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\"\"<\/a><\/p>\n

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\"\"<\/a><\/p>\n

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\"\"<\/a><\/p>\n

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\u30b5\u30f3\u30ac\u30fc\u6cd5\u306b\u3088\u308b\u30c0\u30a4\u30ec\u30af\u30c8\u30b7\u30fc\u30b1\u30f3\u30b9\u306b\u3088\u308b\u89e3\u6790\u3067\u306f\u3001\u521d\u8a3a\u6642\u306b\u63a1\u53d6\u3055\u308c\u305f197\u691c\u4f53\u3068\u30d0\u30ed\u30ad\u30b5\u30d3\u30eb\u6cbb\u7642\u3092\u53d7\u3051\u305f\u60a3\u8005\u3067\u518d\u8a3a\u6642\u306b\u63a1\u53d6\u3055\u308c\u305f34\u691c\u4f53\u306e\u30a4\u30f3\u30d5\u30eb\u30a8\u30f3\u30b6\u30a6\u30a4\u30eb\u30b9\u306b\u5bfe\u3057\u3001\u30d0\u30ed\u30ad\u30b5\u30d3\u30eb\u306e\u611f\u53d7\u6027\u4f4e\u4e0b\u306b\u95a2\u4e0e\u3059\u308bPA\u907a\u4f1d\u5b50\u306e\u5909\u7570\u306b\u3064\u3044\u3066\u89e3\u6790\u3057\u307e\u3057\u305f\uff08\u88683\uff09\u3002\u521d\u8a3a\u6642\u691c\u4f53197\u691c\u4f53\u304b\u3089\u306f\u3001A(H1N1)pdm09\u3001A(H3N2)\u3001B\u578b\u30a4\u30f3\u30d5\u30eb\u30a8\u30f3\u30b6\u30a6\u30a4\u30eb\u30b9\u3044\u305a\u308c\u306b\u304a\u3044\u3066\u3082\u3001PA\u907a\u4f1d\u5b50\u306e\u85ac\u5264\u8010\u6027\u5909\u7570\u306f\u691c\u51fa\u3055\u308c\u307e\u305b\u3093\u3067\u3057\u305f\u3002\u4e00\u65b9\u3001\u30d0\u30ed\u30ad\u30b5\u30d3\u30eb\u6cbb\u7642\u3092\u3046\u3051\u305fA(H1N1)pdm09\u967d\u6027\u60a3\u800517\u4f8b\u306e\u3046\u30611\u4f8b\u306bPA\/E23K\u306e\u85ac\u5264\u8010\u6027\u5909\u7570\u304c\u78ba\u8a8d\u3055\u308c\u3001\u983b\u5ea6\u306f5.9%\uff081\/17\uff09\u3067\u3057\u305f\u3002\u307e\u305f\u3001A(H3N2)\u967d\u6027\u60a3\u800513\u4f8b\u306e\u3046\u3061\u6295\u85ac\u5f8c\u306e\u691c\u4f53\uff11\u4ef6\u306bPA\/I38T\u306e\u85ac\u5264\u8010\u6027\u5909\u7570\u304c\u78ba\u8a8d\u3055\u308c\u3001\u983b\u5ea6\u306f7.7\uff05\uff081\/13\uff09\u3067\u3057\u305f\u3002\u540c\u3058\u304fB\u578b\u967d\u6027\u60a3\u80054\u4f8b\u306e\u3046\u3061\u6295\u85ac\u5f8c\u306e\u691c\u4f53\uff11\u4ef6\u306bPA\/I38T\u306e\u85ac\u5264\u8010\u6027\u5909\u7570\u304c\u78ba\u8a8d\u3055\u308c\u3001\u983b\u5ea6\u306f25.0\uff05\uff081\/4\uff09\u3067\u3057\u305f\u3002\u307e\u305f\u3001\u30d0\u30ed\u30ad\u30b5\u30d3\u30eb\u6295\u85ac\u5f8c\u306e\u691c\u4f53\u3067\u30b5\u30f3\u30ac\u30fc\u6cd5\u306b\u3088\u308a\u89e3\u6790\u3067\u304d\u305f\u30a4\u30f3\u30d5\u30eb\u30a8\u30f3\u30b6A(H1N1)pdm09\u30a6\u30a4\u30eb\u30b96\u4ef6\u3001A(H3N2)\u30a6\u30a4\u30eb\u30b9\uff14\u4ef6\u3001B\u578b\u30a6\u30a4\u30eb\u30b9\uff13\u4ef6\u3092\u5206\u6bcd\u306b\u3059\u308b\u3068\u3001\u305d\u308c\u305e\u308c\u983b\u5ea6\u306f16.7%\uff081\/6\uff09\u300125.0\uff05\uff081\/4\uff09\u300133.3\uff05\uff081\/3\uff09\u3067\u3057\u305f\u3002\u306a\u304a\u3001A(H1N1)pdm09\u967d\u6027\u60a3\u8005\u306e1\u4f8b\u3067\u30b5\u30f3\u30ac\u30fc\u6cd5\u306b\u3088\u308a\u78ba\u8a8d\u3055\u308c\u305fPA\/E23K\u306e\u5909\u7570\u306f\u3001NGS\u306b\u3088\u308b\u89e3\u6790\u3067\u78ba\u8a8d\u3067\u304d\u3066\u3044\u306a\u3044\u3053\u3068\u304b\u3089\u3001\u518d\u5ea6\u89e3\u6790\u3092\u884c\u3063\u3066\u3044\u307e\u3059\u3002<\/p>\n

