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Matsuzaki Y, Ohmiya S, Ota R, Kitai Y, Watanabe O, Kitaoka S, Kumaki S, Onuma R, Watanabe Y, Nagai Y, Kadowaki Y, Shimotai Y, Nishimura H. Epidemiologic, clinical, and genetic characteristics of influenza C virus infections among outpatients and inpatients in Sendai, Japan from 2006 to 2020. J Clin Virol 2023; 162:105429. [PMID: 37031609 DOI: 10.1016/j.jcv.2023.105429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 03/17/2023] [Accepted: 03/22/2023] [Indexed: 04/05/2023]
Abstract
BACKGROUND Influenza C virus is a pathogen that causes acute respiratory illness in children. The clinical information about this virus is limited because of the small number of isolated viruses compared to influenza A or B viruses. METHODS A total of 60 influenza C viruses were isolated by clinical tests using cell culture methods conducted in one hospital and one clinic during the 15 years from 2006 to 2020. These 60 cases were retrospectively analyzed by comparing outpatients and inpatients. Moreover, isolated viruses were analyzed for genomic changes during the study period. RESULTS All were younger than 7 years, and 73% of inpatients (19 out of 26) were under 2 years of age. A significant difference was found in the frequency of pneumonia, accounting for 45% and 4% of inpatients and outpatients, respectively. Most of the viruses isolated from 2006 to 2012 belonged to the S/A sublineage of the C/Sao Paulo lineage, but three sublineage viruses, including the S/A sublineage with K190N mutation, S/V sublineage, and C/Kanagawa lineage, have cocirculated since 2014. Moreover, S/A sublineage viruses were undergoing reassortment since 2014, suggesting significant changes in the virus, both antigenically and genetically. Of the 10 strains from patients with pneumonia, 7 were in the S/A sublineage, which had circulated from 2006 to 2012. CONCLUSION Infants under 2 years of age were more likely to be hospitalized with pneumonia. The genomic changes that occurred in 2014 were suggested to affect the ability of the virus to spread.
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Affiliation(s)
- Yoko Matsuzaki
- Department of Infectious Diseases, Yamagata University Faculty of Medicine, Iida-Nishi, 990-9585, Yamagata Japan.
| | - Suguru Ohmiya
- Virus Research Center, Clinical Research Division, Sendai Medical Center, Miyagino-ku, 983-8520, Sendai, Miyagi Japan
| | - Reiko Ota
- Virus Research Center, Clinical Research Division, Sendai Medical Center, Miyagino-ku, 983-8520, Sendai, Miyagi Japan
| | - Yuki Kitai
- Virus Research Center, Clinical Research Division, Sendai Medical Center, Miyagino-ku, 983-8520, Sendai, Miyagi Japan
| | - Oshi Watanabe
- Virus Research Center, Clinical Research Division, Sendai Medical Center, Miyagino-ku, 983-8520, Sendai, Miyagi Japan
| | - Setsuko Kitaoka
- Department of Pediatrics, Sendai Medical Center, Miyagino-ku, 983-8520, Sendai, Miyagi Japan
| | - Satoru Kumaki
- Department of Pediatrics, Sendai Medical Center, Miyagino-ku, 983-8520, Sendai, Miyagi Japan
| | - Ryoichi Onuma
- Department of Pediatrics, Sendai Medical Center, Miyagino-ku, 983-8520, Sendai, Miyagi Japan
| | - Yohei Watanabe
- Department of Pediatrics, Sendai Medical Center, Miyagino-ku, 983-8520, Sendai, Miyagi Japan
| | - Yukio Nagai
- Nagai Children's Clinic, Miyagino-ku, 983-0045, Sendai, Miyagi Japan
| | - Yoko Kadowaki
- Department of Infectious Diseases, Yamagata University Faculty of Medicine, Iida-Nishi, 990-9585, Yamagata Japan
| | - Yoshitaka Shimotai
- Department of Infectious Diseases, Yamagata University Faculty of Medicine, Iida-Nishi, 990-9585, Yamagata Japan
| | - Hidekazu Nishimura
- Virus Research Center, Clinical Research Division, Sendai Medical Center, Miyagino-ku, 983-8520, Sendai, Miyagi Japan
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Daniels RS, Galiano M, Ermetal B, Kwong J, Lau CS, Xiang Z, McCauley JW, Lo J. Temporal and Gene Reassortment Analysis of Influenza C Virus Outbreaks in Hong Kong, SAR, China. J Virol 2022; 96:e0192821. [PMID: 34787455 PMCID: PMC8826914 DOI: 10.1128/jvi.01928-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 11/09/2021] [Indexed: 11/29/2022] Open
Abstract
