Reappearance of influenza B/Victoria/2/87-lineage viruses: epidemic activity, genetic diversity and vaccination efficacy in the Finnish Defence Forces.

A new B/Shangdong/7/97-like influenza virus (Victoria/2/87 lineage) predominated during the 2002/2003 epidemic season in Finland and was estimated to account for 2246 of the 13,496 feverish upper respiratory tract infections (URIs) occurring among conscripts in the Finnish army. The incidence (1716/10,000 conscripts) was indicative of moderate epidemic activity at most. Analysis of the cross-reactive antibodies induced in 1988 suggests that the basis of the protection was probably established during the childhood of the conscripts. Vaccination in autumn 2002 prevented 42% of the URIs during the influenza B outbreak and 71% (95% CI 42-85) of infections interpreted as influenza B. Despite the low genetic variability of the Shangdong/7/97-like viruses, breakages of a potential glycosylation site in haemagglutinin (HA1, position 197) were frequent; their biological significance is discussed. The Shangdong/7/97-like strains were HA1/NA reassortants, as were also the less abundant strains that for HA1 belonged to the B/Yamagata/16/88 lineage. A further reassortment, which probably emerged during the outbreak in one of the garrisons, supports our hypothesis that circumstances in these settings may especially favour the emergence of diversity by reassortment.