Molecular epidemiology of influenza B virus and implications in immunization strategy,Southern Brazil |
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| Affiliation: | 1. Infectious Diseases Division, Hospital de Clínicas, Universidade Federal do Paraná (HC-UFPR), Brazil;2. Virology Laboratory, Universidade Federal do Paraná, Brazil;3. Health Public Laboratory (LACEN-PR), Brazil;1. Key Laboratory of Medical Molecular Virology of MoE & MoH, and Institutes of Biomedical Sciences, Fudan University, Shanghai, China;2. Key Laboratory of Medical Molecular Virology of MoE & MoH, School of Basic Medical Sciences, Fudan University, Shanghai, China;3. Zhengding County Center for Disease Control and Prevention, Zhengding, Hebei, China;4. Laboratory of Molecular Biology, Training Center of Medical Experiments, School of Basic Medical Sciences, Fudan University, Shanghai, China;5. Hebei Province Center for Disease Control and Prevention, Shijiazhuang, Hebei, China;1. Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, USA;2. Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, USA;3. United Nations Children’s Fund, Gujarat, India;4. Department of Preventive and Social Medicine, Medical College Baroda, Baroda, India;5. Department of Preventive and Social Medicine, Government Medical College, Surat, India;6. United Nations Children’s Fund, Delhi, India;1. Department of Preventive Medicine, Faculty of Veterinary Science, Universidad de Chile, Santiago, Chile;2. Epidemiology, Human Genetics and Environmental Sciences, Center For Infectious Diseases, University of Texas, Houston, TX, United States;3. Comparative Biomedical Science Program, School of Veterinary Medicine, University of Wisconsin-Madison, United States;4. Department of Infectious Diseases, St Jude Children’s Research Hospital, Memphis, TN, United States;1. Stanford School of Medicine, Stanford University, 291 Campus Dr, Stanford, CA, 94305, USA;2. Department of Emergency Medicine, Stanford University, Alway Building, M023, 300 Pasteur Drive - MC: 5768, Stanford, CA, 94305, USA |
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| Abstract: | Epidemiological indicators have shown the substantial impact of influenza B (Flu B) on the development of severe acute respiratory infection (SARI) and on mortality rates. In Brazil, the trivalent vaccine, composed of only one Flu B lineage is available. We investigated Flu B infections in clinical samples collected by the epidemiological surveillance service of Paraná State, Brazil, from 2013 to 2016. The Flu B lineages Yamagata- (B/Yam) and Victoria-like (B/Vic) were identified using the qRT-PCR assay, and notification forms were reviewed. Among 379 Flu B positive samples evaluated, 370 (98%) were characterized as B/Yam or B/Vic lineages. Both co-circulated with a frequency of 47% and 53%, respectively. B/Yam infected equally both genders, while B/Vic was more frequent in females (71%). The median age of patients infected by B/Vic (23y; 11–35) was lower than that of patients infected by B/Yam (32y; 12–50). Mismatch between the vaccine and the circulating strain was observed in the 2013 season, with a high number of SARI cases. B/Vic lineage was associated with a larger number of SARI cases (62%), while B/Yam with influenza-like illness (ILI) (61%). Differences were observed in the strains circulating in separate regions of Paraná State. B/Vic was prevalent in the northwestern (67%) and B/Yam in the southeastern region (60%). The unpredictability of Flu B lineage circulation causes a substantial increase in severe disease during epidemics in a vaccine mismatch season. In addition, the differences in the epidemiological profile of the target population of Flu B infections in relation to other respiratory viruses, as well as among the B/Vic and B/Yam lineages may also be associated to an increase in disease burden. These findings have direct consequences on vaccination strategies. Therefore, further molecular epidemiology studies of Flu B in Brazil are required to corroborate these primary results. |
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| Keywords: | Influenza B lineages Influenza vaccine Respiratory infection surveillance |
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