Clinical and molecular epidemiology of influenza viruses from Romanian patients hospitalized during the 2019/20 season.

Two main mechanisms contribute to the continuous evolution of influenza viruses: accumulation of mutations in the hemagglutinin and neuraminidase genes (antigenic drift) and genetic re-assortments (antigenic shift). Epidemiological surveillance is important in identifying new genetic variants of inf...

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Autores principales:	Victor Daniel Miron, Leontina Bănică, Oana Săndulescu, Simona Paraschiv, Marius Surleac, Dragoș Florea, Ovidiu Vlaicu, Petre Milu, Anca Streinu-Cercel, Anuta Bilașco, Dan Oțelea, Daniela Pițigoi, Adrian Streinu-Cercel, Anca Cristina Drăgănescu
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/5e8aba7df3f64b5bb47a66f77376559d
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spelling	oai:doaj.org-article:5e8aba7df3f64b5bb47a66f77376559d2021-12-02T20:13:15ZClinical and molecular epidemiology of influenza viruses from Romanian patients hospitalized during the 2019/20 season.1932-620310.1371/journal.pone.0258798https://doaj.org/article/5e8aba7df3f64b5bb47a66f77376559d2021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0258798https://doaj.org/toc/1932-6203Two main mechanisms contribute to the continuous evolution of influenza viruses: accumulation of mutations in the hemagglutinin and neuraminidase genes (antigenic drift) and genetic re-assortments (antigenic shift). Epidemiological surveillance is important in identifying new genetic variants of influenza viruses with potentially increased pathogenicity and transmissibility. In order to characterize the 2019/20 influenza epidemic in Romania, 1042 respiratory samples were collected from consecutive patients hospitalized with acute respiratory infections in the National Institute for Infectious Diseases "Prof. Dr. Matei Balș", Bucharest Romania and tested for influenza A virus, influenza B virus and respiratory syncytial virus (RSV) by real-time PCR. Out of them, 516 cases were positive for influenza, with relatively equal distribution of influenza A and B. Two patients had influenza A and B co-infection and 8 patients had influenza-RSV co-infection. The most severe cases, requiring supplemental oxygen administration or intensive care, and the most deaths were reported in patients aged 65 years and over. Subtyping showed the predominance of A(H3N2) compared to A(H1N1)pdm09 pdm09 (60.4% and 39.6% of all subtyped influenza A isolates, respectively), and the circulation of Victoria B lineage only. Influenza B started to circulate first (week 47/2019), with influenza A appearing slightly later (week 50/2019), followed by continued co-circulation of A and B viruses throughout the season. Sixty-eight samples, selected to cover the entire influenza season and all circulating viral types, were analysed by next generation sequencing (NGS). All A(H1N1)pdm09 sequences identified during this season in Romania were clustered in the 6b1.A clade (sub-clades: 6b1.A.183P -5a and 6b1.A.187A). For most A(H1N1)pdm09 sequences, the dominant epitope was Sb (pepitope = 0.25), reducing the vaccine efficacy by approximately 60%. According to phylogenetic analysis, influenza A(H3N2) strains circulating in this season belonged predominantly to clade 3C.3A, with only few sequences in clade 3C.2A1b. These 3C.2A1b sequences, two of which belonged to vaccinated patients, harbored mutations in antigenic sites leading to potential reduction of vaccine efficacy. Phylogenetic analysis of influenza B, lineage Victoria, sequences showed that the circulating strains belonged to clade V1A3. As compared to the other viral types, fewer mutations were observed in B/Victoria strains, with limited impact on vaccine efficiency based on estimations.Victor Daniel MironLeontina BănicăOana SăndulescuSimona ParaschivMarius SurleacDragoș FloreaOvidiu VlaicuPetre MiluAnca Streinu-CercelAnuta BilașcoDan OțeleaDaniela PițigoiAdrian Streinu-CercelAnca Cristina DrăgănescuPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 11, p e0258798 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Victor Daniel Miron Leontina Bănică Oana Săndulescu Simona Paraschiv Marius Surleac Dragoș Florea Ovidiu Vlaicu Petre Milu Anca Streinu-Cercel Anuta Bilașco Dan Oțelea Daniela Pițigoi Adrian Streinu-Cercel Anca Cristina Drăgănescu Clinical and molecular epidemiology of influenza viruses from Romanian patients hospitalized during the 2019/20 season.
