Serial Vaccination and the Antigenic Distance Hypothesis: Effects on Influenza Vaccine Effectiveness During A(H3N2) Epidemics in Canada, 2010-2011 to 2014-2015.
Identifieur interne : 000113 ( Main/Corpus ); précédent : 000112; suivant : 000114Serial Vaccination and the Antigenic Distance Hypothesis: Effects on Influenza Vaccine Effectiveness During A(H3N2) Epidemics in Canada, 2010-2011 to 2014-2015.
Auteurs : Danuta M. Skowronski ; Catharine Chambers ; Gaston De Serres ; Suzana Sabaiduc ; Anne-Luise Winter ; James A. Dickinson ; Jonathan B. Gubbay ; Kevin Fonseca ; Steven J. Drews ; Hugues Charest ; Christine Martineau ; Mel Krajden ; Martin Petric ; Nathalie Bastien ; Yan Li ; Derek J. SmithSource :
- The Journal of infectious diseases [ 1537-6613 ] ; 2017.
English descriptors
- KwdEn :
- Adolescent (MeSH), Adult (MeSH), Aged (MeSH), Canada (epidemiology), Case-Control Studies (MeSH), Child (MeSH), Epidemics (prevention & control), Female (MeSH), Hemagglutination Inhibition Tests (MeSH), Humans (MeSH), Influenza A Virus, H3N2 Subtype (MeSH), Influenza Vaccines (immunology), Influenza Vaccines (therapeutic use), Influenza, Human (epidemiology), Influenza, Human (prevention & control), Logistic Models (MeSH), Male (MeSH), Middle Aged (MeSH), Seasons (MeSH), Sentinel Surveillance (MeSH), Vaccination (statistics & numerical data), Young Adult (MeSH).
- MESH :
- chemical , immunology : Influenza Vaccines.
- epidemiology : Canada, Influenza, Human.
- prevention & control : Epidemics, Influenza, Human.
- statistics & numerical data : Vaccination.
- chemical , therapeutic use : Influenza Vaccines.
- Adolescent, Adult, Aged, Case-Control Studies, Child, Female, Hemagglutination Inhibition Tests, Humans, Influenza A Virus, H3N2 Subtype, Logistic Models, Male, Middle Aged, Seasons, Sentinel Surveillance, Young Adult.
Abstract
Background
The antigenic distance hypothesis (ADH) predicts that negative interference from prior season's influenza vaccine (v1) on the current season's vaccine (v2) protection may occur when the antigenic distance is small between v1 and v2 (v1 ≈ v2) but large between v1 and the current epidemic (e) strain (v1 ≠ e).
Methods
Vaccine effectiveness (VE) against medically attended, laboratory-confirmed influenza A(H3N2) illness was estimated by test-negative design during 3 A(H3N2) epidemics (2010-2011, 2012-2013, 2014-2015) in Canada. Vaccine effectiveness was derived with covariate adjustment across v2 and/or v1 categories relative to no vaccine receipt among outpatients aged ≥9 years. Prior vaccination effects were interpreted within the ADH framework.
Results
Prior vaccination effects varied significantly by season, consistent with the ADH. There was no interference by v1 in 2010-2011 when v1 ≠ v2 and v1 ≠ e, with comparable VE for v2 alone or v2 + v1: 34% (95% confidence interval [CI] = -51% to 71%) versus 34% (95% CI = -5% to 58%). Negative interference by v1 was suggested in 2012-2013 with nonsignificant reduction in VE when v1 ≈ v2 and v1 ≠ e: 49% (95% CI = -47% to 83%) versus 28% (95% CI = -12% to 54%). Negative effects of prior vaccination were pronounced and statistically significant in 2014-2015 when v1 ≡ v2 and v1 ≠ e: 65% (95% CI = 25% to 83%) versus -33% (95% CI = -78% to 1%).
Conclusions
Effects of repeat influenza vaccination were consistent with the ADH and may have contributed to findings of low VE across recent A(H3N2) epidemics since 2010 in Canada.
