Human seasonal influenza under COVID-19 and the potential consequences of influenza lineage elimination

Vijaykrishna Dhanasekaran (), Sheena Sullivan, Kimberly M. Edwards, Ruopeng Xie, Arseniy Khvorov, Sophie A. Valkenburg, Benjamin J. Cowling and Ian G. Barr
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Vijaykrishna Dhanasekaran: The University of Hong Kong
Sheena Sullivan: Peter Doherty Institute for Infection and Immunity
Kimberly M. Edwards: The University of Hong Kong
Ruopeng Xie: The University of Hong Kong
Arseniy Khvorov: Peter Doherty Institute for Infection and Immunity
Sophie A. Valkenburg: The University of Hong Kong
Benjamin J. Cowling: The University of Hong Kong
Ian G. Barr: Peter Doherty Institute for Infection and Immunity

Nature Communications, 2022, vol. 13, issue 1, 1-11

Abstract: Abstract Annual epidemics of seasonal influenza cause hundreds of thousands of deaths, high levels of morbidity, and substantial economic loss. Yet, global influenza circulation has been heavily suppressed by public health measures and travel restrictions since the onset of the COVID-19 pandemic. Notably, the influenza B/Yamagata lineage has not been conclusively detected since April 2020, and A(H3N2), A(H1N1), and B/Victoria viruses have since circulated with considerably less genetic diversity. Travel restrictions have largely confined regional outbreaks of A(H3N2) to South and Southeast Asia, B/Victoria to China, and A(H1N1) to West Africa. Seasonal influenza transmission lineages continue to perish globally, except in these select hotspots, which will likely seed future epidemics. Waning population immunity and sporadic case detection will further challenge influenza vaccine strain selection and epidemic control. We offer a perspective on the potential short- and long-term evolutionary dynamics of seasonal influenza and discuss potential consequences and mitigation strategies as global travel gradually returns to pre-pandemic levels.

Date: 2022
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DOI: 10.1038/s41467-022-29402-5

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