Humoral immunity to influenza and severe influenza cases in Russia in 2018-2019

The aim of our work was to investigate the herd immunity to influenza viruses among population of Russia during autumn 2918; evaluation of severe cases of the infection over the season of2018-2019 epidemics, and confirmed cases of influenza in vaccinated persons. A total of 1835 samples of blood serum were studied. Neither sample did react in hemagglutination inhibition test with highly pathogenic A(H5N8) and A(H7N9) viral strains. 41 to 58% of samples, dependent on sampling region, showed significant antibody titers (> 40) against против вакцинного штамма the vaccinal A/Michigan/45/2015 strain (H1N1pdm09). 40 to 63% of the same sera were positive for epidemic A/Lipetsk/1V/2018 strain (H1N1pdm09), isolated at the start of epidemic season (26.11.2018). From 26 to 46% of the samples were seropositive towards vaccinal strain A/Singapore/ INFIMH-16-0019/2016 (H3N2), and 10 to 23% towards Yamagata influenza B genetic strain. Severe influenza cases during the 2018-2019 epidemic season were caused, mainly, by influenza A virus, with predominance of A/H1N1pdm09 (52.5%), with only 3% of cases caused by influenza A viruses. 217 cases of influenza with lethal outcome were confirmed, of them about a half of these cases (44.7%) affected older persons (> 60 years old), 29% were diagnosed in the group of 46-59 years old. Eight lethal cases of influenza infection (3.7%) were documented in the persons vaccinated before the vaccination season. Over 75% of patients with lethal influenza cases had concomitant diseases, with cardiovascular disorders, obesity, diabetes, urogenital diseases, infectious diseases (HIV, hepatitis) being most often. Hence, vaccination against influenza remains the most effective protective tool, especially in the risk groups. The study was performed in the frames of the state task contract (ГЗ-1/16 and ГЗ-2/18).

1. Board of Rospotrebnadzor following the results of the influenza epidemic and SARS 2018-2019 [Electronic resource]. Access mode: https://www.rospotrebnadzor.ru/about/info/news/news_details.php?ELEMENT_ID=11806.

2. Black S., Nicolay U., Vesikari T., Knuf M., del Giudice G., Della Cioppa G. Hemagglutination inhibition antibody titers as a correlate of protection for inactivated influenza vaccines in children. Pediatr. Infect. Dis. J., 2011, Vol. 30, no. 12, pp. 1081-1085.

3. Chowell G., Miller M.A., Viboud C. Seasonal influenza in the United States, France, and Australia: transmission and prospects for control. Epidemiol. Infect., 2008, Vol. 136, no. 6, pp. 852-864.

4. Foppa I.M., Cheng P.Y., Reynolds S.B., Shay D.K., Carias C., Bresee J.S., Kim I.K., Gambhir M., Fry A.M. Deaths averted by influenza vaccination in the US during the seasons 2005/06 through 2013/14. Vaccine, 2015, Vol. 33, no. 26, pp. 3003-3009.

5. Francis T., Salk J.E., Pearson H.E., Brown P.N. Protective effect of vaccination against induced influenza A. J. Clin. Invest., 1945, Vol. 24, no. 4, pp. 536-546.

6. Hobson D., Curry R.L., Beare A.S., Ward-Gardner A. The role of serum haemagglutination-inhibiting antibody in protection against challenge infection with influenza A2 and B viruses. J. Hyg. Camb., 1972, Vol. 70, no. 4, pp. 767-777.

7. Ilyicheva T., Durymanov A., Susloparov I., Kolosova N., Goncharova N., Svyatchenko S., Petrova O., Bondar A., Mikheev V., Ryzhikov A. Fatal cases of seasonal influenza in Russia in 2015-2016. PLoS ONE, 2016, Vol. 11, no. 10, e0165332. doi: 10.1371/journal.pone.0165332.

8. Iuliano A.D., Roguski K.M., Chang H.H., et al. Estimates of global seasonal influenza-associated respiratory mortality: a modelling study. Lancet, 2017, Vol. 391, no. 10127, pp. 1285-1300.