DOI: 10.1093/infdis/jix074
PubMed: 28180277
PubMed Central: PMC5853783
Links to Exploration step
pubmed:28180277Le document en format XML
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Skowronski</name><affiliation><nlm:affiliation>Communicable Disease Prevention and Control Services, British Columbia Centre for Disease Control, Vancouver.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>School of Population and Public Health, University of British Columbia, Vancouver.</nlm:affiliation></affiliation></author><author><name sortKey="Chambers, Catharine" sort="Chambers, Catharine" uniqKey="Chambers C" first="Catharine" last="Chambers">Catharine Chambers</name><affiliation><nlm:affiliation>Communicable Disease Prevention and Control Services, British Columbia Centre for Disease Control, Vancouver.</nlm:affiliation></affiliation></author><author><name sortKey="De Serres, Gaston" sort="De Serres, Gaston" uniqKey="De Serres G" first="Gaston" last="De Serres">Gaston De Serres</name><affiliation><nlm:affiliation>Direction of Biological and Occupational Risks, Institut national de santé publique du Québec.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Department of Social and Preventive Medicine, Laval University, Québec.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Infection and Immunity, Centre Hospitalier Universitaire de Québec Research Centre.</nlm:affiliation></affiliation></author><author><name sortKey="Sabaiduc, Suzana" sort="Sabaiduc, Suzana" uniqKey="Sabaiduc S" first="Suzana" last="Sabaiduc">Suzana Sabaiduc</name><affiliation><nlm:affiliation>British Columbia Centre for Disease Control Public Health Laboratory, Vancouver.</nlm:affiliation></affiliation></author><author><name sortKey="Winter, Anne Luise" sort="Winter, Anne Luise" uniqKey="Winter A" first="Anne-Luise" last="Winter">Anne-Luise Winter</name><affiliation><nlm:affiliation>Communicable Diseases, Emergency Preparedness and Response, Public Health Ontario, Toronto.</nlm:affiliation></affiliation></author><author><name sortKey="Dickinson, James A" sort="Dickinson, James A" uniqKey="Dickinson J" first="James A" last="Dickinson">James A. 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Gubbay</name><affiliation><nlm:affiliation>Public Health Ontario Laboratory, Public Health Ontario, Toronto.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Departments of Laboratory Medicine and Pathobiology and Paediatrics, University of Toronto.</nlm:affiliation></affiliation></author><author><name sortKey="Fonseca, Kevin" sort="Fonseca, Kevin" uniqKey="Fonseca K" first="Kevin" last="Fonseca">Kevin Fonseca</name><affiliation><nlm:affiliation>Diagnostic Virology, Alberta Provincial Laboratory, Calgary.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Department of Microbiology, Immunology and Infectious Diseases, University of Calgary.</nlm:affiliation></affiliation></author><author><name sortKey="Drews, Steven J" sort="Drews, Steven J" uniqKey="Drews S" first="Steven J" last="Drews">Steven J. Drews</name><affiliation><nlm:affiliation>Diagnostic Virology, Alberta Provincial Laboratory, Edmonton.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton.</nlm:affiliation></affiliation></author><author><name sortKey="Charest, Hugues" sort="Charest, Hugues" uniqKey="Charest H" first="Hugues" last="Charest">Hugues Charest</name><affiliation><nlm:affiliation>Laboratoire de santé publique du Québec, Institut national de santé publique du Québec.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Département de microbiologie, d'infectiologie et d'immunologie, l'Université de Montréal.</nlm:affiliation></affiliation></author><author><name sortKey="Martineau, Christine" sort="Martineau, Christine" uniqKey="Martineau C" first="Christine" last="Martineau">Christine Martineau</name><affiliation><nlm:affiliation>Laboratoire de santé publique du Québec, Institut national de santé publique du Québec.</nlm:affiliation></affiliation></author><author><name sortKey="Krajden, Mel" sort="Krajden, Mel" uniqKey="Krajden M" first="Mel" last="Krajden">Mel Krajden</name><affiliation><nlm:affiliation>British Columbia Centre for Disease Control Public Health Laboratory, Vancouver.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver.</nlm:affiliation></affiliation></author><author><name sortKey="Petric, Martin" sort="Petric, Martin" uniqKey="Petric M" first="Martin" last="Petric">Martin Petric</name><affiliation><nlm:affiliation>Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver.