Li Wen-Chen, Shih Shin-Ru, Huang Yhu-Chering, Chen Guang-Wu, Chang Shih-Cheng, Hsiao Mei-Jen, Tsao Kuo-Chien, Lin Tzou-Yien
Division of Pediatric Infectious Diseases, Chang Gung Children's Hospital, Taoyuan, Taiwan.
J Clin Virol. 2008 May;42(1):45-51. doi: 10.1016/j.jcv.2007.11.026. Epub 2008 Mar 5.
Mismatches between circulating and vaccine strains of influenza virus had been observed in Taiwan. A comprehensive clinical and genetic analysis of influenza B viruses-associated important diseases was lacking.
Clinical and phylogenetic analysis of influenza B viruses during an outbreak in Taiwan.
Clinical manifestations of hospitalized, culture-confirmed patients were analyzed from July 2004 to June 2005. Partial genome sequence analysis of hemagglutinin (HA), neuraminidase (NA), and nonstructural (NS) genes were performed in 54 influenza B isolates during the study period, and nine srandomly chosen isolates during 2000 and 2003.
Three specific diseases were found in these patients, including 13 of encephalitis/encephalopathy, 28 of influenza-associated myositis (IAM), and one of acute respiratory distress syndrome (ARDS). Three phylogenetic groups were identified, including reassortant strains-group 1 (Victoria lineage of HA, Yamagata lineage of NA, clade A of NS), group 2 (Yamagata lineage of HA, Yamagata lineage of NA, clade A of NS), and group 3 (Yamagata lineage of HA, Yamagata lineage of NA, clade B of NS).
Severe influenza B-associated disease in children was not rare and might be fatal. We offered the evidence of co-circulation of the two HA lineages in the same outbreak.
台湾曾观察到流感病毒的流行株与疫苗株不匹配的情况。此前缺乏对乙型流感病毒相关重要疾病的全面临床和基因分析。
对台湾一次流感暴发期间的乙型流感病毒进行临床和系统发育分析。
分析2004年7月至2005年6月期间住院且经培养确诊患者的临床表现。对研究期间分离出的54株乙型流感病毒以及2000年和2003年随机选取的9株病毒进行血凝素（HA）、神经氨酸酶（NA）和非结构（NS）基因的部分基因组序列分析。
在这些患者中发现了三种特定疾病，包括13例脑炎/脑病、28例流感相关性肌炎（IAM）和1例急性呼吸窘迫综合征（ARDS）。鉴定出三个系统发育组，包括重配株——第1组（HA为维多利亚系、NA为山形系、NS为A进化枝）、第2组（HA为山形系、NA为山形系、NS为A进化枝）和第3组（HA为山形系、NA为山形系、NS为B进化枝）。
儿童中严重的乙型流感相关疾病并不罕见，且可能致命。我们提供了在同一暴发中两种HA谱系共同流行的证据。
