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. 2016 Jul 7;11(7):e0158244.
doi: 10.1371/journal.pone.0158244. eCollection 2016.

Epidemiological, Clinical and Virological Characteristics of Influenza B Virus from Patients at the Hospital Tertiary Care Units in Bangkok during 2011-2014

Affiliations

Epidemiological, Clinical and Virological Characteristics of Influenza B Virus from Patients at the Hospital Tertiary Care Units in Bangkok during 2011-2014

Navin Horthongkham et al. PLoS One. .

Abstract

Influenza B virus, which causes acute respiratory infections, has increased in prevalence in recent years. Based on the nucleotide sequence of the hemagglutinin (HA) gene, influenza B virus can be divided into two lineages, Victoria and Yamagata, that co-circulate during the influenza season. However, analysis of the potential association between the clinical and virological characteristic and the lineage of influenza B viruses isolated in Thailand was lacking. To investigate influenza B virus genetically and determine its neuraminidase (NA) inhibitor susceptibility phenotype, a total of 6920 nasopharyngeal-wash samples were collected from patients with influenza-like illness between the years 2011 and 2014 and were screened for influenza B virus by real-time PCR. Of these samples, 3.1% (216/6920) were confirmed to contain influenza B viruses, and 110 of these influenza viruses were randomly selected for nucleotide sequence analysis of the HA and NA genes. Phylogenetic analysis of the HA sequences showed clustering into various clades: Yamagata clade 3 (11/110, 10%), Yamagata clade 2 (71/110, 64.5%), and Victoria clade 1 (28/110, 25.5%). The analysis of clinical characteristic demonstrated that the Victoria lineage was significantly associated with the duration of hospitalization, number of deceased cases, pneumonia, secondary bacterial infection and underlying disease. When combined with phylogenetic analysis of the NA sequences, four samples showed viruses with reassortant sequences between the Victoria and Yamagata lineages. Statistical analysis of the clinical outcomes and demographic data for the reassortant strains did not differ from those of the other strains in circulation. Oseltamivir-resistant influenza B viruses were not detected. Our findings indicated the co-circulation of the Victoria and Yamagata lineages over the past four cold seasons in Bangkok. We also demonstrated differences in the clinical symptoms between these lineages.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Monthly distribution of influenza B viruses specimens from patients in Thailand from January 2011 to December 2014.
Total number of specimens are indicated by a bar and the positive rate of detection of influenza B virus is shown by a dotted line.
Fig 2
Fig 2. Phylogenetic tree of the HA gene sequences of influenza B viruses.
▲ represents the vaccine strain.
Fig 3
Fig 3. Yearly distribution of influenza B viruses, isolated in Thailand from 2011 to 2014, by lineage.
Fig 4
Fig 4. Phylogenetic tree of the NA gene sequences of influenza B viruses.
▲ represents the vaccine strains.
Fig 5
Fig 5. The 50% inhibitory concentration (IC50) of oseltamivir against influenza B virus isolates.

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Grants and funding

This work was funded by Faculty of Medicine, Srinakharinwirot University (to S. Srisurapanont).