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      Multiple Reassortment Events in the Evolutionary History of H1N1 Influenza A Virus Since 1918

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          Abstract

          The H1N1 subtype of influenza A virus has caused substantial morbidity and mortality in humans, first documented in the global pandemic of 1918 and continuing to the present day. Despite this disease burden, the evolutionary history of the A/H1N1 virus is not well understood, particularly whether there is a virological basis for several notable epidemics of unusual severity in the 1940s and 1950s. Using a data set of 71 representative complete genome sequences sampled between 1918 and 2006, we show that segmental reassortment has played an important role in the genomic evolution of A/H1N1 since 1918. Specifically, we demonstrate that an A/H1N1 isolate from the 1947 epidemic acquired novel PB2 and HA genes through intra-subtype reassortment, which may explain the abrupt antigenic evolution of this virus. Similarly, the 1951 influenza epidemic may also have been associated with reassortant A/H1N1 viruses. Intra-subtype reassortment therefore appears to be a more important process in the evolution and epidemiology of H1N1 influenza A virus than previously realized.

          Author Summary

          The periodic occurrence of influenza epidemics in humans caused by viruses of the A/H1N1 subtype remains a key question in viral epidemiology and evolution and a major issue for public health. Since the first documentation of A/H1N1 in humans in 1918, this virus has been associated with a variety of epidemics and influenza vaccine failures. Using 71 representative whole-genome sequences of A/H1N1 influenza virus sampled between 1918 and 2005, we show that reassortment occurs frequently throughout the evolutionary history of this virus. Critically, two of these reassortment events appear to be associated with particularly severe epidemics, those of 1947 and 1951. Our analysis reveals that the virus associated with the 1947 epidemic was composed of genome segments with differing phylogenetic histories, suggesting that this virus was created through an intra-subtype reassortment event. Notably, of the two main antigenic proteins, the segment encoding the HA (hemagglutinin) is related to isolates circulating in a later time period, while the NA (neuraminidase) is related to earlier sampled isolates. This explains previous observations that the HA circulating at this time exhibited extensive antigenic drift while the NA appeared to be conserved. In addition, a virus likely associated with the 1951 epidemic also appears to have been generated by a reassortment event. Overall, our findings suggest that reassortment is an important factor in the long-term evolution of influenza A virus, including the periodic emergence of epidemic viruses. However, to more fully capture the evolutionary history of this important virus, additional sequencing of influenza viruses from earlier time periods is clearly needed.

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          1918 Influenza: the Mother of All Pandemics

          The "Spanish" influenza pandemic of 1918–1919, which caused ≈50 million deaths worldwide, remains an ominous warning to public health. Many questions about its origins, its unusual epidemiologic features, and the basis of its pathogenicity remain unanswered. The public health implications of the pandemic therefore remain in doubt even as we now grapple with the feared emergence of a pandemic caused by H5N1 or other virus. However, new information about the 1918 virus is emerging, for example, sequencing of the entire genome from archival autopsy tissues. But, the viral genome alone is unlikely to provide answers to some critical questions. Understanding the 1918 pandemic and its implications for future pandemics requires careful experimentation and in-depth historical analysis.
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            Updating the accounts: global mortality of the 1918-1920 "Spanish" influenza pandemic.

            The influenza pandemic of 1918-20 is recognized as having generally taken place in three waves, starting in the northern spring and summer of 1918. This pattern of three waves, however, was not universal: in some locations influenza seems to have persisted into or returned in 1920. The recorded statistics of influenza morbidity and mortality are likely to be a significant understatement. Limitations of these data can include nonregistration, missing records, misdiagnosis, and nonmedical certification, and may also vary greatly between locations. Further research has seen the consistent upward revision of the estimated global mortality of the pandemic, which a 1920s calculation put in the vicinity of 21.5 million. A 1991 paper revised the mortality as being in the range 24.7-39.3 million. This paper suggests that it was of the order of 50 million. However, it must be acknowledged that even this vast figure may be substantially lower than the real toll, perhaps as much as 100 percent understated.
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              Ecological and immunological determinants of influenza evolution.

              In pandemic and epidemic forms, influenza causes substantial, sometimes catastrophic, morbidity and mortality. Intense selection from the host immune system drives antigenic change in influenza A and B, resulting in continuous replacement of circulating strains with new variants able to re-infect hosts immune to earlier types. This 'antigenic drift' often requires a new vaccine to be formulated before each annual epidemic. However, given the high transmissibility and mutation rate of influenza, the constancy of genetic diversity within lineages over time is paradoxical. Another enigma is the replacement of existing strains during a global pandemic caused by 'antigenic shift'--the introduction of a new avian influenza A subtype into the human population. Here we explore ecological and immunological factors underlying these patterns using a mathematical model capturing both realistic epidemiological dynamics and viral evolution at the sequence level. By matching model output to phylogenetic patterns seen in sequence data collected through global surveillance, we find that short-lived strain-transcending immunity is essential to restrict viral diversity in the host population and thus to explain key aspects of drift and shift dynamics.
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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS Pathog
                plos
                plpa
                plospath
                PLoS Pathogens
                Public Library of Science (San Francisco, USA )
                1553-7366
                1553-7374
                February 2008
                February 2008
                29 February 2008
                : 4
                : 2
                : e1000012
                Affiliations
                [1 ]Department of Biology, Center for Infectious Disease Dynamics, The Pennsylvania State University, University Park, Pennsylvania, United States of America
                [2 ]Fogarty International Center, National Institutes of Health, Bethesda, Maryland, United States of America
                [3 ]Department of Global Health, School of Public Health and Health Services, The George Washington University, Washington, D.C., United States of America
                [4 ]Wadsworth Center, New York State Department of Health, Albany, New York, United States of America
                [5 ]The J. Craig Venter Institute, Rockville, Maryland, United States of America
                [6 ]Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, Maryland, United States of America
                [7 ]Division of Infectious Diseases, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
                [8 ]Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America
                University of Wisconsin-Madison, United States of America
                Author notes

                Conceived and designed the experiments: MN EH. Performed the experiments: RB SG KS JT DS NS EG. Analyzed the data: MN. Wrote the paper: MN CV LS RB SG KS JT DS NS EG JKT EH. Performed the sequence analysis: MN. Advised on epidemiological aspects of the study: CV LS. Collected a subset of the viral samples: RB SG KS JT. Undertook the viral genome sequencing: DS NS EG. Advised on virological aspects of the study: JKT.

                Article
                07-PLPA-RA-0663R2
                10.1371/journal.ppat.1000012
                2262849
                18463694
                f6dc0220-13df-40a5-a566-9ed17d1a27d4
                This is an open-access article distributed under the terms of the Creative Commons Public Domain declaration which stipulates that, once placed in the public domain, this work may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose.
                History
                : 20 September 2007
                : 17 January 2008
                Page count
                Pages: 12
                Categories
                Research Article
                Evolutionary Biology/Microbial Evolution and Genomics
                Infectious Diseases/Epidemiology and Control of Infectious Diseases
                Virology/Virus Evolution and Symbiosis

                Infectious disease & Microbiology
                Infectious disease & Microbiology

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