Cent Eur J Public Health 2016, 24(3):180-187
Virological Surveillance of Influenza in Four Recent Post-Pandemic Seasons (2010/11 to 2013/14) in Bulgaria
- National Reference Laboratory "Influenza and ARD", National Centre of Infectious and Parasitic Diseases, Sofia, Bulgaria
Aim: Influenza virological surveillance is an essential tool for studying the evolution of influenza viruses as well as for annual updating of the vaccine composition. The aim of the present study is to analyse the circulation of the influenza viruses in Bulgaria during the four recent post-pandemic seasons.
Methods: A total of 3,681 respiratory samples from patients with influenza like illness (ILI) or acute respiratory illness (ARI) were tested for influenza viruses using Real Time RT-PCR.
Results: Influenza viruses were detected in 1,367 (37%) samples. Of those viruses, 941 (69%) were of type A and 426 (31%) of type B. Among the subtyped A viruses, 543 (60%) were A(H1N1)pdm09 and 369 (40%) A(H3N2). Co-circulation of all seasonal influenza types/subtypes was registered during each season, with the exception of A(H1N1)pdm09 virus in the 2011/12 season. In this study, data gathered from the antigenic and genetic analyses of influenza viruses, their antiviral susceptibility, and the epidemiological and clinical characteristics of the infections are presented.
Conclusions: Yearly variations in the distribution and frequency of influenza types/subtypes and an annual shift of the predominant type/subtype were observed. In the seasons with predominant spread of A(H1N1)pdm09 virus - 2010/11 and 2013/14, a greater number of influenza-related pneumonia cases, ICU admissions and fatal cases was registered (p<0.05). The results of the present study confirm the need for continuous and comprehensive influenza surveillance.
Keywords: influenza, antigenic and genetic characterizations, pneumonia, neurologic complications
Received: February 5, 2015; Revised: March 14, 2016; Accepted: March 14, 2016; Published: September 1, 2016 Show citation
References
- World Health Organization. Media centre. Influenza (seasonal) [Internet]. Geneva: WHO; 2014 [cited 2016 Mar 14]. Available from: http://www.who.int/mediacentre/factsheets/fs211/en/.
- Badar N, Bashir Aamir U, Mehmood MR, Nisar N, Alam MM, et al. Influenza virus surveillance in Pakistan during 2008-2011. PLoS One. 2013 Nov 8;8(11):e79959. doi: 10.1371/journal.pone.0079959.
Go to original source...
Go to PubMed...
- El MoussiA, Pozo F, Ben Hadj Kacem MA, Ledesma J, Cuevas MT, et al. Virological Surveillance of InfluenzaViruses during the 2008-09, 2009-10 and 2010-11 Seasons in Tunisia. PLoS One. 2013 Sep 19;8(9):e74064. doi: 10.1371/journal.pone.0074064.
Go to original source...
Go to PubMed...
- Chuang JH, Huang AS, Huang WT, Liu MT, Chou JH, Chang FY, et al. Nationwide surveillance of influenza during the pandemic (200910) and post-pandemic (2010-11) periods in Taiwan. PLoS One. 2012;7(4):e36120. doi: 10.1371/journal.pone.0036120.
Go to original source...
Go to PubMed...
- European Centre of Disease Prevention and Control (ECDC). Influenza case definitions [Internet]. ECDC; 2016 [cited 2016 Mar 14]. Available from: http://www.ecdc.europa.eu/en/activities/surveillance/eisn/surveillance/pages/influenza_case_definitions.aspx.
- Shu B,Wu KH, Emery S,Villanueva J, Johnson R, Guthrie E, et al. Design and performance of the CDC real-time reverse transcriptase PCR swine flu panel for detection of 2009 A (H1N1) pandemic influenza virus. J Clin Microbiol. 2011 Jul;49(7):2614-9.
Go to original source...
Go to PubMed...
- WHO Global Influenza Surveillance Network. Manual for the laboratory diagnosis and virological surveillance of influenza [Internet]. Geneva: WHO; 2011 [cited 2016 Mar 14].Available from: http://whqlibdoc.who.int/publications/2011/9789241548090_eng.pdf.
- European Centre for Disease Prevention and Control. Weekly influenza surveillance overview [Internet]. Stockholm: ECDC; c2005-2016 [cited 2016 Mar 14].Available from: http://ecdc.europa.eu/en/publications/surveillance_reports/influenza/Pages/weekly_influenza_surveillance_overview.aspx?p=15.
