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Influenza Branch Division of Viral and Rickettsial Diseases

INFORMATION FOR THE VACCINES AND RELATED BIOLOGICAL PRODUCTS ADVISORY COMMITTEE, CBER, FDA. February 20, 2003. Bethesda, MD. WHO COLLABORATING CENTER FOR SURVEILLANCE, EPIDEMIOLOGY AND CONTROL OF INFLUENZA. Influenza Branch Division of Viral and Rickettsial Diseases

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Influenza Branch Division of Viral and Rickettsial Diseases

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  1. INFORMATION FOR THE VACCINES AND RELATED BIOLOGICAL PRODUCTS ADVISORY COMMITTEE, CBER, FDA February 20, 2003 Bethesda, MD WHO COLLABORATING CENTER FOR SURVEILLANCE, EPIDEMIOLOGY AND CONTROL OF INFLUENZA Influenza Branch Division of Viral and Rickettsial Diseases National Center for Infectious Diseases Centers for Disease Control and Prevention Atlanta, GA 30333

  2. U.S. SURVEILLANCE

  3. WHO/NREVSS Collaborating Laboratories National Summary, 2002-03

  4. Percentage of Visits for ILI Reported by Sentinel ProvidersNational Summary, 2002-03

  5. No Activity Sporadic Regional Widespread No Report Weekly Influenza Activity Estimates Reported by State & Territorial Epidemiologists Week ending February 8, 2003 - Week 6

  6. Pneumonia and Influenza Mortality for 122 U.S. CitiesWeek Ending 02/08/03 “Epidemic” Threshold Seasonal Baseline 1999 2000 2001 2002 2003 10 20 30 40 50 10 20 30 40 50 10 20 30 40 50 10 20 30 40 50 10

  7. INFLUENZA A(H1) VIRUSES

  8. * serology antigen # egg isolate (LR) low reactor to A/New Caledonia/20/99 vaccine strain EVOLUTIONARY RELATIONSHIPS AMONG INFLUENZA A(H1) HA1 GENES Canada/649/2002* Michigan/2/2003 T96A New York/3/2003 Washington/8/2002 Canada/642/2002(LR) A193T, A218T, V178I H1N2 North Carolina/7/2002 Peru/3084/2002 New York/2/2003 Pennsylvania/1/2003 New York/26/2002 V169A Hawaii/10/2002# South Dakota/2/2002 Jilin/5/2002# Florida/7/2002 Peru/3090/2002(LR)* Colombia/3575/2002 W255R Wuhan/6/2002 Neimongol/31/2002# Neimongol/43/2002# Hong Kong/841/2002 Alaska/1/2002 Texas/49/2002 Hubei/18/2002(LR)# Sichuan/656/2002 Mexico/935/2002 Wisconsin/12/2002 Guatemala/48/2002 Texas/52/2002 Guizhou/198/2002 Massachussetts/5/2002* Oklahoma/3/2002 Texas/1/2003 bafbKorea/1136/2002 New Jersey/5/2002 Michigan/1/2003 New York/1/2003 Chile/10751/2002# Chile/8196/2002# E82G Chile/13309/2002# Chile/8829/2002(LR)# nihjAkita/25/2002# D275G Chile/8885/2002(LR)# Alaska/3/2002 Arizona/13/2002 E125bG, K166M Yamaguchi/12/2002 Georgia/8/2002 Hawaii/15/2001(LR) Russia/2187/2002(LR)# New Caledonia/20/99#*

