Evaluation of influenza virus A/H3N2 and B vaccines on the basis of cross-reactivity of postvaccination human serum antibodies against influenza viruses A/H3N2 and B isolated in MDCK cells and embryonated hen eggs.

The vaccine strains against influenza virus A/H3N2 for the 2010-2011 season and influenza virus B for the 2009-2010 and 2010-2011 seasons in Japan are a high-growth reassortant A/Victoria/210/2009 (X-187) strain and an egg-adapted B/Brisbane/60/2008 (Victoria lineage) strain, respectively. Hemagglutination inhibition (HI) tests with postinfection ferret antisera indicated that the antisera raised against the X-187 and egg-adapted B/Brisbane/60/2008 vaccine production strains poorly inhibited recent epidemic isolates of MDCK-grown A/H3N2 and B/Victoria lineage viruses, respectively. The low reactivity of the ferret antisera may be attributable to changes in the hemagglutinin (HA) protein of production strains during egg adaptation. To evaluate the efficacy of A/H3N2 and B vaccines, the cross-reactivities of postvaccination human serum antibodies against A/H3N2 and B/Victoria lineage epidemic isolates were assessed by a comparison of the geometric mean titers (GMTs) of HI and neutralization (NT) tests. Serum antibodies elicited by the X-187 vaccine had low cross-reactivity to both MDCK- and egg-grown A/H3N2 isolates by HI test and narrow cross-reactivity by NT test in all age groups. On the other hand, the GMTs to B viruses detected by HI test were below the marginal level, so the cross-reactivity was assessed by NT test. The serum neutralizing antibodies elicited by the B/Brisbane/60/2008 vaccine reacted well with egg-grown B viruses but exhibited remarkably low reactivity to MDCK-grown B viruses. The results of these human serological studies suggest that the influenza A/H3N2 vaccine for the 2010-2011 season and B vaccine for the 2009-2010 and 2010-2011 seasons may possess insufficient efficacy and low efficacy, respectively.

[Evaluation of flow-through immunoassay for rapid detection of influenza A and B viruses].

We evaluated a flow-through immunoassay for rapid detection of influenza A and B viral antigens, RapidTesta FLU AB (Daiichi Pure Chemicals Co., Ltd., Tokyo, Japan), by using 507 specimens collected from patients with influenza-like symptoms during the 2002/2003 influenza season in Japan. The specimens consisted of 239 nasal swabs and 268 nasal aspirates; 374 specimens were collected from pediatric patients (under 16 years of age) and 133 from adult patients. RapidTesta FLU AB was compared with cell culture and nested reverse transcription-polymerase chain reaction (RT-PCR). Cell culture detected influenza virus from 66.7% of the 507 specimens (influenza AH3: 44.0%, B: 22.7%). For nasal swabs, it had a sensitivity of 81.9% (77/94), a specificity of 97.9% (142/145) and an efficiency of 91.6% (219/239) for influenza A virus as well as a sensitivity of 80.0% (52/65), a specificity of 98.3% (171/174) and an efficiency of 93.3% (223/239) for influenza B. For nasal aspirates, RapidTesta FLU AB had a sensitivity of 83.2% (109/131), a specificity of 98.5% (135/137) and an efficiency of 91.0% (244/268) for influenza A as well as a sensitivity of 82.7% (43/52), a specificity of 97.7% (211/216) and an efficiency of 94.8% (254/268) for influenza B. RapidTesta FLU AB is characterized by high specificity, low false positive rate, and 10-minute detection of influenza virus. These advantages suggest that RapidTesta FLU AB is a useful kit to assist physicians in making a diagnosis of influenza on candidates for antiviral therapy.

[Evaluation of an immunochromatography test using enzyme immunoassay for rapid detection of influenza A and B viruses].

We evaluated the performance of an improved version of Espline Influenza A & B-N (Fujirebio Inc., Japan), an immunochromatography test using enzyme immunoassay for rapid diagnosis of influenza A and B. The test produced positive results for four strains of influenza viruses and thirty-one influenza viral antigens and negative results for all of thirty strains of other respiratory viruses that were tested. The detection limit of this test was 5.8 x 10(2) to 5.8 x 10(3) pfu/assay, which is more sensitive than the old version of Espline. Furthermore, 715 respiratory specimens collected from the patients (children, 79.4%; adults, 18.5%; unknown, 2.1%) with influenza-like illnesses during the 2002/2003 influenza season in Japan were tested as part of a clinical evaluation of this test. The relative performance of this test compared to cell culture and nested RT-PCR results were examined. In the cell cultures, influenza viruses were detected in 488 of the 715 specimens (overall, 68.3%; AH3, 41.7%; B, 26.4%; AH3 and B, 0.1%). For influenza A, the sensitivity of this test was 95.4% (125/131) for nasal aspirates, 96.8% (92/95) for nasal swabs, and 85.1% (63/74) for throat swabs. For influenza B, the sensitivity of this test was 91.2% (52/57) for nasal aspirates, 88.1% (59/67) for nasal swabs, and 71.6% (48/67) for throat swabs. The new test exhibited a remarkably higher sensitivity to influenza A in throat swabs than the old version of Espline. Only two false positive results were obtained out of a total of 223 virus negative specimens; the specificity of the test was 100% (88/88) for nasal aspirates, 97.6% (81/83) for nasal swabs, and 100% (52/52) for throat swabs. We conclude that the new Espline Influenza A&B-N rapid diagnostic test is easy to use and has a high sensitivity and specificity, especially for influenza A.