@article{Shtepa_Rezvykh_Bredykhina_2017, title={Surveillance of Influenza A/California/H1N1 in Dnipropetrovsk, Ukraine}, volume={9}, url={https://ojphi.org/ojs/index.php/ojphi/article/view/7755}, DOI={10.5210/ojphi.v9i1.7755}, abstractNote={<div style="left: 79.8182px; top: 284.47px; font-size: 12.564px; font-family: sans-serif; transform: scaleX(1.11744);" data-canvas-width="73.28565488215487">Introduction</div><div style="left: 93.1212px; top: 297.73px; font-size: 12.564px; font-family: serif; transform: scaleX(0.962392);" data-canvas-width="337.01350067340064">Ukraine’s ability to respond to the spread of viruses that cause</div><div style="left: 79.8182px; top: 312.511px; font-size: 12.564px; font-family: serif; transform: scaleX(1.02468);" data-canvas-width="351.94201346801333">pandemics and reduce economic losses from influenza, can be</div><div style="left: 79.8182px; top: 327.292px; font-size: 12.564px; font-family: serif; transform: scaleX(0.978265);" data-canvas-width="348.4743569023569">strengthened only in the presence of a developed surveillance network</div><div style="left: 79.8182px; top: 342.073px; font-size: 12.564px; font-family: serif; transform: scaleX(1.0241);" data-canvas-width="349.88403468013473">including the monitoring of virus circulation in humans. Specialists</div><div style="left: 79.8182px; top: 356.855px; font-size: 12.564px; font-family: serif; transform: scaleX(1.03715);" data-canvas-width="352.21465168350124">of Dnipropetrovsk Oblast have great experience in virological</div><div style="left: 79.8182px; top: 371.636px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00799);" data-canvas-width="349.2357336700337">surveillance on the circulation of influenza virus A/California/H1N1</div><div style="left: 79.8182px; top: 386.417px; font-size: 12.564px; font-family: serif; transform: scaleX(1.02022);" data-canvas-width="349.62898602693605">and timely determination of the etiology of outbreaks caused by the</div><div style="left: 79.8182px; top: 401.198px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00067);" data-canvas-width="28.26893939393939">virus.</div><div style="left: 79.8182px; top: 429.326px; font-size: 12.564px; font-family: sans-serif; transform: scaleX(1.0727);" data-canvas-width="51.65049326599326">Methods</div><div style="left: 93.1212px; top: 442.585px; font-size: 12.564px; font-family: serif; transform: scaleX(1.09268);" data-canvas-width="340.5892074074074">Laboratory diagnostics of influenza was performed using</div><div style="left: 79.8182px; top: 457.366px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00467);" data-canvas-width="349.15658063973063">serological methods, PCR, and virological studies in the cell culture.</div><div style="left: 79.8182px; top: 472.148px; font-size: 12.564px; font-family: serif; transform: scaleX(1.02654);" data-canvas-width="349.5875249158249">During the last seven epidemic seasons, including the flu pandemic</div><div style="left: 79.8182px; top: 486.929px; font-size: 12.564px; font-family: serif; transform: scaleX(1.01126);" data-canvas-width="349.4078601010101">of 2009-2010, most of samples came from four health-care facilities</div><div style="left: 79.8182px; top: 501.71px; font-size: 12.564px; font-family: serif; transform: scaleX(0.984676);" data-canvas-width="350.61023232323254">of Dnipropetrovsk, which were determined as basic hospitals for</div><div style="left: 79.8182px; top: 516.491px; font-size: 12.564px; font-family: serif; transform: scaleX(1.02907);" data-canvas-width="350.0209819865321">the sentinel center. Patients with severe acute respiratory infections</div><div style="left: 79.8182px; top: 531.272px; font-size: 12.564px; font-family: serif; transform: scaleX(1.02984);" data-canvas-width="349.9229829966328">(SARI) were examined. Nasopharyngeal washouts and swabs were</div><div style="left: 79.8182px; top: 546.053px; font-size: 12.564px; font-family: serif; transform: scaleX(0.995959);" data-canvas-width="348.8512760942761">collected into cryo-tubes with a transport medium. The samples were</div><div style="left: 79.8182px; top: 560.834px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00459);" data-canvas-width="175.87049494949494">stored at hospitals in Dewar flasks.