Abstract
The objective of this study was to provide seroepidemiological information on influenza A and B antibodies in children and adolescents. Viral immunoglobulin G antibodies were determined retrospectively using enzyme-linked immunosorbent assays in a group of 1,111 children and adolescents. Sera (809) from healthy adult blood donors served as controls. In children, the prevalence of antibodies against influenza A was 82.0% and against influenza B 9.6%, whereas in adults the prevalence of antibodies against influenza A was calculated as 99.4% and against influenza B 56.7%. After decline of maternal antibodies during the first year of life, there was an increase of prevalence of influenza A antibodies up to 100% by the age of 12 years. In contrast, only 1–2% of children up to 9 years had influenza B antibodies increasing to 25% by the age of 18 years and to 70% among adults aged 30 years. Children aged 0–6 years had significantly lower concentrations and >12–15-year-old adolescents had significantly higher concentrations of antibodies against influenza A than adults. For all age groups of children and adolescents, significantly lower antibody concentrations against influenza B were measured in comparison to the blood donor control group. In conclusion, the annual influenza vaccination in children and adolescents may improve considerably the protection against influenza virus infection occurring during epidemics.
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Allwinn R, Preiser W, Rabenau H et al (2002) Laboratory diagnosis of influenza—virology or serology? Med Microbiol Immunol (Berl) 191:157–160. doi:10.1007/s00430-002-0137-y
American Academy of Pediatrics Committee on Infectious Diseases (2002) Reduction of the burden of influenza in children—policy statement. Pediatrics 110:1246–1252. doi:10.1542/peds.110.6.1246
Arbeitsgemeinschaft Influenza Saisonabschlussberichte 1991–2006. http://www.influenza.rki.de/agi. Accessed 10 August 2007
Belay ED, Bresee JS, Holman RC et al (1999) Reye’s syndrome in the United States from 1981 through 1997. N Engl J Med 340:1377–1382. doi:10.1056/NEJM199905063401801
Centers for Disease Control, Prevention (2007) Prevention and control of influenza. MMWR 56:1–54
Chiu SS, Tse CY, Lau YL, Peiris M (2001) Influenza A infection is an important cause of febrile seizures. Pediatrics 108:e63. doi:10.1542/peds.108.4.e63
Cinatl J Jr, Michaelis M, Doerr HW (2007) The threat of avian influenza A (H5N1). Part I: epidemiologic concerns and virulence determinants. Med Microbiol Immunol (Berl) 196:181–190. doi:10.1007/s00430-007-0042-5
Cinatl J Jr, Michaelis M, Doerr HW (2007) The threat of avian influenza A (H5N1). Part IV: development of vaccines. Med Microbiol Immunol (Berl) 196:213–225. doi:10.1007/s00430-007-0052-3
Corbel L (2007) Should healthy children be vaccinated against influenza? Comments about this query. Eur J Pediatr 166:629–631. doi:10.1007/s00431-006-0285-y
Doerr HW, Varwig D, Allwinn R, Ciantl J (2006) Will the next human influenza pandemic be caused by the virus of the avian flu A/H5N1? Arguments pro and conter. Med Microbiol Immunol (Berl) 195:45–47. doi:10.1007/s00430-005-0008-4
Frank AL, Taber LH, Wells CR et al (1981) Patterns of shedding of myxoviruses and paramyxoviruses in children. J Infect Dis 144:433–441
Glezen WP, Couch RB (1978) Interpandemic influenza in the Houston area, 1974–76. N Engl J Med 298:587–592
Glezen WP, Decker M, Joseph SW, Mercready RG Jr (1987) Acute respiratory disease associated with influenza epidemics in Houston, 1981–1983. J Infect Dis 155:1119–1126