From 2014 to week 07/2020 the Centre for Health Protection in Hong Kong conducted screening for influenza C virus (ICV). A retrospective analysis of ICV detections to week 26/2019 revealed persistent low-level circulation with outbreaks occurring biennially in the winters of 2015 to 2016 and 2017 to 2018 (R. S. Daniels et al., J Virol 94:e01051-20, 2020, https://doi.org/10.1128/JVI.01051-20). Here, we report on an outbreak occurring in 2019 to 2020, reinforcing the observation of biennial seasonality in Hong Kong. All three outbreaks occurred in similar time frames, were subsequently dwarfed by seasonal epidemics of influenza types A and B, and were caused by similar proportions of C/Kanagawa/1/76 (K)-lineage and C/São Paulo/378/82 S1- and S2-sublineage viruses. Ongoing genetic drift was observed in all genes, with some evidence of amino acid substitution in the hemagglutinin-esterase-fusion (HEF) glycoprotein possibly associated with antigenic drift. A total of 61 ICV genomes covering the three outbreaks were analyzed for reassortment, and 9 different reassortant constellations were identified, 1 K-lineage, 4 S1-sublineage, and 4 S2-sublineage, with 6 of these being identified first in the 2019-1920 outbreak (2 S2-lineage and 4 S1-lineage). The roles that virus interference/enhancement, ICV persistent infection, genome evolution, and reassortment might play in the observed seasonality of ICV in Hong Kong are discussed. IMPORTANCE Influenza C virus (ICV) infection of humans is common, with the great majority of people being infected during childhood, though reinfection can occur throughout life. While infection normally results in "cold-like" symptoms, severe disease cases have been reported in recent years. However, knowledge of ICV is limited due to poor systematic surveillance and an inability to propagate the virus in large amounts in the laboratory. Following recent systematic surveillance in Hong Kong SAR, China, and direct ICV gene sequencing from clinical specimens, a 2-year cycle of disease outbreaks (epidemics) has been identified, with gene mixing playing a significant role in ICV evolution. Studies like those reported here are key to developing an understanding of the impact of influenza C virus infection in humans, notably where comorbidities exist and severe respiratory disease can develop.
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Affiliation(s)
- Rodney S. Daniels
- Worldwide Influenza Centre, The Francis Crick Institute, London, United Kingdom
| | - Monica Galiano
- Worldwide Influenza Centre, The Francis Crick Institute, London, United Kingdom
| | - Burcu Ermetal
- Worldwide Influenza Centre, The Francis Crick Institute, London, United Kingdom
| | - Jasmine Kwong
- Centre for Health Protection, Department of Health, Hong Kong SAR, China
| | - Chi S. Lau
- Centre for Health Protection, Department of Health, Hong Kong SAR, China
| | - Zheng Xiang
- Worldwide Influenza Centre, The Francis Crick Institute, London, United Kingdom
| | - John W. McCauley
- Worldwide Influenza Centre, The Francis Crick Institute, London, United Kingdom
| | - Janice Lo
- Centre for Health Protection, Department of Health, Hong Kong SAR, China
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Sreenivasan CC, Sheng Z, Wang D, Li F. Host Range, Biology, and Species Specificity of Seven-Segmented Influenza Viruses-A Comparative Review on Influenza C and D. Pathogens 2021; 10:1583. [PMID: 34959538 PMCID: PMC8704295 DOI: 10.3390/pathogens10121583] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 11/26/2021] [Accepted: 11/30/2021] [Indexed: 02/06/2023] Open
Abstract
Other than genome structure, influenza C (ICV), and D (IDV) viruses with seven-segmented genomes are biologically different from the eight-segmented influenza A (IAV), and B (IBV) viruses concerning the presence of hemagglutinin-esterase fusion protein, which combines the function of hemagglutinin and neuraminidase responsible for receptor-binding, fusion, and receptor-destroying enzymatic activities, respectively. Whereas ICV with humans as primary hosts emerged nearly 74 years ago, IDV, a distant relative of ICV, was isolated in 2011, with bovines as the primary host. Despite its initial emergence in swine, IDV has turned out to be a transboundary bovine pathogen and a broader host range, similar to influenza A viruses (IAV). The receptor specificities of ICV and IDV determine the host range and the species specificity. The recent findings of the presence of the IDV genome in the human respiratory sample, and high traffic human environments indicate its public health significance. Conversely, the presence of ICV in pigs and cattle also raises the possibility of gene segment interactions/virus reassortment between ICV and IDV where these viruses co-exist. This review is a holistic approach to discuss the ecology of seven-segmented influenza viruses by focusing on what is known so far on the host range, seroepidemiology, biology, receptor, phylodynamics, species specificity, and cross-species transmission of the ICV and IDV.
