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Open Forum Infect Dis . Evolution of Influenza A(H3N2) Viruses in 2 Consecutive Seasons of Genomic Surveillance, 2021-2023

tetano

Editor, Senior Moderator
Open Forum Infect Dis


. 2023 Nov 16;10(12):ofad577.
doi: 10.1093/ofid/ofad577. eCollection 2023 Dec. Evolution of Influenza A(H3N2) Viruses in 2 Consecutive Seasons of Genomic Surveillance, 2021-2023

Amary Fall[SUP] 1 [/SUP], Lijie Han[SUP] 1 [/SUP], Madeline Yunker[SUP] 1 [/SUP], Yu-Nong Gong[SUP] 2 3 4 5 [/SUP], Tai-Jung Li[SUP] 2 3 [/SUP], Julie M Norton[SUP] 1 [/SUP], Omar Abdullah[SUP] 1 [/SUP], Richard E Rothman[SUP] 6 [/SUP], Katherine Z J Fenstermacher[SUP] 6 [/SUP], C Paul Morris[SUP] 1 7 [/SUP], Andrew Pekosz[SUP] 6 8 [/SUP], Eili Klein[SUP] 6 9 [/SUP], Heba H Mostafa[SUP] 1 [/SUP]



Affiliations
Free PMC article Abstract

Background: The circulation and the genomic evolution of influenza A(H3N2) viruses during the 2021/2022 and 2022/2023 seasons were studied and associated with infection outcomes.
Methods: Remnant influenza A-positive samples following standard-of-care testing from patients across the Johns Hopkins Health System (JHHS) were used for the study. Samples were randomly selected for whole viral genome sequencing. The sequence-based pEpitope model was used to estimate the predicted vaccine efficacy (pVE) for circulating H3N2 viruses. Clinical data were collected and associated with viral genomic data.
Results: A total of 121 683 respiratory specimens were tested for influenza at JHHS between 1 September 2021 and 31 December 2022. Among them, 6071 (4.99%) tested positive for influenza A. Of these, 805 samples were randomly selected for sequencing, with hemagglutinin (HA) segments characterized for 610 samples. Among the characterized samples, 581 were H3N2 (95.2%). Phylogenetic analysis of HA segments revealed the exclusive circulation of H3N2 viruses with HA segments of the 3C.2a1b.2a.2 clade. Analysis of a total of 445 complete H3N2 genomes revealed reassortments; 200 of 227 of the 2022/2023 season genomes (88.1%) were found to have reassorted with clade 3C.2a1b.1a. The pVE was estimated to be -42.53% for the 2021/2022 season and 30.27% for the 2022/2023 season. No differences in clinical presentations or admissions were observed between the 2 seasons.
Conclusions: The increased numbers of cases and genomic diversity of influenza A(H3N2) during the 2022/2023 season were not associated with a change in disease severity compared to the previous influenza season.

Keywords: H3N2; influenza; reassortment; vaccine.

 
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