\"\"<\/a><\/p>\n

\u30aa\u30bb\u30eb\u30bf\u30df\u30d3\u30eb\u306e\u611f\u53d7\u6027\u306b\u5f71\u97ff\u3092\u4e0e\u3048\u308bNA\u907a\u4f1d\u5b50\u306e\u5909\u7570\u306b\u3064\u3044\u3066\u3001NGS\u89e3\u6790\u3092\u5b9f\u65bd\u3057\u307e\u3057\u305f\u3002\u6cbb\u7642\u524d\u306b\u63a1\u53d6\u3055\u308c\u305f181\u691c\u4f53\u3059\u3079\u3066\u3067\u3001NA\u907a\u4f1d\u5b50\u306b\u30aa\u30bb\u30eb\u30bf\u30df\u30d3\u30eb\u306b\u5bfe\u3059\u308b\u85ac\u5264\u8010\u6027\u5909\u7570\u306f\u691c\u51fa\u3055\u308c\u307e\u305b\u3093\u3067\u3057\u305f\uff08\u88684\uff09\u3002\u307e\u305f\u3001\u30aa\u30bb\u30eb\u30bf\u30df\u30d3\u30eb\u6cbb\u7642\u5f8c\u306b\u63a1\u53d6\u3055\u308c\u305f\u691c\u4f53\u306f\u3001\u30a4\u30f3\u30d5\u30eb\u30a8\u30f3\u30b6A(H1N1)pdm09\u967d\u6027\u60a3\u8005\u304c4\u691c\u4f53\u3001A(H3N2)\u967d\u6027\u60a3\u8005\u304c5\u691c\u4f53\u3067\u3057\u305f\u3002\u3053\u308c\u3089\u5168\u3066\u306e\u518d\u8a3a\u6642\u691c\u4f53\u306b\u3064\u3044\u3066\u3082\u3001\u30aa\u30bb\u30eb\u30bf\u30df\u30d3\u30eb\u8010\u6027\u5909\u7570\u306f\u78ba\u8a8d\u3055\u308c\u307e\u305b\u3093\u3067\u3057\u305f\uff08\u88683\uff09\u3002<\/p>\n

\"\"<\/a><\/p>\n

 <\/p>\n

 <\/p>\n

 <\/p>\n

Overview of Circulating Influenza Viruses and Antiviral Reduced-Susceptibility Strains in Japan during the 2023-2024 Season (as of December 25, 2024)<\/strong><\/p>\n

Between October 2023 and September 2024, we conducted a study across Japan to monitor influenza activity and assess the occurrence of antiviral reduced-susceptibility influenza strains against baloxavir and oseltamivir.<\/p>\n

Eight outpatient medical facilities nationwide participated in the study. Upper respiratory tract swabs were collected from patients diagnosed with influenza-like illness (ILI) who tested positive using rapid diagnostic test kits (RDT). All clinical specimens were sent to Niigata University, where RT-PCR was used to detect the type and subtype of influenza viruses. Of the 209 collected specimens, 80 (38.3%) were A(H1N1)pdm09, 68 (32.5%) were A(H3N2), 10 (4.8%) were unsubtyped influenza A, 33 (15.8%) were B\/Victoria, 1 (0.5%) showed coinfection with A and B viruses, and 17 (8.1%) were negative by RT-PCR (Table 1).<\/p>\n

