Comparative epidemiology of influenza B by lineage in intensive care unit-admitted patients with complications: A nationwide study in Taiwan, 2013-2017

Int J Infect Dis. 2019 Oct:87:67-74. doi: 10.1016/j.ijid.2019.07.017. Epub 2019 Jul 26.

Abstract

Background: We describe the relative proportions and epidemiological features of influenza B/Victoria and B/Yamagata, using data from nationwide surveillance systems.

Methods: We collected respiratory samples from outpatients with influenza-like illness (ILI) and intensive care unit (ICU)-admitted patients with complications (pulmonary or neurological complications, myocarditis/pericarditis or invasive bacterial infection) for virus isolation and lineage typing. Demographics, epidemiological features, and vaccination history from ICU-admitted patients with complications were analyzed.

Results: From July 2013-June 2017, 21% of 11517 influenza isolates were influenza B. B/Victoria was the predominant circulating strain in 2013-2014, accounted for 56% of all influenza B positive samples and B/Yamagata was predominant in 2014-2017 (82%, 69%, and 85%, respectively). Among all typed viruses, the proportion of B/Yamagata was higher among specimens from ICU-admitted patients with complications (77%, 154/199) than from ILI outpatients (66%, 276/418, p<0.005). Compared to B/Victoria, B/Yamagata infected ICU-admitted patients with complications were older, median age (71 vs. 59 years, p<0.05), had longer durations of hospitalization (15 vs. 7.5 days, p<0.05) and ICU stays (8.5 vs. 5.5 days, p<0.05).

Conclusions: Two lineages of influenza B viruses co-circulate annually in Taiwan. Among ICU-admitted patients with complications, B/Yamagata causes more severe illness than B/Victoria.

Keywords: Comparative epidemiology; Influenza B; Lineage; Lineage-mismatch; Vaccine.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Child
  • Child, Preschool
  • Critical Care
  • Female
  • Hospitalization
  • Humans
  • Infant
  • Influenza B virus / classification
  • Influenza B virus / genetics
  • Influenza B virus / isolation & purification*
  • Influenza, Human / complications
  • Influenza, Human / epidemiology
  • Influenza, Human / virology*
  • Intensive Care Units / statistics & numerical data
  • Male
  • Middle Aged
  • Outpatients / statistics & numerical data
  • Taiwan / epidemiology
  • Time Factors
  • Young Adult