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<p>Influenza A(H1N1)pdm09 viruses pose a significant disease burden on children worldwide, with high rates of hospitalization and substantial morbidity and mortality. Outpatient &lt; 18&#xa0;years of age with upper respiratory infections (URIs) were enrolled through active surveillance at Shanxi Children's Hospital (SCH) between 7/1/2024 and 6/30/2025. Nasal swabs were collected for the detection of influenza virus and other respiratory pathogens by PCR-based methods. Influenza strains were obtained through in vitro culture, and their antigenic characterization were determined by hemagglutinin-inhibition (HI) assay. Genetic analyses were conducted using next-generation sequencing (NGS), while the fluorescence neuraminidase inhibition assay (FNIA) was employed to ascertain antiviral resistance. A total of 987 throat swab samples were collected. A(H1N1)pdm09 was the main pathogens causing URIs in children during the 2024–2025 influenza season and belongs to the 6B.1A.5a.2a evolutionary branch along with vaccine strains. Four novel HA and six NA non-synonymous substitutions were identified in pH1N1, which are related to antigenic drift and varying degrees of drug resistance, respectively. Three S137P-R142K-V152I-substituted strains were identified as low reactive strains, and strains with T188I, S247N, G249E, I264T, M314I, and K331R substitutions did not demonstrate a significant escalation in drug resistance. Despite the absence of drug-resistant A(H1N1)pdm09 strains in children, the emergence of low-response strains, attributable to mutations associated with antigen drift, necessitates continuous genomic monitoring to ensure preparedness for future seasonal influenza outbreaks.</p>

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Surveillance reveals a prevalent pediatric A(H1N1)pdm09 virus with hemagglutinin substitutions S137P-R142K-V152I that diminish vaccine efficacy

  • 期刊论文

  • 发表日期：

    2026年2月4日

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  • Lifeng Zhao,
  • Jing Wang,
  • Jihong Xu,
  • Jiane Guo,
  • Ping Zhang,
  • Xiaofang Guo,
  • Zhihong Zuo,
  • Ruihong Gao,
  • Li Gao,
  • Jitao Wang

摘要

Influenza A(H1N1)pdm09 viruses pose a significant disease burden on children worldwide, with high rates of hospitalization and substantial morbidity and mortality. Outpatient < 18 years of age with upper respiratory infections (URIs) were enrolled through active surveillance at Shanxi Children's Hospital (SCH) between 7/1/2024 and 6/30/2025. Nasal swabs were collected for the detection of influenza virus and other respiratory pathogens by PCR-based methods. Influenza strains were obtained through in vitro culture, and their antigenic characterization were determined by hemagglutinin-inhibition (HI) assay. Genetic analyses were conducted using next-generation sequencing (NGS), while the fluorescence neuraminidase inhibition assay (FNIA) was employed to ascertain antiviral resistance. A total of 987 throat swab samples were collected. A(H1N1)pdm09 was the main pathogens causing URIs in children during the 2024–2025 influenza season and belongs to the 6B.1A.5a.2a evolutionary branch along with vaccine strains. Four novel HA and six NA non-synonymous substitutions were identified in pH1N1, which are related to antigenic drift and varying degrees of drug resistance, respectively. Three S137P-R142K-V152I-substituted strains were identified as low reactive strains, and strains with T188I, S247N, G249E, I264T, M314I, and K331R substitutions did not demonstrate a significant escalation in drug resistance. Despite the absence of drug-resistant A(H1N1)pdm09 strains in children, the emergence of low-response strains, attributable to mutations associated with antigen drift, necessitates continuous genomic monitoring to ensure preparedness for future seasonal influenza outbreaks.