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Surveillance and vaccine effectiveness of an influenza epidemic predominated by vaccine-mismatched influenza b/yamagata-lineage viruses in taiwan, 201

tetano

Editor, Senior Moderator
PLoS One. 2013;8(3):e58222. doi: 10.1371/journal.pone.0058222. Epub 2013 Mar 5.
Surveillance and vaccine effectiveness of an influenza epidemic predominated by vaccine-mismatched influenza b/yamagata-lineage viruses in taiwan, 2011-12 season.
Lo YC, Chuang JH, Kuo HW, Huang WT, Hsu YF, Liu MT, Chen CH, Huang HH, Chang CH, Chou JH, Chang FY, Lin TY, Chiu WT.
Source

Centers for Disease Control, Taipei, Taiwan, Republic of China.
Abstract
INTRODUCTION:

The 2011-12 trivalent influenza vaccine contains a strain of influenza B/Victoria-lineage viruses. Despite free provision of influenza vaccine among target populations, an epidemic predominated by influenza B/Yamagata-lineage viruses occurred during the 2011-12 season in Taiwan. We characterized this vaccine-mismatched epidemic and estimated influenza vaccine effectiveness (VE).
METHODS:

Influenza activity was monitored through sentinel viral surveillance, emergency department (ED) and outpatient influenza-like illness (ILI) syndromic surveillance, and case-based surveillance of influenza with complications and deaths. VE against laboratory-confirmed influenza was evaluated through a case-control study on ILI patients enrolled into sentinel viral surveillance. Logistic regression was used to estimate VE adjusted for confounding factors.
RESULTS:

During July 2011-June 2012, influenza B accounted for 2,382 (72.5%) of 3,285 influenza-positive respiratory specimens. Of 329 influenza B viral isolates with antigen characterization, 287 (87.2%) were B/Yamagata-lineage viruses. Proportions of ED and outpatient visits being ILI-related increased from November 2011 to January 2012. Of 1,704 confirmed cases of influenza with complications, including 154 (9.0%) deaths, influenza B accounted for 1,034 (60.7%) of the confirmed cases and 103 (66.9%) of the deaths. Reporting rates of confirmed influenza with complications and deaths were 73.5 and 6.6 per 1,000,000, respectively, highest among those aged ≥65 years, 50-64 years, 3-6 years, and 0-2 years. Adjusted VE was -31% (95% CI: -80, 4) against all influenza, 54% (95% CI: 3, 78) against influenza A, and -66% (95% CI: -132, -18) against influenza B.
CONCLUSIONS:

This influenza epidemic in Taiwan was predominated by B/Yamagata-lineage viruses unprotected by the 2011-12 trivalent vaccine. The morbidity and mortality of this vaccine-mismatched epidemic warrants careful consideration of introducing a quadrivalent influenza vaccine that includes strains of both B lineages.

PMID:
23472161
[PubMed - in process]

http://www.ncbi.nlm.nih.gov/pubmed/23472161
 
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