Fatal cases of influenza A(H3N2) in children: insights from whole genome sequence analysis

PLoS One. 2012;7(3):e33166. doi: 10.1371/journal.pone.0033166. Epub 2012 Mar 6.

Abstract

During the Northern Hemisphere winter of 2003-2004 the emergence of a novel influenza antigenic variant, A/Fujian/411/2002-like(H3N2), was associated with an unusually high number of fatalities in children. Seventeen fatal cases in the UK were laboratory confirmed for Fujian/411-like viruses. To look for phylogenetic patterns and genetic markers that might be associated with increased virulence, sequencing and phylogenetic analysis of the whole genomes of 63 viruses isolated from fatal cases and non fatal "control" cases was undertaken. The analysis revealed the circulation of two main genetic groups, I and II, both of which contained viruses from fatal cases. No associated amino acid substitutions could be linked with an exclusive or higher occurrence in fatal cases. The Fujian/411-like viruses in genetic groups I and II completely displaced other A(H3N2) viruses, but they disappeared after 2004. This study shows that two A(H3N2) virus genotypes circulated exclusively during the winter of 2003-2004 in the UK and caused an unusually high number of deaths in children. Host factors related to immune state and differences in genetic background between patients may also play important roles in determining the outcome of an influenza infection.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Amino Acid Substitution
  • Child
  • Genome, Viral
  • Hemagglutinin Glycoproteins, Influenza Virus / chemistry
  • Hemagglutinin Glycoproteins, Influenza Virus / genetics
  • Humans
  • Influenza A Virus, H3N2 Subtype / classification
  • Influenza A Virus, H3N2 Subtype / genetics*
  • Influenza A Virus, H3N2 Subtype / isolation & purification
  • Influenza, Human / mortality*
  • Influenza, Human / virology
  • Models, Molecular
  • Molecular Sequence Data
  • Open Reading Frames
  • Phylogeny
  • Prevalence
  • Protein Conformation
  • Protein Multimerization
  • Reassortant Viruses / genetics
  • Sequence Analysis, DNA
  • United Kingdom / epidemiology

Substances

  • Hemagglutinin Glycoproteins, Influenza Virus

Associated data

  • GENBANK/CY087969
  • GENBANK/CY087970
  • GENBANK/CY087971
  • GENBANK/CY087972
  • GENBANK/CY087973
  • GENBANK/CY087974
  • GENBANK/CY087975
  • GENBANK/CY087976
  • GENBANK/CY087977
  • GENBANK/CY087978
  • GENBANK/CY087979
  • GENBANK/CY087980
  • GENBANK/CY087981
  • GENBANK/CY087982
  • GENBANK/CY087983
  • GENBANK/CY087984
  • GENBANK/CY087985
  • GENBANK/CY087986
  • GENBANK/CY087987
  • GENBANK/CY087988
  • GENBANK/CY087989
  • GENBANK/CY087990
  • GENBANK/CY087991
  • GENBANK/CY087992
  • GENBANK/CY087993
  • GENBANK/CY087994
  • GENBANK/CY087995
  • GENBANK/CY087996
  • GENBANK/CY087997
  • GENBANK/CY087998
