DOI: 10.4103/cmrp.cmrp_134_25 ISSN: 2352-0817

Predominance of influenza A(H3N2) and Victoria lineage of influenza B in patients with influenza-like illness: A laboratory-based surveillance study from Rajasthan, India

Shiv Prakash Sharma, Neha Sharma

ABSTRACT

Background:

The relative prevalence of specific influenza subtypes and lineages significantly impacts seasonal epidemiology and the effectiveness of vaccines. Detailed virological data from regional centres in India are crucial, yet often limited.

Aims:

The objective is to determine the subtype and lineage-specific distribution of influenza viruses and analyse their distinct temporal patterns and clinical correlations.

Methods:

A detailed analysis was conducted on 598 influenza-positive samples identified through prospective surveillance of 7,231 patients with influenza-like illness (July 2019–June 2020). Subtyping for A(H1N1) pdm09 and A(H3N2) and lineage determination for B/Victoria and B/Yamagata were performed using real-time RT-PCR. Statistical comparisons were performed using Chi-square tests.

Results:

Influenza A accounted for 83.6% (500/598) of all positive results. Among these,A(H3N2) was overwhelmingly predominant (379/500, 75.8%; P < 0.001 vs. A(H1N1) pdm09). All influenza B viruses (98/598, 16.4%) belonged to the B/Victoria lineage. Temporal analysis revealed distinct patterns: A(H3N2) circulated during both monsoon and winter peaks, whereas A(H1N1) pdm09 cases were concentrated significantly in winter (51.2% of total, P < 0.001). Influenza B (Victoria) activity was restricted exclusively to the monsoon season (96.9% of cases, P < 0.001). A(H1N1) pdm09 infected a significantly higher proportion of individuals aged 41–59 years compared to A(H3N2) (25.6% vs. 17.4%, P = 0.037). The clinical presentations did not differ significantly between the subtypes.

Conclusion:

The complex co-circulation of influenza viruses in North India, with a significant predominance of A(H3N2) and exclusive circulation of B/Victoria. The clear temporal separation and age-specific differences highlight the importance of subtype-specific surveillance for informing regional vaccination strategies and preparedness for waves of illness caused by different viruses.

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