Glezen WP, Taber LH, Frank AL et al (1997) Influenza virus infections in infants. Pediatr Infect Dis J 16:1065–1068. doi:10.1097/00006454-199711000-00012
Guarner J, Paddock CD, Shieh WJ et al (2006) Histopathologic and immunohistochemical features of fatal influenza virus infection in children during the 2003–2004 season. Clin Infect Dis 43:132–140. doi:10.1086/505122
Hall CB, Douglas RG Jr, Geiman JM, Meagher MP (1979) Viral shedding patterns of children with influenza B infection. J Infect Dis 140:610–613
Heikkinen T, Booy R, Campins M et al (2006) Should healthy children be vaccinated against influenza? A consensus report of the Summit of Independent European Vaccination Experts. Eur J Pediatr 165:223–228. doi:10.1007/s00431-005-0040-9
Heikkinen T, Silvennoinen H, Peltole V et al (2004) Burden of influenza in children in the community. J Infect Dis 190:1369–1373. doi:10.1086/424527
Hite LK, Glezen WP, Demmler GJ, Munoz FM (2007) Medically attended pediatric influenza during the resurgence of the Victoria lineage of influenza B virus. Int J Infect Dis 11:40–47. doi:10.1016/j.ijid.2005.10.008
Hurwitz ES, Haber M, Chang A et al (2000) Studies of the 1996–1997 inactivated influenza vaccine among children attending day care: immunologic response, protection against infection, and clinical effectiveness. J Infect Dis 182:1218–1221. doi:10.1086/315820
Izurieta HS, Thompson WW, Kramarz P et al (2000) Influenza and the rates of hospitalization for respiratory disease among infants and young children. N Engl J Med 342:232–239. doi:10.1056/NEJM200001273420402
Khoury MJ, Erickson JD, Cordero JF, McCarthy BJ (1988) Congenital malformations and intrauterine growth retardation: a population study. Pediatrics 82:83–90
Lansdown AB (1977) Coxsackievirus B3 infection in pregnancy and its influence on foetal heart development. Br J Exp Pathol 58:378–385
Lange W, Vogel GE, Uphoff H (1999) Influenza. Virologie, Epidemiologie, Klinik, Therapie und Prophylaxe. Blackwell, Berlin
Li WC, Shih SR, Huang YC et al (2008) Clinical and genetic characterization of severe influenza B-associated diseases during an outbreak in Taiwan. J Clin Virol 42:45–51. doi:10.1016/j.jcv.2007.11.026
Londo DR, Davis AR, Nayak DP (1983) Complete nucleotide sequence of the nucleoprotein gene of influenza B virus. J Virol 47:642–648
Maricich SM, Neul JL, Lotze TE et al (2004) Neurologic complications associated with influenza A in children during the 2003–2004 influenza season in Houston, Texas. Pediatrics 114:e626–e633. doi:10.1542/peds.2004-0143
Monto AS, Sullivan KM (1993) Acute respiratory illness in the community. Frequency of illness and the agents involved. Epidemiol Infect 110:145–160
Müller D, Wutzler P, Szucs T (2005) Influenza vaccination coverage rates in Germany. Med Klin 100:6–13. doi:10.1007/s00063-005-1113-2
Munoz FM (2003) Influenza virus infection in infancy and early childhood. Paediatr Respir Rev 4:99–104. doi:10.1016/S1526-0542(03)00027-7
National Advisory Committee on Immunization (NACI) (2006) Statement on influenza vaccination for the 2006–2007 season. An Advisory Committee Statement (ACS). Can Commun Dis Rep 32:1–27
Neuzil KM, Mellen BG, Wright PF et al (2000) The effect of influenza on hospitalizations, outpatient visits, and courses of antibiotics in children. N Engl J Med 342:225–231. doi:10.1056/NEJM200001273420401
Neuzil KM, Wright PF, Mitchel EF Jr, Griffin MR (2000) The burden of influenza illness in children with asthma and other chronic medical conditions. J Pediatr 137:856–864. doi:10.1067/mpd.2000.110445
Neuzil KM, Zhu Y, Griffin MR et al (2002) Burden of interpandemic influenza in children younger than 5 years: a 25-year prospective study. J Infect Dis 185:147–152. doi:10.1086/338363