9. Katz J., Englund J.A., Steinhoff M.C., Khatry S.K., Shrestha L., Kuypers J., Mullany L.C., Chu H.Y., LeClerq S.C., Kozuki N., Tielsch J.M. Impact of timing of influenza vaccination in pregnancy on transplacental antibody transfer, influenza incidence, and birth outcomes: a randomized trial in rural. Nepal. Clin. Infect. Dis., 2018, Vol. 67, pp. 334-340.

10. Madhi S.A., Nunes M.C., Cutland C.L. Influenza vaccination of pregnant women and protection of their infants. N. Engl. J. Med., 2014, Vol. 371, no. 24, p. 2340.

11. Marchenko V.Y., Susloparov I.M., Komissarov A.B., Fadeev A., Goncharova N.I., Shipovalov A.V., Svyatchenko S.V., Durymanov A.G., Ilyicheva T.N., Salchak L.K., Svintitskaya E.P., Mikheev V.N., Ryzhikov A.B. Reintroduction of highly pathogenic avian influenza A/H5N8 virus of clade 2.3.4.4. in Russia. Arch. Virol., 2017, Vol. 162, no. 5, pp. 1381-1385.

12. McVernon J., Laurie K., Faddy H., Irving D., Nolan T., Barr I., Kelso A. Seroprevalence of antibody to influenza A(H1N1)pdm09 attributed to vaccination or infection, before and after the second (2010) pandemic wave in Australia. Influenza Other Respir. Viruses, 2014, Vol. 8, no. 2, pp. 194-200.

13. Meiklejohn G., Kempe C.H., Thalman W.G., Lennette E.H. Evaluation of monovalent influenza vaccines. II. Observations during an influenza A-prime epidemic. Am. J. Hyg., 1952, Vol. 55, no. 1, pp. 12-21.

14. Mertz D., Geraci J., Winkup J., Gessner B.D., Ortiz J.R., Loeb M. Pregnancy as a risk factor for severe outcomes from influenza virus infection: a systematic review and meta-analysis of observational studies. Vaccine, 2017, Vol. 35, no. 4, pp. 521-528.

15. Nair H., Brooks WA., Katz M., et al. Global burden of respiratory infections due to seasonal influenza in young children: a systematic review and meta-analysis. Lancet, 2011, Vol. 378, no. 9807, pp. 1917-1930.

16. Noah D.L., Hill H., Hines D., White E.L., Wolff M.C. Qualification of the hemagglutination inhibition assay in support of pandemic influenza vaccine licensure. Clin. Vaccine Immunol., 2009, Vol. 16, no. 4, pp. 558-566.

17. Palmeira P., Quinello C., Silveira-Lessa A.L., Zago C.A., Carneiro-Sampaio M. IgG placental transfer in healthy and pathological pregnancies. Clin. Dev. Immunol., 2012, Vol. 2012, 985646. doi: 10.1155/2012/985646.

18. Sullivan S.G., Price O.H., Regan A.K. Burden, effectiveness and safety of influenza vaccines in elderly, paediatric and pregnant populations. Ther. Adv. Vaccines Immunother., 2019, Vol. 7, 2515135519826481. doi: 10.1177/2515135519826481.

19. Weber M.A., Hartley J.C., Ashworth M.T., Malone M., Sebire N.J. Virological investigations in sudden unexpected deaths in infancy (SUDI). Forensic Sci. Med. Pathol., 2010, Vol. 6, no. 4, pp. 261-267.

20. World Health Organization. Recommended composition of influenza virus vaccines for use in the 2019-2020 northern hemisphere influenza season. Available at: https://www.who.int/influenza/vaccines/virus/recommendations/2019_20_north/en/.

21. World Health Organization. Seasonal vaccination policies and coverage in the European Region. Available at: http://www.euro.who.int/data/assets/pdf_file/0003/241644/Evaluation-of-seasonal-influenza-vaccination-policies-and-coverage-in-the-WHO-European-Region.pdf.

22. Wu P., Goldstein E., Ho L.M., Wu J.T., Tsang T., Leung G.M., Cowling B.J. Excess mortality impact of two epidemics of pandemic influenza A(H1N1pdm09) virus in Hong Kong. Influenza Other Respir. Viruses, 2014, Vol. 8, no. 1, pp. 1-7.