</nlm:affiliation></affiliation></author><author><name sortKey="Bastien, Nathalie" sort="Bastien, Nathalie" uniqKey="Bastien N" first="Nathalie" last="Bastien">Nathalie Bastien</name><affiliation><nlm:affiliation>Infectious Disease Prevention and Control Branch, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Canada; and.</nlm:affiliation></affiliation></author><author><name sortKey="Li, Yan" sort="Li, Yan" uniqKey="Li Y" first="Yan" last="Li">Yan Li</name><affiliation><nlm:affiliation>Infectious Disease Prevention and Control Branch, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Canada; and.</nlm:affiliation></affiliation></author><author><name sortKey="Smith, Derek J" sort="Smith, Derek J" uniqKey="Smith D" first="Derek J" last="Smith">Derek J. Smith</name><affiliation><nlm:affiliation>Department of Zoology, University of Cambridge, England.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2017">2017</date><idno type="RBID">pubmed:28180277</idno><idno type="pmid">28180277</idno><idno type="doi">10.1093/infdis/jix074</idno><idno type="pmc">PMC5853783</idno><idno type="wicri:Area/Main/Corpus">000113</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000113</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Serial Vaccination and the Antigenic Distance Hypothesis: Effects on Influenza Vaccine Effectiveness During A(H3N2) Epidemics in Canada, 2010-2011 to 2014-2015.</title><author><name sortKey="Skowronski, Danuta M" sort="Skowronski, Danuta M" uniqKey="Skowronski D" first="Danuta M" last="Skowronski">Danuta M. Skowronski</name><affiliation><nlm:affiliation>Communicable Disease Prevention and Control Services, British Columbia Centre for Disease Control, Vancouver.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>School of Population and Public Health, University of British Columbia, Vancouver.</nlm:affiliation></affiliation></author><author><name sortKey="Chambers, Catharine" sort="Chambers, Catharine" uniqKey="Chambers C" first="Catharine" last="Chambers">Catharine Chambers</name><affiliation><nlm:affiliation>Communicable Disease Prevention and Control Services, British Columbia Centre for Disease Control, Vancouver.</nlm:affiliation></affiliation></author><author><name sortKey="De Serres, Gaston" sort="De Serres, Gaston" uniqKey="De Serres G" first="Gaston" last="De Serres">Gaston De Serres</name><affiliation><nlm:affiliation>Direction of Biological and Occupational Risks, Institut national de santé publique du Québec.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Department of Social and Preventive Medicine, Laval University, Québec.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Infection and Immunity, Centre Hospitalier Universitaire de Québec Research Centre.</nlm:affiliation></affiliation></author><author><name sortKey="Sabaiduc, Suzana" sort="Sabaiduc, Suzana" uniqKey="Sabaiduc S" first="Suzana" last="Sabaiduc">Suzana Sabaiduc</name><affiliation><nlm:affiliation>British Columbia Centre for Disease Control Public Health Laboratory, Vancouver.</nlm:affiliation></affiliation></author><author><name sortKey="Winter, Anne Luise" sort="Winter, Anne Luise" uniqKey="Winter A" first="Anne-Luise" last="Winter">Anne-Luise Winter</name><affiliation><nlm:affiliation>Communicable Diseases, Emergency Preparedness and Response, Public Health Ontario, Toronto.</nlm:affiliation></affiliation></author><author><name sortKey="Dickinson, James A" sort="Dickinson, James A" uniqKey="Dickinson J" first="James A" last="Dickinson">James A. Dickinson</name><affiliation><nlm:affiliation>Departments of Family Medicine and Community Health Sciences, University of Calgary.</nlm:affiliation></affiliation></author><author><name sortKey="Gubbay, Jonathan B" sort="Gubbay, Jonathan B" uniqKey="Gubbay J" first="Jonathan B" last="Gubbay">Jonathan B. Gubbay</name><affiliation><nlm:affiliation>Public Health Ontario Laboratory, Public Health Ontario, Toronto.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Departments of Laboratory Medicine and Pathobiology and Paediatrics, University of Toronto.</nlm:affiliation></affiliation></author><author><name sortKey="Fonseca, Kevin" sort="Fonseca, Kevin" uniqKey="Fonseca K" first="Kevin" last="Fonseca">Kevin Fonseca</name><affiliation><nlm:affiliation>Diagnostic Virology, Alberta Provincial Laboratory, Calgary.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Department of Microbiology, Immunology and Infectious Diseases, University of Calgary.