description	Two main mechanisms contribute to the continuous evolution of influenza viruses: accumulation of mutations in the hemagglutinin and neuraminidase genes (antigenic drift) and genetic re-assortments (antigenic shift). Epidemiological surveillance is important in identifying new genetic variants of influenza viruses with potentially increased pathogenicity and transmissibility. In order to characterize the 2019/20 influenza epidemic in Romania, 1042 respiratory samples were collected from consecutive patients hospitalized with acute respiratory infections in the National Institute for Infectious Diseases "Prof. Dr. Matei Balș", Bucharest Romania and tested for influenza A virus, influenza B virus and respiratory syncytial virus (RSV) by real-time PCR. Out of them, 516 cases were positive for influenza, with relatively equal distribution of influenza A and B. Two patients had influenza A and B co-infection and 8 patients had influenza-RSV co-infection. The most severe cases, requiring supplemental oxygen administration or intensive care, and the most deaths were reported in patients aged 65 years and over. Subtyping showed the predominance of A(H3N2) compared to A(H1N1)pdm09 pdm09 (60.4% and 39.6% of all subtyped influenza A isolates, respectively), and the circulation of Victoria B lineage only. Influenza B started to circulate first (week 47/2019), with influenza A appearing slightly later (week 50/2019), followed by continued co-circulation of A and B viruses throughout the season. Sixty-eight samples, selected to cover the entire influenza season and all circulating viral types, were analysed by next generation sequencing (NGS). All A(H1N1)pdm09 sequences identified during this season in Romania were clustered in the 6b1.A clade (sub-clades: 6b1.A.183P -5a and 6b1.A.187A). For most A(H1N1)pdm09 sequences, the dominant epitope was Sb (pepitope = 0.25), reducing the vaccine efficacy by approximately 60%. According to phylogenetic analysis, influenza A(H3N2) strains circulating in this season belonged predominantly to clade 3C.3A, with only few sequences in clade 3C.2A1b. These 3C.2A1b sequences, two of which belonged to vaccinated patients, harbored mutations in antigenic sites leading to potential reduction of vaccine efficacy. Phylogenetic analysis of influenza B, lineage Victoria, sequences showed that the circulating strains belonged to clade V1A3. As compared to the other viral types, fewer mutations were observed in B/Victoria strains, with limited impact on vaccine efficiency based on estimations.
format	article
author	Victor Daniel Miron Leontina Bănică Oana Săndulescu Simona Paraschiv Marius Surleac Dragoș Florea Ovidiu Vlaicu Petre Milu Anca Streinu-Cercel Anuta Bilașco Dan Oțelea Daniela Pițigoi Adrian Streinu-Cercel Anca Cristina Drăgănescu
author_facet	Victor Daniel Miron Leontina Bănică Oana Săndulescu Simona Paraschiv Marius Surleac Dragoș Florea Ovidiu Vlaicu Petre Milu Anca Streinu-Cercel Anuta Bilașco Dan Oțelea Daniela Pițigoi Adrian Streinu-Cercel Anca Cristina Drăgănescu
author_sort	Victor Daniel Miron
title	Clinical and molecular epidemiology of influenza viruses from Romanian patients hospitalized during the 2019/20 season.
title_short	Clinical and molecular epidemiology of influenza viruses from Romanian patients hospitalized during the 2019/20 season.
title_full	Clinical and molecular epidemiology of influenza viruses from Romanian patients hospitalized during the 2019/20 season.
title_fullStr	Clinical and molecular epidemiology of influenza viruses from Romanian patients hospitalized during the 2019/20 season.
title_full_unstemmed	Clinical and molecular epidemiology of influenza viruses from Romanian patients hospitalized during the 2019/20 season.
title_sort	clinical and molecular epidemiology of influenza viruses from romanian patients hospitalized during the 2019/20 season.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/5e8aba7df3f64b5bb47a66f77376559d
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Clinical and molecular epidemiology of influenza viruses from Romanian patients hospitalized during the 2019/20 season.

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