  • GENBANK/CY087999
  • GENBANK/CY088000
  • GENBANK/CY088001
  • GENBANK/CY088002
  • GENBANK/CY088003
  • GENBANK/CY088004
  • GENBANK/CY088005
  • GENBANK/CY088006
  • GENBANK/CY088007
  • GENBANK/CY088008
  • GENBANK/CY088009
  • GENBANK/CY088010
  • GENBANK/CY088011
  • GENBANK/CY088012
  • GENBANK/CY088013
  • GENBANK/CY088014
  • GENBANK/CY088015
  • GENBANK/CY088016
  • GENBANK/CY088017
  • GENBANK/CY088018
  • GENBANK/CY088019
  • GENBANK/CY088020
  • GENBANK/CY088021
  • GENBANK/CY088022
  • GENBANK/CY088023
  • GENBANK/CY088024
  • GENBANK/CY088025
  • GENBANK/CY088026
  • GENBANK/CY088027
  • GENBANK/CY088028
  • GENBANK/CY088029
  • GENBANK/CY088030
  • GENBANK/CY088031
  • GENBANK/CY088032
  • GENBANK/CY088033
  • GENBANK/CY088034
  • GENBANK/CY088035
  • GENBANK/CY088036
  • GENBANK/CY088037
  • GENBANK/CY088038
  • GENBANK/CY088039
  • GENBANK/CY088040
  • GENBANK/CY088041
  • GENBANK/CY088042
  • GENBANK/CY088043
  • GENBANK/CY088044
  • GENBANK/CY088045
  • GENBANK/CY088046
  • GENBANK/CY088047
  • GENBANK/CY088048
  • GENBANK/CY088049
  • GENBANK/CY088050
  • GENBANK/CY088051
  • GENBANK/CY088052
  • GENBANK/CY088053
  • GENBANK/CY088054
  • GENBANK/CY088055
  • GENBANK/CY088056
  • GENBANK/CY088057
  • GENBANK/CY088058
  • GENBANK/CY088059
  • GENBANK/CY088060
  • GENBANK/CY088061
  • GENBANK/CY088062
  • GENBANK/CY088063
  • GENBANK/CY088064
  • GENBANK/CY088065
  • GENBANK/CY088066
  • GENBANK/CY088067
  • GENBANK/CY088068
  • GENBANK/CY088069
  • GENBANK/CY088070
  • GENBANK/CY088071
  • GENBANK/CY088072
  • GENBANK/CY088073
  • GENBANK/CY088074
  • GENBANK/CY088075
  • GENBANK/CY088076
  • GENBANK/CY088077
  • GENBANK/CY088078
  • GENBANK/CY088079
  • GENBANK/CY088080
  • GENBANK/CY088081
  • GENBANK/CY088082
  • GENBANK/CY088083
  • GENBANK/CY088084
  • GENBANK/CY088085
  • GENBANK/CY088086
  • GENBANK/CY088087
  • GENBANK/CY088088
  • GENBANK/CY088089
  • GENBANK/CY088090
  • GENBANK/CY088091
  • GENBANK/CY088092
  • GENBANK/CY088093
  • GENBANK/CY088094
  • GENBANK/CY088095
  • GENBANK/CY088096
  • GENBANK/CY088097
  • GENBANK/CY088098
  • GENBANK/CY088099
  • GENBANK/CY088100
  • GENBANK/CY088101
  • GENBANK/CY088102
  • GENBANK/CY088103
  • GENBANK/CY088104
  • GENBANK/CY088105
  • GENBANK/CY088106
  • GENBANK/CY088107
  • GENBANK/CY088108
  • GENBANK/CY088109
  • GENBANK/CY088110
  • GENBANK/CY088111
  • GENBANK/CY088112
  • GENBANK/CY088113
  • GENBANK/CY088114
  • GENBANK/CY088115
  • GENBANK/CY088116
  • GENBANK/CY088117
  • GENBANK/CY088118
  • GENBANK/CY088119
  • GENBANK/CY088120
  • GENBANK/CY088121
  • GENBANK/CY088122
  • GENBANK/CY088123
  • GENBANK/CY088124
  • GENBANK/CY088125
  • GENBANK/CY088126
  • GENBANK/CY088127
  • GENBANK/CY088128
  • GENBANK/CY088129
  • GENBANK/CY088130
  • GENBANK/CY088131
  • GENBANK/CY088132
  • GENBANK/CY088133
  • GENBANK/CY088134