  9. EVOLUTIONARY RELATIONSHIPS AMONG INFLUENZA A(N1) NA GENES Hong Kong/1252/2000 D386N Wuhan/251/2000# Hong Kong/241/2000 Wuhan/292/2000# Russia/11/2001 Shenzhen/201/2000# Hawaii/18/99 Fujian/156/2000# Hawaii/1/2000 Nanchang/8/2000# nimr-Hong Kong/1799/2000 Taiwan/1486/2001 Hubei/288/2001*# Hong Kong/747/2001* Brazil/821/2001* Pusan/124/99 Vaccine strain New Caledonia/20/99*# aus-New Caledonia/11/2000 nimr-Ishikawa/42/98 V75I Colorado/2/2001 R222Q D344N Hawaii/15/2001* Bangkok/255/2001*# Washington/6/2001 nimr-Asuncion/1041/2000 nimr-Brazil/202/2000 Bangkok/163/2000 California/26/99 Peru/1261/99 Peru/1798/99 nimr-Moscow/17/98 nimr-Hong Kong/4859/98 Beijing/262/95 New York/14/2000 Colorado/1/2001 Chile/5255/2000 *Serology Antigen # Egg isolate Chile/5724/2000 nimr-Oslo/1734/98 Bayern/7/95 10 nucleotides Taiwan/1/86

  10. Summary: Influenza A(H1N1 and H1N2) Viruses • Since last winter, H1N1 and H1N2 viruses have been reported primarily from the Americas (Canada, Chile and the U.S.). • Most (>95%) of recent H1 viruses have HAs that are antigenically and genetically similar to that of the current vaccine strain, A/New Caledonia/20/99 • The NAs of current H1N1 viruses are similar antigenically and genetically to the N1 of A/New Caledonia/20/99 • The NAs of current H1N2 viruses are similar to to those of currently circulating H3N2 viruses

  11. INFLUENZA A(H3N2) VIRUSES

  12. EVOLUTIONARY RELATIONSHIPS AMONG INFLUENZA A(H3) HA1 GENES Sydney/5/97 # Moscow/10/99 # Beijing/301/2002 (LR) Anhui/550/2002 (LR) Fujian/411/2002 ** Beijing/178/2002 (LR) BAFB-Korea/172/2003 Georgia/1/2003 (LR) NIID-Ishikawa/102/2002 ** NIID-Osaka-c/70/2002 Q 156 H Washington/3/2003 Memphis/4/2003 (LR) Memphis/1/2003 (LR) PHLS-England/448/2002 (LR) NIID-Toyama/29/2002 Massachusetts/1/2003 (LR) Hawaii/19/2002 (LR) Hunan/407/2002 Korea/770/2002 (LR) California/9/2002 Alaska/4/2002 L 25 I H 75 Q H 155 T Japan/910/2002 (LR) NIMR-Egypt/151/2002 New Jersey/4/2002 (LR) ** NIMR-Switzerland/7494/2002 Guam/228/2002 (LR) Taiwan/1521/2002 (LR) A 131 T Philippines/160283/2002 (LR) Hong Kong/1143/2002 (LR) Hong Kong/1554/2002 Aus-Singapore/44/2002 (LR) Can-Canada/rv6222/2002 R 50 G E 83 K V 202 I W 222 R G 225 D NIID-Shiga/41/2002 Hawaii/13/2002 Aus-Taiwan/8/2002 Guangzhou/405/2002 Hubei/61/2002 (LR) Zhejiang/8/2002 (LR) India/25502/2002 Aus-Perth/200/2002 (LR) # NIID-Hyogo/3/2002 Vaccine Strain Egg-Grown Isolate # Serology Antigen ** Low Reactor (LR) Aus-Brisbane/5/2002 (LR) # Hong Kong/1550/2002 # Beijing/144/2001 NIID-Akita/69/2002 # England/1/2003 Arizona/1/2002 A 304 P Oklahoma/2/2002 Wisconsin/17/2001 Washington/3/2002 Aus-Bangkok/109/2002 (LR) # Texas/4/2002 Illinois/1/2002 Connecticut/1/2002 Brazil/2458/2002 10 nucleotides Brazil/1727/2002 (LR) # NIMR-Dakar/50/2002 ** Turkey/1035/2002 Chile/6416/2001 # A 106 V N 144 D North Carolina/8/2002 England/449/2002 New York/21/2002 Louisiana/2/2002 Hawaii/11/2002 Aus-Sydney/23/2002 NIID-Fukuoka/15/2002 Utah/6/2002 New York/55/2001 (LR) Hawaii/4/2002 Aus-Victoria/241/2002 New York/28/2002 NIMR-Madagascar/66213/2002 Fujian/140/2000 # Panama/2007/99 # ** Moscow/5/2000 #

