[The 2002/2003 influenza season in the Netherlands and the vaccine composition for the 2003/2004 season]

Abstract

As in the 2000/2001 and 2001/2002 seasons, the influenza epidemic in the 2002/2003 season started late (week 7 of 2003) and was only moderate in size. Influenza A (H3N2) and B viruses were detected in equal numbers among patients of general practitioners and these two viruses were therefore equally responsible for the epidemic. However, H3N2 viruses dominated isolates taken from hospitals. In haemagglutination-inhibition (HI) assays most of the H3N2 viruses proved highly reactive with antiserum to the vaccine-reference strain A/Moscow/10/99. This was also true for a number of isolates, including those obtained from nursing home residents, closely related to the reference strain A/Finland/170/03. However, an estimated 4% of the H3N2 isolates belonged to the variant A/Fujian/411/02 from China, which constituted the majority of the H3N2 viruses isolated in Europe in the later phase of the season. This variant reacted poorly with antiserum to A/Moscow/10/99. In H1 tests all influenza A(H1N1)-virus isolates and all B-virus isolates were closelyrelated to the corresponding vaccine-reference strains. Taking this data into consideration, the World Health Organization has advised the same vaccine composition for the 2003/2004 season as for the 2002/2003 season, namely: A/Moscow/10/99 (H3N2), A/New Caledonia/20/99 (H1N1) and B/Hong Kong/330/01. There is the possibility of a mismatch occurring between the H3N2-vaccine strain and the circulating H3N2 viruses in the coming influenza season. In March and April 2003 there was an outbreak of influenza-A (H7N7) fowl plague in the Netherlands. A special monitoring survey revealed that 91 people who had handled infected poultry became infected with the H7N7 virus. One of these later died as a result of this. None of the avian and human H7N7-virus isolates examined contained human or porcine influenza-A virus genes.