PHYLOGENETICANALYSISOFHA1 PROTEINOFINFLUENZAA (H1N1) ISOLATESOBTAINEDINKENYAIN2007-2008 Meshack Wadegu USAMRU-KENYA
Introduction •
Type A influenza viruses are unique among influenza viruses:
1. -Show the greatest genetic diversity 2. -Infect widest range of host species 3. -Cause most of the severe disease in humans including the great pandemics.
Introduction cont’ • Among influenza A viruses, influenza A/H1N1 viruses have been responsible for the pandemics of 1918 and 2009. • Amino acid variants of the HA1 domain enable virus to evade immunity, replicate and infect more hosts. • Anecdotal reports of a mismatch in the H1N1 component in the 2008 vaccine highlighted need to analyze Kenyan isolates. USAMRU-K Kenya Influenza Sentinel Surveillance Site Network • Mbagathi District Hospital (DH) • Malindi DH • Kondele Children’s Hospital • Isiolo DH • Port Reitz DH • Alupe Sub DH • Kericho DH • Kisii DH 4
Laboratory Analysis • ILI specimens delivered in Liquid Nitrogen once a week and initially screened and subtyped by real time RT-PCR • PCR Machine provided by CDC • Isolations performed in MDCK cells followed by HAI assays using guinea pig RBCs and reference antisera •
Nucleotide sequencing by US Air Force School of Aerospace Medicine or commercially 5 1 2 4 8 16 32 64 128 256 512 1024 C A/H1N1 A/H3N2 Bs Bm Results (epidemiologic) • 6044 influenza like illness(ILI) specimen were collected • 1643 were positive for influenza by Real Time PCR • Using RT-PCR assay, 21.9%(1322/6044) of ILI cases were caused by influenza A • 140 influenza A isolates were obtained • 37.1%(52/140) of the influenza A isolates were H1N1 subtype Strategy of Phylogenetic analysis • Nucleotide (nt) sequencing of PCR amplified HA1 gene segment was carried out. • Amino acid sequence from conceptual translation of ntwere used for phylogeneticanalysis • The comparison with WHO-recommended vaccine strains. • Multiple sequence alignment done using Muscle 3.6 •

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Phylogeny carried out using MrBayes
0.0040A_Mbagathi_4825_2007H1N1A_Mbagathi_4844_2007H1N1A_Kericho_4831_2007H1N1A_Malindi_4836_2007H1N1A_Mbagathi_4834_2007H1N1A_Kisii_4839_2007H1N1A_Solomon_Islands_3_2006H1N1A_Brisbane_59_2007H1N1A_Kisumu_4830_2007H1N1A_Mbagathi_4826_2007H1N1A_Mbagathi_4840_2007H1N1A_Malindi_4837_2007H1N1A_Kisii_4823_2007H1N1A_New_Caledonia_20_99H1N1A_Kericho_4822_2007H1N1A_Malindi_4835_2007H1N1A_Mbagathi_4827_2007H1N155%99%58%100%100%70% 2007 Season
K273E D221G Q104H S121N
0.0040A_Mbagathi_4825_2007H1N1A_Mbagathi_4844_2007H1N1A_Kericho_4831_2007H1N1A_Malindi_4836_2007H1N1A_Mbagathi_4834_2007H1N1A_Kisii_4839_2007H1N1A_Solomon_Islands_3_2006H1N1A_Brisbane_59_2007H1N1A_Kisumu_4830_2007H1N1A_Mbagathi_4826_2007H1N1A_Mbagathi_4840_2007H1N1A_Malindi_4837_2007H1N1A_Kisii_4823_2007H1N1A_New_Caledonia_20_99H1N1A_Kericho_4822_2007H1N1A_Malindi_4835_2007H1N1A_Mbagathi_4827_2007H1N155%99%58%100%100%70% 2007 Season