</div><div style="left: 93.1212px; top: 575.616px; font-size: 12.564px; font-family: serif; transform: scaleX(0.998628);" data-canvas-width="337.80251818181813">The delivery of the samples to the laboratory was performed</div><div style="left: 79.8182px; top: 590.397px; font-size: 12.564px; font-family: serif; transform: scaleX(0.973383);" data-canvas-width="350.20692878787884">according to cold-chain rules. After sample preparation stage, the</div><div style="left: 79.8182px; top: 605.178px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00525);" data-canvas-width="349.1050683501683">samples were tested for the presence of influenza A/B virus RNA by</div><div style="left: 79.8182px; top: 619.959px; font-size: 12.564px; font-family: serif; transform: scaleX(0.964034);" data-canvas-width="350.3137225589225">PCR using Bio-Rad CFX-96 cycler and the following commercial</div><div style="left: 79.8182px; top: 634.74px; font-size: 12.564px; font-family: serif; transform: scaleX(0.985128);" data-canvas-width="348.5384331649829">test-kits AmpliSens® Influenza virus A/B-FL, AmpliSens® Influenza</div><div style="left: 79.8182px; top: 649.521px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00305);" data-canvas-width="321.51207070707056">virus A/H1-swine, and AmpliSens® Influenza virus A-type-FL.</div><div style="left: 93.1212px; top: 664.302px; font-size: 12.564px; font-family: serif; transform: scaleX(1.04219);" data-canvas-width="338.7975848484848">All positive samples with detected RNA of influenza virus</div><div style="left: 79.8182px; top: 679.084px; font-size: 12.564px; font-family: serif; transform: scaleX(1.02525);" data-canvas-width="349.88277828282787">A/H1-swine were tested using MDSK cell cultures (Canine Kidney</div><div style="left: 79.8182px; top: 693.865px; font-size: 12.564px; font-family: serif; transform: scaleX(1.04335);" data-canvas-width="350.21949276094256">Epithelial Cells). Flu viruses caused cytopathic changes in the cell</div><div style="left: 79.8182px; top: 708.646px; font-size: 12.564px; font-family: serif; transform: scaleX(1.03074);" data-canvas-width="349.96946969696955">cultures in the form of poppy-sand-like degeneracy not earlier than</div><div style="left: 79.8182px; top: 723.427px; font-size: 12.564px; font-family: serif; transform: scaleX(0.991367);" data-canvas-width="348.7959946127947">in 72 hours after the infection of the cells followed by cell monolayer</div><div style="left: 79.8182px; top: 738.208px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00147);" data-canvas-width="73.62488215488216">fragmentation.</div><div style="left: 93.1212px; top: 752.989px; font-size: 12.564px; font-family: serif; transform: scaleX(1.04432);" data-canvas-width="133.65554545454552">Fig. 1 MDSK cell culture</div><div style="left: 93.1212px; top: 767.77px; font-size: 12.564px; font-family: serif; transform: scaleX(1.02752);" data-canvas-width="335.38269696969667">Fig. 2 MDSK cell culture 72 hours after infection with influenza</div><div style="left: 79.8182px; top: 782.552px; font-size: 12.564px; font-family: serif; transform: scaleX(1.0355);" data-canvas-width="82.35684343434343">virus A (H1N1)</div><div style="left: 93.1212px; top: 797.333px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00298);" data-canvas-width="337.9884649831649">Express immunochromatic tests «Cito test influenza A+B» or</div><div style="left: 79.8182px; top: 812.114px; font-size: 12.564px; font-family: serif; transform: scaleX(1.02329);" data-canvas-width="349.64280639730634">agglutination test (AT) using erythrocyte suspension of human 0 (I)</div><div style="left: 79.8182px; top: 826.895px; font-size: 12.564px; font-family: serif; transform: scaleX(1.03886);" data-canvas-width="350.164211279461">group blood were used for the determination of haemagglutinating</div><div style="left: 79.8182px; top: 841.676px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00119);" data-canvas-width="35.241944444444435">agents.</div><div style="left: 79.8182px; top: 869.804px; font-size: 12.564px; font-family: sans-serif; transform: scaleX(1.08437);" data-canvas-width="45.38107070707071">Results</div><div style="left: 93.1212px; top: 883.063px; font-size: 12.564px; font-family: serif; transform: scaleX(1.0191);" data-canvas-width="336.4054043771044">During the seven epidemic seasons, 5,467 people were examined</div><div style="left: 79.8182px; top: 897.844px; font-size: 12.564px; font-family: serif; transform: scaleX(0.959241);" data-canvas-width="350.25090269360265">for flu and acute respiratory viral infections. During the swine flu</div><div style="left: 79.8182px; top: 912.626px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00721);" data-canvas-width="351.56509427609416">pandemic in 2009-2010, 1,217 severely ill patients were tested.