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Canadian Journal of Infectious Diseases
Volume 9 (1998), Issue 3, Pages 143-148
Original Article

Influenza Vaccine Match with Circulating Strains and Indicators of Influenza Strain Impact - Canada 1980 to 1992

Edward Ellis, John M Weber, Wilf Cuff, and Susan G Mackenzie

Health Canada, Laboratory Centre for Disease Control, Ottawa, Ontario, Canada

Received 23 April 1997; Accepted 23 September 1997

Copyright © 1998 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


OBJECTIVES: To determine the similarity between influenza vaccine antigens and viruses associated with laboratory-confirmed infections by virus type/subtype, strain and influenza season; to correlate pneumonia and influenza hospitalization and mortality rates with the number of laboratory-confirmed influenza infections in an influenza season; and to develop predictive indicators of the likely incidence of current strains in the following season.

DESIGN: Ecological study using national laboratory, pneumonia and influenza hospitalization and mortality data.

SETTING: Canada, influenza seasons from 1980 to 1992.

POPULATION STUDIED: Individuals with laboratory-confirmed influenza infections, pneumonia and influenza hospitalizations or deaths.

INTERVENTION: Influenza immunization.

MAIN RESULTS: Similarity of circulating strains and vaccine antigens was 99% for A(H1N1), 65% for A(H3N2) and 65% for B strains. During outbreaks, pneumonia and influenza hospitalization, and mortality rates increased 19% or less and 21% or less for A(H1N1), respectively; 28% or less and 51% or less for A(H3N2), and 19% or less and 16% or less for B strains. There were usually fewer than 25 laboratory-confirmed A(H1N1) infections with a particular strain in a season if there had been more than 25 infections with similar strains the previous season. For A(H3N2), the figure was 100, and for B it was 150.

CONCLUSIONS: Matches were excellent for A(H1N1) and good for A(H3N2) plus B strains. Hospitalization and mortality rates increased substantially during outbreaks, eg, estimated 1609 excess deaths during a widespread A(H3N2) outbreak. This study identifies relationships that provide some ability to predict the incidence of a particular influenza strain in a coming season based on the incidence of strains similar to it in the previous season.