K273E D221G Q104H S121N
0.0040A_Mbagathi_4825_2007H1N1A_Mbagathi_4844_2007H1N1A_Kericho_4831_2007H1N1A_Malindi_4836_2007H1N1A_Mbagathi_4834_2007H1N1A_Kisii_4839_2007H1N1A_Solomon_Islands_3_2006H1N1A_Brisbane_59_2007H1N1A_Kisumu_4830_2007H1N1A_Mbagathi_4826_2007H1N1A_Mbagathi_4840_2007H1N1A_Malindi_4837_2007H1N1A_Kisii_4823_2007H1N1A_New_Caledonia_20_99H1N1A_Kericho_4822_2007H1N1A_Malindi_4835_2007H1N1A_Mbagathi_4827_2007H1N155%99%58%100%100%70% 2007 Season
K273E D221G Q104H S121N
0.0040A_Mbagathi_4825_2007H1N1A_Mbagathi_4844_2007H1N1A_Kericho_4831_2007H1N1A_Malindi_4836_2007H1N1A_Mbagathi_4834_2007H1N1A_Kisii_4839_2007H1N1A_Solomon_Islands_3_2006H1N1A_Brisbane_59_2007H1N1A_Kisumu_4830_2007H1N1A_Mbagathi_4826_2007H1N1A_Mbagathi_4840_2007H1N1A_Malindi_4837_2007H1N1A_Kisii_4823_2007H1N1A_New_Caledonia_20_99H1N1A_Kericho_4822_2007H1N1A_Malindi_4835_2007H1N1A_Mbagathi_4827_2007H1N155%99%58%100%100%70% 2007 Season
K273E D221G Q104H S121N
0.0040A_Kisii_7543_2008A_Kisumu_5928_2008A_Kericho_7530_2008A_Mbagathi_7596_2008A_Kericho_7535_2008A_Kisii_7565_2008A_Kisii_7577_2008A_Kisii_5886_2008A_Kisii_7559_2008A_Kisumu_5933_2008A_Kisii_7541_2008A_Kisumu_7611_2008A_Solomon_Islands_3_2006A_Kisii_7576_2008A_Kisii_7562_2008A_Kisii_7554_2008A_Kisii_7570_2008A_Kisumu_5923_2008A_Kisii_7547_2008A_Kenya_6901_2008A_Kericho_7529_2008A_Brisbane_59_2007A_Kericho_7525_2008A_Kisii_5896_2008A_New_Caledonia_20_99A_Kisumu_5934_2008A_Kisumu_6543_200898%84%99%100%100%94% 2008 Season
0.0040A_Kisii_7543_2008A_Kisumu_5928_2008A_Kericho_7530_2008A_Mbagathi_7596_2008A_Kericho_7535_2008A_Kisii_7565_2008A_Kisii_7577_2008A_Kisii_5886_2008A_Kisii_7559_2008A_Kisumu_5933_2008A_Kisii_7541_2008A_Kisumu_7611_2008A_Solomon_Islands_3_2006A_Kisii_7576_2008A_Kisii_7562_2008A_Kisii_7554_2008A_Kisii_7570_2008A_Kisumu_5923_2008A_Kisii_7547_2008A_Kenya_6901_2008A_Kericho_7529_2008A_Brisbane_59_2007A_Kericho_7525_2008A_Kisii_5896_2008A_New_Caledonia_20_99A_Kisumu_5934_2008A_Kisumu_6543_200898%84%99%100%100%94% 2008 Season
0.0040A_Kisii_7543_2008A_Kisumu_5928_2008A_Kericho_7530_2008A_Mbagathi_7596_2008A_Kericho_7535_2008A_Kisii_7565_2008A_Kisii_7577_2008A_Kisii_5886_2008A_Kisii_7559_2008A_Kisumu_5933_2008A_Kisii_7541_2008A_Kisumu_7611_2008A_Solomon_Islands_3_2006A_Kisii_7576_2008A_Kisii_7562_2008A_Kisii_7554_2008A_Kisii_7570_2008A_Kisumu_5923_2008A_Kisii_7547_2008A_Kenya_6901_2008A_Kericho_7529_2008A_Brisbane_59_2007A_Kericho_7525_2008A_Kisii_5896_2008A_New_Caledonia_20_99A_Kisumu_5934_2008A_Kisumu_6543_200898%84%99%100%100%94% 2008 Season
