Influenza virus surveillance in Argentina during the 2012 season: antigenic characterization, genetic analysis and antiviral susceptibility.

The activity and circulation of influenza viruses in Argentina was studied during 2012 as part of the Argentinean Surveillance for Influenza and other Respiratory Viruses, in the context of Global Influenza Surveillance. The antigenicity and molecular characteristics of haemagglutinins (HA) of circulating influenza A and B viruses were analysed to assess the emergence of virus variants. Susceptibility to oseltamivir and zanamivir was evaluated by enzymatic assay and results were backed-up by sequencing of the neuraminidase (NA) genes. During the 2012 season, influenza virus circulation in Argentina was detected from weeks 24 to 51. The HA sequences of the studied A(H1N1)pdm09 subtype viruses segregated in a different genetic group compared to those identified during the 2009 pandemic, although they were still closely related antigenically to the vaccine virus A/California/07/2009. The HA sequences of the A(H3N2) viruses analysed fell into the A/Victoria/208/2009 clade, genetic group 3C. A mixed circulation of virus variants belonging to B/Victoria and B/Yamagata lineages was detected, with B/Victoria being dominant. All viruses tested were sensitive to oseltamivir and zanamivir except one. This isolate, an A(H1N1)pdm09 virus possessing the substitution NA-N295S, showed highly reduced inhibition by oseltamivir and reduced inhibition by zanamivir. Virological and epidemiological surveillance remains critical for detection of evolving influenza viruses.

Pregnant women infected with pandemic influenza A(H1N1)pdm09 virus showed differential immune response correlated with disease severity.

BACKGROUND: During pregnancy, immunological and hormonal alterations place women at increased risk for influenza-related severe illnesses including hospitalization and death. Although A(H1N1) pdm09 infection resulted in increased disease severity in pregnant women, the precise mechanisms responsible for this risk have yet to be established. OBJECTIVES: The present study was aimed to investigate the role of host chemokines and cytokine profiles in A(H1N1) pdm09 infection regarding disease severity in pregnant women. STUDY DESIGN: This retrospective survey examined 41 pregnant women with confirmed A(H1N1) pdm09 infection. Of them, 12 died (D), 29 survived (S), and 17 remained uninfected and served as controls (C). Antiviral response was evaluated for IFN-ß expression and gene expression profiles of cytokines (TNF-α, IL-6, IL-12, TGF-ß) and chemokines (IL-8, RANTES, MCP-1, IP-10), and the viral Matrix (M1) gene was quantified and normalized using the housekeeping gene product ß-actin mRNA. RESULTS: Higher IL-8 and TNF-α mRNA expression were found in D and S compared with C, while IL-6 showed higher expression in D. Interestingly, these results were associated with a decrease in the anti-inflammatory response of TGF-ß mRNA and IFN-ß. These alterations would lead to an imbalance in the immune response of those patients. CONCLUSIONS: Pregnancy-related reductions in IFN-ß and TGF-ß expression levels and elevated levels of pro-inflammatory cytokines could explain the increased severity of infection and death of pregnant women. These findings may help improve the understanding of the high susceptibility and disease severity to influenza virus infection during pregnancy.

[Seroprevalence of the swine influenza virus in fattening pigs in Argentina in the 2002 season: evaluation by hemagglutination-inhibition and ELISA tests]. / Prevalencia serológica del virus de influenza A en cerdos en Argentina durante la temporada 2002: evaluación mediante inhibición de la hemaglutinación y ELISA.

