WHO NIC at Research Institute of Influenza and D.I. Ivanovsky Institute of Virology INTEGRATED DATA OF INFLUENZA MORBIDITY AND DIAGNOSIS
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1 WHO NIC at Research Institute of Influenza and D.I. Ivanovsky Institute of Virology 1 of 7 Year: 2018 Week: 6 Period: Influenza and ARI morbidity data Epidemiological data show increase of influenza and other ARI activity in Russia in comparison with previous week. The ILI & ARI incidence rate (77.5 per of population) was above by 6.8% the new nationalwide baseline (72.6) calculated by RII NIC for season. ILI and ARI epidemic thresholds were exceeded in 6 of 61 cities collaborating with two WHO NICs in Russia. Exceeding of morbidity epidemic thresholds for overall population - No data - less 20% % - 50% and more
2 2 of 7 Cumulative number of diagnosed influenza cases Cumulative results of influenza laboratory diagnosis by different tests were submitted by 52 RBLs and two WHO NICs. According to these data as a result of 2583 investigation the percent of samples positive for influenza was estimated as 10.0%. Proportion of influenza A(H1N1)pdm09, A(H3N2) and B viruses was estimated as 29.0%, 35.1% and 35.5%, respectively. Results of influenza diagnosis - No data - No detection - H1pdm09 - H1pdm09+H1 - H1pdm09+B - H1pdm09+B+H1 - H1pdm09+H3 - H1pdm09+H3+H1 - H1pdm09+H3+B - H1pdm09+H3+H1+B - H1 - B - B+H1 - H3 - H3+H1 - H3+B - H3+H1+B
3 3 of 7 Influenza Virus Isolation - B - A(H1N1) - A(H3N2) - A(H1N1)pdm09
4 4 of 7 Influenza Virus Antigen Detection by Immunofluorescence Assay (IFA) - B - A(H1N1) + A(H1N1)pdm09 - A(H3N2) - PIV - AD - RS
5 5 of 7 Influenza Virus RNA Detection by RT-PCR - B - A(H1N1) - A(H3N2) - A(H1N1)pdm09 - PIV - AD - RS
6 6 of 7 Table N1. Influenza Virus Isolation viruses isolated H1 H3 B H1pdm09 Untyped virus BL of RII (%) 0,0 2,5 4,4 4,4 0,0 11,4 BL of IV (%) 0,0 0,0 7,3 12,2 0,0 19,5 TOTAL (%) 0,0 2,0 5,0 6,0 0,0 13,1 Table N2. Influenza Virus Antigen Detection by Immunofluorescence assay (IFA) Influenza Parainfluenza H1+H1pdm09 H3 B I II III Total AD RS Total BL of RII (%) 1,6 1,5 1,1 2,7 1,1 2,5 7,0 9,3 26,9 BL of IV (%) 1,7 0,0 0,8 4,2 1,7 13,3 9,2 9,2 40,0 TOTAL (%) 1,6 1,3 1,1 2,9 1,2 4,0 7,3 9,3 28,7 Table N3. A (not subtyped) Influenza Virus RNA detection by RT-PCR Influenza H1 H3 H5 B H1pdm09 PIV AD RS BL of RII / / / / / / / / / 1195 (%) 0,2 0,0 4,8 0,0 3,6 4,2 0,9 4,1 12,6 BL of IV / / / / / / / / / 179 (%) 0,0 0,0 7,1 0,0 7,4 8,1 1,1 1,7 7,3 TOTAL / / / / / / / / / 1374 (%) 0,1 0,0 5,0 0,0 4,2 4,7 1,0 3,8 11,9 Table N4. H1 Cumulative Diagnosed Influenza Cases H1+H1pdm09 (IFA) diagnosed influenza cases H3 A (not subtyped) B H1pdm09 Total BL of RII (%) 0,0 0,5 3,6 0,09 3,2 2,6 9,5 BL of IV (%) 0,0 0,5 3,1 0,0 5,4 4,4 12,9 TOTAL (%) 0,0 0,5 3,5 0,08 3,6 2,9 10,0
7 7 of 7 Conclusion Influenza and ARI morbidity data. Increase of influenza and other ARI activity was registered during week in Russia. The ILI & ARI incidence rate (77.5 per of population) was above by 6.8% the nationalwide baseline. Etiology of ILI & ARI morbidity. The overall percent of respiratory samples positive for influenza was estimated as 10.0%. Proportion of influenza A(H1N1)pdm09, A(H3N2) and B viruses was estimated as 29.0%, 35.1% and 35.5%, respectively. Antigenic characterization. 39 influenza viruses were characterized antigenically in two NICs, including 14 influenza A(H1N1)pdm09 viruses, 7 influenza A(H3N2) strains and 18 influenza type B strains. All influenza A(H1N1)pdm09 and A(H3N2) strains matched influenza vaccine strains for the season influenza type B strains of Yamagata lineage were like B/Phuket/3073/2013 reference virus, 3 influenza type B strains of Victoria lineage were antigenically related to B/Brisbain/60/2008 virus. Genetic characterization. Full-genome NGS of 58 influenza positive samples and viruses from 6 cities was conducted. 16 influenza A(H1N1)pdm09 viruses belonged to phylogenetic group 6B.1 with amino acid substitutions in HA S84N, S162N and I216T. According to phylogenetic analisis of HA 18 of 22 tested influenza A(H3N2) viruses belonged to clade 3C.2a carring aa substitutions L3I, N144S, F159Y, K160T, N225D and Q311H in HA1. Four influenza A(H3N2) viruses belonged to genetic subgroup 3C.2a1 and carried aa substitutions K92R, N121K, T135K and H311Q. 2 influenza B viruses of Victoria-lineage belonged to genetic subgroup 1A (B/Brisbane/60/2008-like). All 18 influenza B viruses of Yamagata-lineage belonged to clade 3 (B/Phuket/3073/2013-like) and had substitution L172Q and M251V in HA1. Susceptibility to antivirals.most viruses were susceptible to NA inhibitors excluding three influenza A(H1N1)pdm09 strains isolated in Moscow which had H275Y amino acid substitution in NA responsible for highly reduced susceptibility to oseltamivir and zanamivir. 14 influenza strains tested in MUNANA-assay for antiviral resistance to NA inhibitors in RII NIC, including 3 A(H1N1)pdm09 strains isolated in St.Petersburg, 4 A(H3N2), two B Victoria strains and 5 B Yamagata viruses were susceptible to oseltamivir and zanamivir. All influenza A strains tested were resistant to rimantadine. Percent of positive ARI cases of non-influenza etiology (PIV, adeno- and RSV) was estimated as 24.7% of by IFA and 16.7% by PCR. Last weeks RSV dominated among ARI agents. In sentinel surveillance system clinical samples from 164 SARI and ILI/ARI were by rrt- PCR. 10 (12.5%) influenza cases were detected among SARI, including 1 influenza A(H1N1)pdm09 case, 5 influenza A(H3N2) cases and 4 influenza B cases. Among ILI/ARI 28 (33.3%) influenza cases were detected, including 4 influenza A(H1N1)pdm09 cases, 14 influenza A(H3N2) cases and 10 influenza B cases. Anna A.SOMININA, professor Deputy Chief of the WHO National Influenza Center of Russia, St.-Petersburg Elena I.BURTSEVA, DMS, Chief of the Laboratory of Etiology and Epidemiology of Influenza, WHO National Influenza Center of Russia, Moscow
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