  13. Panama/2007/99*# EVOLUTIONARY RELATIONSHIPS AMONG INFLUENZA A(N2) NA GENES Wuhan/396/2001 Wuhan/388/2001 V30T, C42F CNIC/114/2001 Hong Kong/1307/2001 Guangzhou/1191/2001 A18S, L23F, V307I Singapore/54/2001 Shenzhen/499/2000# Hong Kong/1269/2001 Singapore/41/2001 Nepal/1610/2001 Singapore/15/2001* Thailand/80891/2001 Vaccine Strain Hawaii/23/2001 Wisconsin/12/2001 nimr-Moscow/10/2001# G414S Hong Kong/762/2001* Hong Kong/648/2001*# Hawaii/21/2001* Philippine/78890/2001* Hawaii/29/2001 K172R Alaska/14/2001* Alaska/8/2001 Chile/6416/2001*# Argentina/302/2001 Argentina/10/2001 Argentina/3758/2001# Argentina/3759/2001*# S332F, Q432E Massachusetts/2/2001 North Carolina/1/2001 South Australia/102/2001* Florida/6/2001 10 nucleotides Sydney/5/97 *Serology antigen # Egg isolate

  14. Summary: Influenza A(H3N2) Viruses • H3N2 viruses have caused recent outbreaks in Japan, Korea and China • An increasing proportion of recent H3N2 isolates are not well inhibited by post-infecton and post-immunization antiserum • H3N2 viruses with aa changes at 155 and 156 (Site B) tend to be poorly inhibited by antibodies to the vaccine virus • Low reacting viruses with aa changes at 155 and 156 have been detected in Asia, Europe and the Americas

  15. INFLUENZA B VIRUSES

  16. Currently Circulating Type B HA Lineages Yamagata Lineage 25 nucleotides Victoria Lineage Hong Kong/330/2001

  17. EVOLUTIONARY RELATIONSHIPS AMONG INFLUENZA B HA1 GENES (YAMAGATA LINEAGE) Harbin/7/94 # NIID-Fukushima/24/2002 Shanghai/361/2002 # Taiwan/143999/2002 (LR) NIMR-Madagascar/65186/2002 Moscow/16/2002 # K 48 R T 168 N Egg-Grown Isolate # Serology Antigen ** Low Reactor (LR) NIID-Astrakhan/10/2002 # California/2/2002 N 126 D NIID-Ulan Ude/4/2002 # Russia/4/2002 (LR) # NIID-Yunnan/406/2001 # H 40 Y Colorado/3/2002 (LR) Fujian/407/2001 # NIMR-St. Petersburg/1/2002 NIMR-Finland/141/2002 Nevada/1/2002 NIMR-Hong Kong/293/2002 NIID-Yunnan/8/2002 # Yunnan/9/2002 (LR) # Yunnan/163/2002 # Aus-Bangkok/60/2002 Ohio/2/2002 R 69 G T 121 A R 136 K N 165 D T 182 A K 183 N Brazil/2459/2002 (LR) Gaughwa/19/2002 (LR) Aus-Sydney/200/2002 Aus-Sydney/3/2002 NIID-Sendai/h1754/2001 (LR) #** NIPH-Oslo/668/2002 NIID-Akita/2/2002 # NIID-Sapporo/7/2002 (LR) Hong Kong/1470/2002 (LR) # NIPH-Oslo/1870/2002 Tennessee/4/2002 (LR) Arizona/4/2002 (LR) Chile/3162/2002 (LR) # New York/44/2002 L 58 F N 126 D NIID-Shizuoka/15/2001 #** NIMR-Lazio/1/2002 NIMR-Lyon/125/2002 Peru/3132/2002 (LR) NIMR-Barcelona/460/2002 Colombia/3438/2002 Mexico/418/2001 (LR) Fujian/141/2001 # Aus-Victoria/504/2000 # 10 nucleotides NIID-Shizuoka/480/2000 # NIMR-Perm/3/2002 Sichuan/379/99 #** Yamanashi/166/98 # Beijing/184/93 #

