Virological, epidemiological, clinic, and molecular genetic features of the influenza epidemic in 2015-2016: prevailing of the influenza A(H1N1)09 pdm virus in Russia and countries of the Northern hemisphere.

This work describes the specific features of the influenza virus circulating in the period from October 2015 to March 2016 in 10 cities of Russia, the basic laboratories of CEEI at the D.I. Ivanovsky Institute of Virology "Federal Research Centre of Epidemilogy and Microbiology named after the honorary academician N.F. Gamaleya" of the Ministry of Health of the Russian Federation. The increase in the morbidity caused by influenza viruses was detected in January-February 2016. The duration of the morbidity peak was 4-5 weeks. The most vulnerable group included children at the age from 3 to 6; a high rate of hospitalization was also detected among people at the age of 15-64 (65%). In clinic symptoms there were middle and severe forms with high frequency of hospitalization as compared with the season of 2009-2010, but much higher in comparison with the season of 2014-2015. Some of the hospitalized patients had virus pneumonias, half of which were bilateral. Among these patients, 10% were children; 30%, adults. The mortality in the intensive care unit of the hospital was 46%. Almost all lethal cases were among unvaccinated patients in the case of late hospitalization and without early antiviral therapy. The predominance of the influenza A(H1N1)09pdm virus both in the Russian Federation and the major part of the countries in the Northern hemisphere was noted. The results of the study of the antigenic properties of influenza strains of A(H1N1)pdm09 virus did not reveal any differences with respect to the vaccine virus. The sequencing data showed the amino acid substitutions in hemagglutinin (receptor binding and Sa sites) and in genes encoding internal proteins (PA, NP, M1, NS1). Strains were sensitive to oseltamivir and zanamivir and maintained resistance to rimantadine. The participation of non-influenza ARI viruses was comparable to that in preliminary epidemic seasons.

[The 2013-2014 epidemic season. Hospital monitoring and antiviral therapy for influenza ].

AIM: To characterize the 2013-2014 epidemic season from the results of detection of influenza infection in patients; to provide the molecular genetic characteristics of the strains isolated from deceased patients. SUBJECTS AND METHODS: The investigators examined 1203 patients (387 children, 509 people older than 16 years of age, 307 pregnant women) admitted to Moscow Clinical Infectious Diseases Hospital One with the clinical signs of acute respiratory viral diseases. Nasal lavage and autopsy specimens were used to isolate viral strains, then to sequence genomic fragments, and to determine receptor specificity. RESULTS: Out of the 1203 examinees, 284 (23.6%) were influenza-positive: 221 (77.8%), 24 (8.5%), and 39 (13.7%) patients had influenza A(H3N2), influenza A(H1N1)pdm09, and influenza B, respectively. Influenza was notified in 42,7% of the pregnant women. There was a preponderance of its moderate form; its severe form developed in single cases having comorbidities. One fatal outcome was registered. The intake of antiviral medications in the first 48 hours of the disease could prevent complications. The investigators revealed mutations in the strain isolated from the bronchoalveolar lavage fluid of a patient with severe pneumonia complicated by acute respiratory distress syndrome. CONCLUSION: There is evidence that there are mutant A(H1N1)pdm09 viruses that have high pneumotropicity. The high risk of their circulation in the population and the risk of severe influenza forms involving the lower respiratory tract remain. Early antiviral therapy in the first 36-48 hours diminishes the clinical manifestations of influenza and reduces the risk of developing complications.

[The peculiarities of the influenza epidemics in some areas of Russia during 2012-2013 season. The influenza A (H1N1) pdm09 virus domination in European countries].

The peculiarities of the influenza viruses circulation in 2012-2013 are discussed. The results were obtained in 10 cities of Russia, where basic laboratories of the Influenza Ecology and Epidemics Center of on the basis of Ivanovsky Institute of Virology, Ministry of Health of the Russian Federation, are situated. The increasing rate of the ARD morbidity caused by influenza viruses was observed in January-March 2013. The highest indices of the morbidity were detected during 6-7 weeks with the following decreasing rate till threshold levels to week 14. The influenza A (H1N1) pdm09, A (H3N2), and B viruses were the cause of the epidemic, but their activity differed over areas of Russia. The results of study of the antigenic and genetic properties of the influenza strains demonstrated closed relatives with respect to vaccine strains. In addition, some heterogeneity of the circulating strains and their drift variants were found as well. All tested strains were sensitive to oseltamivir (excluding one A (H1N1) pdm09 strain), zanamivir, arbidol, and remained resistant to rimantadine. The ratio of the ARD viruses was comparable with the last epidemic seasons.

[Development of the influenza epidemic in season 2011-2012 in some areas of Russia: results of activity of the Influenza Etiology and Epidemiology Center of the Ivanovsky Institute of Virology].

