Molecular Characterization of Influenza B Virus Outbreak on a Cruise Ship in Brazil 2012

Abstract

In February 2012, an outbreak of respiratory illness occurred on the cruise ship MSC Armonia in Brazil. A 31-year-old female crew member was hospitalized with respiratory failure and subsequently died. To study the etiology of the respiratory illness, tissue taken at necropsy from the deceased woman and respiratory specimens from thirteen passengers and crew members with respiratory symptoms were analyzed. Influenza real-time RT-PCR assays were performed, and the full-length hemagglutinin (HA) gene of influenza-positive samples was sequenced. Influenza B virus was detected in samples from seven of the individuals, suggesting that it was the cause of this respiratory illness outbreak. The sequence analysis of the HA gene indicated that the virus was closely related to the B/Brisbane/60/2008-like virus, Victoria lineage, a virus contained in the 2011-12 influenza vaccine for the Southern Hemisphere. Since the recommended composition of the influenza vaccine for use during the 2013 season changed, an intensive surveillance of viruses circulating worldwide is crucial. Molecular analysis is an important tool to characterize the pathogen responsible for an outbreak such as this. In addition, laboratory disease surveillance contributes to the control measures for vaccine-preventable influenza.

Patterns of influenza B circulation in Brazil and its relevance to seasonal vaccine composition

“…Of 11 hospitalized cases of acute respiratory illness, there were six cases with influenza B virus detected in the nasopharyngeal isolates. 35 In another study by Borborema et al 32 , it was shown that the influenza B virus was the cause of the outbreak (detected in seven individuals with respiratory illness).…”

“…In all, 12 articles presenting evidence on influenza B virus circulation in Brazil for the years 1996-2013 were included. [30][31][32][33][34][35][36][37][38][39][40][41] Details for each of the studies are shown in Supplementary File 1.…”

“…Two studies detailed characteristics of an influenza outbreak in February 2012 on cruise ships. 32,35 Fernandes et al 35 reported findings from the first influenza outbreak detected by Brazilian public health authorities in a vessel cruising in South America. Of 11 hospitalized cases of acute respiratory illness, there were six cases with influenza B virus detected in the nasopharyngeal isolates.…”

COVID-19 outbreak on the Diamond Princess cruise ship: estimating the epidemic potential and effectiveness of public health countermeasures

“…2 In February 2012, an outbreak of respiratory illness occurred on the cruise ship off Brazil, resulting in 16 hospitalizations due to severe ARI and one death. 3 In May 2020, a dual outbreak of pandemic (H1N1) 2009 and influenza A (H3N2) on a cruise ship occurred: of 1,970 passengers and 734 crew members, 82 (3.0%) were infected with pandemic (H1N1) 2009 virus, and 98 (3.6%) with influenza A (H3N2) virus. 4 Four subsequent cases were epidemiologically linked to passengers but no evidence of sustained transmission to the community or passengers on the next cruise was reported.…”

http://ojs.wpro.who.int/ojs/index.php/wpsar/article/view/328/616

“…[17][18][19][20] Mismatches were found between the vaccines and circulating strains throughout the study years, suggesting the vaccines may not have been effective for northern Viet Nam in those years. Table 2).…”