The seroprevalence of the Influenza virus against H1N1 and H3N2 was determined by the hemagglutination-inhibition test (HI) and a commercial swine influenza ELISA kit, in 13 Argentinean swine herds. The results of within-herd and between-herd prevalence obtained by both tests were statistically correlated. The within-herd prevalence observed by the HI test varied from 38.46 to 100% against H1 and 7.69 to 100% for H3. When the within-herd prevalence was measured with the ELISA test, it varied from 2.33 to 6.9% for H1 and 9.65 to 48% for H3. No statistical differences were observed at herd level between HI and ELISA (H1: p = 0. 20; H3: p=0.11). No agreement between HI and ELISA detected prevalence was observed when the within-herd prevalence was compared (H1: 0.005; H3: 0.070), while the agreement at herd level was considered poor (H1: 0,350; H3: 0,235). The high within-herd prevalence values observed with the HI test and the high sensibility of this test might show that human strains or swine strains phylogenetically closely related to the humans strains used in the HI test in this study have been affecting the swine population since 2002.

Prevalencia serológica del virus de influenza A en cerdos en Argentina durante la temporada 2002: evaluación mediante inhibición de la hemaglutinación y ELISA / Seroprevalence of the swine Influenza virus in fattening pigs in Argentina in the 2002 season: evaluation by hemagglutination-inhibition and ELISA tests

Se evaluó la prevalencia serológica del virus de influenza mediante las pruebas de inhibición de la hemaglutinación (IHA) y ELISA para los subtipos H1N1 y H3N2 en 13 granjas porcinas de Argentina. Se compararon los resultados obtenidos mediante ambas pruebas en términos individuales y de establecimientos. La prevalencia individual por la técnica de IHA fue de 38,46% a 100% para H1 y de 7,69% a 100% para H3. Por la técnica de ELISA, la prevalencia individual fue de 2,33% a 6,9% para H1 y de 9,65% a 48% para H3. No se observaron diferencias significativas entre ambas técnicas a escala de granja (H1: p=0,20; H3: p=0,11). La concordancia entre las pruebas fue nula al tomar como unidad de referencia el animal (H1: 0,005; H3: 0,070), mientras que en términos de establecimiento fue escasa (H1: 0,350; H3: 0,235). Considerando la alta prevalencia individual obtenida por la prueba de IHA y la alta sensibilidad de esta técnica, se podría sugerir que en las poblaciones porcinas de la Argentina circularon cepas virales humanas o cepas porcinas con gran proximidad filogenética a las utilizadas en este estudio desde el año 2002.

The seroprevalence of the Influenza virus against H1N1 and H3N2 was determined by the hemagglutination-inhibition test (HI) and a commercial swine influenza ELISA kit, in 13 Argentinean swine herds. The results of within-herd and between-herd prevalence obtained by both tests were statistically correlated. The within-herd prevalence observed by the HI test varied from 38.46 to 100% against H1 and 7.69 to 100% for H3. When the within-herd prevalence was measured with the ELISA test, it varied from 2.33 to 6.9% for H1 and 9.65 to 48% for H3. No statistical differences were observed at herd level between HI and ELISA (H1: p = 0. 20; H3: p=0.11). No agreement between HI and ELISA detected prevalence was observed when the within-herd prevalence was compared (H1: 0.005; H3: 0.070), while the agreement at herd level was considered poor (H1: 0,350; H3: 0,235). The high within-herd prevalence values observed with the HI test and the high sensibility of this test might show that human strains or swine strains phylogenetically closely related to the humans strains used in the HI test in this study have been affecting the swine population since 2002.

Surveillance of adamantane resistance among influenza A H3 viruses isolated in Argentina between 2001 and 2007.

A dramatic rise in the frequency of resistance to adamantane drugs by influenza A H3 viruses, associated with a single amino acid replacement in the viral matrix M2 protein, has occurred in multiple countries worldwide in recent years. We investigated the frequency of adamantane-resistant influenza A H3 viruses in Argentina during the period 2001-2007. We used reverse transcription followed by polymerase chain reaction. The obtained products were sequenced for the detection of mutations of the M2 gere relevant to the resistance phenotypes. The HA1 sequences of the sensitive and resistant strains were also analyzed to clarify whether they had any relevance to the resistant mutations. Twenty out of 55 (36%) strains were identified with the resistance-conferring substitution at amino acid 31 (Serine 31 Asparagine). No resistant viruses were detected between 2001 and 2005. All strains isolated in 2006 and four out of five isolates from 2007 were resistant. None of the patients had received previous treatment with amantadine and/or rimantadine. The HA1 analysis showed that there were only two changes (Serine193 Phenylalanine and Aspartic acid 225 Asparagine) present in the strains with the M2 substitution at position 31. Our data indicate that since 2006 there has been a significant increase of adamantane-resistant influenza A H3 viruses, which raises concern over the spread of these viruses in Argentina.

