Journal of Clinical Virology - Volume 82 - Supplement 1 - September 2016

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S128 Abstracts / Journal of Clinical Virology 82S (2016) S1–S142
Abstract no: 42
Presentation at ESCV 2016: Poster 216
Cluster of severe influenza infections in a
smoke-related environment
Angeliki Melidou ∗, Maria Exindari,
Georgia Gioula, Nikolaos Malisiovas
National Influenza Centre for N. Greece, Aristotle
University of Thessaloniki, Greece
Background: Influenza season 2015–2016 was characterized
as severe influenza season with an increased incidence of ICU
hospitalizations and fatalities at a younger mean age. Influenza
A(H1N1)pdm09 predominated in Greece and the rest of Europe.
Methods: Laboratory influenza surveillance is performed at
the National Influenza Centre for N Greece. RNA from pharyngeal
and/or bronchial aspirates was extracted using the Qiamp RNA
mini kit according to the manufacturer’s instructions. Real-time
RT-PCR was used for the detection and typing of influenza viruses,
according to the CDC guidelines. RT-PCR was performed for the
amplification of the viral haemaglutinin (HA), followed by Sanger
Sequencing, as previously described by Melidou et al., 2015.
Conclusion: 104 patients admitted in ICUhad amean age of 55.9
years, while a total of 41 influenza related fatalities were reported
at a mean age of 55.9 years. Interestingly, 30% of them reported
no other underlying medical conditions. A cluster of influenza
A(H1N1)pdm09 infections was observed duringweek 5/2016 in the
Fire Department of N. Greece. One of the patients, aged 43, whowas
an otherwise healthy individual, suffered from ARDS and pneumo-
nia and was eventually deceased, while a colleague of his, aged 44
and an otherwise healthy individual as well, was treated for ARDS
in the ICU for one month. He had endotracheal intubation, timely
administered oseltamivir and eventually recovered. Genetic analy-
sis of the isolated influenza viruses revealed that the HA gene of the
viruses belonged to the 6B.1 genetic group, and possessed no varia-
tions in antigenic or potential N-linked glycosylation sites, towhich
increased pathogenicity could be attributed. HA viruses also did not
possess the D222G variation, previously associated with increased
pathogenicity of influenza A(H1N1)pdm09 viruses. While genetic
analysis of the whole viral genomes is pending, the importance
of the work environment cannot be overlooked. Individuals with
smoke-related activities/employment, thatmight affect their respi-
ratory health, should be included in the high risk groups, strongly
urged to vaccinate annually against influenza viruses and to timely
use oseltamivir in the case of a suspected respiratory tract infection.
The importance of employment reporting during national surveil-
lance of influenza is highlighted.
Abstract no: 61
Presentation at ESCV 2016: Poster 217
Prevalence of influenza virus types A and B in
patients with acute respiratory infection:
2002–2015
Candan Cicek ∗, Eylem Ulas Saz ,
Haydar Soydaner Karakus , Husnu Pullukcu
1 Ege University Faculty of Medicine, Dept of Medical
Microbiology, Izmir, Turkey
2 Ege University Faculty of Medicine, Dept of
Pediatrics, Izmir, Turkey
3 Ege University Faculty of Medicine, Dept of Chest
Diseases, Izmir, Turkey
4 Ege University Faculty of Medicine, Dept of
Infectious Diseases, Izmir, Turkey
Objectives: In this study, we aimed to investigate the preva-
lence of influenza viruses in patients with the upper and lower
respiratory tract infections of outpatient or inpatient monitoring
who admitted to Ege University Medical Faculty Hospital.
Methods: Respiratory tract specimenswere collected from6665
patients [2911 (43.7%) outpatients and 3754 (56.3%) inpatients]
with upper and lower respiratory tract infections between January
2002 and September 2015. The age range of patients [4983 (74.8%)
pediatric and 1682 (25.2%) adult patients] is between five days to
94 years (median: 4 years). All specimens were tested by two or
three assays [Direct fluorescent antibody (DFA), shell vial cell cul-
ture (SVCC), and multiplex PCR (mPCR)]. All specimens were tested
by both DFA by using fluorescein isothiocynate labelled polyclonal
antibody pool (Respiratory Screen Kit, Light Diagnostics, Chemicon
International, USA) with cytospin and SVCC from 2002 to 2015. Iso-
lation of influenza virus type A and B (INF-A, INF-B) were done by
shell vial assay usingMDCK cell line. Coverslips were stainedwith a
fluorescein isothiocynate labelledmonoclonal antibody specific for
INF-A and INF-B (Light Diagnostics, Chemicon International, USA)
according to themanufacturer’s protocol. Three different mPCR kits
(Respiratuvar RealAccurateTM, PathoFinder, Netherlands, Seeplex
RV15 ACE Detection, and Annyplex II RV16 Detection, Seegene,
South Korea) were used between 2007 and 2015.
Results: Of the 6665 specimens tested, 706 (10.6%) were found
positive for INF-A and INF-B. In the 706 influenza virus positive
specimens, 618 (87.5%) were INF-A and 88 (12.5%) were INF-B. In
the group of 2911 outpatients, 404 (13.9%, INF-A 12.9%, INF-B %1.3)
of them were positive, in the group of 3754 inpatients, 302 (8.0%,
INF-A %6.7, INF-B %1.3) of them were positive for INF-A and INF-B.
476 (9.6%) patients were positive in the pediatric group and 230
(13.7%) patients were positive in the adult group for INF-A and INF-
B. Influenza virus activity was started in October and it continued
until the end of April in our region, it was observed that the peak
was November–December–January period.
Conclusion: Influenza viruses were identified approximately
11% of patients with acute respiratory tract infection. Influenza
viruses were detected more frequently in adult patients than
pediatric patients.When the activity of influenza A and B virus com-
pared; INF-A was found positive at higher rates. INF-A was isolated
frommore outpatients than inpatients. Influenza virus activity was
observed most frequently in February in our region.