#Review analysis and impact of co-circulating #H5N1 and #H9N2 #avian #influenza viruses in #Bangladesh (Epidemiol Infect., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Epidemiol Infect. 2018 Jul;146(10):1259-1266. doi: 10.1017/S0950268818001292. Epub 2018 May 21.

Review analysis and impact of co-circulating H5N1 and H9N2 avian influenza viruses in Bangladesh.

Parvin R1, Begum JA1, Nooruzzaman M1, Chowdhury EH1, Islam MR1, Vahlenkamp TW2.

Author information: 1 Department of Pathology,Faculty of Veterinary Science,Bangladesh Agricultural University,Mymensingh 2202,Bangladesh. 2 Faculty of Veterinary Medicine,Center of Infectious Diseases, Institute of Virology, University of Leipzig,An den Tierkliniken 29, 04103 Leipzig,Germany.

 

Abstract

Almost the full range of 16 haemagglutinin (HA) and nine neuraminidase subtypes of avian influenza viruses (AIVs) has been detected either in waterfowl, land-based poultry or in the environment in Bangladesh. AIV infections in Bangladesh affected a wide range of host species of terrestrial poultry. The highly pathogenic avian influenza (AI) H5N1 and low pathogenic AI H9N2 were found to co-circulate and be well entrenched in the poultry population, which has caused serious damage to the poultry industry since 2007. By reviewing the available scientific literature, the overall situation of AIVs in Bangladesh is discussed. All Bangladeshi (BD) H5N1 and H9N2 AIV sequences available at GenBank were downloaded along with other representative sequences to analyse the genetic diversity among the circulating AIVs in Bangladesh and to compare with the global situation. Three different H5N1 clades, 2.2.2, 2.3.2.1 and 2.3.4.2, have been detected in Bangladesh. Only 2.3.2.1a is still present. The BD LP H9N2 viruses mostly belonged to the H9 G1 lineage but segregated into many branches, and some of these shared internal genes with HP viruses of subtypes H7N3 and H5N1. However, these reassortment events might have taken place before introduction to Bangladesh. Currently, H9N2 viruses continue to evolve their HA cleavage, receptor binding and glycosylation sites. Multiple mutations in the HA gene associated with adaptation to mammalian hosts were also observed. Strict biosecurity at farms and gradual phasing out of live-bird markets could be the key measures to better control AIVs, whereas stamping out is not a practicable option in Bangladesh. Vaccination also could be an additional tool, which however, requires careful planning. Continuous monitoring of AIVs through systematic surveillance and genetic characterisation of the viruses remains a hallmark of AI control.

KEYWORDS: Avian influenza; Bangladesh; H5N1; H9N2; co-circulation; genetic evolution

PMID: 29781424 DOI: 10.1017/S0950268818001292 [Indexed for MEDLINE]

Keywords: Avian Influenza; H5N1; H7N3; H9N2; Poultry; Wild Birds; Bangladesh.

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#Surveillance for #avian #influenza viruses in #wildbirds at live #bird #markets, #Egypt, 2014-2016 (Influenza Other Respir Viruses, abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Influenza Other Respir Viruses. 2019 Feb 3. doi: 10.1111/irv.12634. [Epub ahead of print]

Surveillance for avian influenza viruses in wild birds at live bird markets, Egypt, 2014-2016.

Kayed AS1, Kandeil A1, Gomaa MR1, El-Shesheny R1,2, Mahmoud S1, Hegazi N3, Fayez M3, Sheta B4, McKenzie PP2, Webby RJ2, Kayali G5,6, Ali MA1.

Author information: 1 Environmental Research Division, Water Pollution Research Department, Center of Scientific Excellence for Influenza Viruses, National Research Centre (NRC), Giza, Egypt. 2 Department of Infectious Diseases, St Jude Children’s Research Hospital, Memphis, Tennessee. 3 Faculty of Agriculture, Department of Microbiology, Cairo University, Giza, Egypt. 4 Faculty of Science, Zoology Department, Damietta University, New Damietta, Egypt. 5 Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas, Houston, Texas. 6 Human Link, Baabda, Lebanon.

