Influenza (flu) |
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Since 1999, the World Health Organization (WHO) has issued annual recommendations for influenza vaccine formulations. One reformulation of the influenza vaccine is for the Northern Hemisphere, and the other is for the Southern Hemisphere. [1] Both recommendations are trivalent, i.e. featuring three strains. [2]
Since the 2012–2013 season, the WHO recommendations have also included the formulation of an annual quadrivalent vaccine, featuring an additional strain of Influenza B virus, B/Yamagata. [2]
Due to the widespread use of non-pharmaceutical interventions at the beginning of the COVID-19 pandemic, the B/Yamagata influenza lineage has not been isolated since March 2020, and may have been eradicated. Starting with the 2024 Southern Hemisphere influenza season, the WHO and other regulatory bodies have removed this strain from influenza vaccine recommendations. [3] [4] [5]
The following is a list of WHO recommended strains for the Northern Hemisphere influenza season. Starting in the 2012–2013 season, the recommendation shifted to include the composition of a quadrivalent influenza vaccine (QIV) that contains both influenza B lineages, alongside a trivalent influenza vaccine (TIV) containing one influenza B lineage. [2]
NH winter season | Influenza A H1N1 | Influenza A H3N2 | Influenza B Victoria | Influenza B Yamagata |
---|---|---|---|---|
1998–1999 [6] | A/Beijing/262/95 (H1N1)-like virus | A/Sydney/5/97 (H3N2)-like virus | N/A | B/Beijing/184/93-like virus |
1999–2000 [7] | A/Beijing/262/95 (H1N1)-like virus | A/Sydney/5/97 (H3N2)-like virus | B/Shangdong/7/97-like virus [note 1] | B/Beijing/184/93-like virus [note 1] |
2000–2001 [8] | A/New Caledonia/20/99 (H1N1)-like virus | A/Moscow/10/99 (H3N2)-like virus | N/A | B/Beijing/184/93-like virus |
2001–2002 [9] | A/New Caledonia/20/99 (H1N1)-like virus | A/Moscow/10/99 (H3N2)-like virus | N/A | B/Sichuan/379/99-like virus |
2002–2003 [10] | A/New Caledonia/20/99 (H1N1)-like virus | A/Moscow/10/99 (H3N2)-like virus | B/Hong Kong/330/2001-like virus | N/A |
2003–2004 [11] | A/New Caledonia/20/99 (H1N1)-like virus | A/Moscow/10/99 (H3N2)-like virus | B/Hong Kong/330/2001-like virus | N/A |
2004–2005 [12] | A/New Caledonia/20/99 (H1N1)-like virus | A/Fujian/411/2002 (H3N2)-like virus | N/A | B/Shanghai/361/2002-like virus |
2005–2006 [13] | A/New Caledonia/20/99 (H1N1)-like virus | A/California/7/2004 (H3N2)-like virus | N/A | B/Shanghai/361/2002-like virus |
2006–2007 [14] | A/New Caledonia/20/99 (H1N1)-like virus | A/Wisconsin/67/2005 (H3N2)-like virus | B/Malaysia/2506/2004-like virus | N/A |
2007–2008 [15] | A/Solomon Islands/3/2006 (H1N1)-like virus | A/Wisconsin/67/2005 (H3N2)-like virus | B/Malaysia/2506/2004-like virus | N/A |
2008–2009 [16] | A/Brisbane/59/2007 (H1N1)-like virus | A/Brisbane/10/2007 (H3N2)-like virus | N/A | B/Florida/4/2006-like virus |
2009–2010 [17] | A/Brisbane/59/2007 (H1N1)-like virus | A/Brisbane/10/2007 (H3N2)-like virus | B/Brisbane/60/2008-like virus | N/A |
2010–2011 [18] | A/California/7/2009 (H1N1)-like virus | A/Perth/16/2009 (H3N2)-like virus | B/Brisbane/60/2008-like virus | N/A |