  • GENBANK/CY088135
  • GENBANK/CY088136
  • GENBANK/CY088137
  • GENBANK/CY088138
  • GENBANK/CY088139
  • GENBANK/CY088140
  • GENBANK/CY088141
  • GENBANK/CY088142
  • GENBANK/CY088143
  • GENBANK/CY088144
  • GENBANK/CY088145
  • GENBANK/CY088146
  • GENBANK/CY088147
  • GENBANK/CY088148
  • GENBANK/CY088149
  • GENBANK/CY088150
  • GENBANK/CY088151
  • GENBANK/CY088152
  • GENBANK/CY088153
  • GENBANK/CY088154
  • GENBANK/CY088155
  • GENBANK/CY088156
  • GENBANK/CY088157
  • GENBANK/CY088158
  • GENBANK/CY088159
  • GENBANK/CY088160
  • GENBANK/CY088161
  • GENBANK/CY088162
  • GENBANK/CY088163
  • GENBANK/CY088164
  • GENBANK/CY088165
  • GENBANK/CY088166
  • GENBANK/CY088167
  • GENBANK/CY088168
  • GENBANK/CY088169
  • GENBANK/CY088170
  • GENBANK/CY088171
  • GENBANK/CY088172
  • GENBANK/CY088173
  • GENBANK/CY088174
  • GENBANK/CY088175
  • GENBANK/CY088176
  • GENBANK/CY088177
  • GENBANK/CY088178
  • GENBANK/CY088179
  • GENBANK/CY088180
  • GENBANK/CY088181
  • GENBANK/CY088182
  • GENBANK/CY088183
  • GENBANK/CY088184
  • GENBANK/CY088185
  • GENBANK/CY088186
  • GENBANK/CY088187
  • GENBANK/CY088188
  • GENBANK/CY088189
  • GENBANK/CY088190
  • GENBANK/CY088191
  • GENBANK/CY088192
  • GENBANK/CY088193
  • GENBANK/CY088194
  • GENBANK/CY088195
  • GENBANK/CY088196
  • GENBANK/CY088197
  • GENBANK/CY088198
  • GENBANK/CY088199
  • GENBANK/CY088200
  • GENBANK/CY088201
  • GENBANK/CY088202
  • GENBANK/CY088203
  • GENBANK/CY088204
  • GENBANK/CY088205
  • GENBANK/CY088206
  • GENBANK/CY088207
  • GENBANK/CY088208
  • GENBANK/CY088209
  • GENBANK/CY088210
  • GENBANK/CY088211
  • GENBANK/CY088212
  • GENBANK/CY088213
  • GENBANK/CY088214
  • GENBANK/CY088215
  • GENBANK/CY088216
  • GENBANK/CY088217
  • GENBANK/CY088218
  • GENBANK/CY088219
  • GENBANK/CY088220
  • GENBANK/CY088221
  • GENBANK/CY088222
  • GENBANK/CY088223
  • GENBANK/CY088224
  • GENBANK/CY088225
  • GENBANK/CY088226
  • GENBANK/CY088227
  • GENBANK/CY088228
  • GENBANK/CY088229
  • GENBANK/CY088230
  • GENBANK/CY088231
  • GENBANK/CY088232
  • GENBANK/CY088233
  • GENBANK/CY088234
  • GENBANK/CY088235
  • GENBANK/CY088236
  • GENBANK/CY088237
  • GENBANK/CY088238
  • GENBANK/CY088239
  • GENBANK/CY088240
  • GENBANK/CY088241
  • GENBANK/CY088242
  • GENBANK/CY088243
  • GENBANK/CY088244
  • GENBANK/CY088245
  • GENBANK/CY088246
  • GENBANK/CY088247
  • GENBANK/CY088248
  • GENBANK/CY088249
  • GENBANK/CY088250
  • GENBANK/CY088251
  • GENBANK/CY088252
  • GENBANK/CY088253
  • GENBANK/CY088254
  • GENBANK/CY088255
  • GENBANK/CY088256
  • GENBANK/CY088257
  • GENBANK/CY088258
  • GENBANK/CY088259
  • GENBANK/CY088260
  • GENBANK/CY088261
  • GENBANK/CY088262
  • GENBANK/CY088263
  • GENBANK/CY088264
  • GENBANK/CY088265
  • GENBANK/CY088266
  • GENBANK/CY088267
  • GENBANK/CY088268
  • GENBANK/CY088269
  • GENBANK/CY088270
  • GENBANK/CY088271