Surveillance of adamantane resistance among influenza A H3 viruses isolated in Argentina between 2001 and 2007 / Vigilancia de la resistencia a los adamantanos entre los virus influenza A H3 aislados en Argentina entre 2001 y 2007

A dramatic rise in the frequency of resistance to adamantane drugs by influenza A H3 viruses, associated with a single amino acid replacement in the viral matrix M2 protein, has occurred in multiple countries worldwide in recent years. We investigated the frequency of adamantane-resistant influenza A H3 viruses in Argentina during the period 2001- 2007. We used reverse transcription followed by polymerase chain reaction. The obtained products were sequenced for the detection of mutations of the M2 gene relevant to the resistance phenotypes. The HA1 sequences of the sensitive and resistant strains were also analyzed to clarify whether they had any relevance to the resistant mutations. Twenty out of 55 (36%) strains were identified with the resistance-conferring substitution at amino acid 31 (Serine 31 Asparagine). No resistant viruses were detected between 2001 and 2005. All strains isolated in 2006 and four out of five isolates from 2007 were resistant. None of the patients had received previous treatment with amantadine and/or rimantadine. The HA1 analysis showed that there were only two changes (Serine193 Phenylalanine and Aspartic acid 225 Asparagine) present in the strains with the M2 substitution at position 31. Our data indicate that since 2006 there has been a significant increase of adamantane-resistant influenza A H3 viruses, which raises concern over the spread of these viruses in Argentina.

En los últimos años, se ha detectado un aumento de virus influenza A H3 resistentes a los adamantanos en distintos países, asociados mayoritariamente con el reemplazo de un único aminoácido de la proteína matriz M2. Se investigó la frecuencia de virus influenza A H3 resistentes a los adamantanos en Argentina entre 2001 y 2007. Se utilizó la transcripción reversa seguida de la reacción en cadena de la polimerasa y de la técnica de secuencia directa para la detección de mutaciones en el gen que codifica para la proteína M2, relevantes para los fenotipos de resistencia. También se analizó la secuencia de la porción HA1 de cepas resistentes y sensibles, para intentar establecer alguna relación con las mutaciones de M2. De un total de 55 cepas, 20 (36%) fueron resistentes debido a un cambio aminoacídico en la posición 31 (serina 31 asparagina). No se detectaron cepas resistentes entre 2001 y 2005. Las cepas aisladas en el 2006 y 4 de 5 cepas obtenidas en el 2007 fueron resistentes. Ninguno de los pacientes de los que se habían aislado esas cepas había recibido tratamiento antiviral con anterioridad. En la porción secuenciada de HA1 se encontraron dos cambios (serina 193 fenilalanina y ácido aspártico 225 asparagina), presentes sólo en las cepas que tuvieron la mutación en la posición 31 de M2. Desde el año 2006 se ha registrado en Argentina un aumento significativo de la circulación de virus influenza A H3 con genotipo resistente, lo que genera expectativa con respecto a su diseminación en nuestro país.