</nlm:affiliation></affiliation></author><author><name sortKey="Drews, Steven J" sort="Drews, Steven J" uniqKey="Drews S" first="Steven J" last="Drews">Steven J. Drews</name><affiliation><nlm:affiliation>Diagnostic Virology, Alberta Provincial Laboratory, Edmonton.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton.</nlm:affiliation></affiliation></author><author><name sortKey="Charest, Hugues" sort="Charest, Hugues" uniqKey="Charest H" first="Hugues" last="Charest">Hugues Charest</name><affiliation><nlm:affiliation>Laboratoire de santé publique du Québec, Institut national de santé publique du Québec.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Département de microbiologie, d'infectiologie et d'immunologie, l'Université de Montréal.</nlm:affiliation></affiliation></author><author><name sortKey="Martineau, Christine" sort="Martineau, Christine" uniqKey="Martineau C" first="Christine" last="Martineau">Christine Martineau</name><affiliation><nlm:affiliation>Laboratoire de santé publique du Québec, Institut national de santé publique du Québec.</nlm:affiliation></affiliation></author><author><name sortKey="Krajden, Mel" sort="Krajden, Mel" uniqKey="Krajden M" first="Mel" last="Krajden">Mel Krajden</name><affiliation><nlm:affiliation>British Columbia Centre for Disease Control Public Health Laboratory, Vancouver.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver.</nlm:affiliation></affiliation></author><author><name sortKey="Petric, Martin" sort="Petric, Martin" uniqKey="Petric M" first="Martin" last="Petric">Martin Petric</name><affiliation><nlm:affiliation>Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver.</nlm:affiliation></affiliation></author><author><name sortKey="Bastien, Nathalie" sort="Bastien, Nathalie" uniqKey="Bastien N" first="Nathalie" last="Bastien">Nathalie Bastien</name><affiliation><nlm:affiliation>Infectious Disease Prevention and Control Branch, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Canada; and.</nlm:affiliation></affiliation></author><author><name sortKey="Li, Yan" sort="Li, Yan" uniqKey="Li Y" first="Yan" last="Li">Yan Li</name><affiliation><nlm:affiliation>Infectious Disease Prevention and Control Branch, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Canada; and.</nlm:affiliation></affiliation></author><author><name sortKey="Smith, Derek J" sort="Smith, Derek J" uniqKey="Smith D" first="Derek J" last="Smith">Derek J. Smith</name><affiliation><nlm:affiliation>Department of Zoology, University of Cambridge, England.</nlm:affiliation></affiliation></author></analytic><series><title level="j">The Journal of infectious diseases</title><idno type="eISSN">1537-6613</idno><imprint><date when="2017" type="published">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adolescent (MeSH)</term><term>Adult (MeSH)</term><term>Aged (MeSH)</term><term>Canada (epidemiology)</term><term>Case-Control Studies (MeSH)</term><term>Child (MeSH)</term><term>Epidemics (prevention & control)</term><term>Female (MeSH)</term><term>Hemagglutination Inhibition Tests (MeSH)</term><term>Humans (MeSH)</term><term>Influenza A Virus, H3N2 Subtype (MeSH)</term><term>Influenza Vaccines (immunology)</term><term>Influenza Vaccines (therapeutic use)</term><term>Influenza, Human (epidemiology)</term><term>Influenza, Human (prevention & control)</term><term>Logistic Models (MeSH)</term><term>Male (MeSH)</term><term>Middle Aged (MeSH)</term><term>Seasons (MeSH)</term><term>Sentinel Surveillance (MeSH)</term><term>Vaccination (statistics & numerical data)</term><term>Young Adult (MeSH)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="immunology" xml:lang="en"><term>Influenza Vaccines</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Canada</term><term>Influenza, Human</term></keywords><keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>Epidemics</term><term>Influenza, Human</term></keywords><keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Vaccination</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Influenza Vaccines</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adolescent</term><term>Adult</term><term>Aged</term><term>Case-Control Studies</term><term>Child</term><term>Female</term><term>Hemagglutination Inhibition Tests</term><term>Humans</term><term>Influenza A Virus, H3N2 Subtype</term><term>Logistic Models</term><term>Male</term><term>Middle Aged</term><term>Seasons</term><term>Sentinel Surveillance</term><term>Young Adult</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>Background</b></p><p>The antigenic distance hypothesis (ADH) predicts that negative interference from prior season's influenza vaccine (v1) on the current season's vaccine (v2) protection may occur when the antigenic distance is small between v1 and v2 (v1 ≈ v2) but large between v1 and the current epidemic (e) strain (v1 ≠ e).