  • GENBANK/CY088272
  • GENBANK/CY088273
  • GENBANK/CY088274
  • GENBANK/CY088275
  • GENBANK/CY088276
  • GENBANK/CY088277
  • GENBANK/CY088278
  • GENBANK/CY088279
  • GENBANK/CY088280
  • GENBANK/CY088281
  • GENBANK/CY088282
  • GENBANK/CY088283
  • GENBANK/CY088284
  • GENBANK/CY088285
  • GENBANK/CY088286
  • GENBANK/CY088287
  • GENBANK/CY088288
  • GENBANK/CY088289
  • GENBANK/CY088290
  • GENBANK/CY088291
  • GENBANK/CY088292
  • GENBANK/CY088293
  • GENBANK/CY088294
  • GENBANK/CY088295
  • GENBANK/CY088296
  • GENBANK/CY088297
  • GENBANK/CY088298
  • GENBANK/CY088299
  • GENBANK/CY088300
  • GENBANK/CY088301
  • GENBANK/CY088302
  • GENBANK/CY088303
  • GENBANK/CY088304
  • GENBANK/CY088305
  • GENBANK/CY088306
  • GENBANK/CY088307
  • GENBANK/CY088308
  • GENBANK/CY088309
  • GENBANK/CY088310
  • GENBANK/CY088311
  • GENBANK/CY088312
  • GENBANK/CY088313
  • GENBANK/CY088314
  • GENBANK/CY088315
  • GENBANK/CY088316
  • GENBANK/CY088317
  • GENBANK/CY088318
  • GENBANK/CY088319
  • GENBANK/CY088320
  • GENBANK/CY088321
  • GENBANK/CY088322
  • GENBANK/CY088323
  • GENBANK/CY088324
  • GENBANK/CY088325
  • GENBANK/CY088326
  • GENBANK/CY088327
  • GENBANK/CY088328
  • GENBANK/CY088329
  • GENBANK/CY088330
  • GENBANK/CY088331
  • GENBANK/CY088332
  • GENBANK/CY088333
  • GENBANK/CY088334
  • GENBANK/CY088335
  • GENBANK/CY088336
  • GENBANK/CY088337
  • GENBANK/CY088338
  • GENBANK/CY088339
  • GENBANK/CY088340
  • GENBANK/CY088341
  • GENBANK/CY088342
  • GENBANK/CY088343
  • GENBANK/CY088344
  • GENBANK/CY088345
  • GENBANK/CY088346
  • GENBANK/CY088347
  • GENBANK/CY088348
  • GENBANK/CY088349
  • GENBANK/CY088350
  • GENBANK/CY088351
  • GENBANK/CY088352
  • GENBANK/CY088353
  • GENBANK/CY088354
  • GENBANK/CY088355
  • GENBANK/CY088356
  • GENBANK/CY088357
  • GENBANK/CY088358
  • GENBANK/CY088359
  • GENBANK/CY088360
  • GENBANK/CY088361
  • GENBANK/CY088362
  • GENBANK/CY088363
  • GENBANK/CY088364
  • GENBANK/CY088365
  • GENBANK/CY088366
  • GENBANK/CY088367
  • GENBANK/CY088368
  • GENBANK/CY088369
  • GENBANK/CY088370
  • GENBANK/CY088371
  • GENBANK/CY088372
  • GENBANK/CY088373
  • GENBANK/CY088374
  • GENBANK/CY088375
  • GENBANK/CY088376
  • GENBANK/CY088377
  • GENBANK/CY088378
  • GENBANK/CY088379
  • GENBANK/CY088380
  • GENBANK/CY088381
  • GENBANK/CY088382
  • GENBANK/CY088383
  • GENBANK/CY088384
  • GENBANK/CY088385
  • GENBANK/CY088386
  • GENBANK/CY088387
  • GENBANK/CY088388
  • GENBANK/CY088389
  • GENBANK/CY088390
  • GENBANK/CY088391
  • GENBANK/CY088392
  • GENBANK/CY088393
  • GENBANK/CY088394
  • GENBANK/CY088395
  • GENBANK/CY088396
  • GENBANK/CY088397
  • GENBANK/CY088398
  • GENBANK/CY088399
  • GENBANK/CY088400
  • GENBANK/CY088401
  • GENBANK/CY088402
  • GENBANK/CY088403
  • GENBANK/CY088404
  • GENBANK/CY088405
  • GENBANK/CY088406
  • GENBANK/CY088407
