结果 7株病毒的核苷酸同源性最高为PB2基因(98.8％～99.9％),最低为NA基因(97.3％～99.2％).总体上,不同月份的H1N1流感分...     

福建省1例不明原因肺炎病例中甲型H1N1流感病毒的全基因组特征分析

目的了解1例不明原因肺炎病例中甲型H1N1流感病毒的生物学特性和变异情况,为临床治疗与疫情防控提供依据。方法利用MDCK细胞分离不明原因肺炎病例中的甲型H1N1流感病毒,分离的毒株经全基因组测序后分析其抗原性、致病性和耐药性等特征。结果从该病例的咽拭子标本中分离得到1株甲型H1N1流感病毒并命名为A/FujianGulou/SWL64/2016(H1N1),其8个节段的核苷酸和氨基酸序列与A/California/07/2009(H1N1)疫苗株的相似性分别为96.9%~98.9%和96.7%~99.5%。氨基酸序列分析显示HA蛋白共有18个位点发生突变,其中K163Q、S185T、S203T和D222N变异涉及到3个不同的抗原位点,提示病毒发生抗原漂移;与受体结合位点相关的D222N突变还提示病毒感染下呼吸道的能力增强。耐药性分析显示该病毒对金刚烷胺耐药,对达菲仍然敏感。结论本次研究的甲型H1N1流感病毒具有抗原漂移现象,且具备引发重症肺炎的分子特征,应进一步加强监测,为疫情防控奠定基础。     

Characterization of influenza A(H1N1)pdm09 viruses isolated from Nepalese and Indian outbreak patients in early 2015

We characterized influenza A(H1N1)pdm09 isolates from large‐scale outbreaks that occurred in Nepal and India in early 2015. Although no specific viral features, which may have caused the outbreaks, were identified, an S84N substitution in hemagglutinin was frequently observed. Chronological phylogenetic analysis revealed that these Nepalese and Indian viruses possessing the S84N substitution constitute potential ancestors of the novel genetic subclade 6B.1 virus that spread globally in the following (2015/16) influenza season. Thus, active surveillance of circulating influenza viruses in the Southern Asia region, including Nepal and India, would be beneficial for detecting novel variant viruses prior to their worldwide spread.     

Whole‐genome analysis of influenza A(H1N1)pdm09 viruses isolated in Uganda from 2009 to 2011

We report a whole‐genome analysis of 19 influenza A(H1N1)pdm09 isolates from four Ugandan hospitals between 2009 and 2011. The isolates differed from the vaccine strain A/California/07/2009 by three amino acid substitutions P100S, S220T, and I338V in the hemagglutinin and by two amino acid substitutions V106I and N248D in the neuraminidase proteins with consistent mutations in all gene segments distinguishing isolates from the 2009/2010 to 2010/2011 seasons. Phylogenetic analysis showed low genetic evolution, with genetic distances of 0%–1.3% and 0.1%–1.6% for HA and NA genes, respectively. The amino acid substitutions did not lead to antigenic differences from the reference strains.     

Differential use of antivirals for treatment of patients with influenza A(H1N1)pdm09 in Germany

Background

The World Health Organization recommends early antiviral treatment for patients with severe influenza illness or those at increased risk for severe illness.

Objectives

The aim of this study was to determine the proportion of cases with laboratory‐confirmed A(H1N1)pdm09 infection that have been treated with antivirals in Germany during the pandemic (H1N1) 2009 and to investigate factors associated with the use of antivirals.

Methods

We analyzed cases with laboratory‐confirmed A(H1N1)pdm09 infection notified to national health authorities in Germany between week 29/2009 and week 17/2010 using multivariable logistic regression. Severity of disease was defined by pneumonia or death.

Results and conclusions

Of 160 804 cases with laboratory‐confirmed A(H1N1)pdm09 infection, 22% were treated with antivirals. Cases with severe disease were more likely to be treated with antivirals than cases without severe disease (odds ratio = 1·66; 95% confidence interval: 1·46–1·89). In the group with at least one underlying medical condition, only children aged between 1 and 4 years had significant lower odds for receiving antiviral treatment compared with cases in the age group 15 to 49 years (odds ratio = 0·75; 95% confidence interval: 0·6–0·94). In conclusion, the implementation of international recommendations on use of antivirals differed according to the age of patients in Germany during the pandemic (H1N1) 2009. This indicates that the potential of antivirals to prevent severe influenza might not have been fully exhausted. The reasons leading to the observed differences in patient management need to be investigated.     