Influenza Epidemic Curve<\/strong><\/p>\n

The number of influenza virus-positive patients was aggregated weekly based on sample collection dates to construct an epidemic curve (Figure 1). Influenza viruses were detected from October 2023 (week 40) at the beginning of the study, with a peak in mid-November (week 46). Thereafter, case numbers gradually decreased, and in Honshu, influenza circulation persisted until approximately April 2024 (week 15). Before the COVID-19 pandemic, the seasonal peak typically occurred between January and February; however, in 2023, the season started earlier. Meanwhile, in Okinawa, influenza cases continued beyond April 2024, with sporadic cases observed monthly until the study concluded in late September.<\/p>\n

Influenza Subtypes and Circulation Patterns<\/strong><\/p>\n

From the early stages of the season, both A(H1N1)pdm09 and A(H3N2) were co-circulating. B\/Victoria was detected in small numbers in December, peaked in late January 2024, and became the dominant strain until mid-April (Figure 1). From May 2024 onward, influenza viruses were mainly detected in Okinawa, and the predominant virus shifted to A(H1N1)pdm09.<\/p>\n

Investigation of Genetic Markers with Reduced Susceptibility to Antivirals.<\/strong><\/p>\n

We investigated genetic markers with reduced susceptibility to baloxavir and oseltamivir. Substitutions in the PA and NA genes associated with reduced susceptibility to these antivirals were examined using RT-PCR, next-generation sequencing (NGS), and Sanger sequencing.<\/p>\n

Pre-Treatment Samples<\/strong><\/p>\n

From pre-treatment samples, 80 A(H1N1)pdm09, 68 A(H3N2), and 33 B\/Victoria (all initial consultation samples) were analyzed. No substitutions associated with reduced susceptibility to baloxavir were detected by RT-PCR or NGS (Table 2).<\/p>\n

Post-Baloxavir Treatment Samples<\/strong><\/p>\n

Initial samples were collected at the first visit, and post-treatment samples were collected 3\u20137 days later for patients who returned for follow-up after baloxavir treatment. Among 14 A(H3N2) patient samples, one exhibited the PA\/I38T substitution, with a prevalence of 7.1% (1\/14) (Table 2). When restricted to nine RT-PCR-positive post-treatment samples, the prevalence increased to 11.1% (1\/9). NGS confirmed the PA\/I38T substitution in the A(H3N2) sample, estimating that mutant viruses constituted 87.9% of the viral population in the sample.<\/p>\n

One of the B\/Victoria-positive post-treatment samples from four patients exhibited the PA\/I38T substitution via NGS (25.0%, 1\/4), with mutant viruses accounting for 61.1% of the viral population. Due to the low viral load, RT-PCR could not detect PA\/I38T substitution. This was the first detection of the I38T substitution in B\/Victoria in this study.<\/p>\n

Sanger Sequencing Analysis<\/strong><\/p>\n

Among 197 analyzable initial consultation samples, no substitutions associated with baloxavir resistance in the PA gene were detected for A(H1N1)pdm09, A(H3N2), or B viruses (Table 3). However, one post-treatment sample from 17 A(H1N1)pdm09-positive patients exhibited PA\/E23K substitutions, with a prevalence of 5.9% (1\/17), and one post-treatment sample from 13 A(H3N2)-positive patients exhibited PA\/I38T substitutions, with a prevalence of 7.7% (1\/13). Similarly, one post-treatment sample from four B-positive patients exhibited PA\/I38T substitutions, with a prevalence of 25.0% (1\/4). When restricted to Sanger-analyzable post-treatment samples, frequencies were 16.7%(1\/6) for (H1N1)pdm09, 25.0% (1\/4) for A(H3N2) and 33.3% (1\/3) for B viruses.<\/p>\n

In addition, the PA\/E23K substitution identified in one A(H1N1)pdm09-positive patient could not be confirmed by NGS analysis, so we are conducting further analysis.<\/p>\n

 <\/p>\n

Oseltamivir Resistance<\/strong><\/p>\n

NGS analysis of the NA gene was performed to assess oseltamivir resistance. No oseltamivir-resistant NA gene substitutions were detected in all 181 pre-treatment samples (Table 4). Post-treatment samples included four from A(H1N1)pdm09-positive patients and five from A(H3N2)-positive patients. No resistance substitutions were detected in these samples (Table 3).<\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

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