Mismatching between circulating strains and vaccine strains of influenza: Effect on Hajj pilgrims from both hemispheres

Figures & data

Figure 1. Matching and mismatching between circulating strains and vaccine strains of influenza in northern hemisphere.

Figure 2. Matching and mismatching between circulating strains and vaccine strains of influenza in southern hemisphere.

Table 1. Recommended influenza vaccine strains by WHO for northern and southern hemispheres since 2003.

Influenza season	Southern hemisphere	Northern hemisphere
Southern: 2014; Northern: 2014–2015	A/H1N1-California, A/H3N2-Texas, B-Massachusetts	A/H1N1-California, A/H3N2-Texas, B-Massachusetts
Southern: 2013; Northern: 2013–2014	A/H1N1-California, A/H3N2-Victoria, B-Wisconsin	A/H1N1-California, A/H3N2-Victoria, B-Massachusetts
Southern: 2012; Northern: 2012–2013	A/H1N1-California, A/H3N2-Perth, B-Brisbane	A/H1N1-California, A/H3N2-Victoria, B-Wisconsin
Southern: 2011; Northern: 2011–2012	A/H1N1-California, A/H3N2-Perth, B-Brisbane	A/H1N1-California, A/H3N2-Perth, B-Brisbane
Southern: 2010; Northern: 2010–2011	A/H1N1-California, A/H3N2-Perth, B-Brisbane	A/H1N1-California, A/H3N2-Perth, B-Brisbane
Southern: 2009; Northern: 2009–2010	A/H1N1-Brisbane, A/H3N2-Brisbane, B-Florida	A/H1N1-Brisbane, A/H3N2-Brisbane, B-Brisbane
Southern: 2008; Northern: 2008–2009	A/H1N1- Solomon Islands, A/H3N2-Brisbane, B-Florida	A/H1N1-Brisbane, A/H3N2-Brisbane, B-Florida
Southern: 2007; Northern: 2007–2008	A/H1N1- New Caledonia, A/H3N2-Wisconsin, B-Malaysia	A/H1N1-Solomon Islands, A/H3N2-Wisconsin, B-Malaysia
Southern: 2006; Northern: 2006–2007	A/H1N1-New Caledonia, A/H3N2-California, B-Malaysia	A/H1N1-New Caledonia, A/H3N2-Wisconsin, B-Malaysia
Southern: 2005; Northern: 2005–2006	A/H1N1-New Caledonia, A/H3N2- Wellington, ^aB-Shanghai	A/H1N1-New Caledonia, A/H3N2-California, B-Shanghai
Southern: 2004; Northern: 2004–2005	A/H1N1-New Caledonia, A/H3N2-Fujian, B-Hong Kong	A/H1N1-New Caledonia, A/H3N2-Fujian, B-Shanghai
Southern: 2003; Northern: 2003–2004	A/H1N1-New Caledonia, A/H3N2-Moscow, B-Hong Kong	A/H1N1-New Caledonia, A/H3N2-Moscow, ^bB-Hong Kong

^a The changes observed in only one hemisphere.

^b The widely used vaccine strain is A/Panama/2007/99.

Italic strains are those appeared firstly in the southern vaccine before appearing in the northern vaccine of the following season.

Bold and italic strains are those appeared firstly in the northern vaccine before appearing in the southern vaccine of the following season.

Table 2. The circulating influenza viruses during Hajj since 2003.

Reference	Hajj year	Pilgrims from	Influenza burden	Vaccine uptake
Balkhy H et al. ^33	2003	International	30/500 (6%) had influenza: 3 (10%) A, 27 (90%) B	22/500 (4.4%) vaccinated, 1/22 (4.5%) had influenza A
El Bashir H et al. ^34	2003	UK	44/115 (38%) had influenza: 42 (95%) A/H3N2, 1 (2%) A/H1N1, 1 (2%) B	30/115 (26%) vaccinated, 9/30 (30%) had influenza
AlSaleh E et al. ^16	2004	International	55/415 (13%) had influenza: 15 (27%) A, 40(73%) B; serotypes were: 4 (7%) A/H1N1, 3 (6%) A/H3N2, 8 (15%) A/untyped, 39 (71%) influenza B-Sichuan, 1 (2%) influenza B-Hong Kong	8/415 (2%) vaccinated, none had influenza
Alanzi F et al. ^35	2005	International	47/483 (7.9%) had influenza: 36 (77%) A, 11 (23%) B; serotypes were: 16 (34%) A/H1N1, 6 (13%) A/H3N2, 14 (30%) A/untyped, 8 (17%) influenza B-Sichuan, 3 (6%) influenza B-Hong Kong	142/483 (29.4%) vaccinated, 7/142 (5%) had influenza
Rashid H et al. ^14	2005	UK	28/205 (14%) had influenza: 20 (71%) A/H3, 1(4%) A/H1, 7 (25%) B	56/202 (28%) vaccinated, 8/56 (14%) had influenza
Rashid H et al. ^36	2006 Jan	UK and Saudi Arabia	17/150 (11%) of UK Hajjis had influenza: 13 (76%) A, 4 (24%) B; 11/110 (10%) of Saudi Arabian Hajjis had influenza: 9 (81%) A, 2 (19%) B	56/150 (37%) of UK pilgrims were vaccinated, 4/56 (7%) had influenza; 4/110 (4%) of Saudi pilgrims were vaccinated, none had influenza
Alborzi A et al. ^37	2006 Dec	Iran	25/255 (9.8%) had influenza: 13 (52%) A, 12 (48%) B	218/255 (85%) vaccinated, 20/218 (9%) had influenza
Moattari A et al. ^38	2009	Iran	33/275 (12%) had influenza: 20 (61%) B, 8 (24%) A H3N2, 5 (15%) pandemic H1N1	All (100%) vaccinated, 33/275 (12%) had influenza
AbdulRahman NK et al. ^39	2010	International	57/713 (8%) had influenza: 22 (39%) A/H1N1, 12 (21%) A/H3N2, 15 (26%) influenza B Sichuan, 8 (14%) influenza B/Hong Kong	192/713 (27%) vaccinated,
Barasheed O et al. ^40	2011	Australia	8/80 (10%) had influenza: 5 (62.5%) A, 3 (37.5%) B	Not reported
Benkouiten S et al. ^9	2012	France	Before Hajj 1/165 (0.6%) had influenza, type C; at Hajj 2/70 (2.8%) symptomatic pilgrims had influenza (type C in one, and dual A & C in the other); after Hajj 2/154 (1.3%) had influenza: both type B	76/167 (46%) vaccinated,
Gautret P et al. ^41	2013	France	10/129 (7.8%) had influenza: 8 (80%) A/H3N2,1(10%) A/H1N1,1 (10%) B	None vaccinated, in 2013, (36% were vaccinated, in 2012)
Barasheed O et al. ^42	2013	Saudi Arabia, Australia, Qatar	5/112 (4%) had influenza: 4 (80%) A/H3N2, 1 (20%) A/H1N1	35/112 (31%) vaccinated, 1/35 (3%) had influenza
Annan A et al. ^43	2013	Ghana	7/651 (1%) of symptomatic pilgrims had influenza (type A), 4/188 (2%) of asymptomatic pilgrims had influenza (type A)	Not reported
Aberle JH et al. ^44	2014	Austria	5/7 (71%) had influenza: 2 (40%) A/H3N2 (A/Hong Kong/146/2013-like viruses), 3 (60%) influenza B (B/Phuket/3073/2013-like viruses)	6 unvaccinated, 1 unknown

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