Influenza A (H3N2) outbreak, Nepal

Luke T Daum1, Michael W Shaw, Alexander I Klimov

  • 1Air Force Institute for Operational Health, Brooks City Base, San Antonio, Texas 78235, USA. Luke.Daum@brooks.af.mil

Insights

Influenza A (H3N2) viruses in Nepal showed significant antigenic drift from the 2004 vaccine strain. This viral evolution necessitated a vaccine strain update for the 2005-2006 influenza season.

Area of Science:

  • Virology
  • Epidemiology
  • Immunology

Background:

  • An influenza A (H3N2) outbreak occurred in Bhutanese refugee camps in Nepal in July 2004.
  • This outbreak provided an opportunity to study viral evolution and vaccine strain matching.

Purpose of the Study:

  • To investigate the antigenic properties of H3N2 influenza viruses isolated during the 2004 Nepal outbreak.
  • To compare these isolates with the contemporary A/Wyoming/3/03 vaccine strain.
  • To inform influenza vaccine strain selection for the subsequent season.

Main Methods:

  • Hemagglutination inhibition assays were used to assess antigenic distinctness.
  • Amino acid sequencing of viral isolates was performed.
  • Comparison of isolate sequences with the A/Wyoming/3/2003 vaccine strain.

Main Results:

  • Approximately 40% of H3N2 isolates were antigenically distinct from the A/Wyoming/3/03 vaccine strain.
  • Four key amino acid substitutions were identified in most isolates compared to the vaccine strain.
  • Substitutions were located in or near antibody-binding sites, including a notable K145N substitution.

Conclusions:

  • H3N2 influenza viruses continue to evolve, demonstrating antigenic drift from established vaccine strains.
  • The observed substitutions suggest ongoing viral adaptation and potential immune escape.
  • The 2005-2006 Northern Hemisphere vaccine strain was updated to A/California/7/2004 to better match circulating strains.

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