Abstract
Influenza C is not included in the annual seasonal influenza vaccine, and has historically been regarded as a minor respiratory pathogen. However, recent work has highlighted its potential role as a cause of pneumonia in infants. We performed nasopharyngeal or nasal swabbing and/or serum sampling (n = 148) in Lancaster, UK, over the winter of 2014–2015. Using enzyme-linked immunosorbent assay (ELISA), we obtain seropositivity of 77%. By contrast, only 2 individuals, both asymptomatic adults, were influenza C-positive by polymerase chain reaction (PCR). Deep sequencing of nasopharyngeal samples produced partial sequences for 4 genome segments in one of these patients. Bayesian phylogenetic analysis demonstrated that the influenza C genome from this individual is evolutionarily distant to those sampled in recent years and represents a novel genome constellation, indicating that it may be a product of a decades-old reassortment event. Although we find no evidence that influenza C was a significant respiratory pathogen during the winter of 2014–2015 in Lancaster, we confirm previous observations of seropositivity in the majority of the population. (170 words).
Highlights
Introduction48 Clinical presentation50 Influenza C (family Orthomyxoviridae, genus Influenzavirus C, species Influenza C virus) produces malaise and coryza when administered to susceptible healthy adult volunteers, with fever in a minority of cases [Joosting et al, 1968]
48 Clinical presentation50 Influenza C produces malaise and coryza when administered to susceptible healthy adult volunteers, with fever in a minority of cases [Joosting et al, 1968]
In a paediatric context, acute respiratory illness and/or pneumonia have been reported as a consequence of influenza C infection [Calvo et al, 2006; Matsuzaki et al, 2007; Matsuzaki et al, 2003; Moriuchi et al, 1991; Peng et al, 1996; Principi et al, 2012; Shimizu et al, 2015] especially in those under 2 years old [Matsuzaki et al, 2006], as well as vomiting, diarrhoea, acute otitis media [Laxdal et al, 1966], a high rate of hospitalization [Gouarin et al, 2008] and even acute encephalopathy [Takayanagi et al, 2009]
Summary
48 Clinical presentation50 Influenza C (family Orthomyxoviridae, genus Influenzavirus C, species Influenza C virus) produces malaise and coryza when administered to susceptible healthy adult volunteers, with fever in a minority of cases [Joosting et al, 1968]. There is increased recognition that under-reporting of influenza C in children is a problem [Pabbaraju et al, 2013]. This growing awareness of the paediatric clinical importance of influenza C raises the issue of its inclusion in the annual seasonal influenza vaccine, or its position as a candidate for vaccine development for infants
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