Development of high yield reassortants for influenza type B viruses and analysis of their gene compositions

A critical step in producing the annual inactivated influenza vaccine is the development of high yield (hy) seed viruses by reassortment for improved growth in ovo. Although hy reassortants for type A influenza viruses have been developed for many years, hy B influenza reassortant virus development for vaccine production has proven difficult. In this study, we have developed fourteen hy influenza type B reassortants as vaccine candidate strains with B/Lee/40 as the donor virus. Upon characterization by the Influenza Division at the Centers for Disease Control and Prevention (CDC) and the verification of HA by sequencing, all B reassortants were found to be antigenically indistinguishable from the wild type (wt) parents and suitable for vaccine production. However, only one hy reassortant seed virus from this group was used by a manufacturer for vaccine production. In general, hy reassortants showed an increase in hemagglutination (HA) titers over their wt parents by approximately 8 fold (range 1–32 fold). Gene compositions of the hy B reassortants were analyzed by restriction fragment length polymorphism (RFLP) and the wt origin of the HA and neuraminidase (NA) were confirmed. However, in contrast to hy A reassortants which require the M gene (hy donor A/PR/8/34) for high yield, all fourteen hy B reassortants obtained the NP gene from the hy donor strain (B/Lee/40). The parental source for the remaining genes varied among the hy B reassortants. The results indicate that the B/Lee/40 NP and PB1 gene segments are important contributors to high yield growth in influenza B reassortant viruses for both Yamagata and Victoria lineages. The B/Lee/40 PB2 gene along with wt NS gene also contributed to the improved growth for hy reassortants of Yamagata lineage.     

The development of vaccine viruses against pandemic A(H1N1) influenza

Wild type human influenza viruses do not usually grow well in embryonated hens’ eggs, the substrate of choice for the production of inactivated influenza vaccine, and vaccine viruses need to be developed specifically for this purpose. In the event of a pandemic of influenza, vaccine viruses need to be created with utmost speed. At the onset of the current A(H1N1) pandemic in April 2009, a network of laboratories began a race against time to develop suitable candidate vaccine viruses. Two approaches were followed, the classical reassortment approach and the more recent reverse genetics approach. This report describes the development and the characteristics of current pandemic H1N1 candidate vaccine viruses.     

An additional oligosaccharide moiety in the HA of a pandemic influenza H1N1 candidate vaccine virus confers increased antigen yield in eggs

The H1N1 influenza pandemic in 2009 highlighted the need for the rapid generation of candidate vaccine viruses (CVVs) against an A/California/7/2009-like virus. The first available CVVs gave low protein yields in eggs but improved yields were achieved for second generation CVVs which contained amino acid substitutions compared to their precursor viruses. In this study, we investigated the basis for the increased virus protein yield of CVV NIBRG-121xp and whether the improved yield characteristics could be transferred between this virus and two other CVVs, NYMC X-179A and NYMC X-181. We generated variant viruses by reverse genetics to contain combinations of amino acid substitutions found in high yielding NIBRG-121xp and NYMC X-181. We found that the increase in total protein yield and functional HA yield of NIBRG-121xp in eggs is attributable to the single amino acid substitution K119N in the HA. We also found that the glycosylation of position 119 is essential for the improved virus protein yield in eggs. However, the K119N yield-enhancing effect was not transferable between viruses, nor was the N129D change found in high yielding NYMC X-181. However, position 119 may be a useful locus to monitor in future for viruses and CVVs with potentially high yield.     

Human infections with novel reassortant influenza A(H3N2)v viruses, United States, 2011

During July-December 2011, a variant virus, influenza A(H3N2)v, caused 12 human cases of influenza. The virus contained genes originating from swine, avian, and human viruses, including the M gene from influenza A(H1N1)pdm09 virus. Influenza A(H3N2)v viruses were antigenically distinct from seasonal influenza viruses and similar to proposed vaccine virus A/Minnesota/11/2010.     