2011–2012 [19] | A/California/7/2009 (H1N1)-like virus | A/Perth/16/2009 (H3N2)-like virus | B/Brisbane/60/2008-like virus | N/A |
2012–2013 [20] | A/California/7/2009 (H1N1)pdm09 [note 2] -like virus [21] | A/Victoria/361/2011 (H3N2)-like virus | B/Brisbane/60/2008-like virus | B/Wisconsin/1/2010-like virus |
2013–2014 [22] | A/California/7/2009 (H1N1)pdm09-like virus | A(H3N2) virus antigenically like the cell-propagated prototype virus A/Victoria/361/2011 [note 3] | B/Brisbane/60/2008-like virus | B/Massachusetts/2/2012-like virus |
2014–2015 [23] | A/California/7/2009 (H1N1)pdm09-like virus | A/Texas/50/2012 (H3N2)-like virus [note 4] | B/Brisbane/60/2008-like virus | B/Massachusetts/2/2012-like virus |
2015–2016 [24] | A/California/7/2009 (H1N1)pdm09-like virus | A/Switzerland/9715293/2013 (H3N2)-like virus | B/Brisbane/60/2008-like virus | B/Phuket/3073/2013-like virus |
2016–2017 [25] [26] | A/California/7/2009 (H1N1)pdm09-like virus | A/Hong Kong/4801/2014 (H3N2)-like virus | B/Brisbane/60/2008-like virus | B/Phuket/3073/2013-like virus |
2017–2018 [27] [28] | A/Michigan/45/2015 (H1N1)pdm09-like virus [29] | A/Hong Kong/4801/2014 (H3N2)-like virus | B/Brisbane/60/2008-like virus | B/Phuket/3073/2013-like virus |
2018–2019 [30] [31] | A/Michigan/45/2015 (H1N1)pdm09-like virus | A/Singapore/INFIMH-16-0019/2016 (H3N2)-like virus | B/Colorado/06/2017-like virus (B/Victoria/2/87 lineage) | B/Phuket/3073/2013-like virus (B/Yamagata/16/88 lineage) |
2019–2020 [32] [33] [34] | A/Brisbane/02/2018 (H1N1)pdm09-like virus | A/Kansas/14/2017 (H3N2)-like virus | B/Colorado/06/2017-like virus (B/Victoria/2/87 lineage) | B/Phuket/3073/2013-like virus (B/Yamagata/16/88 lineage) |
2020–2021 egg-based vaccines [35] | A/Guangdong-Maonan/SWL1536/2019 (H1N1)pdm09-like virus | A/Hong Kong/2671/2019 (H3N2)-like virus | B/Washington/02/2019 (B/Victoria lineage)-like virus | B/Phuket/3073/2013 (B/Yamagata lineage)-like virus |
2020–2021 cell- or recombinant-based vaccines [35] | A/Hawaii/70/2019 (H1N1)pdm09-like virus | A/Hong Kong/45/2019 (H3N2)-like virus | B/Washington/02/2019 (B/Victoria lineage)-like virus | B/Phuket/3073/2013 (B/Yamagata lineage)-like virus |
2021–2022 egg-based vaccines [36] | A/Victoria/2570/2019 (H1N1)pdm09-like virus | A/Cambodia/e0826360/2020 (H3N2)-like virus | B/Washington/02/2019 (B/Victoria lineage)-like virus | B/Phuket/3073/2013 (B/Yamagata lineage)-like virus |
2021–2022 cell- or recombinant-based vaccines [36] | A/Wisconsin/588/2019 (H1N1)pdm09-like virus | A/Cambodia/e0826360/2020 (H3N2)-like virus | B/Washington/02/2019 (B/Victoria lineage)-like virus | B/Phuket/3073/2013 (B/Yamagata lineage)-like virus |
2022–2023 egg-based vaccines [37] | A/Victoria/2570/2019 (H1N1)pdm09-like virus | A/Darwin/9/2021 (H3N2)-like virus | B/Austria/1359417/2021 (B/Victoria lineage)-like virus | B/Phuket/3073/2013 (B/Yamagata lineage)-like virus |
2022–2023 cell- or recombinant-based vaccines [37] | A/Wisconsin/588/2019 (H1N1)pdm09-like virus | A/Darwin/6/2021 (H3N2)-like virus | B/Austria/1359417/2021 (B/Victoria lineage)-like virus | B/Phuket/3073/2013 (B/Yamagata lineage)-like virus |