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Affiliation(s)
- Chithra C. Sreenivasan
- Maxwell H. Gluck Equine Research Center, University of Kentucky, Lexington, KY 40546, USA; (C.C.S.); (D.W.)
| | - Zizhang Sheng
- Aaron Diamond AIDS Research Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA;
| | - Dan Wang
- Maxwell H. Gluck Equine Research Center, University of Kentucky, Lexington, KY 40546, USA; (C.C.S.); (D.W.)
| | - Feng Li
- Maxwell H. Gluck Equine Research Center, University of Kentucky, Lexington, KY 40546, USA; (C.C.S.); (D.W.)
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Matsuzaki Y, Sugawara K, Shimotai Y, Kadowaki Y, Hongo S, Mizuta K, Nishimura H. Growth Kinetics of Influenza C Virus Antigenic Mutants That Escaped from Anti-Hemagglutinin Esterase Monoclonal Antibodies and Viral Antigenic Changes Found in Field Isolates. Viruses 2021; 13:401. [PMID: 33802440 PMCID: PMC7998938 DOI: 10.3390/v13030401] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 02/24/2021] [Accepted: 02/25/2021] [Indexed: 01/16/2023] Open
Abstract
The antigenicity of the hemagglutinin esterase (HE) glycoprotein of influenza C virus is known to be stable; however, information about residues related to antigenic changes has not yet been fully acquired. Using selection with anti-HE monoclonal antibodies, we previously obtained some escape mutants and identified four antigenic sites, namely, A-1, A-2, A-3, and Y-1. To confirm whether the residues identified as the neutralizing epitope possibly relate to the antigenic drift, we analyzed the growth kinetics of these mutants. The results showed that some viruses with mutations in antigenic site A-1 were able to replicate to titers comparable to that of the wild-type, while others showed reduced titers. The mutants possessing substitutions in the A-2 or A-3 site replicated as efficiently as the wild-type virus. Although the mutant containing a deletion at positions 192 to 195 in the Y-1 site showed lower titers than the wild-type virus, it was confirmed that this region in the 190-loop on the top side of the HE protein is not essential for viral propagation. Then, we revealed that antigenic changes due to substitutions in the A-1, A-3, and/or Y-1 site had occurred in nature in Japan for the past 30 years. These results suggest that some residues (i.e., 125, 176, 192) in the A-1 site, residue 198 in the A-3 site, and residue 190 in the Y-1 site are likely to mediate antigenic drift while maintaining replicative ability.
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Affiliation(s)
- Yoko Matsuzaki
- Department of Infectious Diseases, Yamagata University Faculty of Medicine, Yamagata 990-9585, Japan; (K.S.); (Y.S.); (Y.K.); (S.H.)
| | - Kanetsu Sugawara
- Department of Infectious Diseases, Yamagata University Faculty of Medicine, Yamagata 990-9585, Japan; (K.S.); (Y.S.); (Y.K.); (S.H.)
| | - Yoshitaka Shimotai
- Department of Infectious Diseases, Yamagata University Faculty of Medicine, Yamagata 990-9585, Japan; (K.S.); (Y.S.); (Y.K.); (S.H.)
| | - Yoko Kadowaki
- Department of Infectious Diseases, Yamagata University Faculty of Medicine, Yamagata 990-9585, Japan; (K.S.); (Y.S.); (Y.K.); (S.H.)
| | - Seiji Hongo
- Department of Infectious Diseases, Yamagata University Faculty of Medicine, Yamagata 990-9585, Japan; (K.S.); (Y.S.); (Y.K.); (S.H.)
| | - Katsumi Mizuta
- Department of Microbiology, Yamagata Prefectural Institute of Public Health, Yamagata 990-0031, Japan;
| | - Hidekazu Nishimura
- Virus Research Center, Clinical Research Division, Sendai Medical Center, Sendai 983-8520, Japan;
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