Monitoring Influenza C and D Viruses in Patients With Respiratory Diseases in Japan, January 2018 to March 2023

Author:

Shimizu Kohei1,Kawakami Chiharu123,Matsuzaki Yoko4,Fujisaki Seiichiro5,Nagata Shiho5,Morita Hiroko5,Watanabe Kayo5,Miura Hideka5,Momoki Tomoko1,Saikusa Miwako1,Ozawa Hiroki1,Kumazaki Makoto1,Usuku Shuzo1,Tanaka Nobuko1,Senda Ryuichi1,Okubo Ichiro1,Watanabe Shinji5,Hasegawa Hideki5,Kawaoka Yoshihiro2367,Takashita Emi5ORCID

Affiliation:

1. Yokohama City Institute of Public Health Yokohama Kanagawa Japan

2. Pandemic Preparedness, Infection, and Advanced Research Center The University of Tokyo Tokyo Japan

3. Research Center for Global Viral Diseases National Center for Global Health and Medicine Research Institute Tokyo Japan

4. Department of Infectious Diseases Yamagata University Faculty of Medicine Yamagata Japan

5. Research Center for Influenza and Respiratory Viruses National Institute of Infectious Diseases Tokyo Japan

6. Influenza Research Institute, Department of Pathobiological Sciences, School of Veterinary Medicine University of Wisconsin‐Madison Madison Wisconsin USA

7. Division of Virology, Institute of Medical Science The University of Tokyo Tokyo Japan

Abstract

ABSTRACTBackgroundInfluenza viruses can cause zoonotic infections that pose public health risks. Surveillance of influenza A and B viruses is conducted globally; however, information on influenza C and D viruses is limited. Longitudinal monitoring of influenza C virus in humans has been conducted in several countries, but there has been no long‐term monitoring of influenza D virus in humans. The public health risks associated with the influenza D virus therefore remain unknown.MethodsWe established a duplex real‐time RT‐PCR to detect influenza C and D viruses and analyzed respiratory specimens collected from 2144 patients in Japan with respiratory diseases between January 2018 and March 2023. We isolated viruses and conducted hemagglutination inhibition tests to examine antigenicity and focus reduction assays to determine susceptibility to the cap‐dependent endonuclease inhibitor baloxavir marboxil.ResultsWe detected three influenza C viruses belonging to the C/Kanagawa‐ or C/Sao Paulo‐lineages, which recently circulated globally. None of the specimens was positive for the influenza D virus. The C/Yokohama/1/2022 strain, isolated from the specimen with the highest viral RNA load and belonging to the C/Kanagawa‐lineage, showed similar antigenicity to the reference C/Kanagawa‐lineage strain and was susceptible to baloxavir.ConclusionsOur duplex real‐time RT‐PCR is useful for the simultaneous detection of influenza C and D viruses from the same specimen. Adding the influenza D virus to the monitoring of the influenza C virus would help in assessing the public health risks posed by this virus.

Funder

Ministry of Health, Labour and Welfare

Japan Society for the Promotion of Science

Japan Agency for Medical Research and Development

Publisher

Wiley

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