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Molecular epidemiology and genetic characterization of influenza B virus in Lebanon during 2016–2018
Institution:1. Department of Experimental Pathology, Immunology & Microbiology, Faculty of Medicine, American University of Beirut, P.O. Box 11-0236, Riad El Solh, 1107-2020 Beirut, Lebanon;2. Center for Infectious Diseases Research, Faculty of Medicine, American University of Beirut, P.O. Box 11-0236, Riad El Solh, 1107-2020, Beirut, Lebanon;3. Medical Laboratory Sciences Program, Faculty of Health Sciences, American University of Beirut, P.O. Box 11-0236, Riad El Solh, 1107-2020 Beirut, Lebanon;4. Department of Biology, Faculty of Sciences, EDST, Lebanese University, Lebanon;5. Department of Pediatrics and Adolescent Medicine, Faculty of Medicine, American University of Beirut Medical Center, P.O. Box 11-0236, Riad El Solh, 1107-2020 Beirut, Lebanon;6. Department of Biochemistry and Molecular Genetics, Faculty of Medicine, American University of Beirut, P.O. Box 11-0236, Riad El Solh, 1107-2020 Beirut, Lebanon;7. Department of Pediatrics, Nini Hospital, Tripoli, Lebanon;8. Department of Pediatrics, Makassed General Hospital, Beirut, Lebanon;9. Department of Pediatrics, Rafic Hariri University Hospital, Beirut, Lebanon;10. Department of Pediatrics, Nabatieh Governmental Hospital, Nabatieh, Lebanon;11. Department of Pediatrics, Hammoud Hospital, Saida, Lebanon
Abstract:BackgroundInfluenza B viruses are a major cause of serious acute respiratory infections in humans.MethodsNasopharyngeal swabs were collected from subjects with influenza-like illness during October 2016–June 2018 and screened for influenza A and B. The hemagglutinin (HA) and neuraminidase (NA) genes of the Lebanese influenza B specimens were sequenced and phylogenetically compared with the vaccine strains and specimens from the Eastern Mediterranean Region and Europe.ResultsInfluenza A and B viruses co-circulated between October and May and peaked between January and March. During the 2016–2017 season, A/H3N2 (33.4%) and B/Yamagata (29.7%) were the predominantly circulating viruses followed by B/Victoria and A/H1N1pdm09 viruses. During the 2017–2018 season, A/H3N2 (31.5%) and A/H1Npdm09 (29.3%) were most prevalent with co-circulation of B/Yamagata and to a lesser extent B/Victoria viruses. The B/Yamagata specimens belonged to clade-3 while the B/Victoria belonged to clade-1A. None of the analyzed specimens had a mutation known to confer resistance to NA inhibitors (NAIs).ConclusionMultiple subtypes of influenza co-circulate each year in Lebanon with a peak between January and March. The trivalent vaccine included a B/Victoria strain which mismatched the B/Yamagata lineage that predominated during the study period, highlighting the importance of quadrivalent vaccines.
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