0.0040A_Kisii_7543_2008A_Kisumu_5928_2008A_Kericho_7530_2008A_Mbagathi_7596_2008A_Kericho_7535_2008A_Kisii_7565_2008A_Kisii_7577_2008A_Kisii_5886_2008A_Kisii_7559_2008A_Kisumu_5933_2008A_Kisii_7541_2008A_Kisumu_7611_2008A_Solomon_Islands_3_2006A_Kisii_7576_2008A_Kisii_7562_2008A_Kisii_7554_2008A_Kisii_7570_2008A_Kisumu_5923_2008A_Kisii_7547_2008A_Kenya_6901_2008A_Kericho_7529_2008A_Brisbane_59_2007A_Kericho_7525_2008A_Kisii_5896_2008A_New_Caledonia_20_99A_Kisumu_5934_2008A_Kisumu_6543_200898%84%99%100%100%94% 2008 Season
#G185N Sb E273K
0.0040A_Kisii_7543_2008A_Kisumu_5928_2008A_Kericho_7530_2008A_Mbagathi_7596_2008A_Kericho_7535_2008A_Kisii_7565_2008A_Kisii_7577_2008A_Kisii_5886_2008A_Kisii_7559_2008A_Kisumu_5933_2008A_Kisii_7541_2008A_Kisumu_7611_2008A_Solomon_Islands_3_2006A_Kisii_7576_2008A_Kisii_7562_2008A_Kisii_7554_2008A_Kisii_7570_2008A_Kisumu_5923_2008A_Kisii_7547_2008A_Kenya_6901_2008A_Kericho_7529_2008A_Brisbane_59_2007A_Kericho_7525_2008A_Kisii_5896_2008A_New_Caledonia_20_99A_Kisumu_5934_2008A_Kisumu_6543_200898%84%99%100%100%94% 2008 Season
A189T Sb #G185N Sb E273K
0.0040A_Kisii_7543_2008A_Kisumu_5928_2008A_Kericho_7530_2008A_Mbagathi_7596_2008A_Kericho_7535_2008A_Kisii_7565_2008A_Kisii_7577_2008A_Kisii_5886_2008A_Kisii_7559_2008A_Kisumu_5933_2008A_Kisii_7541_2008A_Kisumu_7611_2008A_Solomon_Islands_3_2006A_Kisii_7576_2008A_Kisii_7562_2008A_Kisii_7554_2008A_Kisii_7570_2008A_Kisumu_5923_2008A_Kisii_7547_2008A_Kenya_6901_2008A_Kericho_7529_2008A_Brisbane_59_2007A_Kericho_7525_2008A_Kisii_5896_2008A_New_Caledonia_20_99A_Kisumu_5934_2008A_Kisumu_6543_200898%84%99%100%100%94% 2008 Season
#N183S G185A A189T Sb T210N #G185N Sb E273K
0.0040A_Mbagathi_4825_2007_H1N1A_Kericho_7530_2008_H1N1A_Kericho_7529_2008_H1N1A_Kisii_4839_2007_H1N1A_Kisii_7554_2008_H1N1A_Kisii_7565_2008_H1N1A_Kenya_6901_2008_H1N1A_Kisii_5886_2008_H1N1A_Solomon_Islands_3_2006_H1N1A_Mbagathi_4834_2007_H1N1A_Kisii_7541_2008_H1N1A_Kisii_7543_2008_H1N1A_Mbagathi_4827_2007_H1N1A_Kisumu_4830_2007_H1N1A_Kisumu_5933_2008_H1N1A_Kisii_7576_2008_H1N1A_Kisumu_5934_2008_H1N1A_Kisii_5896_2008_H1N1A_Kericho_7535_2008_H1N1A_Kisumu_5923_2008_H1N1A_Kisii_7547_2008_H1N1A_Mbagathi_4840_2007_H1N1A_Kisii_7570_2008_H1N1A_Kisii_7562_2008_H1N1A_Kisii_7577_2008_H1N1A_Malindi_4835_2007_H1N1A_Kericho_7525_2008_H1N1A_Kisumu_6543_2008_H1N1A_Kericho_4831_2007_H1N1A_Malindi_4837_2007_H1N1A_Kisii_7559_2008_H1N1A_Mbagathi_4844_2007_H1N1A_Kisumu_5928_2008_H1N1A_Kisumu_7611_2008_H1N1A_Kericho_4822_2007_H1N1A_Brisbane_59_2007_H1N1A_New_Caledonia_20_99_H1N1A_Mbagathi_7596_2008_H1N1A_Mbagathi_4826_2007_H1N1A_Kisii_4823_2007_H1N1A_Malindi_4836_2007_H1N199%97%61%99%72%99%98%98%93% 2007-2008 seasons
#N183S A189T Sb G185A T210N #185N Sb S121N K273E