 

Abstract

AIM:

Egypt is the habitat for a large number of bird species and serves as a vital stopover for millions of migratory birds during their annual migration between the Palearctic and Afrotropical ecozones. Surveillance for avian influenza viruses (AIVs) is critical to assessing risks for potential spreading of these viruses among domestic poultry. Surveillance for AIV among hunted and captured wild birds in Egypt was conducted in order to understand the characteristics of circulating viruses.

METHODS:

Sampling of wild bird species occurred in two locations along the Mediterranean Coast of Egypt in the period from 2014 to 2016. A total of 1316 samples (cloacal and oropharyngeal swabs) were collected from 20 different species of hunted or captured resident and migratory birds sold at live bird markets. Viruses were propagated then sequenced. Phylogenetic analysis and receptor binding affinities were studied.

RESULTS:

Eighteen AIVs (1.37%) were isolated from migratory Anseriformes at live bird markets. Further characterization of the viral isolates identified five hemagglutinin (H3, H5, H7, H9, and H10) and five neuraminidase (N1, N2, N3, N6, and N9) subtypes, which were related to isolates reported in the Eurasian region. Two of the 18 isolates were highly pathogenic H5N1 viruses related to clade 2.2.1, while three isolates were G1-like H9N2 viruses.

CONCLUSIONS:

Our data show significant diversity of AIVs in Anserifromes sold at live bird markets in Egypt. This allows for genetic exchanges between imported and enzootic viruses and put the exposed humans at a higher risk of infection.

© 2019 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.

PMID: 30714323 DOI: 10.1111/irv.12634

Keywords: Avian Influenza; H5N1; H9N2; Wild Birds; Poultry; Live Birds Markets; Egypt.

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#Clinical and epidemiological characteristics of a young #child infected with #avian #influenza A (#H9N2) virus in #China (J Int Med Res., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

J Int Med Res. 2018 Aug;46(8):3462-3467. doi: 10.1177/0300060518779959. Epub 2018 Jun 13.

Clinical and epidemiological characteristics of a young child infected with avian influenza A (H9N2) virus in China.

Liu R1, Zhao B2, Li Y1, Zhang X1, Chen S1, Chen T1.

Author information: 1 Changsha Center for Disease Control and Prevention, Changsha, Hunan Province, People’s Republic of China. 2 State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, Fujian Province, People’s Republic of China.

 

Abstract

Three cases of the avian influenza A (H9N2) virus have been documented in Changsha, which is a large city that has nine districts and a population of 7.04 million in central South China. Among these patients, one was a girl and two were boys. The ages of the patients were 9 months, 2 years, and 15 years. Two cases of H9N2 were detected in September, 2015 and one was detected in 2017. Two patients were children who had not reached the age for kindergarten and one was a student. These three cases were all mild and were detected in a sentinel hospital of the Chinese Influenza Surveillance System. We describe the clinical and epidemiological features of the youngest patient with H9N2 in 2017 and the surveillance results of the H9N2 virus in live poultry markets in Changsha. From January 2014 to December 2017, 4212 samples were collected in live poultry markets in Changsha, among which 25.81% (1087/4212) were H9N2-positive. Public health concerns should be addressed for emerging H9N2 virus infection, and more strategies should be performed before this virus mutates to be more transmissible and highly pathogenic.

KEYWORDS: Avian influenza; H9N2; children; mild case; poultry; public health

PMID: 29896990 PMCID: PMC6134662 DOI: 10.1177/0300060518779959 [Indexed for MEDLINE]  Free PMC Article

Keywords: Avian Influenza; H9N2; Human; Poultry; China.

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Genetic #evolution of #HA and #NA #genes of #H9N2 #influenza viruses isolated in regions of #Hunan Province, #China, in 2015 (Sheng Wu Gong Cheng Xue Bao, abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Sheng Wu Gong Cheng Xue Bao. 2018 Apr 25;34(4):537-547. doi: 10.13345/j.cjb.170309.