</p></div><div type="abstract" xml:lang="en"><p><b>Methods</b></p><p>Vaccine effectiveness (VE) against medically attended, laboratory-confirmed influenza A(H3N2) illness was estimated by test-negative design during 3 A(H3N2) epidemics (2010-2011, 2012-2013, 2014-2015) in Canada. Vaccine effectiveness was derived with covariate adjustment across v2 and/or v1 categories relative to no vaccine receipt among outpatients aged ≥9 years. Prior vaccination effects were interpreted within the ADH framework.</p></div><div type="abstract" xml:lang="en"><p><b>Results</b></p><p>Prior vaccination effects varied significantly by season, consistent with the ADH. There was no interference by v1 in 2010-2011 when v1 ≠ v2 and v1 ≠ e, with comparable VE for v2 alone or v2 + v1: 34% (95% confidence interval [CI] = -51% to 71%) versus 34% (95% CI = -5% to 58%). Negative interference by v1 was suggested in 2012-2013 with nonsignificant reduction in VE when v1 ≈ v2 and v1 ≠ e: 49% (95% CI = -47% to 83%) versus 28% (95% CI = -12% to 54%). Negative effects of prior vaccination were pronounced and statistically significant in 2014-2015 when v1 ≡ v2 and v1 ≠ e: 65% (95% CI = 25% to 83%) versus -33% (95% CI = -78% to 1%).</p></div><div type="abstract" xml:lang="en"><p><b>Conclusions</b></p><p>Effects of repeat influenza vaccination were consistent with the ADH and may have contributed to findings of low VE across recent A(H3N2) epidemics since 2010 in Canada.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">28180277</PMID><DateCompleted><Year>2017</Year><Month>06</Month><Day>12</Day></DateCompleted><DateRevised><Year>2018</Year><Month>12</Month><Day>10</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Electronic">1537-6613</ISSN><JournalIssue CitedMedium="Internet"><Volume>215</Volume><Issue>7</Issue><PubDate><Year>2017</Year><Month>04</Month><Day>01</Day></PubDate></JournalIssue><Title>The Journal of infectious diseases</Title><ISOAbbreviation>J. Infect. Dis.</ISOAbbreviation></Journal><ArticleTitle>Serial Vaccination and the Antigenic Distance Hypothesis: Effects on Influenza Vaccine Effectiveness During A(H3N2) Epidemics in Canada, 2010-2011 to 2014-2015.</ArticleTitle><Pagination><MedlinePgn>1059-1099</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1093/infdis/jix074</ELocationID><Abstract><AbstractText Label="Background">The antigenic distance hypothesis (ADH) predicts that negative interference from prior season's influenza vaccine (v1) on the current season's vaccine (v2) protection may occur when the antigenic distance is small between v1 and v2 (v1 ≈ v2) but large between v1 and the current epidemic (e) strain (v1 ≠ e).</AbstractText><AbstractText Label="Methods">Vaccine effectiveness (VE) against medically attended, laboratory-confirmed influenza A(H3N2) illness was estimated by test-negative design during 3 A(H3N2) epidemics (2010-2011, 2012-2013, 2014-2015) in Canada. Vaccine effectiveness was derived with covariate adjustment across v2 and/or v1 categories relative to no vaccine receipt among outpatients aged ≥9 years. Prior vaccination effects were interpreted within the ADH framework.</AbstractText><AbstractText Label="Results">Prior vaccination effects varied significantly by season, consistent with the ADH. There was no interference by v1 in 2010-2011 when v1 ≠ v2 and v1 ≠ e, with comparable VE for v2 alone or v2 + v1: 34% (95% confidence interval [CI] = -51% to 71%) versus 34% (95% CI = -5% to 58%). Negative interference by v1 was suggested in 2012-2013 with nonsignificant reduction in VE when v1 ≈ v2 and v1 ≠ e: 49% (95% CI = -47% to 83%) versus 28% (95% CI = -12% to 54%). Negative effects of prior vaccination were pronounced and statistically significant in 2014-2015 when v1 ≡ v2 and v1 ≠ e: 65% (95% CI = 25% to 83%) versus -33% (95% CI = -78% to 1%).</AbstractText><AbstractText Label="Conclusions">Effects of repeat influenza vaccination were consistent with the ADH and may have contributed to findings of low VE across recent A(H3N2) epidemics since 2010 in Canada.</AbstractText><CopyrightInformation>© The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Skowronski</LastName><ForeName>Danuta M</ForeName><Initials>DM</Initials><AffiliationInfo><Affiliation>Communicable Disease Prevention and Control Services, British Columbia Centre for Disease Control, Vancouver.