2023–2024 egg-based vaccines [38] [39] | A/Victoria/4897/2022 (H1N1)pdm09-like virus | A/Darwin/9/2021 (H3N2)-like virus | B/Austria/1359417/2021 (B/Victoria lineage)-like virus | B/Phuket/3073/2013 (B/Yamagata lineage)-like virus |
2023–2024 cell- or recombinant-based vaccines [38] [39] | A/Wisconsin/67/2022 (H1N1)pdm09-like virus | A/Darwin/6/2021 (H3N2)-like virus | B/Austria/1359417/2021 (B/Victoria lineage)-like virus | B/Phuket/3073/2013 (B/Yamagata lineage)-like virus |
2024–2025 egg-based vaccines [40] [4] | A/Victoria/4897/2022 (H1N1)pdm09-like virus | A/Thailand/8/2022 (H3N2)-like virus | B/Austria/1359417/2021 (B/Victoria lineage)-like virus | B/Phuket/3073/2013 (B/Yamagata lineage)-like virus [note 5] |
2024–2025 cell- or recombinant-based vaccines [40] [4] | A/Wisconsin/67/2022 (H1N1)pdm09-like virus | A/Massachusetts/18/2022 (H3N2)-like virus | B/Austria/1359417/2021 (B/Victoria lineage)-like virus | B/Phuket/3073/2013 (B/Yamagata lineage)-like virus [note 5] |
The following is a list of WHO recommended strains for the Southern Hemisphere influenza season.
SH winter season | Influenza A H1N1 | Influenza A H3N2 | Influenza B Victoria | Influenza B Yamagata |
---|---|---|---|---|
1999 [41] | A/Beijing/262/95 (H1N1)-like virus | A/Sydney/5/97 (H3N2)-like virus | N/A | B/Beijing/184/93-like virus |
2000 [42] | A/New Caledonia/20/99 (H1N1)-like virus | A/Moscow/10/99 (H3N2)-like virus | B/Shangdong/7/97-like virus [note 1] | B/Beijing/184/93-like virus [note 1] |
2001 [43] | A/New Caledonia/20/99 (H1N1)-like virus | A/Moscow/10/99 (H3N2)-like virus | N/A | B/Sichuan/379/99-like virus |
2002 [44] | A/New Caledonia/20/99 (H1N1)-like virus | A/Moscow/10/99 (H3N2)-like virus | N/A | B/Sichuan/379/99-like virus |
2003 [45] | A/New Caledonia/20/99 (H1N1)-like virus | A/Moscow/10/99 (H3N2)-like virus | B/Hong Kong/330/2001-like virus | N/A |
2004 [46] | A/New Caledonia/20/99 (H1N1)-like virus | A/Fujian/411/2002 (H3N2)-like virus | B/Hong Kong/330/2001-like virus | N/A |
2005 [47] | A/New Caledonia/20/99 (H1N1)-like virus | A/Wellington/1/2004 (H3N2)-like virus | N/A | B/Shanghai/361/2002-like virus |
2006 [48] | A/New Caledonia/20/99 (H1N1)-like virus | A/California/7/2004 (H3N2)-like virus | B/Malaysia/2506/2004-like virus | N/A |
2007 [49] | A/New Caledonia/20/99 (H1N1)-like virus | A/Wisconsin/67/2005 (H3N2)-like virus | B/Malaysia/2506/2004-like virus | N/A |
2008 [50] | A/Solomon Islands/3/2006 (H1N1)-like virus | A/Brisbane/10/2007 (H3N2)-like virus | N/A | B/Florida/4/2006-like virus |
2009 [51] | A/Brisbane/59/2007 (H1N1)-like virus | A/Brisbane/10/2007 (H3N2)-like virus | N/A | B/Florida/4/2006-like virus |
2010 [52] | A/California/7/2009 (H1N1)-like virus | A/Perth/16/2009 (H3N2)-like virus | B/Brisbane/60/2008-like virus | N/A |
2011 [53] | A/California/7/2009 (H1N1)-like virus | A/Perth/16/2009 (H3N2)-like virus | B/Brisbane/60/2008-like virus | N/A |
2012 [54] | A/California/7/2009 (H1N1)pdm09 [note 2] -like virus [21] | A/Perth/16/2009 (H3N2)-like virus | B/Brisbane/60/2008-like virus | N/A |