[Genetic evolution of HA and NA genes of H9N2 influenza viruses isolated in regions of Hunan Province, China, in 2015].

[Article in Chinese; Abstract available in Chinese from the publisher]

Zhang S1,2, Chen Q3, Bi Y2, Liu W2, Sheng W1, Zhang T3, Li J2.

Author information: 1 Beijing University of Technology, Beijing 100124, China. 2 Key Laboratory of Pathogenic Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences, Beijing 100101, China. 3 Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan 430071, Hubei, China.

Abstract

The high prevalence of influenza A virus is identified in Hunan Province because of the high density of poultry farms. To survey the variations of H9N2 subtype avian influenza virus in Hunan province, we analyzed HA and NA genes of 10 virus strains isolated from different areas of Hunan Province. All these strains belong to the Eurasian lineage, Y280-like sub-lineage. The cleavage sites in their HA genes were all RSSR↓GLT, corresponding to the feature of low pathogenic AIV. All strains had an L (Leu) at the site 234 in the HA genes, indicating the ability of binding with the SAα-2,6 receptor. NA gene stalk deletions at aa 63-65 were also detected from all the isolates, indicating a possibility of increased virus replication in mammals. Our findings suggest that more attention should be paid to the surveillance of H9N2 influenza virus and its direction of reassortment.

KEYWORDS: H9N2 subtype influenza viruses; HA genes; NA genes; genetic evolution

PMID: 29701027 DOI: 10.13345/j.cjb.170309 [Indexed for MEDLINE]  Free full text

Keywords: Avian Influenza; H9N2; Hunan; China; Poultry.

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Co-infections, genetic, and #antigenic relatedness of #avian #influenza #H5N8 and #H5N1 viruses in domestic and #wildbirds in #Egypt (Poult Sci., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Poult Sci. 2019 Jan 22. doi: 10.3382/ps/pez011. [Epub ahead of print]

Co-infections, genetic, and antigenic relatedness of avian influenza H5N8 and H5N1 viruses in domestic and wild birds in Egypt.

Shehata AA1, Sedeik ME2, Elbestawy AR3, Zain El-Abideen MA4, Ibrahim HH5, Kilany WH4, Ali A6.

Author information: 1 Avian and Rabbit Diseases Department, Faculty of Veterinary Medicine, University of Sadat City, Egypt. 2 Department of Poultry and Fish Diseases, Faculty of Veterinary Medicine, Alexandria University, Alexandria, Egypt. 3 Poultry Diseases Department, Faculty of Veterinary medicine, Damanhur University, Behaira, Egypt. 4 Veterinary Quality Control on Poultry Production (RLQP), Animal Health Research Institute (AHRI), Dokki, Giza, Egypt. 5 Poultry Diseases Department, Faculty of Veterinary Medicine, Aswan University, Aswan, Egypt. 6 Poultry Diseases Department, Faculty of Veterinary Medicine, Beni-Suef University, Beni-Suef 62511, Egypt.

 

