Clinical and genetic characterization of severe influenza B-associated diseases during an outbreak in Taiwan

Wen Chen Li, Shin Ru Shih, Yhu Chering Huang, Guang Wu Chen, Shih Cheng Chang, Mei Jen Hsiao, Kuo Chien Tsao, Tzou Yien Lin

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42 Citations (Scopus)


Background: Mismatches between circulating and vaccine strains of influenza virus had been observed in Taiwan. A comprehensive clinical and genetic analysis of influenza B viruses-associated important diseases was lacking. Objectives: Clinical and phylogenetic analysis of influenza B viruses during an outbreak in Taiwan. Study designs: Clinical manifestations of hospitalized, culture-confirmed patients were analyzed from July 2004 to June 2005. Partial genome sequence analysis of hemagglutinin (HA), neuraminidase (NA), and nonstructural (NS) genes were performed in 54 influenza B isolates during the study period, and nine srandomly chosen isolates during 2000 and 2003. Results: Three specific diseases were found in these patients, including 13 of encephalitis/encephalopathy, 28 of influenza-associated myositis (IAM), and one of acute respiratory distress syndrome (ARDS). Three phylogenetic groups were identified, including reassortant strains-group 1 (Victoria lineage of HA, Yamagata lineage of NA, clade A of NS), group 2 (Yamagata lineage of HA, Yamagata lineage of NA, clade A of NS), and group 3 (Yamagata lineage of HA, Yamagata lineage of NA, clade B of NS). Conclusions: Severe influenza B-associated disease in children was not rare and might be fatal. We offered the evidence of co-circulation of the two HA lineages in the same outbreak.

Original languageEnglish
Pages (from-to)45-51
Number of pages7
JournalJournal of Clinical Virology
Issue number1
Publication statusPublished - May 2008
Externally publishedYes



  • Acute respiratory distress syndrome
  • Encephalitis/encephalopathy
  • Genetic evolution
  • Influenza B virus
  • Influenza-associated myositis

ASJC Scopus subject areas

  • Applied Microbiology and Biotechnology
  • Virology
  • Immunology and Allergy
  • Infectious Diseases

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