2013 [55] | A/California/7/2009 (H1N1)pdm09-like virus | A/Victoria/361/2011 (H3N2)-like virus | B/Brisbane/60/2008-like virus | B/Wisconsin/1/2010-like virus |
2014 [56] | A/California/7/2009 (H1N1)pdm09-like virus | A/Texas/50/2012 (H3N2)-like virus [note 4] | B/Brisbane/60/2008-like virus | B/Massachusetts/2/2012-like virus |
2015 [57] | A/California/7/2009 (H1N1)pdm09-like virus | A/Switzerland/9715293/2013 (H3N2)-like virus | B/Brisbane/60/2008-like virus | B/Phuket/3073/2013-like virus |
2016 [58] | A/California/7/2009 (H1N1)pdm09-like virus | A/Hong Kong/4801/2014 (H3N2)-like virus | B/Brisbane/60/2008-like virus | B/Phuket/3073/2013-like virus |
2017 [59] [60] | A/Michigan/45/2015 (H1N1)pdm09-like virus [29] | A/Hong Kong/4801/2014 (H3N2)-like virus | B/Brisbane/60/2008-like virus | B/Phuket/3073/2013-like virus |
2018 [61] [62] | A/Michigan/45/2015 (H1N1)pdm09-like virus | A/Singapore/INFIMH-16-0019/2016 (H3N2)-like virus | B/Brisbane/60/2008-like virus | B/Phuket/3073/2013-like virus |
2019 [63] [64] | A/Michigan/45/2015 (H1N1)pdm09-like virus | A/Switzerland/8060/2017 (H3N2)-like virus | B/Colorado/06/2017-like virus (B/Victoria/2/87 lineage) | B/Phuket/3073/2013-like virus (B/Yamagata/16/88 lineage) |
2020 [65] [66] | A/Brisbane/02/2018 (H1N1)pdm09-like virus | A/South Australia/34/2019 (H3N2)-like virus | B/Washington/02/2019-like (B/Victoria lineage) virus | B/Phuket/3073/2013-like (B/Yamagata lineage) virus |
2021 egg-based vaccines [67] | A/Victoria/2570/2019 (H1N1)pdm09-like virus | A/Hong Kong/2671/2019 (H3N2)-like virus | B/Washington/02/2019 (B/Victoria lineage)-like virus | B/Phuket/3073/2013 (B/Yamagata lineage)-like virus |
2021 cell- or recombinant-based vaccines [67] | A/Wisconsin/588/2019 (H1N1)pdm09-like virus | A/Hong Kong/45/2019 (H3N2)-like virus | B/Washington/02/2019 (B/Victoria lineage)-like virus | B/Phuket/3073/2013 (B/Yamagata lineage)-like virus |
2022 egg-based vaccines [68] | A/Victoria/2570/2019 (H1N1)pdm09-like virus | A/Darwin/9/2021 (H3N2)-like virus | B/Austria/1359417/2021 (B/Victoria lineage)-like virus | B/Phuket/3073/2013 (B/Yamagata lineage)-like virus |
2022 cell- or recombinant-based vaccines [68] | A/Wisconsin/588/2019 (H1N1)pdm09-like virus | A/Darwin/6/2021 (H3N2)-like virus | B/Austria/1359417/2021 (B/Victoria lineage)-like virus | B/Phuket/3073/2013 (B/Yamagata lineage)-like virus |
2023 egg-based vaccines [69] | A/Sydney/5/2021 (H1N1)pdm09-like virus | A/Darwin/9/2021 (H3N2)-like virus | B/Austria/1359417/2021 (B/Victoria lineage)-like virus | B/Phuket/3073/2013 (B/Yamagata lineage)-like virus |
2023 cell- or recombinant-based vaccines [69] | A/Sydney/5/2021 (H1N1)pdm09-like virus | A/Darwin/6/2021 (H3N2)-like virus | B/Austria/1359417/2021 (B/Victoria lineage)-like virus | B/Phuket/3073/2013 (B/Yamagata lineage)-like virus |
2024 egg-based vaccines [70] | A/Victoria/4897/2022 (H1N1)pdm09-like virus | A/Thailand/8/2022 (H3N2)-like virus | B/Austria/1359417/2021 (B/Victoria lineage)-like virus | B/Phuket/3073/2013 (B/Yamagata lineage)-like virus |
2024 cell- or recombinant-based vaccines [70] | A/Wisconsin/67/2022 (H1N1)pdm09-like virus | A/Massachusetts/18/2022 (H3N2)-like virus | B/Austria/1359417/2021 (B/Victoria lineage)-like virus | B/Phuket/3073/2013 (B/Yamagata lineage)-like virus |