</div><div style="left: 79.8182px; top: 927.407px; font-size: 12.564px; font-family: serif; transform: scaleX(0.968776);" data-canvas-width="350.47077222222214">Positive results were found in 50% of cases (607 persons). From</div><div style="left: 79.8182px; top: 942.188px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00785);" data-canvas-width="351.1366627946129">those, pandemic influenza virus (RNA of influenza A/H1-swine</div><div style="left: 79.8182px; top: 956.969px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00061);" data-canvas-width="231.69222727272722">virus) was detected in 100% of positive cases.</div><div style="left: 93.1212px; top: 971.75px; font-size: 12.564px; font-family: serif; transform: scaleX(1.08978);" data-canvas-width="338.6505863636363">Fig.3 Data on the determined pandemic flu virus strains</div><div style="left: 79.8182px; top: 986.531px; font-size: 12.564px; font-family: serif; transform: scaleX(1.13338);" data-canvas-width="353.4635106060604">(RNA of influenza A/H1-swine virus) using PCR during</div><div style="left: 79.8182px; top: 1001.31px; font-size: 12.564px; font-family: serif; transform: scaleX(1.02423);" data-canvas-width="350.7811023569022">epidemiological seasons from 2009 to 2016 in Dnipropetrovsk</div><div style="left: 79.8182px; top: 1016.09px; font-size: 12.564px; font-family: serif; transform: scaleX(1.08025);" data-canvas-width="85.86219191919193">Oblast, Ukraine</div><div style="left: 93.1212px; top: 1030.87px; font-size: 12.564px; font-family: serif; transform: scaleX(1.01403);" data-canvas-width="336.11643299663297">Frequency of pandemic influenza virus detection declined to zero</div><div style="left: 79.8182px; top: 1045.66px; font-size: 12.564px; font-family: serif; transform: scaleX(1.01631);" data-canvas-width="351.6932468013467">in the following epidemic seasons (2010-2011 and 2011-2012).</div><div style="left: 79.8182px; top: 1060.44px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00766);" data-canvas-width="351.23843097643123">However, incidence of the virus variant (influenza A/H1-swine)</div><div style="left: 79.8182px; top: 1075.22px; font-size: 12.564px; font-family: serif; transform: scaleX(0.996932);" data-canvas-width="351.25225134680153">began to grow slowly during the last four epidemic flu seasons</div><div style="left: 452.303px; top: 282.949px; font-size: 12.564px; font-family: serif; transform: scaleX(1.01621);" data-canvas-width="349.4417828282827">from separate cases (6 in 2012-2013, 1 in 2012-2013) to 26 cases in</div><div style="left: 452.303px; top: 297.73px; font-size: 12.564px; font-family: serif; transform: scaleX(0.986807);" data-canvas-width="348.4743569023566">2014-2015. During the last epidemic season (2015-2016), the number</div><div style="left: 452.303px; top: 312.511px; font-size: 12.564px; font-family: serif; transform: scaleX(0.976413);" data-canvas-width="348.44922895622886">of pandemic influenza cases increased dramatically to 166, accounting</div><div style="left: 452.303px; top: 327.292px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00076);" data-canvas-width="148.99615656565658">29% of all examined persons.</div><div style="left: 465.606px; top: 342.073px; font-size: 12.564px; font-family: serif; transform: scaleX(1.02854);" data-canvas-width="337.6178277777778">Fig. 4 Results of isolation of pandemic strains of influenza</div><div style="left: 452.303px; top: 356.855px; font-size: 12.564px; font-family: serif; transform: scaleX(1.01795);" data-canvas-width="348.5623047138048">viruses in cell culture MDSK flu epidemic seasons from 2009-2010</div><div style="left: 452.303px; top: 371.636px; font-size: 12.564px; font-family: serif; transform: scaleX(1.05802);" data-canvas-width="258.9686127946128">to 2015-2016 in Dnipropetrovsk Oblast, Ukraine</div><div style="left: 465.606px; top: 386.417px; font-size: 12.564px; font-family: serif; transform: scaleX(1.03674);" data-canvas-width="336.57627441077415">Most of the virus isolates were