- Review of the 2010-2011 winter influenza season, northern hemisphere. Wkly Epidemiol Rec. 2011 May 27;86(22):222-7.
Go to PubMed...
- Review of the 2011-2012 winter influenza season, northern hemisphere. Wkly Epidemiol Rec. 2012 Jun 15;87(24):233-40.
Go to PubMed...
- Review of the 2012-2013 winter influenza season, northern hemisphere. Wkly Epidemiol Rec. 2013 May 31;88(22):225-32.
- Review of the 2013-2014 winter influenza season, northern hemisphere. Wkly Epidemiol Rec. 2014 Jun 6;89(23):245-56.
Go to PubMed...
- Hay AJ, Gregory V, Douglas AR, Lin YP. The evolution of human influenza viruses. Philos Trans R Soc Lond B Biol Sci. 2001 Dec 29;356(1416):1861-70.
Go to original source...
Go to PubMed...
- Barr IG, McCauley J, Cox N, Daniels R, Engelhardt OG, Fukuda K, et al.; Writing Committee of the World Health Organization Consultation on Northern Hemisphere Influenza Vaccine Composition for 2009-2010. Epidemiological, antigenic and genetic characteristics of seasonal influenza A(H1N1), A(H3N2) and B influenza viruses: basis for the WHO recommendation on the composition of influenza vaccines for use in the 2009-2010 northern hemisphere season. Vaccine. 2010 Feb 3;28(5):115667.
Go to original source...
Go to PubMed...
- Bonmarin I, Belchior E, Le Strat Y, Levy-Bruhl D. First estimates of influenza vaccine effectiveness among severe influenza cases, France, 2011/12. Euro Surveill. 2012 May 3;17(18). pii: 20163.
Go to original source...
- Lee BE, Mukhi SN, Drews SJ. Association between patient age and influenza A subtype during influenza outbreaks. Infect Control Hosp Epidemiol. 2010 May;31(5):535-7.
- Beauté J, Broberg E, Plata F, Bonmarin I, O Donnell J, Delgado C, et al. Overrepresentation of influenza A(H1N1)pdm09 virus among severe influenza cases in the 2011/12 season in four European countries. Euro Surveill. 2012 Mar 1;17(9). pii: 20105.
Go to original source...
- Pariani E, Amendola A, Ebranati E, Ranghiero A, Lai A, Anselmi G, et al. Genetic drift influenza A(H3N2) virus hemagglutinin (HA) variants originated during the last pandemic turn out to be predominant in the 2011-2012 season in Northern Italy. Infect Genet Evol. 2013 Jan;13:25260.
Go to original source...
Go to PubMed...
- Punpanich W, Chotpitayasunondh T. A review on the clinical spectrum and natural history of human influenza. Int J Infect Dis. 2012 Oct;16(10):e714-23.
Go to original source...
Go to PubMed...
- WilkingAN, Elliott E, Garcia MN, Murray KO, Munoz FM. Central nervous system manifestations in pediatric patients with influenza A H1N1 infection during the 2009 pandemic. Pediatr Neurol. 2014 Sep;51(3):3706.
Go to original source...
Go to PubMed...
- Goenka A, Michael BD, Ledger E, Hart IJ, Absoud M, Chow G, et al. Neurological manifestations of influenza infection in children and adults: results of a National British Surveillance Study. Clin Infect Dis. 2014 Mar;58(6):775-84.
Go to original source...
Go to PubMed...
- Gutiérrez-Pizarraya A, Pérez-Romero P, Alvarez R, Aydillo TA, OsorioGómez G, Milara-Ibáñez C, et al. Unexpected severity of cases of influenza B infection in patients that required hospitalization during the first postpandemic wave. J Infect. 2012 Nov;65(5):423-30.
Go to original source...
Go to PubMed...
- Mytton OT, Rutter PD, Donaldson LJ. Influenza A(H1N1)pdm09 in England, 2009 to 2011: a greater burden of severe illness in the year after the pandemic than in the pandemic year. Euro Surveill. 2012 Apr 5;17(14). pii: 20139.
Go to original source...
- Lehners N, Geis S, Eisenbach C, Neben K, Schnitzler P. Changes in severity of influenza A(H1N1)pdm09 infection from pandemic to first postpandemic season, Germany. Emerg Infect Dis. 2013 May;19(5):74855.
Go to original source...
Go to PubMed...
- GISAD [Internet]. The GISAD Initiative; 2016 [cited 2016 March 14]. Available from: http://platform.gisaid.org/.