  • GENBANK/CY088408
  • GENBANK/CY088409
  • GENBANK/CY088410
  • GENBANK/CY088411
  • GENBANK/CY088412
  • GENBANK/CY088413
  • GENBANK/CY088414
  • GENBANK/CY088415
  • GENBANK/CY088416
  • GENBANK/CY088417
  • GENBANK/CY088418
  • GENBANK/CY088419
  • GENBANK/CY088420
  • GENBANK/CY088421
  • GENBANK/CY088422
  • GENBANK/CY088423
  • GENBANK/CY088424
  • GENBANK/CY088425
  • GENBANK/CY088426
  • GENBANK/CY088427
  • GENBANK/CY088428
  • GENBANK/CY088429
  • GENBANK/CY088430
  • GENBANK/CY088431
  • GENBANK/CY088432
  • GENBANK/CY088433
  • GENBANK/CY088434
  • GENBANK/CY088435
  • GENBANK/CY088436
  • GENBANK/CY088437
  • GENBANK/CY088438
  • GENBANK/CY088439
  • GENBANK/CY088440
  • GENBANK/CY088441
  • GENBANK/CY088442
  • GENBANK/CY088443
  • GENBANK/CY088444
  • GENBANK/CY088445
  • GENBANK/CY088446
  • GENBANK/CY088447
  • GENBANK/CY088448
  • GENBANK/CY088449
  • GENBANK/CY088450
  • GENBANK/CY088451
  • GENBANK/CY088452
  • GENBANK/CY088453
  • GENBANK/CY088454
  • GENBANK/CY088455
  • GENBANK/CY088456
  • GENBANK/CY088457
  • GENBANK/CY088458
  • GENBANK/CY088459
  • GENBANK/CY088460
  • GENBANK/CY088461
  • GENBANK/CY088462
  • GENBANK/CY088463
  • GENBANK/CY088464
  • GENBANK/CY088465
  • GENBANK/CY088466
  • GENBANK/CY088467
  • GENBANK/CY088468
  • GENBANK/CY088469
  • GENBANK/CY088470
  • GENBANK/CY088471
  • GENBANK/CY088472
  • GENBANK/CY088473
  • GENBANK/CY088474
  • GENBANK/CY088475
  • GENBANK/CY088476
  • GENBANK/CY088477
  • GENBANK/CY088478
  • GENBANK/CY088479
  • GENBANK/CY088480
  • GENBANK/CY088481
  • GENBANK/CY088482
  • GENBANK/CY088483
  • GENBANK/CY088484
  • GENBANK/CY088485
  • GENBANK/CY088486
  • GENBANK/CY088487
  • GENBANK/CY088488
  • GENBANK/CY088489
  • GENBANK/CY088490
  • GENBANK/CY088491
  • GENBANK/CY088492
  • GENBANK/CY088493
  • GENBANK/CY088494
  • GENBANK/CY088495
  • GENBANK/CY088496
  • GENBANK/CY088497
  • GENBANK/CY088498
  • GENBANK/CY088499
  • GENBANK/CY088500
  • GENBANK/CY088501
  • GENBANK/CY088502
  • GENBANK/CY088503
  • GENBANK/CY088504
  • GENBANK/CY088505
  • GENBANK/CY088506
  • GENBANK/CY088507
  • GENBANK/CY088508
  • GENBANK/CY088509
  • GENBANK/CY088510
  • GENBANK/CY088511
  • GENBANK/CY088512
  • GENBANK/CY088513
  • GENBANK/CY088514
  • GENBANK/CY088515
  • GENBANK/CY088516
  • GENBANK/CY088517
  • GENBANK/CY088518
  • GENBANK/CY088519
  • GENBANK/CY088520
  • GENBANK/CY088521
  • GENBANK/CY088522
  • GENBANK/CY088523
  • GENBANK/CY088524
  • GENBANK/CY088525
  • GENBANK/CY088526
  • GENBANK/CY088527
  • GENBANK/CY088528
  • GENBANK/CY088529
  • GENBANK/CY088530
  • GENBANK/CY088531
  • GENBANK/CY088532
  • GENBANK/CY088533
  • GENBANK/CY088534
  • GENBANK/CY088535
  • GENBANK/CY088536
  • GENBANK/CY088537
  • GENBANK/CY088538
  • GENBANK/CY088539
  • GENBANK/CY088540
  • GENBANK/CY088541
  • GENBANK/CY088542
  • GENBANK/CY088543
  • GENBANK/CY088544