Pathobiology of triple reassortant H3N2 influenza viruses in breeder turkeys and its potential implication for vaccine studies in turkeys

Triple reassortant (TR) H3N2 influenza viruses have been isolated from turkeys in the United States since 2003. These TR H3N2 virus infections have been associated with drastic declines in egg production in breeder turkeys although co-infection with multiple agents could have been responsible for exacerbating the clinical signs. In this study, we experimentally confirmed that TR H3N2 influenza virus alone can cause drastic reduction/complete cessation of egg production and pathology of the reproductive tract in 26-week-old breeder turkeys. We confirmed high levels of virus replication and abundant distribution of avian specific α2,3 sialic acid-galactose receptors in the oviduct of these turkeys. Although 2–6-week-old turkeys are routinely used for pathogenicity and vaccine protection studies, the low levels of viral shedding and asymptomatic infections in this age group often pose difficulty in interpretation of results. Our study shows that breeder turkeys should be used to assess the potential pathogenicity of TR H3N2 viruses and the viral titers and pathology of the oviduct as well as egg production data can be good measures of protection following in vivo challenge in vaccine efficacy studies.     

Assessment of viral replication in eggs and HA protein yield of pre-pandemic H5N1 candidate vaccine viruses

H5N1 infection and the potential for spread from human to human continue to pose a severe public health concern. Since vaccination remains the most effective way to prevent a potential H5N1 pandemic, the World Health Organization (WHO) Collaborating Centers (CCs) and Essential Regulatory Laboratories (ERLs) engineered and developed a panel of H5N1 pre-pandemic vaccine viruses for pandemic vaccine preparedness as well as production of antigen potency testing reagents (reference antigen and reference anti-serum) for vaccine standardization. To develop a strategy utilizing a number of biochemical methods for the characterization of the viral growth properties and protein yield in eggs, we have selected eight H5N1 pre-pandemic viruses and determined the viral Egg Infectious Dose 50 (EID₅₀), total protein yield, hemagglutinin (HA) to nucleoprotein (NP) ratios (HA:NP), and HA1 content of each virus. Our results showed that all the tested H5N1 vaccine viruses grew to high titers in eggs. The total viral protein yield varies within a narrow range, whereas there were greater differences in the HA:NP protein ratios among the eight viruses. The RP-HPLC based HA1 content analysis demonstrated that the viruses A/Anhui/1/2010, A/Hubei/1/2005, and A/goose/Guiyang/337/2006 contained higher HA contents than other five viruses including A/Vietnam/1203/2003. Our approach for analyzing virus growth and protein yield will allow us identify optimal vaccine virus in a timely manner. In addition, we successfully purified the HA proteins of H5N1 vaccine viruses by optimizing bromelain cleavage conditions. Our studies on the HA protein purification may improve the quality control of the production of influenza vaccine test reagent.     

甲型H1N1流感疫苗接种对其暴发疫情的影响

目的了解甲型H1N1流感(甲流)疫苗接种后对甲流暴发疫情的影响。方法对2011年4—5月发生在学校的1起甲流暴发疫情进行流行病学描述性分析,用回顾性队列研究的方法分析甲流疫苗接种对该起暴发疫情的影响。结果该校542名师生中191人患病,罹患率为35.24%,发病时间主要集中在4月19—25日,发病人群主要为1～6年级的小学生(χ2=9.972,P0.01),住校生发病高于非住校生,112名接种过甲流疫苗的师生发病率为16.96%,明显低于未接种疫苗的师生(40%),差异有统计学意义(χ2=20.661,P0.05),OR=0.306(95%CI∶0.180～0.521)。结论接种甲流疫苗可以有效预防甲型H1N1流感的发生,减少暴发疫情的发病率。     

A mid-term estimate of 2018/2019 vaccine effectiveness to prevent laboratory confirmed A(H1N1)pdm09 and A(H3N2) influenza cases in Sicily (Italy)