Abstract

A total of 50 poultry farms of commercial broilers (N = 39) and commercial layers (N = 11) suffered from respiratory problems and mortality during the period from January 2016 to December 2017 were investigated. Also, samples were collected from quail (N = 4), Bluebird (Sialis, N = 1), and Greenfinch (Chloris chloris, N = 1) for analysis. Respiratory viral pathogens were screened by PCR and positive samples were subjected to virus isolation and genetic identification. Antigenic relatedness of isolated avian influenza (AI) H5 subtype was evaluated using cross-hemagglutination inhibition. Results revealed that the incidence of single virus infections in commercial broilers was 64.1% (25/39), with the highest incidence for ND (33.3%) and H9N2 (20.5%), followed by H5N1 (7.7%) and H5N8 (2.7). Meanwhile, H9N2/ND mixed infection was the most observed case (7.7%). Other mixed infections H5N1/ND, H5N1/H9N2/ND, H5N1/H9N2/ND/IB, H9N2/IB, and H9N2/ILT were also observed (2.6% each). In commercial layers, H5N1 and ILT were the only detected single infections (18.1% each). Mixed H9N2/ND was the most predominant infection in layers (27.3%). Other mixed infections of H9N2/IB, H5N1/H5N8/H9N2, and H9N2/ND/IB were observed in 3 separate farms (9.1% each). The H5N8 virus was detected in one quail farm and 2 out of 3 wild bird’s samples. Partial HA gene sequence analysis showed the clustering of the selected AI H5N8 within the 2.3.4.4 clade, while H5N1 clustered with the clade 2.2.1.2. Interestingly, the H5N8 isolated from chickens possessed 6 amino acids substitutions at HA1 compared to those isolated from wild birds with low antigenic relatedness to AI H5N1 clades 2.2.1 or 2.2.1.2. In conclusion, mixed viral infections were observed in both broiler and layer chickens in Egypt. The detected triple H5N1, H9N2, and H5N8 influenza co-infection raises the concern of potential AI epidemic strain emergence. The low genetic and antigenic relatedness between AI H5N1 and H5N8 viruses suggest the need for modification of vaccination strategies of avian influenza in Egypt along with strict biosecurity measures.

PMID:  30668795 DOI: 10.3382/ps/pez011

Keywords: Avian Influenza; H5N1; H5N8; H9N2; Poultry; Wild Birds; Egypt.

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The PA #Subunit of the #Influenza Virus #Polymerase Complex Affects Replication and #Airborne Transmission of the #H9N2 Subtype #Avian Influenza Virus (Viruses, abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Viruses. 2019 Jan 9;11(1). pii: E40. doi: 10.3390/v11010040.

The PA Subunit of the Influenza Virus Polymerase Complex Affects Replication and Airborne Transmission of the H9N2 Subtype Avian Influenza Virus.

Hao M1,2, Han S3,4, Meng D5,6, Li R7, Lin J8, Wang M9, Zhou T10, Chai T11.

Author information: 1 College of Veterinary Medicine, Shandong Agricultural University, 61 Daizong Street, Taian 271018, China. mengchan1993@126.com. 2 Collaborative Innovation Center for the Origin and Control of Emerging Infectious Diseases, Taishan Medical University, Taian 270016, China. mengchan1993@126.com. 3 College of Veterinary Medicine, Shandong Agricultural University, 61 Daizong Street, Taian 271018, China. 18763896230@163.com. 4 Collaborative Innovation Center for the Origin and Control of Emerging Infectious Diseases, Taishan Medical University, Taian 270016, China. 18763896230@163.com. 5 College of Veterinary Medicine, Shandong Agricultural University, 61 Daizong Street, Taian 271018, China. iamli_z@126.com. 6 Collaborative Innovation Center for the Origin and Control of Emerging Infectious Diseases, Taishan Medical University, Taian 270016, China. iamli_z@126.com. 7 College of Veterinary Medicine, Shandong Agricultural University, 61 Daizong Street, Taian 271018, China. lirong19900129@163.com. 8 College of Veterinary Medicine, Shandong Agricultural University, 61 Daizong Street, Taian 271018, China. 18763806701@163.com. 9 College of Veterinary Medicine, Shandong Agricultural University, 61 Daizong Street, Taian 271018, China. 18854937499@163.com. 10 College of Veterinary Medicine, Shandong Agricultural University, 61 Daizong Street, Taian 271018, China. 13864453175@163.com. 11 College of Veterinary Medicine, Shandong Agricultural University, 61 Daizong Street, Taian 271018, China. chaitj117@163.com.

