title: Potential antigenic explanation for atypical H1N1 infections among middle-aged adults during the 2013-2014 influenza season.
abstract: Influenza viruses typically cause the most severe disease in children and elderly individuals. However, H1N1 viruses disproportionately affected middle-aged adults during the 2013-2014 influenza season. Although H1N1 viruses recently acquired several mutations in the hemagglutinin (HA) glycoprotein, classic serological tests used by surveillance laboratories indicate that these mutations do not change antigenic properties of the virus. Here, we show that one of these mutations is located in a region of HA targeted by antibodies elicited in many middle-aged adults. We find that over 42% of individuals born between 1965 and 1979 possess antibodies that recognize this region of HA. Our findings offer a possible antigenic explanation of why middle-aged adults were highly susceptible to H1N1 viruses during the 2013-2014 influenza season. Our data further suggest that a drifted H1N1 strain should be included in future influenza vaccines to potentially reduce morbidity and mortality in this age group.
authors.affiliation: Wistar Institute, Philadelphia, PA 19104; Institute for Immunology.
authors.forename: Susanne L
authors.initials: SL
authors.lastname: Linderman
authors.affiliation: Wistar Institute, Philadelphia, PA 19104; Department of Microbiology, and.
authors.forename: Benjamin S
authors.initials: BS
authors.lastname: Chambers
authors.affiliation: Wistar Institute, Philadelphia, PA 19104; Department of Microbiology, and.
authors.forename: Seth J
authors.initials: SJ
authors.lastname: Zost
authors.affiliation: Wistar Institute, Philadelphia, PA 19104;
authors.forename: Kaela
authors.initials: K
authors.lastname: Parkhouse
authors.affiliation: Wistar Institute, Philadelphia, PA 19104; Department of Microbiology, and.
authors.forename: Yang
authors.initials: Y
authors.lastname: Li
authors.affiliation: Wistar Institute, Philadelphia, PA 19104; Department of Microbiology, and.
authors.forename: Christin
authors.initials: C
authors.lastname: Herrmann
authors.affiliation: Emory Vaccine Center and Department of Microbiology and Immunology, Emory University School of Medicine, Atlanta, GA 30322;
authors.forename: Ali H
authors.initials: AH
authors.lastname: Ellebedy
authors.affiliation: Department of Vaccine and Viral Immunity, Vaccine and Gene Therapy Institute of Florida, Port St. Lucie, FL 34987;
authors.forename: Donald M
authors.initials: DM
authors.lastname: Carter
authors.affiliation: Department of Medicine, University of Chicago, Chicago, IL 60637;
authors.forename: Sarah F
authors.initials: SF
authors.lastname: Andrews
authors.affiliation: Department of Medicine, University of Chicago, Chicago, IL 60637;
authors.forename: Nai-Ying
authors.initials: NY
authors.lastname: Zheng
authors.affiliation: Department of Medicine, University of Chicago, Chicago, IL 60637;
authors.forename: Min
authors.initials: M
authors.lastname: Huang
authors.affiliation: Department of Medicine, University of Chicago, Chicago, IL 60637;
authors.forename: Yunping
authors.initials: Y
authors.lastname: Huang
authors.affiliation: New York Blood Center, New York, NY 10065;
authors.forename: Donna
authors.initials: D
authors.lastname: Strauss
authors.affiliation: New York Blood Center, New York, NY 10065;
authors.forename: Beth H
authors.initials: BH
authors.lastname: Shaz
authors.affiliation: Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104; Clinical Virology Laboratory, Children's Hospital of Philadelphia, Philadelphia, PA 19104;
authors.forename: Richard L
authors.initials: RL
authors.lastname: Hodinka
authors.affiliation: Center for Research in Infectious Diseases, National Institute of Respiratory Diseases, 14080 Mexico City, Mexico; and.
authors.forename: Gustavo
authors.initials: G
authors.lastname: Reyes-Terán
authors.affiliation: Department of Vaccine and Viral Immunity, Vaccine and Gene Therapy Institute of Florida, Port St. Lucie, FL 34987;
authors.forename: Ted M
authors.initials: TM
authors.lastname: Ross
authors.affiliation: Department of Medicine, University of Chicago, Chicago, IL 60637;
authors.forename: Patrick C
authors.initials: PC
authors.lastname: Wilson
authors.affiliation: Emory Vaccine Center and Department of Microbiology and Immunology, Emory University School of Medicine, Atlanta, GA 30322;
authors.forename: Rafi
authors.initials: R
authors.lastname: Ahmed
authors.affiliation: Division of Basic Sciences and Computational Biology Program, Fred Hutchinson Cancer Research Center, Seattle, WA 98109.
authors.forename: Jesse D
authors.initials: JD
authors.lastname: Bloom
authors.affiliation: Wistar Institute, Philadelphia, PA 19104; Institute for Immunology, Department of Microbiology, and shensley@wistar.org.
authors.forename: Scott E
authors.initials: SE
authors.lastname: Hensley
mesh_terms: D000328:Adult; D000818:Animals; D000956:Antigens, Viral / Q000235:genetics* / Q000276:immunology; D005260:Female; D019267:Hemagglutinin Glycoproteins, Influenza Virus; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype / Q000235:genetics* / Q000276:immunology / Q000472:pathogenicity*; D007252:Influenza Vaccines; D007251:Influenza, Human / Q000235:genetics* / Q000276:immunology / Q000401:mortality; D008297:Male; D051379:Mice; D008807:Mice, Inbred BALB C; D008875:Middle Aged; D009154:Mutation
chemical_list: D000956:Antigens, Viral; D019267:Hemagglutinin Glycoproteins, Influenza Virus; D007252:Influenza Vaccines
keywords: antibody; antigenic drift; hemagglutinin; influenza; vaccine