Influenza season started in Italy during the month of October 2018, approaching the epidemic peak in January 2019. This report aim to explore the mid-term virologic surveillance data of the 2018–2019 influenza season in Sicily and to estimate the effectiveness of seasonal influenza vaccine (VE) against A(H1N1)pdm09 and A(H3N2) influenza viruses. A test-negative design was used to evaluate influenza VE.In Sicily, almost all influenza infections were sustained by influenza type A viruses, of which 62.3% were A(H3N2) and 36.3% A(H1N1)pdm09. A reduction of laboratory confirmed influenza cases in Sicilian population immunized against influenza were observed. In particular, an overall significant protective values were observed for any influenza A viruses (Adj-VE = 44.0%; 95%CI: 11.2–64.7%), especially among 15–64 years old age group (Adj-VE = 59.5%; 95%CI: 0.03–83.1) and among the elderly (Adj-VE = 73.6%; 95% CI: 29.4–90.2).     

广东省2003年甲3型流行性感冒病毒血凝素重链区基因的特征

目的了解广东省2003年甲型流行性感冒(流感)病毒的抗原变异情况和血凝素重链区(HA1)基因的特征.方法对广东省流感分子流行病学资料进行分析.结果全年分离到481株甲型流感病毒,全部是H3N2亚型,其抗原性与疫苗株甲/马拿马/2007/99(H3N2)有所不同,类似于疫苗变异株甲/福建/411/02(H3N2).在HA1区氨基酸序列上,与疫苗株甲/巴拿马/2007/99(H3N2)存在25～30个氨基酸的差异,同源性为92.1%.抗原决定族A、B、D、E区以及受体结合部的左侧臂和前臂均发生氨基酸替换,并在144位增加了1个糖基化位点.结论广东省2003年甲3型流感活动比2002年进一步加强,与疫苗株相比,病毒基因发生突变,抗原性发生了漂移.     

2010-2013年中山市流感病毒(H3N2)血凝素基因特征分析

目的研究中山市2010-2013年流行的H3N2亚型流感病毒的血凝素基因特征,分析其基因变异情况。方法选取2010-2013年中山市流行的H3N2亚型流感病毒6株,用MDCK细胞分离病毒,提取病毒RNA,RT-PCR扩增HA基因并测定序列,利用BLASTn对序列进行相似性检索,分析其与疫苗株,不同年份、区域流行株的进化变异情况。结果共分离鉴定到6株H3N2亚型流感病毒,其中2株为2010年流行株,2株为2012年流行株,2株为2013年流行株。各年流行株与其他国家或地区当年大部分流行株在一个分支上,其进化距离随着进化时间变长而变远。2012年流行株相对2010年流行株在HA1区发生12个氨基酸位点变异,有3个位于B、C区。2013年流行株相对2012年流行株发生4个氨基酸位点变异,有2个位于A区。2012年、2013年流行株相对于疫苗株分别发生6、8个氨基酸位点变异,分别有2、4个位于A、B、C区。受体结合位点未发生变异。结论中山市H3N2亚型流感病毒流行株在年度之间存在一定变异程度,进化距离随着进化时间变长而变远,相对于疫苗株也存在一定程度上的变异。     

Safety and immunogenicity of inactivated monovalent influenza A/H1N1 vaccine candidate manufactured in Vietnam

We tested a new A/H1N1 inactivated influenza vaccine (IIV) manufactured by Institute of Vaccines and Medical Biologics (IVAC), Vietnam in 48 adults in a Phase 1, double-blinded, randomized, placebo-controlled trial. Two doses of unadjuvanted vaccine or placebo were administered three weeks apart. The vaccine was well tolerated with only transient mild local reactions and low-grade fever in a small proportion of the subjects. One serious adverse event considered unrelated to the study product was reported. The IVAC vaccine proved to be highly immunogenic with 91 percent (95% CI: 0.78, 1) of the subjects developing a ≥4 fold immune responses by hemagglutination inhibition (HAI) assay, and 96 percent (95% CI: 0.78, 1) by the microneutralization (MN) assay. Post-vaccination geometric mean titers (GMTs) were 283.7 (95% CI: 161.7, 497.5) in the HAI and 725.7 (95% CI: 411.3, 1280.3) in the MN assay. These promising results merit further development of the vaccine.ClinicalTrials.gov number: NCT01507779.     