  • GENBANK/CY088545
  • GENBANK/CY088546
  • GENBANK/CY088547
  • GENBANK/CY088548
  • GENBANK/CY088549
  • GENBANK/CY088550
  • GENBANK/CY088551
  • GENBANK/CY088552
  • GENBANK/CY088553
  • GENBANK/CY088554
  • GENBANK/CY088555
  • GENBANK/CY088556
  • GENBANK/CY088557
  • GENBANK/CY088558
  • GENBANK/CY088559
  • GENBANK/CY088560
  • GENBANK/CY088561
  • GENBANK/CY088562
  • GENBANK/CY088563
  • GENBANK/CY088564
  • GENBANK/CY088565
  • GENBANK/CY088566
  • GENBANK/CY088567
  • GENBANK/CY088568
  • GENBANK/CY107071
  • GENBANK/CY107072
  • GENBANK/CY107073
  • GENBANK/CY107074
  • GENBANK/CY107075
  • GENBANK/CY107076
  • GENBANK/CY107077
  • GENBANK/CY107078
  • GENBANK/CY107079
  • GENBANK/CY107080
  • GENBANK/CY107081
  • GENBANK/CY107082
  • GENBANK/CY107083
  • GENBANK/CY107084
  • GENBANK/CY107085
  • GENBANK/CY107086
  • GENBANK/CY107087
  • GENBANK/CY107088
  • GENBANK/CY107089
  • GENBANK/CY107090
  • GENBANK/CY107091
  • GENBANK/CY107092
  • GENBANK/CY107093
  • GENBANK/CY107094
  • GENBANK/CY107095
  • GENBANK/CY107096
  • GENBANK/CY107097
  • GENBANK/CY107098
  • GENBANK/CY107099
  • GENBANK/CY107100
  • GENBANK/CY107101
  • GENBANK/CY107102
  • GENBANK/CY107103
  • GENBANK/CY107104
  • GENBANK/CY107105
  • GENBANK/CY107106
  • GENBANK/CY107107
  • GENBANK/CY107108
  • GENBANK/CY107109
  • GENBANK/CY107110
  • GENBANK/CY107111
  • GENBANK/CY107112
  • GENBANK/CY107113
  • GENBANK/CY107114
  • GENBANK/CY107115
  • GENBANK/CY107116
  • GENBANK/CY107117
  • GENBANK/CY107118
  • GENBANK/CY107119
  • GENBANK/CY107120
  • GENBANK/CY107121
  • GENBANK/CY107122
  • GENBANK/CY107123
  • GENBANK/CY107124
  • GENBANK/CY107125
  • GENBANK/CY107126
  • GENBANK/CY107127
  • GENBANK/CY107128
  • GENBANK/CY107129
  • GENBANK/CY107130
  • GENBANK/CY107131
  • GENBANK/CY107132
  • GENBANK/CY107133
  • GENBANK/CY107134
  • GENBANK/CY107135
  • GENBANK/CY107136
  • GENBANK/CY107137
  • GENBANK/CY107138
  • GENBANK/CY107139
  • GENBANK/CY107140
  • GENBANK/CY107141
  • GENBANK/CY107142
  • GENBANK/CY107143
  • GENBANK/CY107144
  • GENBANK/CY107145
  • GENBANK/CY107146
  • GENBANK/CY107147
  • GENBANK/CY107148
  • GENBANK/CY107149
  • GENBANK/CY107150
  • GENBANK/CY107151
  • GENBANK/CY107152
  • GENBANK/CY107153
  • GENBANK/CY107154
  • GENBANK/CY107155
  • GENBANK/CY107156
  • GENBANK/CY107157
  • GENBANK/CY107158
  • GENBANK/CY107159
  • GENBANK/CY107160
  • GENBANK/CY107161
  • GENBANK/CY107162
  • GENBANK/CY107163
  • GENBANK/CY107164
  • GENBANK/CY107165
  • GENBANK/CY107166
  • GENBANK/CY107167
  • GENBANK/CY107168
  • GENBANK/CY107169
  • GENBANK/CY107170
  • GENBANK/CY107171
  • GENBANK/CY107172
  • GENBANK/CY107173
  • GENBANK/CY107174
  • GENBANK/CY107175
  • GENBANK/CY107176
  • GENBANK/CY107177
  • GENBANK/CY107178
  • GENBANK/CY107179
  • GENBANK/CY107180
  • GENBANK/CY107181
  • GENBANK/CY107182