The system of genetic control of innate immune responses to influenza infection and gene function allows for the development of systemic treatment of influenza with a focus on the phenotype of mutations based on individual genetic susceptibility to severe disease and/or the development of complications.
The goal of this study was to compare the data on the intensity of the influenza A(H3N2) and B epidemic (especially the death toll) in 2014–2015 season with the previous epidemic of 2013-2014. The data on weekly morbidity, hospitalization, deaths from influenza and acute respiratory diseases in different age groups of inhabitants of 59 cities located in 7 Federal districts of the Russian Federation were collected using the database of the Research Institute of Influenza.
Analysis of this data showed, that the influenza epidemic in 2014-2015 began earlier (in December), compared with the epidemic of 2013-2014, and spread mainly from Europe through Russia to the East. The intensity of the epidemic 2014-2015 was higher, compared to the previous one. The epidemic was more prevalent by regions and cities and wider engagement of different age groups (except children up to 2 years) was observed. At the peak of the epidemic the morbidity level was higher, the average duration of the epidemic was longer and the number of patients among cities inhabitants (especially among children 7-14 years of age and adults) was higher than in the previous season. The rates of hospitalization with influenza and ARI among patients older than 65 years were also higher (1.4 times) as well as frequency of hospitalization with a diagnosis of “influenza” (2.7 times) and the number of deaths from laboratory confirmed influenza (1.8 times).
Although the pandemic influenza virus A(H1N1)pdm09, was not the main causative agent of the epidemic 2015, it still was the main cause of deaths from influenza (45.5% of all cases). In spite of influenza A(H1N1)pdm09 virus sporadic prevalence, deaths from it were reported only on the European part of territory of Russia.
The share of influenza A(H3N2) viruses varied from 10% in the 1st post pandemic year to approx. 60% in 2008-2009 and 2011- 2012 epidemic seasons. All of the influenza A strains isolated during the last years of the period, covered in this study, were found to be susceptible to neuraminidase inhibitors and resistant to adamantane antivirals.
Influenza B viruses of both Yamagata and Victoria lineages circulated in Russia in the period from 2006 to 2013. The vast majority of these influenza B viruses belonged to the Victoria lineage. Phylogenetic and antigenic analyses of influenza B viruses have demonstrated a gradual drift of Russian isolates from the reference strains. No changes leading to resistance to oseltamivir or zanamivir were found in influenza B strains isolated until 2013.
The sensitive version of cell-ELISA was developed for the subtype-specific differentiation of current influenza A(H1N1)pdm09 and A(H3N2) viruses that are circulating in the human population. This method is based on the estimation of virus reproduction in the infected MDCK cells. The detection step of this method is an interaction of the subtype-specific monoclonal antibodies (mAbs) with the viral hemagglutinin (НА). The influenza A virus strains, isolated in 2014 epidemic season, were used to validate this method.
It was shown that by using mAb # 1/ # 2 or # 4 at a concentration of 10-15 µg / ml the developed variant of cell-ELISA allows the detection of НА protein, synthesized in the cells infected with influenza A(H3N2) or A(H1N1)pdm09 virus, respectively.
The developed method can be used for identification of HA subtype of modern influenza A viruses with low HA activity, which is not possible by the conventional hemagglutination inhibition test.
According to the results of the antigenic and genetic analysis, most influenza A(H1N1)pdm09 and A(H3N2) viruses circulating in St. Petersburg matched the vaccine strains recommended by the WHO for vaccine composition in the 2012-2013 and 2013-2014 seasons.
Analysis of this data showed that the influenza epidemic in 2014-2015 began earlier (in December) compared to the epidemic of 2013-2014, and spread mainly from Europe through Russia to the East. The intensity of the epidemic of 2014-2015 was higher compared to the previous one. The epidemic was more prevalent by regions and cities and a wider engagement of different age groups (except children up to 2 years of age) was observed. At the peak of the epidemic, the morbidity level was higher, the average duration of the epidemic was longer, and the number of patients among cities’ inhabitants (especially among children 7-14 years of age and adults) was higher than in the previous season. The rates of hospitalization with influenza and acute respiratory viral infections (ARVI) among patients older than 65 years were also higher (1.4 times) as well as the frequency of hospitalization with a diagnosis of “influenza” (2.7 times) and the number of deaths from laboratory confirmed influenza (1.8 times).
Although the influenza pandemic virus strain A(H1N1)pdm09 was not the main causative agent of the 2015 epidemic and was distributed sporadically it still remained the leading cause of deaths from influenza in the course of this epidemic (45.5% of all cases). The deaths associated with this strain were recorded only in the European part of Russian Federation.
It was shown that when using mAbs # 1/ # 2 or # 4 at a concentration of 10-15 µg/ml, the developed variant of cell-ELISA was able to detect НА protein synthesized in the infected cells of influenza A(H3N2) and A(H1N1)pdm09 viruses, respectively.
The developed method can be used for the identification of modern influenza A viruses with low hemagglutination activity, which is not possible by the conventional hemagglutination inhibition test.