0.0040A_Mbagathi_4825_2007_H1N1A_Kericho_7530_2008_H1N1A_Kericho_7529_2008_H1N1A_Kisii_4839_2007_H1N1A_Kisii_7554_2008_H1N1A_Kisii_7565_2008_H1N1A_Kenya_6901_2008_H1N1A_Kisii_5886_2008_H1N1A_Solomon_Islands_3_2006_H1N1A_Mbagathi_4834_2007_H1N1A_Kisii_7541_2008_H1N1A_Kisii_7543_2008_H1N1A_Mbagathi_4827_2007_H1N1A_Kisumu_4830_2007_H1N1A_Kisumu_5933_2008_H1N1A_Kisii_7576_2008_H1N1A_Kisumu_5934_2008_H1N1A_Kisii_5896_2008_H1N1A_Kericho_7535_2008_H1N1A_Kisumu_5923_2008_H1N1A_Kisii_7547_2008_H1N1A_Mbagathi_4840_2007_H1N1A_Kisii_7570_2008_H1N1A_Kisii_7562_2008_H1N1A_Kisii_7577_2008_H1N1A_Malindi_4835_2007_H1N1A_Kericho_7525_2008_H1N1A_Kisumu_6543_2008_H1N1A_Kericho_4831_2007_H1N1A_Malindi_4837_2007_H1N1A_Kisii_7559_2008_H1N1A_Mbagathi_4844_2007_H1N1A_Kisumu_5928_2008_H1N1A_Kisumu_7611_2008_H1N1A_Kericho_4822_2007_H1N1A_Brisbane_59_2007_H1N1A_New_Caledonia_20_99_H1N1A_Mbagathi_7596_2008_H1N1A_Mbagathi_4826_2007_H1N1A_Kisii_4823_2007_H1N1A_Malindi_4836_2007_H1N199%97%61%99%72%99%98%98%93% 2007-2008 seasons
#N183S A189T Sb G185A T210N #185N Sb S121N K273E Discussion •
The 2007 viruses were genetically distinct from A/Solomon Islands/3/2006(H1N1), but similar to A/Brisbane/59/2007(H1N1) • The 2008 viruses were also genetically divergent compared to A/Brisbane/59/2007(H1N1) – The 2008 Kenyan isolates contained G185N and A189T mutations compared to A/Brisbane/59/2007(H1N1); – Both mutations are at the antigenic site Sb – Position 185 is involved at the sialic acid receptor binding site – Most mutations(G185N, A189T, N183S) occurred within the receptor binding domain and at site Sb Conclusion • A/H1N1 viruses circulating in Kenya during years 2007 to 2008 were genetically distinct from recommended vaccine strains • Genetic evidence of the mismatch reported elsewhere in 2008, appeared early in Kenya. • Characterization of genetic variation reinforces the importance of continuing surveillance and molecular characterization of influenza viruses from Africa. 22 Disclaimer •
The views expressed are those of the author and should not be construed to represent the positions of the US Department of the Army or Department of Defense Acknowledgments USAMRU-K Dr. Wallace Bulimo Berhane Assefa COL Scott Gordon MAJ Mike Walter COL Sam Martin MAJ Sheryl Bedno NIC LAB PERSONNEL Rachel Achila Finnley Osunna Josephat Mwangi Meshack Wadegu Janet Majanja Sylvanos Mukunzi Dennis Mwala James Njiri Jane Wangui KEMRI Director KEMRI Director CVR Director CPHR Dr. Walter Ochieng James Magana James Simwa
SITE COs AND LAB TECHSDuke OmaribaMartha NderituAlfred OdindoCharles AdegaJeremiah KipondaRuth MupaFrida MunyaziGeorge KissingerMohammed MukwazimuDiana KamolaIsaiah OndusoElias MuhidinDaniel KamauSteve KairithiaMargaret KoechAlice SangLynette Onge’ta DOD-GEIS COL Bob DeFraites CAPT Kevin Russell LTC Kelly Vest CDR David Blazes Dr. Toti Sanchez CDC –Kenya, GDD Dr. Robert Breiman Dr. Kariuki Njenga Dr. Mark Katz USAFSAM Maj Tom Gibbons Dr. Elizabeth Macias CDC-AtlantaDr. Nancy CoxRichard DavisAmanda Balish NIMR, England World Influenza Centre Dr. Alan Hay

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