Protection of trivalent inactivated influenza vaccine against hospitalizations among pandemic influenza A (H1N1) cases in Argentina

The aim of this study was to estimate the effectiveness of 2009 seasonal trivalent inactivated vaccine in reducing hospitalizations due to the novel influenza A H1N1 virus among positive cases. Data collected from Argentina's national epidemiological surveillance system were analyzed. All patients had a clinical diagnosis and underwent positive serological tests for pandemic influenza A H1N1. Logistic regression was used to estimate vaccine effectiveness to prevent severe cases of the disease, measured as hospitalizations. The adjusted effectiveness of the vaccine was 50% (95% CI: 40–59%). Vaccination was significantly associated with hospitalizations in all age groups, and within groups that had and had not received antiviral treatment. These results suggest that seasonal influenza vaccine might have conferred partial protection against severe cases due to the novel pandemic influenza.     

Impacts on influenza A(H1N1)pdm09 infection from cross-protection of seasonal trivalent influenza vaccines and A(H1N1)pdm09 vaccines: systematic review and meta-analyses

Cross-protection by seasonal trivalent influenza vaccines (TIVs) against pandemic influenza A H1N1 2009 (now known as A[H1N1]pdm09) infection is controversial; and the vaccine effectiveness (VE) of A(H1N1)pdm09 vaccines has important health-policy implications. Systematic reviews and meta-analyses are needed to assess the impacts of both seasonal TIVs and A(H1N1)pdm09 vaccines against A(H1N1)pdm09.We did a systematic literature search to identify observational and/or interventional studies reporting cross-protection of TIV and A(H1N1)pdm09 VE from when the pandemic started (2009) until July 2011. The studies fulfilling inclusion criteria were meta-analysed. For cross-protection and VE, respectively, we stratified by vaccine type, study design and endpoint. Seventeen studies (104,781 subjects) and 10 studies (2,906,860 subjects), respectively, reported cross-protection of seasonal TIV and VE of A(H1N1)pdm09 vaccines; six studies (17,229 subjects) reported on both. Thirteen studies (95,903 subjects) of cross-protection, eight studies (859,461 subjects) of VE, and five studies (9,643 subjects) of both were meta-analysed and revealed: (1) cross-protection for confirmed illness was 19% (95% confident interval=13-42%) based on 13 case-control studies with notable heterogeneity. A higher cross-protection of 34% (9-52%) was found in sensitivity analysis (excluding five studies with moderate/high risk of bias). Further exclusion of studies that recruited early in the pandemic (when non-recipients of TIV were more likely to have had non-pandemic influenza infection that may have been cross-protective) dramatically reduced heterogeneity. One RCT reported cross-protection of 38% (19-53%) for confirmed illness. One case-control study reported cross-protection of 50% (40-59%) against hospitalisation. (2) VE of A(H1N1)pdm09 for confirmed illness was 86% (73-93%) based on 11 case-control studies and 79% (22-94%) based on two cohort studies; VE against medically-attended ILI was 32% (8-50%) in one cohort study. TIVs provided moderate cross-protection against both laboratory-confirmed A(H1N1)pdm09 illness (based on eight case-control studies with low risk of bias and one RCT) and also hospitalisation. A finding of increased risk from seasonal vaccine was limited to cases recruited early in the pandemic. A(H1N1)pdm09 vaccines were highly effective against confirmed A(H1N1)pdm09 illness. Although cross-protection was less than the direct effect of strain-specific vaccination against A(H1N1)pdm09, TIV was generally beneficial before A(H1N1)pdm09 vaccine was available.     