Síndrome respiratorio agudo grave. El laboratorio de salud pública frente a una emergencia global / Severe acute respiratory syndrome: the public health laboratory in a global emergency

By the end of year 2002 there was an outbreak of atypical pneumonia in Southeast Asia which soon spread to other continents. This new severe acute respiratory syndrome (SARS) was produced by a novel coronavirus. Due to the severity of the situation and risk of introduction of this pathology in our country, the need to arrange specific laboratory diagnostic tests arose. Classic techniques, such as the electron microscopy and molecular biology test such as retrotranscription followed by the polymerase chain reaction (RT-PCR) were implemented. The araldit included cells infected with bovine coronavirus which allowed the viral particles to be visualized easily but it took more time in comparison with the negative staining of free particles from viral cultures. RT-PCR was able to detect RNA of isolated viruses from cases in Hong Kong and Germany.

A fines del año 2002 se inicia un brote de neumonía atípica en el Sudeste asiático el cual se extiende posteriormente a otros continentes. El nuevo síndrome respiratorio agudo grave (SARS) era producido por un coronavirus novedoso. Debido a la gravedad de la situación y al riesgo de introducción de esta patología en Argentina, se implementaron técnicas de diagnóstico clásicas como la microscopía electrónica, y moleculares como una reacción de retrotranscripción seguida de una reacción en cadena de la polimerasa (RT-PCR). La inclusiónen araldita de células infectadas con un coronavirus bovino permitió visualizar más fácilmente las partículas virales, pero requirió más tiempo en comparación con la coloración negativa de partículas libres de cultivos virales.La RT-PCR implementada fue capaz de detectar ARN de cepas de casos de Hong Kong y de Alemania.

Síndrome respiratorio agudo grave. El laboratorio de salud pública frente a una emergencia global / Severe acute respiratory syndrome: the public health laboratory in a global emergency

By the end of year 2002 there was an outbreak of atypical pneumonia in Southeast Asia which soon spread to other continents. This new severe acute respiratory syndrome (SARS) was produced by a novel coronavirus. Due to the severity of the situation and risk of introduction of this pathology in our country, the need to arrange specific laboratory diagnostic tests arose. Classic techniques, such as the electron microscopy and molecular biology test such as retrotranscription followed by the polymerase chain reaction (RT-PCR) were implemented. The araldit included cells infected with bovine coronavirus which allowed the viral particles to be visualized easily but it took more time in comparison with the negative staining of free particles from viral cultures. RT-PCR was able to detect RNA of isolated viruses from cases in Hong Kong and Germany. (AU)

A fines del año 2002 se inicia un brote de neumonía atípica en el Sudeste asiático el cual se extiende posteriormente a otros continentes. El nuevo síndrome respiratorio agudo grave (SARS) era producido por un coronavirus novedoso. Debido a la gravedad de la situación y al riesgo de introducción de esta patología en Argentina, se implementaron técnicas de diagnóstico clásicas como la microscopía electrónica, y moleculares como una reacción de retrotranscripción seguida de una reacción en cadena de la polimerasa (RT-PCR). La inclusiónen araldita de células infectadas con un coronavirus bovino permitió visualizar más fácilmente las partículas virales, pero requirió más tiempo en comparación con la coloración negativa de partículas libres de cultivos virales.La RT-PCR implementada fue capaz de detectar ARN de cepas de casos de Hong Kong y de Alemania. (AU)

Influenza circulating strains in Argentina exhibit differential induction of cytotoxicity and caspase-3 in vitro.