Peltola V, Ziegler T, Ruuskanen O (2003) Influenza A and B virus infections in children. Clin Infect Dis 36:299–305. doi:10.1086/345909
Principi N, Esposito S, Gasparini R et al (2004) Burden of influenza in healthy children and their households. Arch Dis Child 89:1002–1007. doi:10.1136/adc.2003.045401
Quach C, Piché-Walker L, Platt R, Moore D (2003) Risk factors associated with severe influenza infections in childhood: implication for vaccine strategy. Pediatrics 112:197–201. doi:10.1542/peds.112.3.e197
Reuman PD, Ayoub EM, Small PA (1987) Effect of passive maternal antibody on influenza illness in children: a prospective study of influenza A in mother infant pairs. Pediatr Infect Dis J 6:398–403
Robert Koch-Institut (1999) Influenza/ARE: Einschätzung der Saison 1998/99. Epidemiol Bull 18:131–133
Robert Koch-Institut (2000) Vorbereitung auf die Influenza: Start der Impfaktion. Epidemiol Bull 37:295–297
Robert Koch-Institut (2000) Influenza—aktuelle Situation. Epidemiol Bull 6:49
Robert Koch-Institut (2007) Empfehlungen der Ständigen Impfkommission (STIKO) am Robert Koch-Institut/Stand: Juli 2007. Epidemiol Bull 30:267–286
Ruuskanen O, Arola M, Putto-Laurila A et al (1989) Acute otitis media and respiratory virus infections. Pediatr Infect Dis J 8:94–99
Schmidt-Ott R, Schwarz T, Haase R et al (2007) Immunogenicity and reactogenicity of a trivalent influenza split vaccine in previously unvaccinated children aged 6–9 and 10–13 years. Vaccine 26:32–40. doi:10.1016/j.vaccine.2007.10.049
Schweiger B (2006) Molecular characterization of human influenza virus—a look back on the last 10 years. Berl Munch Tierarztl Wochenschr 119:167–178
Shikuma CM, Zackin R, Sattler F et al (2004) Changes in weight and lean body mass during highly active antiretroviral therapy. Clin Infect Dis 39:1223–1230. doi:10.1086/424665
Smith NM, Bresee JS, Shay DK et al (2006) Prevention and control of influenza: recommendations on the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 55:1–42
Thompson WW, Shay DK, Weintraub E et al. (2003) Mortality associated with influenza and respiratory syncytial virus in the United States. JAMA 289:179–186
Tompkins SM, Zhao ZS, Lo CY et al (2007) Matrix protein 2 vaccination and protection against influenza viruses, including subtype H5N1. Emerg Infect Dis 13:426–435
Watanabe S, Imai M, Ohara Y, Odagiri T (2003) Influenza B virus BM2 protein is transported through the trans-Golgi network as an integral membrane protein. J Virol 77:10630–10637. doi:10.1128/JVI.77.19.10630-10637.2003
Weigl JA, Puppe W, Schmitt HJ (2002) The incidence of influenza-associated hospitalizations in children in Germany. Epidemiol Infect 129:525–533. doi:10.1017/S0950268802007707
Wright PF, Ross KB, Thompson J, Karzon DT (1977) Influenza A infections in young children. Primary natural infection and protective efficacy of live vaccine-induced or naturally acquired immunity. N Engl J Med 296:829–834
Zentrale Ethikkommission (2003) Die (Weiter-)Verwendung von menschlichen Körpermaterialien für Zwecke der medizinischen. Forschung, pp 1–7. http://www.zentrale-ethikkommission.de/page.asp?his=0.1.21. Accessed May 15, 2008
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This work was supported by grants of the GlaxoSmithKline GmbH and Co. KG, Munich, Germany.
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Sauerbrei, A., Schmidt-Ott, R., Hoyer, H. et al. Seroprevalence of influenza A and B in German infants and adolescents. Med Microbiol Immunol 198, 93–101 (2009). https://doi.org/10.1007/s00430-009-0108-7
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DOI: https://doi.org/10.1007/s00430-009-0108-7