Parental socioeconomic and psychological determinants of the 2009 pandemic influenza A(H1N1) vaccine uptake in children

BackgroundBefore COVID-19, the previous pandemic was caused by influenza A(H1N1)pdm09 virus in 2009. Identification of factors behind parental decisions to have their child vaccinated against pandemic influenza could be helpful in planning of other pandemic vaccination programmes. We investigated the association of parental socioeconomic and psychosocial factors with uptake of the pandemic influenza vaccine in children in 2009–2010.MethodsThis study was conducted within a prospective birth-cohort study (STEPS Study), where children born in 2008–2010 are followed from pregnancy to adulthood. Demographic and socioeconomic factors of parents were collected through questionnaires and vaccination data from electronic registers. Before and after the birth of the child, the mother’s and father’s individual and relational psychosocial well-being, i.e. depressive symptoms, dissatisfaction with the relationship, experienced social and emotional loneliness, and maternal anxiety during pregnancy, were measured by validated questionnaires (BDI-II, RDAS, PRAQ, and UCLA).ResultsOf 1020 children aged 6–20 months at the beginning of pandemic influenza vaccinations, 820 (80%) received and 200 (20%) did not receive the vaccine against influenza A(H1N1)pdm09. All measures of parents’ psychosocial well-being were similar between vaccinated and non-vaccinated children. Children of younger mothers had a higher risk of not receiving the influenza A(H1N1)pdm09 vaccine than children of older mothers (OR 2.59, 95% CI 1.52–4.43, for mothers < 27.7 years compared to ≥ 33.6 years of age). Children of mothers with lower educational level had an increased risk of not receiving the vaccine (OR 1.46, 95% CI 1.00–2.14).ConclusionsMother’s younger age and lower education level were associated with an increased risk for the child not to receive the 2009 pandemic influenza vaccine, but individual or relational psychosocial well-being of parents was not associated with children’s vaccination. Our findings suggest that young and poorly educated mothers should receive targeted support in order to promote children’s vaccinations during a pandemic.     

甲型H1N1流行性感冒病毒血凝素蛋白基因进化研究

推算全球各地近年来分离的甲型H1N1流行性感冒(简称流感)病毒株血凝素(HA)蛋白片段的进化速率和进化分歧时间,从而初步探索流感病毒的起源和传播关系.方法搜集GenBank数据库中2008年以来登录的全球流感病毒H1序列共344条(人源性248条,猪源性84条,禽源性11条,其他1条)及本课题组分离的7条人源性H1序列,按照"分子钟"进化理论和基于markov chain monte carlo(MCMC)算法的Bayesian推断方法估算进化速率和进化分歧时间,并利用后验概率方法构建系统进化树.结果 系统进化树显示,美国人源性、猪源性与禽源性H1序列与部分亚洲猪源性H1序列构成一个主要分支(美国分支);全球其他地区的人源性H1序列构成另一个主要分支(欧亚人分支);而部分中国猪源性、禽源性H1序列与意大利分离的禽源性序列也构成一个分支(欧亚动物分支).全球H1N1和H1N2流感病毒株H1序列930 bp核苷酸序列的年平均进化速率约为2.57×10-3/位点(95%最高后验概率区间:1.96×10-33.03×10-3/位点).其中,欧洲人源性H1序列和中国大陆猪H1序列的起源时间最早,年进化速率分别为6.46×10-3/位点、0.97×10-3/位点;而美国的人源性与猪源性H1序列的起源时间相近,年进化速率则分别为5.86×10-3/位点、5.02×10-3/位点.结论 本次甲型H1N1流感暴发是北美地区H1N1病毒株长期人畜共患性积累的基因变异所致.中国大陆地区并非本次流感疫情病毒株的发源地,尚无证据能够表明北美暴发株属于一个全新的流感病毒变种.     