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>School of Population and Public Health, University of British Columbia, Vancouver.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Chambers</LastName><ForeName>Catharine</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Communicable Disease Prevention and Control Services, British Columbia Centre for Disease Control, Vancouver.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>De Serres</LastName><ForeName>Gaston</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Direction of Biological and Occupational Risks, Institut national de santé publique du Québec.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Social and Preventive Medicine, Laval University, Québec.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Infection and Immunity, Centre Hospitalier Universitaire de Québec Research Centre.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Sabaiduc</LastName><ForeName>Suzana</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>British Columbia Centre for Disease Control Public Health Laboratory, Vancouver.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Winter</LastName><ForeName>Anne-Luise</ForeName><Initials>AL</Initials><AffiliationInfo><Affiliation>Communicable Diseases, Emergency Preparedness and Response, Public Health Ontario, Toronto.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Dickinson</LastName><ForeName>James A</ForeName><Initials>JA</Initials><AffiliationInfo><Affiliation>Departments of Family Medicine and Community Health Sciences, University of Calgary.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Gubbay</LastName><ForeName>Jonathan B</ForeName><Initials>JB</Initials><AffiliationInfo><Affiliation>Public Health Ontario Laboratory, Public Health Ontario, Toronto.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Departments of Laboratory Medicine and Pathobiology and Paediatrics, University of Toronto.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Fonseca</LastName><ForeName>Kevin</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>Diagnostic Virology, Alberta Provincial Laboratory, Calgary.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Microbiology, Immunology and Infectious Diseases, University of Calgary.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Drews</LastName><ForeName>Steven J</ForeName><Initials>SJ</Initials><AffiliationInfo><Affiliation>Diagnostic Virology, Alberta Provincial Laboratory, Edmonton.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Charest</LastName><ForeName>Hugues</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>Laboratoire de santé publique du Québec, Institut national de santé publique du Québec.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Département de microbiologie, d'infectiologie et d'immunologie, l'Université de Montréal.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Martineau</LastName><ForeName>Christine</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Laboratoire de santé publique du Québec, Institut national de santé publique du Québec.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Krajden</LastName><ForeName>Mel</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>British Columbia Centre for Disease Control Public Health Laboratory, Vancouver.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Petric</LastName><ForeName>Martin</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bastien</LastName><ForeName>Nathalie</ForeName><Initials>N</Initials><AffiliationInfo><Affiliation>Infectious Disease Prevention and Control Branch, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Canada; and.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Li</LastName><ForeName>Yan</ForeName><Initials>Y</Initials><AffiliationInfo><Affiliation>Infectious Disease Prevention and Control Branch, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Canada; and.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Smith</LastName><ForeName>Derek J</ForeName><Initials>DJ</Initials><AffiliationInfo><Affiliation>Department of Zoology, University of Cambridge, England.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType><PublicationType UI="D052061">Research Support, N.I.H., Extramural</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>J Infect 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