Clinical and genetic characterization of severe influenza B-associated diseases during an outbreak in Taiwan

• Published in: Journal of clinical virology 2008-05, Vol.42 (1), p.45-51
• Main Authors: Li, Wen-Chen, Shih, Shin-Ru, Huang, Yhu-Chering, Chen, Guang-Wu, Chang, Shih-Cheng, Hsiao, Mei-Jen, Tsao, Kuo-Chien, Lin, Tzou-Yien
• Format: Article
• Language: English
• Subjects: Acute respiratory distress syndrome; Allergy and Immunology; Biological and medical sciences; Child; Child, Preschool; Disease Outbreaks; Encephalitis - virology; Encephalitis/encephalopathy; Female; Fundamental and applied biological sciences. Psychology; Genetic evolution; Genetics; Hemagglutinin Glycoproteins, Influenza Virus - genetics; Hospitalization; Human viral diseases; Humans; Infectious Disease; Infectious diseases; Influenza B virus; Influenza B virus - classification; Influenza B virus - genetics; Influenza B virus - isolation & purification; Influenza virus; Influenza, Human - complications; Influenza, Human - epidemiology; Influenza, Human - physiopathology; Influenza, Human - virology; Influenza-associated myositis; Male; Medical sciences; Microbiology; Miscellaneous; Molecular Epidemiology; Myositis - virology; Phylogeny; Respiratory Distress Syndrome, Adult - virology; RNA, Viral - genetics; Sequence Analysis, DNA; Taiwan - epidemiology; Viral diseases; Viral Nonstructural Proteins - genetics; Virology
• ISSN: 1386-6532; 1873-5967
• DOI: 10.1016/j.jcv.2007.11.026

Abstract Background Mismatches between circulating and vaccine strains of influenza virus had been observed in Taiwan. A comprehensive clinical and genetic analysis of influenza B viruses-associated important diseases was lacking. Objectives Clinical and phylogenetic analysis of influenza B viruses during an outbreak in Taiwan. Study designs Clinical manifestations of hospitalized, culture-confirmed patients were analyzed from July 2004 to June 2005. Partial genome sequence analysis of hemagglutinin (HA), neuraminidase (NA), and nonstructural (NS) genes were performed in 54 influenza B isolates during the study period, and nine srandomly chosen isolates during 2000 and 2003. Results Three specific diseases were found in these patients, including 13 of encephalitis/encephalopathy, 28 of influenza-associated myositis (IAM), and one of acute respiratory distress syndrome (ARDS). Three phylogenetic groups were identified, including reassortant strains—group 1 (Victoria lineage of HA, Yamagata lineage of NA, clade A of NS), group 2 (Yamagata lineage of HA, Yamagata lineage of NA, clade A of NS), and group 3 (Yamagata lineage of HA, Yamagata lineage of NA, clade B of NS). Conclusions Severe influenza B-associated disease in children was not rare and might be fatal. We offered the evidence of co-circulation of the two HA lineages in the same outbreak.