BACKGROUND: Human influenza infections are a significant cause of morbidity worldwide. Though damage to the respiratory epithelium and has been related to apoptosis, which occurs subsequent to influenza virus infection, little information is available regarding cell cytotoxicity of human strains. OBJECTIVE: To study cytotoxicity performed in vitro by various circulating strains in Argentina. The study sample consisted of three vaccine strains (H1N1, H3N2, and B) administered during 1999-2000 in South America and three strains isolated from clinical samples, one, NAC (H1N1) obtained from an adult inpatient with human pneumonia; and the other two (T) and (T2) (H3N2) with influenza syndrome. Viral antigen was detected by an immunofluorescence test, conducted prior to viral isolation in MDCK cells. Strains were subtyped by the hemmaglutination inhibition test. Cytotoxic properties were determined by lactate dehydrogenase reaction (LDH), crystal violet staining and Hoechst staining. Caspase-3 activity, morphological changes of apoptosis, and viral yields were measured in MDCK infected cells. RESULTS AND CONCLUSIONS: Cells infected by each of the strains exhibited apoptosis morphology by Hoechst staining and caspase-3 activity was high for both H1N1 strains. Further, high levels of LDH activity were detected for NAC and H3N2 strains tested, indicating the possible role of different viral proteins or functions on cell cytotoxicity. The NAC strain, isolated from human pneumonia and antigenically related to A/New Caledonia /20/99 (H1N1), was the highest cytotoxic strain and an excellent inducer of caspase-3 activity. In turn, no parameter was related to different viral yields. We conclude that human strains studied in this paper may be useful tools in the characterization of molecular determinants involved in viral cytopathogenicity.

Antigenic and genomic relation between human influenza A (H3N2) viruses circulating in Argentina during 1998 and the H3N2 vaccine component.

OBJECTIVE: Due to the lack of correlation from 1994 to 1997 between the A H3N2 component of the influenza vaccine recommended for this period and the circulating viruses in Argentina, we decided to study the antigenic and genomic relationships of the 1998 A H3N2 Argentine circulating strains with the corresponding vaccine component for that year as recommended by the World Health Organization (WHO). METHODS: We selected 18 influenza A H3N2 strains isolated in Argentina during 1998 to carry out an antigenic and genomic study of their hemagglutinin (HA) and neuraminidase (NA) proteins. For the genomic study we added 3 isolates from Uruguay. We compared the Argentine and Uruguayan strains with available reference strains. RESULTS: We found that all 18 strains from Argentina were similar to the A/Sydney/5/97 (H3N2) strain, as opposed to the A/Wuhan/359/95 (H3N2) strain, which was the vaccine component. This result was confirmed by the genomic study. CONCLUSIONS: The approach that we applied in Argentina has improved the quality and quantity of information about influenza in the country. This type of work should be encouraged in other countries in order to help choose the most appropriate vaccine components each year and provide individuals with the best possible protection against influenza.

[Comparison of 2 techniques for the laboratory diagnosis of influenza virus infections]. / Comparación de dos técnicas para el diagnóstico de laboratorio de infecciones por el virus influenza.

The clinical or epidemiological influenza diagnosis require fast, sensitive and accessible techniques for small laboratories. In order to investigate the sensitivity of the methods currently used in Argentina, the rapid diagnosis by indirect immunofluorescent assay (IF) was compared to the rapid viral culture in MDCK cells. The diagnosis of influenza virus infection was performed on 81 nasal and pharyngeal swabs collected from outpatients with upper respiratory infection, influenza-like syndrome. The samples were collected during 1998 winter season and both techniques were tested. The IF specificity and sensitivity obtained were 91.9% and 59.5%, respectively. In the selection of the assay to be used for influenza diagnosis, the limitations of the simplest techniques such as IF should be considered. Furthermore, it is advisable to set up an optimized culture method in complex laboratories since culture is the only technique which allows the reference centers to perform the full characterization of the isolates.

Comparación de dos técnicas para el diagnóstico de laboratorio de infecciones por el virus influenza / Comparison of 2 techniques for the laboratory diagnosis of influenza virus infections

The clinical or epidemiological influenza diagnosis require fast, sensitive and accessible techniques for small laboratories. In order to investigate the sensitivity of the methods currently used in Argentina, the rapid diagnosis by indirect immunofluorescent assay (IF) was compared to the rapid viral culture in MDCK cells. The diagnosis of influenza virus infection was performed on 81 nasal and pharyngeal swabs collected from outpatients with upper respiratory infection, influenza-like syndrome. The samples were collected during 1998 winter season and both techniques were tested. The IF specificity and sensitivity obtained were 91.9 and 59.5, respectively. In the selection of the assay to be used for influenza diagnosis, the limitations of the simplest techniques such as IF should be considered. Furthermore, it is advisable to set up an optimized culture method in complex laboratories since culture is the only technique which allows the reference centers to perform the full characterization of the isolates.(AU)