Epidemiology of influenza A (H1N1)pdm09‐associated deaths in the United States,September–October 2009

Please cite this paper as: Regan et al. (2012) Epidemiology of influenza A (H1N1)pdm09‐associated deaths in the United States, September–October 2009. Influenza and Other Respiratory Viruses 6(601), e169–e177. Background From April to July 2009, the United States experienced a wave of influenza A (H1N1)pdm09 virus (H1N1pdm09) infection. The majority of the deaths during that period occurred in persons <65 years of age with underlying medical conditions. Objective To describe the epidemiology of H1N1pdm09‐associated deaths in the US during the fall of 2009. Methods We collected demographic, medical history, and cause of death information on a nationally representative, stratified random sample of 323 H1N1pdm09‐associated deaths that occurred during September 1–October 31, 2009. Results Data were available for 302/323 (93%) deaths. Most cases (74%) were 18–64 years of age and had ≥1 underlying medical condition (72%). Among cases aged <18 years, 16/43 (37%) had a chronic lung disease, and 15/43 (35%) a neurological disorder; among cases aged ≥18 years, 94/254 (37%) had a chronic lung disease and 84/254 (33%) had a metabolic disorder. The median number of days between symptom onset and death was six among children (range, 1–48) and 12 among adults (range, 0–109). Influenza antiviral agents were prescribed for 187/268 (70%) of cases, but only 48/153 (31%) received treatment within 2 days of illness onset. Conclusions The characteristics of H1N1pdm09 deaths identified during the fall of 2009 were similar to those occurring April–July 2009. While most cases had conditions that were known to increase the risk for severe outcomes and were recommended to receive antiviral therapy, a minority of cases received antivirals early in the course of illness.     

A(H1N1)pdm09 hemagglutinin D222G and D222N variants are frequently harbored by patients requiring extracorporeal membrane oxygenation and advanced respiratory assistance for severe A(H1N1)pdm09 infection

Background

In patients with A(H1N1)pdm09 infection, severe lung involvement requiring admission to intensive care units (ICU) has been reported. Mutations at the hemagglutinin (HA) receptor binding site (RBS) have been associated with increased virulence and disease severity, representing a potential marker of critical illness.

Objectives

To assess the contribution of HA‐RBS variability in critically ill patients, A(H1N1)pdm09 virus from adult patients with severe infection admitted to ICU for extracorporeal membrane oxygenation support (ECMO) during influenza season 2009–2011 in Piemonte (4·2 million inhabitants), northwestern Italy, was studied.

Patients and methods

We retrospectively analyzed HA‐RBS polymorphisms in ICU patients and compared with those from randomly selected inpatients with mild A(H1N1)pdm09 disease and outpatients with influenza from the local surveillance program.

Results

By HA‐RBS direct sequencing of respiratory specimens, D222G and D222N viral variants were identified in a higher proportion in ICU patients (n = 8/24, 33·3%) than in patients with mild disease (n = 2/34, 6%) or in outpatients (n = 0/44) (Fisher''s exact test P < 0·0001; OR 38·5; CI 95% 4·494–329·9). Eleven ICU patients died (42%), three of them carrying the D222G variant, which was associated with RBS mutation S183P in two. D222G and D222N mutants were identified in upper and lower respiratory samples.

Conclusions

A(H1N1)pdm09 HA substitutions D222G and D222N were harbored in a significantly higher proportion by patients with acute respiratory distress for A(H1N1)pdm09 severe infection requiring ICU admission and ECMO. These data emphasize the importance of monitoring viral evolution for understanding virus–host adaptation aimed at the surveillance of strain circulation and the study of viral correlates of disease severity.     

Relationships between A(H1N1)pdm09 influenza infection and infections with other respiratory viruses

Background

A(H1N1)pdm09, a new influenza pandemic virus emerged in 2009. The A(H1N1)pdm09 infection had several unique characteristics which included rapid transmissibility and high morbidity in obese individuals, pregnant women and individuals suffering from chronic diseases.

Objectives

To study the relationships between A(H1N1)pdm09 influenza infection and infections with other respiratory viruses such as respiratory syncytial virus (RSV), human metapneumo virus (hMPV), adenovirus and seasonal influenza.

Methods

Samples (nasopharyngeal swabs or aspirates) collected between 2007 until 2012 from patients of various ages that were hospitalized due to respiratory virus infections were analyzed for the presence of various respiratory viruses, using qRT-PCR.

Results

In 2009–2010, when the pandemic influenza A(H1N1)pdm09 first appeared, two major infection peaks were noted and individuals of various ages were infected. Following the decline of the A(H1N1)pdm09 virus infection, the percentages of patients infected with adenovirus and hMPV increased, while infection frequency with RSV B and with seasonal influenza virus decreased. Furthermore, RSV infections were delayed and very few percentages of patients were co-infected with more than one virus. Interestingly, the A(H1N1)pdm09 virus lost its dominancy when it reappeared in the winter of 2010–2011, and at this time, only the incidence of RSV infections was affected by the A(H1N1)pdm09 virus.

Conclusions

The A(H1N1)pdm09 virus had distinct effects on other respiratory viruses when it first appeared versus later, when it evolved from being a pandemic to a seasonal virus.