sent for confirmation and further</div><div style="left: 452.303px; top: 401.198px; font-size: 12.564px; font-family: serif; transform: scaleX(1.02751);" data-canvas-width="351.92316750841735">identification to the Ukrainian Center for Influenza and to the</div><div style="left: 452.303px; top: 415.979px; font-size: 12.564px; font-family: serif; transform: scaleX(1.01756);" data-canvas-width="349.48198754208755">world influenza centers (Atlanta, USA and London, UK) in order to</div><div style="left: 452.303px; top: 430.76px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00084);" data-canvas-width="348.86007087542083">support Ukraine’s participation in the worldwide pandemic influenza</div><div style="left: 452.303px; top: 445.541px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00395);" data-canvas-width="351.1479703703707">surveillance. The world flu centers confirmed the isolates to be</div><div style="left: 452.303px; top: 460.323px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00406);" data-canvas-width="263.1147239057239">influenza virus strain A/California/(H1N1)/07/2009.</div><div style="left: 452.303px; top: 488.45px; font-size: 12.564px; font-family: sans-serif; transform: scaleX(1.10256);" data-canvas-width="75.39640235690236">Conclusions</div><div style="left: 465.606px; top: 501.71px; font-size: 12.564px; font-family: serif; transform: scaleX(0.980702);" data-canvas-width="332.2944723905724">1. Circulation of the pandemic type of influenza virus A/California/</div><div style="left: 452.303px; top: 516.491px; font-size: 12.564px; font-family: serif; transform: scaleX(1.02056);" data-canvas-width="349.78101010101">(H1N1)/ 07/2009 among the population of Dnipropetrovsk oblast is</div><div style="left: 452.303px; top: 531.272px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00749);" data-canvas-width="108.4899074074074">of sporadic character.</div><div style="left: 465.606px; top: 546.053px; font-size: 12.564px; font-family: serif; transform: scaleX(1.02974);" data-canvas-width="336.6742734006733">2. The return of the virus A/California/(H1N1)/07/2009 after the</div><div style="left: 452.303px; top: 560.834px; font-size: 12.564px; font-family: serif; transform: scaleX(1.03563);" data-canvas-width="350.18054444444425">2009-2010 pandemic occurred during the last 2015-2016 epidemic</div><div style="left: 452.303px; top: 575.616px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00145);" data-canvas-width="36.63654545454545">season.</div><div style="left: 465.606px; top: 590.397px; font-size: 12.564px; font-family: serif; transform: scaleX(0.990448);" data-canvas-width="335.2997747474747">3. Application of PCR can significantly shorten the examination of</div><div style="left: 452.303px; top: 605.178px; font-size: 12.564px; font-family: serif; transform: scaleX(1.03252);" data-canvas-width="349.95439292929285">patients with severe course of influenza, but cannot help with virus</div><div style="left: 452.303px; top: 619.959px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00159);" data-canvas-width="46.423880471380464">isolation.</div><div style="left: 465.606px; top: 634.74px; font-size: 12.564px; font-family: serif; transform: scaleX(1.09082);" data-canvas-width="340.4258757575756">4. The use of express immunoassay tests accelerates the</div><div style="left: 452.303px; top: 649.521px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00545);" data-canvas-width="163.31908585858585">identification of viruses isolates.</div><div style="left: 465.606px; top: 664.302px; font-size: 12.564px; font-family: serif; transform: scaleX(1.04955);" data-canvas-width="339.320246127946">5. The employment MDSK cell culture for influenza virus</div><div style="left: 452.303px; top: 679.084px; font-size: 12.564px; font-family: serif; transform: scaleX(1.06429);" data-canvas-width="352.61544242424253">isolation allows obtaining of a spectrum of influenza strains</div><div style="left: 452.303px; top: 693.865px; font-size: 12.564px; font-family: serif; transform: scaleX(1.03431);" data-canvas-width="354.21609259259253">circulating during an epidemic period including the strain</div>A/California/(H1N1)/07/2009.}, number={1}, journal={Online Journal of Public Health Informatics}, author={Shtepa, Oleksandr and Rezvykh, Valentyna and Bredykhina, Maryna}, year={2017}, month={May} }