Seasonal influenza vaccines induced high levels of neutralizing cross-reactive antibody responses against different genetic group influenza A(H1N1)pdm09 viruses

Influenza A(H1N1)pdm09 viruses have been circulating throughout the world since the 2009 pandemic. A/California/07/2009 (H1N1) virus was included in seasonal influenza vaccines for seven years altogether, providing a great opportunity to analyse vaccine-induced immunity in relation to the postpandemic evolution of the A(H1N1)pdm09 virus. Serum antibodies against various epidemic strains of influenza A(H1N1)pdm09 viruses were measured among health care workers (HCWs) by haemagglutination inhibition and microneutralization tests before and after 2010 and 2012 seasonal influenza vaccinations. We detected high responses of vaccine-induced neutralizing antibodies to six distinct genetic groups. Our results indicate antigenic similarity between vaccine and circulating A(H1N1)pdm09 strains, and substantial vaccine-induced immunity against circulating epidemic viruses.     

2005年-2009年大连市季节性甲型H1N1流感病毒HA基因序列分析

目的:分析大连市2005年-2009年流感病毒H1N1亚型血凝素抗原性及其基因变异情况,为流感防治提供技术支持。方法:采集流感样病例的鼻咽拭子标本,用MDCK细胞进行流感病毒的病原分离,采用红细胞凝集实验测定病毒的滴度,用血凝抑制试验和RT-PCR进行流感病毒型别鉴定,通过RT-PCR扩增血凝素HA片段的基因,电泳、纯化后进行基因序列测定,利用生物信息学进行序列分析。结果:2005年-2009年共分离到季节性甲型H1N1流感病毒39株,其中28株进行了测序。与当年的疫苗株相比,2005年、2006年、2007年和2008年分离株的HA1区分别发生了11个、9个、15、15个突变。结论:在近几个年度的流行季节中,该地区有H1N1亚型流感的存在。该地H1N1流感病毒分离株有多处氨基酸发生替换,氨基酸的替换导致毒株的抗原性发生了漂移。     

Influenza bivalent vaccine comprising recombinant H3 hemagglutinin (HA) and H1 HA containing replaced H3 hemagglutinin transmembrane domain exhibited improved heterosubtypic protection immunity in mice

Influenza caused by infection of influenza viruses is still a leading cause of morbidity and mortality in human. Vaccination is the main defense against influenza virus, but current influenza trivalent or quatrivalent vaccines (TIV/QIV) would lose their effectiveness when vaccine strains are mismatched with circulating strains. Our early study showed that recombinant influenza Hx-TM HA proteins containing H3 HA transmembrane domain(TM) had improved immunogenicity and heterosubtypic protection over corresponding wild-type Hx-WT HA proteins. In present study, bivalent vaccines containing H3-WT + Hx-TM were investigated for their immune responses and heterosubtypic protection immunities. The data showed that the bivalent vaccines containing H3-WT and H5-TM or H1-TM had improved immune responses and heterosubtypic protection over the bivalent vaccines containing H3-WT and H5-WT or H1-WT respectively. These results demonstrated that the improved immune responses and heterosubtypic protection of Hx-TM HA proteins could be translated into bivalent vaccines, suggesting a feasible strategy of improving the immune responses and heterosubtypic protection of influenza multivalent vaccines such as TIV and QIV.     

医务人员计划接种季节性和甲型H1N1流感疫苗情况调查

2009年甲型H1N1流感在世界范围内的流行,医务人员作为特殊人群[1],流感疫苗是预防和控制流感的最有效途径.多年来我国将医务人员指定为流感疫苗接种的重点人群[2],为此,2009年8月我们对北京市东城区医务人员对计划接种季节性和甲型H1N1流感疫苗等情况进行了调查.