Comparación de dos técnicas para el diagnóstico de laboratorio de infecciones por el virus influenza / Comparison of 2 techniques for the laboratory diagnosis of influenza virus infections

The clinical or epidemiological influenza diagnosis require fast, sensitive and accessible techniques for small laboratories. In order to investigate the sensitivity of the methods currently used in Argentina, the rapid diagnosis by indirect immunofluorescent assay (IF) was compared to the rapid viral culture in MDCK cells. The diagnosis of influenza virus infection was performed on 81 nasal and pharyngeal swabs collected from outpatients with upper respiratory infection, influenza-like syndrome. The samples were collected during 1998 winter season and both techniques were tested. The IF specificity and sensitivity obtained were 91.9 and 59.5, respectively. In the selection of the assay to be used for influenza diagnosis, the limitations of the simplest techniques such as IF should be considered. Furthermore, it is advisable to set up an optimized culture method in complex laboratories since culture is the only technique which allows the reference centers to perform the full characterization of the isolates.

Genetic characterization of wild-type measles viruses isolated during the 1998 measles epidemic in Argentina.

This study reports on genomic characterization of six measles virus (MV) isolates obtained from a measles epidemic in Argentina in 1998. Reverse transcription-polymerase chain reaction (RT-PCR) and nucleotide sequence analysis of the carboxyl-terminal region of the nucleoprotein (N) gene of these isolates classified all of them as wild type MV of D6 genotype. MVs of D6 genotype with identical nucleotide sequences in the region analyzed were also identified during the 1997 measles epidemic in Brazil and the 1999 measles outbreak in Uruguai. These results suggest that the MVs associated with the 1998 measles epidemic in Argentina might have originated from Brazil. As the D6 genotype is also widely distributed in Europe, it is possible that this genotype was brought to South America from Europe.

Comparación de dos técnicas para el diagnóstico de laboratorio de infecciones por el virus influenza. / [Comparison of 2 techniques for the laboratory diagnosis of influenza virus infections]

The clinical or epidemiological influenza diagnosis require fast, sensitive and accessible techniques for small laboratories. In order to investigate the sensitivity of the methods currently used in Argentina, the rapid diagnosis by indirect immunofluorescent assay (IF) was compared to the rapid viral culture in MDCK cells. The diagnosis of influenza virus infection was performed on 81 nasal and pharyngeal swabs collected from outpatients with upper respiratory infection, influenza-like syndrome. The samples were collected during 1998 winter season and both techniques were tested. The IF specificity and sensitivity obtained were 91.9

and 59.5

, respectively. In the selection of the assay to be used for influenza diagnosis, the limitations of the simplest techniques such as IF should be considered. Furthermore, it is advisable to set up an optimized culture method in complex laboratories since culture is the only technique which allows the reference centers to perform the full characterization of the isolates.

[Antigenic relationship between influenza A (H3N2) strains circulating in Argentina and vaccine strains]. / Estudio antigenico de cepas de influenza A (H3N2) circulantes en la Argentina y su relacion con las cepas vacunales.

