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Six people have died in a group
influenza infection at a hospital in Akita Prefecture, while more than
30 others, including inpatients and staff members at the medical
facility, are being treated for infection, the prefectural government
Four men in their 60s to 90s and two women in their 70s and 80s, who tested positive in simple flu tests, died between Oct. 31 and Friday at the hospital in Kitaakita in northwestern Japan, the local government said.
The above comments describe fatal H3N2 infections in elderly patients in a hospital in Akita, Japan. One of the patients tested positive for the “Hong Kong influenza A” strain, which is in reference to H3N2 which was called the “Hong Kong flu” at the beginning of the 1968 pandemic.
H3N2 has been a component of seasonal flu since 1968, but last season levels were low in most countries because of pandemic H1N1. However, it began to emerge in larger numbers in China at the end of last season, and the CDC issued a warning in August because of two H3N2 outbreaks in eastern Iowa.
The H3N2 in circulation is the Perth/16/2009 strain, which is the H3N2 target of the current vaccine. However, Perth/16 was isolated in early 2009 and the strain has evolved considerably in the past year. Recently released H3N2 sequences increased the number of low reactors in an emerging sub-clade, which was also reported in Japan. The low reactor status means that the virus reduces the titer four- fold or more when tested against ferret reference sera generated with Perth/16. This reduction in titer signals vaccine failure, as well as failure by antibodies generated against earlier versions of H3N2.
Consequently, a sharp uptick in deaths in those over 65 is expected.
The number of H3N2 deaths should increase significantly in the elderly population as H3N2 infections rise.