The results of analysis of the peculiarities of the epidemic 2011-2012 development in the areas of 10 cities of Russia obtained by basic laboratories of IEES on the base of D.I. Ivanovsky Research Institute of Virology, Ministry of Public Health and Social Development of Russia, are presented. The increasing ARD morbidity caused by the influenza viruses was detected rather late--in February-March 2012. The highest indices of the morbidity were detected during weeks 10-13 followed by decreasing to threshold levels by week 27. Children 0-2 and 3-6 years old were involved the most, meantime the high rate of hospitalization was found for 15-64 years old aged group (25%). Influenza A(H3N2) and B viruses were the cause of the epidemic. The results of studies of the antigenic and genetic properties of the influenza strains showed most of them to be close relatives to the vaccine strains. Some heterogeneity of circulating strains and their drift variants were found as well. All tested strains were sensitive to arbidol, oseltamivir and zanamivir, and saved resistance to rimantadine. The ratio of ARD viruses was comparable with the last epidemic seasons.

[The specific features of the cocirculation of influenza viruses in the 2010-2011 postpandemic period according to the results of activities of the D. I. Ivanovsky Research Institute of Virology, Ministry of Health and Social Development of Russia].

The paper gives the results of monitoring the circulation of influenza viruses in the 2010-2011 season, that covers the second year of circulation of pandemic A(H1N1)v virus strains, and their interaction with seasonal A (H3N2) and B strains. Unlike the previous season, the beginning of an increase in morbidity was recorded in January 2011; its peak in the most of contiguous areas was noted at 5-7 weeks of 2011, with its further decline to threshold levels at week 11 of 2011. Preschool and school children were most involved in the epidemic process. Three influenza virus strains (A(H1N1)v, A(H3N2), and B) were found to circulate. Differences were found in the level of participation of the isolated strains in individual areas of the Russian Federation. Detailed typing of the isolated strains determined the compliance of the vast majority of them with vaccine viruses. The pandemic influenza A(H1N1)v virus strains retained their susceptibility to oseltamivir and were resistant to rimantadine. The participation of non-influenza acute respiratory viral infection pathogens was estimated as follows: 11.9% for parainfluenza viruses, 5.9% for adenoviruses, and 3.5% for PC viruses, and 0.7% for pneumonia Mycoplasma, which was comparable with the previous epidemic seasons.

[The characteristics of epidemic influenza A and B virus strains circulating in Russia during the 2007-2008 season].

In 2007-2008 in Russia, the epidemic upsurge of influenza morbidity was caused by the active circulation of influenza A(H1N1, A(H3N2), and B viruses. The center for Ecology and Epidemiology of Influenza studied 334 epidemic strains. The results of a comparative study of the svirus specificity of commercial test systems (AmpliSens Influenza virus A/B and AmpliSens Influenza virus A/H5N1) for the polymerase chain reaction diagnosis and virological assays, including virus isolation, revealed their high correlation, which confirms that they may be expensively used to monitor the circulation of influenza viruses in the Russian Federation. All the strains were isolated in the MDCK cell culture. Influenza A(H1N1) viruses (n = 127) were antigenic variants of the reference strains A/Solomon Islands/3/06 and A/Brisbane/59107. Influenza A(H3N2) viruses (n = 49) were antigenic variants of the reference strains A/Wisconsin/67/05 and A/Brisbane/10/08. One hundred and fifty seven Influenza B strains were drift variants of the reference strains B/Florida/4/06 and B/Shanghai/361/02 of lineage B/Yamagata/16/88 and one strain, a variant of Malaysia/2506/04 related to lineage B/victoria/2/87. The isolates interacted actively with human 0(I) blood group erythrocytes and much more weakly with chicken ones. All study influenza A(H1N1) viruses (n = 74) preserved their sensitivity to rimantadine while 24 (77%) of the 31 study influenza A(H3N2) virus strains were resistant. A study of the time course of changes in the generation of antibodies in the donor sera obtained in Moscow and the Moscow Region in different periods of the epidemic process revealed an increase in antibodies to the reference influenza A and B virus strains circulating in this period.

[Monitoring of the sensitivity of epidemic influenza virus strains isolated in Russia to etiotropic chemical agents].

The paper presents the results of studying the spectrum of influenza A and B viruses to rimantadine, arbidol, and oseltamivir and describes the methods used for these purposes for epidemiological surveillance. Different sensitivities to rimantadine were found among influenza A viruses. During the 2007-2008 season, the vast majority of influenza A(H3N2) virus strains were resistant to rimantadine (77%) while all influenza A(H1N1) virus strains preserved their resistance to this drug. The fact that the epidemic influenza A(H1N1) virus strains that carry the mutation responsible for resistance to the neuraminidase inhibitor oseltamivir (Tamiflu) circulated in the Russian Federation was first established. At the same time all the study influenza A(H1N1) virus strains preserved their susceptibility to rimantadine. The sensitivity of the epidemic strains to arbidol has been confirmed.

[Prospects of use coryneformic bacteria drug to prevent and treat respiratory infections].

