Determinants of epidemic size and the impacts of lulls in seasonal influenza virus circulation

Simon P. J. Jong, Zandra C. Felix Garza, Joseph C. Gibson, Sarah Leeuwen, Robert P. Vries, Geert-Jan Boons, Marliek Hoesel, Karen Haan, Laura E. Groeningen, Katina D. Hulme, Hugo D. G. Willigen, Elke Wynberg, Godelieve J. Bree, Amy Matser, Margreet Bakker, Lia Hoek, Maria Prins, Neeltje A. Kootstra, Dirk Eggink, Brooke E. Nichols, Alvin X. Han, Menno D. Jong and Colin A. Russell ()
Additional contact information
Simon P. J. Jong: University of Amsterdam
Zandra C. Felix Garza: University of Amsterdam
Joseph C. Gibson: University of Amsterdam
Sarah Leeuwen: University of Amsterdam
Robert P. Vries: Utrecht University
Geert-Jan Boons: Utrecht University
Marliek Hoesel: University of Amsterdam
Karen Haan: University of Amsterdam
Laura E. Groeningen: University of Amsterdam
Katina D. Hulme: University of Amsterdam
Hugo D. G. Willigen: University of Amsterdam
Elke Wynberg: University of Amsterdam
Godelieve J. Bree: University of Amsterdam
Amy Matser: Public Health Service of Amsterdam
Margreet Bakker: University of Amsterdam
Lia Hoek: University of Amsterdam
Maria Prins: Public Health Service of Amsterdam
Neeltje A. Kootstra: University of Amsterdam
Dirk Eggink: University of Amsterdam
Brooke E. Nichols: University of Amsterdam
Alvin X. Han: University of Amsterdam
Menno D. Jong: University of Amsterdam
Colin A. Russell: University of Amsterdam

Nature Communications, 2024, vol. 15, issue 1, 1-11

Abstract: Abstract During the COVID-19 pandemic, levels of seasonal influenza virus circulation were unprecedentedly low, leading to concerns that a lack of exposure to influenza viruses, combined with waning antibody titres, could result in larger and/or more severe post-pandemic seasonal influenza epidemics. However, in most countries the first post-pandemic influenza season was not unusually large and/or severe. Here, based on an analysis of historical influenza virus epidemic patterns from 2002 to 2019, we show that historic lulls in influenza virus circulation had relatively minor impacts on subsequent epidemic size and that epidemic size was more substantially impacted by season-specific effects unrelated to the magnitude of circulation in prior seasons. From measurements of antibody levels from serum samples collected each year from 2017 to 2021, we show that the rate of waning of antibody titres against influenza virus during the pandemic was smaller than assumed in predictive models. Taken together, these results partially explain why the re-emergence of seasonal influenza virus epidemics was less dramatic than anticipated and suggest that influenza virus epidemic dynamics are not currently amenable to multi-season prediction.

Date: 2024
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DOI: 10.1038/s41467-023-44668-z

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