Oseltamivir, sold under the brand name Tamiflu, is an antiviral medication used to treat and prevent influenza A and influenza B, viruses that cause the flu. Many medical organizations recommend it in people who have complications or are at high risk of complications within 48 hours of first symptoms of infection. They recommend it to prevent infection in those at high risk, but not the general population. The Centers for Disease Control and Prevention (CDC) recommends that clinicians use their discretion to treat those at lower risk who present within 48 hours of first symptoms of infection. It is taken by mouth, either as a pill or liquid.
Influenza vaccines, colloquially known as flu shots, are vaccines that protect against infection by influenza viruses. New versions of the vaccines are developed twice a year, as the influenza virus rapidly changes. While their effectiveness varies from year to year, most provide modest to high protection against influenza. Vaccination against influenza began in the 1930s, with large-scale availability in the United States beginning in 1945.
Live attenuated influenza vaccine (LAIV) is a type of influenza vaccine in the form of a nasal spray that is recommended for the prevention of influenza. It was developed by the Syrian-American epidemiologist Hunein Maassab.
The Hong Kong flu, also known as the 1968 flu pandemic, was a flu pandemic that occurred in 1968 and 1969 and which killed between one and four million people globally. It is among the deadliest pandemics in history, and was caused by an H3N2 strain of the influenza A virus. The virus was descended from H2N2 through antigenic shift, a genetic process in which genes from multiple subtypes are reassorted to form a new virus.
Flu season is an annually recurring time period characterized by the prevalence of an outbreak of influenza (flu). The season occurs during the cold half of the year in each hemisphere. It takes approximately two days to show symptoms. Influenza activity can sometimes be predicted and even tracked geographically. While the beginning of major flu activity in each season varies by location, in any specific location these minor epidemics usually take about three weeks to reach its pinnacle, and another three weeks to significantly diminish.
An influenza pandemic is an epidemic of an influenza virus that spreads across a large region and infects a large proportion of the population. There have been six major influenza epidemics in the last 140 years, with the 1918 flu pandemic being the most severe; this is estimated to have been responsible for the deaths of 50–100 million people. The 2009 swine flu pandemic resulted in under 300,000 deaths and is considered relatively mild. These pandemics occur irregularly.
Influenza A virus subtype H3N2 (A/H3N2) is a subtype of viruses that causes influenza (flu). H3N2 viruses can infect birds and mammals. In birds, humans, and pigs, the virus has mutated into many strains. In years in which H3N2 is the predominant strain, there are more hospitalizations.