This work shows the Codivac efficiency in its aerosol form to treat children sick of influenza and acute respiratory viral infections. Course of therapy with the Codivac drug leads to improve clinical picture and rapid elimination virus from human organism as compared with children undergone traditional therapy. Recovery is accompanied with improving of indices of cell immunity. The article shows the prospects of use Codivac to prevent and treat respiratory infections.

[The use of a virazole aerosol in young children with a respiratory syncytial virus infection]. / Primenenie aérozolia virazola u detei rannego vozrasta s respiratorno-sintsitial'noi virusnoi infektsiei.

The therapeutic effect of aerosol virasol was studied in young infants suffering from RS virus infection with concomitant broncho-obstructive syndrome. The study involved 60 children between 1 month and 4 years of age of whom 30 were treated with virasol and another 30 made a control group. Virasol was shown to reduce the severity of the clinical picture to a considerable degree and speed up the recovery in infants with RS virus disease. Virasol is recommended for inhalation treatment of infants with RS virus infection and concomitant broncho-obstructive syndrome. The daily dose of virasol is 10 mg per kilo of body weight. The duration of one course is 3 to 5 days.

[A comparative study of the protective properties of live recombinant and inactivated influenza vaccines made from strain A/Philippines/2/82 (H3N2) in 8- to 15-year-old children]. / Sravnitel'noe izuchenie zashchitnykh svoistv zhivoi rekombinantnoi i inaktivirovannoi grippoznykh vaktsin iz shtamma A/Filippiny/2/82 (H3N2) u detei 8--15 let.

A limited controlled comparative study for the evaluation of the epidemiological efficacy of live recombinant and inactivated virion vaccines from A/Philippines/2/82-like strains of influenza A (H3N2) virus was carried out in schoolchildren of 8 to 15 years of age. During the influenza epidemic of 1987-1988 caused by influenza A/Sichuan/2/87 (H3N2)-like strains and by influenza B virus in 8.2-17% of cases, a statistically significant efficacy index for live influenza vaccine was 1.8 for the laboratory confirmed A (H3N2) cases. In the group vaccinated with the inactivated vaccine the number of serologically diagnosed A (H3N2) cases was 1.6 times lower than in the group receiving placebo, this difference being statistically significant. Thus, under the conditions of significant difference in the antigenic structure of the vaccine and epidemic A (H3N2) strains, both vaccines produced some diminished but statistically significant preventive effect in vaccinated children although its level was below the optimal. Revaccination of some children with a live influenza vaccine from a new A/Sichuan/2/87-like variant of A (H3N2) virus in the autumn of 1988 with reisolation of the vaccine strain also revealed the presence of some, though weak, resistance to this strain in the children vaccinated with both vaccines.

[A comparative study of the inoculation properties of live recombinant and inactivated influenza vaccines made from strain A/Philippines/2/82 (H3N2) in 8- to 15-year-old children]. / Sravnitel'noe izuchenie privivochnykh svoistv zhivoi rekombinantnoi i inaktivirovannoi grippoznykh vaktsin iz shtamma A/Filippiny/2/82 (H3N2) u detei 8--15 let.

This study was carried out to compare reactogenicity, immunogenicity, and efficacy of live attenuated and inactivated influenza vaccines prepared from influenza A/Philippines/2/82-like virus strains. Schoolchildren of a boarding school of Moscow were randomly divided into three groups: (1) vaccinated with a live attenuated vaccine, (2) vaccinated with inactivated influenza vaccine, and (3) given placebo. Both vaccines were well tolerated by the children, with practically no severe general or local reactions. The inactivated vaccine was found to be superior to the live one in its capacity to stimulate humoral immunity studied by HI, EIA, and microneutralization tests. In 69.7% of the children given the inactivated vaccine, seroconversion to the vaccine strain was detected by two or three methods of antibody titration used. Only 35.4% seroconversions were demonstrated in children immunized with the live influenza vaccine. Enzyme immunoassay was found to be a more sensitive but less specific method for antibody titration as compared with HI test whereas microneutralization proved to be more specific but less sensitive for titration of antibodies to influenza A (H3N2) viruses.

[Indices of T-lymphocytes and their subpopulations in children with influenza]. / Pokazateli T-limfotsitov i ikh subpopuliatsii u detei pri grippe.

The results of the study of T lymphocytes and their subpopulations in 150 children ranging in age from 2 months to 5 years suffering from influenza complicated with croup, pneumonia, and obstructive syndrome are presented. In 47 children, mixed infection: influenza with concomitant adenovirus infection or respiratory-syncytial infection was observed. The control group consisted of 22 normal children. In the acute period of influenza the number of T lymphocytes and their subpopulations was found to decrease. The greatest decrease in the levels of T lymphocytes and especially of E-theophylline-sensitive ones was observed in cases complicated with pneumonia and obstructive syndrome. In mixed infections, inhibition of E-RFC and their subpopulations was more marked in influenza and adenovirus disease. The data obtained by catamnestic observations of children with lowered levels of T lymphocytes suggest that such children should be referred to a risk group and apparently require immunocorrective therapy.