 

Abstract

The polymerase acidic (PA) protein is the third subunit of the influenza A virus polymerase. In recent years, studies have shown that PA plays an important role in overcoming the host species barrier and host adaptation of the avian influenza virus (AIV). The objective of this study was to elucidate the role of the PA subunit on the replication and airborne transmission of the H9N2 subtype AIV. By reverse genetics, a reassortant rSD01-PA was derived from the H9N2 subtype AIV A/Chicken/Shandong/01/2008 (SD01) by introducing the PA gene from the pandemic influenza A H1N1 virus A/swine/Shandong/07/2011 (SD07). Specific pathogen-free (SPF) chickens and guinea pigs were selected as the animal models for replication and aerosol transmission studies. Results show that rSD01-PA lost the ability of airborne transmission among SPF chickens because of the single substitution of the PA gene. However, rSD01-PA could infect guinea pigs through direct contact, while the parental strain SD01 could not, even though the infection of rSD01-PA could not be achieved through aerosol. In summary, our results indicate that the protein encoded by the PA gene plays a key role in replication and airborne transmission of the H9N2 subtype AIV.

KEYWORDS: H9N2 AIV; airborne transmission; pandemic 2009 H1N1 virus; reassortment; replication

PMID: 30634394 DOI: 10.3390/v11010040

Keywords: Avian Influenza; H9N2; Reassortant Strain; H1N1pdm09; Animal models.

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A novel linear epitope crossing Group 1 and Group 2 #influenza A viruses located in the helix A of HA2 derived from #H7N9 (Vet Microbiol., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Vet Microbiol. 2019 Jan;228:39-44. doi: 10.1016/j.vetmic.2018.11.002. Epub 2018 Nov 10.

A novel linear epitope crossing Group 1 and Group 2 influenza A viruses located in the helix A of HA2 derived from H7N9.

Li Z1, Wan Z2, Li T3, Xie Q4, Sun H5, Chen H6, Liang G7, Shao H8, Qin A9, Ye J10.