National Influenza Centers are institutions which are formally recognized as such by the World Health Organization (WHO).
"The WHO Global Influenza Surveillance Network was established in 1952. The network comprises 4 WHO Collaborating Centres and 112 institutions in 83 countries, which are recognized by WHO as WHO National Influenza Centres (NICs). These NICs collect specimens in their country, perform primary virus isolation and preliminary antigenic characterization. They ship newly isolated strains to WHO CCs for high level antigenic and genetic analysis, the result of which forms the basis for WHO recommendations on the composition of influenza vaccine for the Northern and Southern Hemisphere each year."
Influenza B virus is the only species in the genus Betainfluenzavirus in the virus family Orthomyxoviridae.
Fujian flu refers to flu caused by either a Fujian human flu strain of the H3N2 subtype of the Influenza A virus or a Fujian bird flu strain of the H5N1 subtype of the Influenza A virus. These strains are named after Fujian, a coastal province in Southeast China.
Hepatitis A vaccine is a vaccine that prevents hepatitis A. It is effective in around 95% of cases and lasts for at least twenty years and possibly a person's entire life. If given, two doses are recommended beginning after the age of one. It is given by injection into a muscle. The first hepatitis A vaccine was approved in Europe in 1991, and the United States in 1995. It is on the World Health Organization's List of Essential Medicines.
The rotavirus vaccine is a vaccine used to protect against rotavirus infections, which are the leading cause of severe diarrhea among young children. The vaccines prevent 15–34% of severe diarrhea in the developing world and 37–96% of the risk of death among young children due to severe diarrhea. Immunizing babies decreases rates of disease among older people and those who have not been immunized.
Typhoid vaccines are vaccines that prevent typhoid fever. Several types are widely available: typhoid conjugate vaccine (TCV), Ty21a and Vi capsular polysaccharide vaccine (ViPS). They are about 30 to 70% effective in the first two years, depending on the specific vaccine in question. The Vi-rEPA vaccine has been shown to be efficacious in children.
Rubella vaccine is a vaccine used to prevent rubella. Effectiveness begins about two weeks after a single dose and around 95% of people become immune. Countries with high rates of immunization no longer see cases of rubella or congenital rubella syndrome. When there is a low level of childhood immunization in a population it is possible for rates of congenital rubella to increase as more women make it to child-bearing age without either vaccination or exposure to the disease. Therefore, it is important for more than 80% of people to be vaccinated. By introducing rubella containing vaccines, rubella has been eradicated in 81 nations, as of mid-2020.
Yellow fever vaccine is a vaccine that protects against yellow fever. Yellow fever is a viral infection that occurs in Africa and South America. Most people begin to develop immunity within ten days of vaccination and 99% are protected within one month, and this appears to be lifelong. The vaccine can be used to control outbreaks of disease. It is given either by injection into a muscle or just under the skin.
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The 2009 swine flu pandemic vaccines were influenza vaccines developed to protect against the pandemic H1N1/09 virus. These vaccines either contained inactivated (killed) influenza virus, or weakened live virus that could not cause influenza. The killed virus was injected, while the live virus was given as a nasal spray. Both these types of vaccine were produced by growing the virus in chicken eggs. Around three billion doses were produced, with delivery in November 2009.
Tetanus vaccine, also known as tetanus toxoid (TT), is a toxoid vaccine used to prevent tetanus. During childhood, five doses are recommended, with a sixth given during adolescence.
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The 1957–1958 Asian flu pandemic was a global pandemic of influenza A virus subtype H2N2 that originated in Guizhou in Southern China. The number of excess deaths caused by the pandemic is estimated to be 1–4 million around the world, making it one of the deadliest pandemics in history. A decade later, a reassorted viral strain H3N2 further caused the Hong Kong flu pandemic (1968–1969).
A/Michigan/45/2015 replaces the longstanding A/California/7/2009 and is recommended to improve protection against two subclades that have emerged over the past season.