  18. 5 nucleotides EVOLUTIONARY RELATIONSHIPS AMONG INFLUENZA B HA1 GENES (VICTORIA LINEAGE) I 121 T Thailand/163343/2002 (LR) South Carolina/8/2002 (LR) Aus-Brisbane/17/2002 # Iowa/3/2002 (LR) # Idaho/4/2002 (LR) Aus-Auckland/14/2002 Aus-Brisbane/32/2002 (LR) #** Aus-Brisbane/28/2002 # Aus-Perth/82/2002 NIMR-Lisbon/190/2002 Louisiana/1/2002 (LR) NIMR-Madagascar/67860/2002 #** Tianjin/130/2002 Oman/16291/2001 (LR) California/5/2002 Taiwan/1519/2002 (LR) Brazil/1730/2002 # Nevada/5/2002 New York/43/2002 Texas/57/2002 (LR) ** Wisconsin/1/2003 Missouri/12/2002 NIMR-Hong Kong/302/2002 Hawaii/5/2002 (LR) Hong Kong/1351/2002 # Vaccine Strain Egg-Grown Isolate # Serology Antigen ** Low Reactor (LR) Panama/486105/2002 Chile/13677/2002 # Mexico/963/2002 (LR) Argentina/mc16/2002 (LR) Brazil/1733/2002 (LR) # Guatemala/20/2002 (LR) New Hampshire/1/2002 Beijing/243/97 # Shandong/7/97 #** Guam/345/2002 NIID-Saitama/22/2002 # NIID-Sendai/h1023/2002 # NIID-Tokyo/127/2002 # NIID-Shiga/20/2002 # Hong Kong/1115/2002 (LR) # Hong Kong/167/2002 # Hong Kong/1345/2002 # Hong Kong/1434/2002 #** H 116 R E 121 N D 164 E Wisconsin/7/2002 Guangzhou/332/2002 (LR) # Taiwan/1507/2002 (LR) Hong Kong/330/2001 #** Hong Kong/335/2001 # NIID-Akita/27/2001 # Taiwan/217/97

  19. EVOLUTIONARY RELATIONSHIPS AMONG INFLUENZA B NA GENES Sichuan/379/99*# Johannesburg/5/99 Alaska/16/2000 Shenzhen/804/2001# P42S, R69E Victoria/504/2000* Shizuoka/480/2000 Brazil/956/2001*# Hong Kong/692/2001* Texas/22/20001* Niid-Shizuoka/15/2001*# E148G nimr-Yamanashi/166/98 Brazil/952/2001# Argentina/132/2001 D329N Argentina/69/2001 Wuhan/2/2001# Johannesburg/69/2001*# Fujian/407/2001 P42Q, N219K, D392E Vaccine Strain Wuhan/356/2001# *Serology Antigen # Egg isolate Osaka/18/2001 Shenzhen/306/2001# Sichuan/317/2001*# Sichuan/776/2001# Harbin/7/94 Hawaii/36/2001 Hawaii/10/2001# M50T, C54S, V60F, R436K Hong Kong/28/2001 Hong Kong/6/2001 Hong Kong/330/2001* Canada/464/2001 Hong Kong/22/2001 Bangkok/34/99 Bangkok/54/99 Shandong/7/97 10 nucleotides Yamagata/16/88

  20. Summary: Influenza B Viruses • Influenza B viruses are predominating in the U.S. and much of Europe during the current season • Influenza B viruses on the “Victoria lineage have predominated worldwide; B viruses on the Sichuan lineage were isolated infrequently • Most recent influenza B viruses have NAs most closely related antigenically and genetically to that of the B/Sichuan ref. Virus • The influenza B viruses have remained stable genetically and antigenically since last September

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