Author information: 1 Key Laboratory of Jiangsu Preventive Veterinary Medicine, Key Laboratory for Avian Preventive Medicine, Ministry of Education, College of Veterinary Medicine, Yangzhou University, Yangzhou, Jiangsu, 225009, China; Jiangsu Co-innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou, Jiangsu, 225009, China; Joint International Research Laboratory of Agriculture and Agri-Product Safety, The Ministry of Education of China, Yangzhou University, Yangzhou, Jiangsu, 225009, China; Institutes of Agricultural Science and Technology Development, Yangzhou University, Yangzhou, Jiangsu, 225009, China. Electronic address: 462407484@qq.com. 2 Key Laboratory of Jiangsu Preventive Veterinary Medicine, Key Laboratory for Avian Preventive Medicine, Ministry of Education, College of Veterinary Medicine, Yangzhou University, Yangzhou, Jiangsu, 225009, China; Jiangsu Co-innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou, Jiangsu, 225009, China; Joint International Research Laboratory of Agriculture and Agri-Product Safety, The Ministry of Education of China, Yangzhou University, Yangzhou, Jiangsu, 225009, China. Electronic address: 723694341@qq.com. 3 Key Laboratory of Jiangsu Preventive Veterinary Medicine, Key Laboratory for Avian Preventive Medicine, Ministry of Education, College of Veterinary Medicine, Yangzhou University, Yangzhou, Jiangsu, 225009, China; Jiangsu Co-innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou, Jiangsu, 225009, China; Joint International Research Laboratory of Agriculture and Agri-Product Safety, The Ministry of Education of China, Yangzhou University, Yangzhou, Jiangsu, 225009, China. Electronic address: 2030579924@qq.com. 4 Key Laboratory of Jiangsu Preventive Veterinary Medicine, Key Laboratory for Avian Preventive Medicine, Ministry of Education, College of Veterinary Medicine, Yangzhou University, Yangzhou, Jiangsu, 225009, China; Jiangsu Co-innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou, Jiangsu, 225009, China; Joint International Research Laboratory of Agriculture and Agri-Product Safety, The Ministry of Education of China, Yangzhou University, Yangzhou, Jiangsu, 225009, China. Electronic address: 809322407@qq.com. 5 Shanghai Veterinary Research Institute, Chinese Academy of Agricultural Sciences, 518 Ziyue Road, Shanghai 200241, China. Electronic address: 845861718@qq.com.  6 Shanghai Veterinary Research Institute, Chinese Academy of Agricultural Sciences, 518 Ziyue Road, Shanghai 200241, China. Electronic address: vetchj@shvri.ac.cn. 7 Key Laboratory of Jiangsu Preventive Veterinary Medicine, Key Laboratory for Avian Preventive Medicine, Ministry of Education, College of Veterinary Medicine, Yangzhou University, Yangzhou, Jiangsu, 225009, China; Jiangsu Co-innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou, Jiangsu, 225009, China; Joint International Research Laboratory of Agriculture and Agri-Product Safety, The Ministry of Education of China, Yangzhou University, Yangzhou, Jiangsu, 225009, China. Electronic address: 1561181511@qq.com. 8 Key Laboratory of Jiangsu Preventive Veterinary Medicine, Key Laboratory for Avian Preventive Medicine, Ministry of Education, College of Veterinary Medicine, Yangzhou University, Yangzhou, Jiangsu, 225009, China; Jiangsu Co-innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou, Jiangsu, 225009, China; Joint International Research Laboratory of Agriculture and Agri-Product Safety, The Ministry of Education of China, Yangzhou University, Yangzhou, Jiangsu, 225009, China; Institutes of Agricultural Science and Technology Development, Yangzhou University, Yangzhou, Jiangsu, 225009, China. Electronic address: 987137092@qq.com. 9 Key Laboratory of Jiangsu Preventive Veterinary Medicine, Key Laboratory for Avian Preventive Medicine, Ministry of Education, College of Veterinary Medicine, Yangzhou University, Yangzhou, Jiangsu, 225009, China; Jiangsu Co-innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou, Jiangsu, 225009, China; Joint International Research Laboratory of Agriculture and Agri-Product Safety, The Ministry of Education of China, Yangzhou University, Yangzhou, Jiangsu, 225009, China; Institutes of Agricultural Science and Technology Development, Yangzhou University, Yangzhou, Jiangsu, 225009, China. Electronic address: aijian@yzu.edu.cn. 10 Key Laboratory of Jiangsu Preventive Veterinary Medicine, Key Laboratory for Avian Preventive Medicine, Ministry of Education, College of Veterinary Medicine, Yangzhou University, Yangzhou, Jiangsu, 225009, China; Jiangsu Co-innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou, Jiangsu, 225009, China; Joint International Research Laboratory of Agriculture and Agri-Product Safety, The Ministry of Education of China, Yangzhou University, Yangzhou, Jiangsu, 225009, China; Institutes of Agricultural Science and Technology Development, Yangzhou University, Yangzhou, Jiangsu, 225009, China. Electronic address: jqye@yzu.edu.cn.

 

Abstract

In this research, four monoclonal antibodies (mAbs) were first generated as an immunogen by using the GST fusion protein that carries the fusion peptide and helix A derived from H7N9 influenza A virus (IAV). These mAbs could react with HA of H7N9, H3N2, and H9N2 with neutralizing activity. A novel linear epitope recognized by these mAbs was identified by peptide-based ELISA, and this epitope was located in TAADYKSTQSAIDQITGKLN at the C terminus of the helix A of H7N9. 3 A11, which is one of the four mAbs, could efficiently recognize the corresponding epitopes derived from H9, H7, H5, H3, and H1. Analysis of sera against the corresponding epitope from different HAs revealed that the C terminus of helix A in H9, H7, and H3 possessed dominant B cell epitopes that cross both Group 1 and Group 2 IAV, whereas the C terminus of helix A in H5 possessed only dominant B cell epitopes that cross subtypes in Group 1 virus. All these results demonstrated that the linear epitope identified in the helix A of H7N9 could be a novel target for developing broad-spectrum influenza diagnostics or vaccine candidates.

KEYWORDS: Cross-reaction; H7N9; HA2; Helix A; Linear epitope; Neutralization; mAb

PMID: 30593378 DOI: 10.1016/j.vetmic.2018.11.002

Keywords: Influenza A; Monoclonal antibodies; Avian Influenza; H7N9; H3N2; H9N2.

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