Influenza epidemic season occurs usually from May to September in Argentina, so that the vaccine produced in the northern hemisphere to be administered during October-November may be out of phase for Argentina. In order to determine if the locally circulating strains in Argentina are antigenically close by related to the vaccine strains administered, they were compared with the influenza viruses isolated from May 1994 to December 1997. Clinical samples (9866) were nasopharyngeal aspirates from children hospitalized for acute lower respiratory tract infection and nasal-pharyngeal swabs from adults with influenza syndrome. Initial laboratory diagnosis was performed by immunofluorescence assay, followed by isolation in MDCK cells. Influenza A viruses (242) were detected and subtyped by hemagglutination inhibition (HAI) with WHO FLU Reagent Kit. A subset of the isolated viruses was antigenically analyzed by the WHO Collaborating Center at CDC, Atlanta, USA. Influenza A (H3N2) viruses characterized as circulating in Argentina during the last four years matched partially with the antigens present in the vaccines administered during 1994-97 period. These antigenic variants sometimes circulate late in the year (October 1994 and 1997) initiating the following influenza season and becoming prevalent. They were present 2 years later in the vaccine formula administered in the southern hemisphere. The HAI results of our isolates show that they are highly specific with the homologous antiserum and much less specific with antibodies against vaccine strains. The difference is 16 to 64 fold different. These results demonstrate the need to intensify influenza laboratory surveillance in order to obtain the best possible vaccine.

Estudio antigenico de cepas de influenza A (H3N2) circulantes en la Argentina y su relacion con las cepas vacunales. / [Antigenic relationship between influenza A (H3N2) strains circulating in Argentina and vaccine strains]

Influenza epidemic season occurs usually from May to September in Argentina, so that the vaccine produced in the northern hemisphere to be administered during October-November may be out of phase for Argentina. In order to determine if the locally circulating strains in Argentina are antigenically close by related to the vaccine strains administered, they were compared with the influenza viruses isolated from May 1994 to December 1997. Clinical samples (9866) were nasopharyngeal aspirates from children hospitalized for acute lower respiratory tract infection and nasal-pharyngeal swabs from adults with influenza syndrome. Initial laboratory diagnosis was performed by immunofluorescence assay, followed by isolation in MDCK cells. Influenza A viruses (242) were detected and subtyped by hemagglutination inhibition (HAI) with WHO FLU Reagent Kit. A subset of the isolated viruses was antigenically analyzed by the WHO Collaborating Center at CDC, Atlanta, USA. Influenza A (H3N2) viruses characterized as circulating in Argentina during the last four years matched partially with the antigens present in the vaccines administered during 1994-97 period. These antigenic variants sometimes circulate late in the year (October 1994 and 1997) initiating the following influenza season and becoming prevalent. They were present 2 years later in the vaccine formula administered in the southern hemisphere. The HAI results of our isolates show that they are highly specific with the homologous antiserum and much less specific with antibodies against vaccine strains. The difference is 16 to 64 fold different. These results demonstrate the need to intensify influenza laboratory surveillance in order to obtain the best possible vaccine.

[Characterization of isolated adenovirus associated with acute lower respiratory infection in pediatrics]. / Caracterización de aislamientos de adenovirus asociados a infección respiratoria aguda baja en pediatría.

BACKGROUND: Acute respiratory infection (ARI) are a health care problem as the adenovirus (ADV) has shown to be one of the most frequent viral agents detected in children admitted for mild ARI in the authors medium. METHODS: Over a 7-year period (1988-1994) ADV isolated from patients under the age of 5, admitted for mild ARI in hospitals in the city of Buenos Aires (Argentina). All the strains were isolated in HEp-2 cell cultures from nasopharyngeal aspirates in which the presence of ADV was detected by indirect immunofluorescence with monoclonal antibodies. Antigenic characterization was performed by sero- and genome neutralization with restriction enzymes. RESULTS: The isolates corresponded to the genomic variants of ADV 7i, ADV 7c and to a greater number of ADV 7h. An increase was observed in the quantity of cases in the second half of the year. In the population studied, the most commonly infected were males (67.9%) and patients from 2 months to 1 year in age (89.2%). Sixty-six percent of the cases were severe infections with the length of hospitalization being greater than that of patients normally admitted for mild ARI by other virus and showed a high mortality. CONCLUSIONS: All the above events suggest that the genomic variants detected are highly pathogenic.