{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T13:55:08Z","timestamp":1774619708847,"version":"3.50.1"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2019,9,30]],"date-time":"2019-09-30T00:00:00Z","timestamp":1569801600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The impact of influenza B virus circulation in Sub-Saharan Africa is not well described.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We analyzed data from acute respiratory illness (ARI) in Kenya. We assessed clinical features and age-specific hospitalization and outpatient visit rates by person-years for influenza B\/Victoria and B\/Yamagata and the extent to which circulating influenza B lineages in Kenya matched the vaccine strain component of the corresponding season (based on Northern Hemisphere [October\u2013March] and Southern Hemisphere [April\u2013September] vaccine availability).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>From 2012 to 2016, influenza B represented 31% of all influenza-associated ARIs detected (annual range, 13\u201361%). Rates of influenza B hospitalization and outpatient visits were higher for &amp;lt;5 vs \u22655 years. Among &amp;lt;5 years, B\/Victoria was associated with pneumonia hospitalization (64% vs 44%; P = .010) and in-hospital mortality (6% vs 0%; P = .042) compared with B\/Yamagata, although the mean annual hospitalization rate for B\/Victoria was comparable to that estimated for B\/Yamagata. The 2 lineages co-circulated, and there were mismatches with available trivalent influenza vaccines in 2\/9 seasons assessed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Influenza B causes substantial burden in Kenya, particularly among children aged &amp;lt;5 years, in whom B\/Victoria may be associated with increased severity. Our findings suggest a benefit from including both lineages when considering influenza vaccination in Kenya.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ofid\/ofz421","type":"journal-article","created":{"date-parts":[[2019,10,1]],"date-time":"2019-10-01T03:23:49Z","timestamp":1569900229000},"source":"Crossref","is-referenced-by-count":14,"title":["The Epidemiology and Burden of Influenza B\/Victoria and B\/Yamagata Lineages in Kenya, 2012\u20132016"],"prefix":"10.1093","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6581-242X","authenticated-orcid":false,"given":"Gideon O","family":"Emukule","sequence":"first","affiliation":[{"name":"Centers for Disease Control and Prevention - Kenya Country Office, Nairobi, Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fredrick","family":"Otiato","sequence":"additional","affiliation":[{"name":"Kenya Medical Research Institute, Kisumu and Nairobi, Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bryan O","family":"Nyawanda","sequence":"additional","affiliation":[{"name":"Kenya Medical Research Institute, Kisumu and Nairobi, Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nancy A","family":"Otieno","sequence":"additional","affiliation":[{"name":"Kenya Medical Research Institute, Kisumu and Nairobi, Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caroline A","family":"Ochieng","sequence":"additional","affiliation":[{"name":"Kenya Medical Research Institute, Kisumu and Nairobi, Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Linus K","family":"Ndegwa","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention - Kenya Country Office, Nairobi, Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Muturi","sequence":"additional","affiliation":[{"name":"IHRC, Nairobi, Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Godfrey","family":"Bigogo","sequence":"additional","affiliation":[{"name":"Kenya Medical Research Institute, Kisumu and Nairobi, Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer R","family":"Verani","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention - Kenya Country Office, Nairobi, Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philip M","family":"Muthoka","sequence":"additional","affiliation":[{"name":"Kenya Ministry of Health, Nairobi, Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"Hunsperger","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention - Kenya Country Office, Nairobi, Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandra S","family":"Chaves","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention - Kenya Country Office, Nairobi, Kenya"},{"name":"Influenza Division, National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2019,9,30]]},"reference":[{"key":"2020081005080500500_CIT0001","doi-asserted-by":"crossref","first-page":"808","DOI":"10.1016\/j.jpeds.2010.05.012","article-title":"Burden of seasonal influenza hospitalization in children, United States, 2003 to 2008","volume":"157","author":"Dawood","year":"2010","journal-title":"J Pediatr"},{"key":"2020081005080500500_CIT0002","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1093\/cid\/cix312","article-title":"Population-based pediatric hospitalization burden of lineage-specific Influenza B in Hong Kong, 2004-2014","volume":"65","author":"Cowling","year":"2017","journal-title":"Clin Infect Dis"},{"key":"2020081005080500500_CIT0003","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1186\/1471-2334-12-7","article-title":"Epidemiology of respiratory viral infections in two long-term refugee camps in Kenya, 2007-2010","volume":"12","author":"Ahmed","year":"2012","journal-title":"BMC Infect Dis"},{"key":"2020081005080500500_CIT0004","doi-asserted-by":"crossref","first-page":"e0139431","DOI":"10.1371\/journal.pone.0139431","article-title":"Striking similarities in the presentation and duration of illness of influenza A and B in the community: a study based on sentinel surveillance networks in France and Turkey, 2010-2012","volume":"10","author":"Cohen","year":"2015","journal-title":"PLoS One"},{"key":"2020081005080500500_CIT0005","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1093\/cid\/ciu269","article-title":"Comparing clinical characteristics between hospitalized adults with laboratory-confirmed influenza A and B virus infection","volume":"59","author":"Su","year":"2014","journal-title":"Clin Infect Dis"},{"key":"2020081005080500500_CIT0006","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1016\/j.jinf.2012.07.004","article-title":"Unexpected severity of cases of influenza B infection in patients that required hospitalization during the first postpandemic wave","volume":"65","author":"Guti\u00e9rrez-Pizarraya","year":"2012","journal-title":"J Infect"},{"key":"2020081005080500500_CIT0007","doi-asserted-by":"crossref","first-page":"895","DOI":"10.1093\/infdis\/jir861","article-title":"Myocardial injury and bacterial pneumonia contribute to the pathogenesis of fatal influenza B virus infection","volume":"205","author":"Paddock","year":"2012","journal-title":"J Infect Dis"},{"key":"2020081005080500500_CIT0008","doi-asserted-by":"crossref","DOI":"10.2807\/1560-7917.ES2014.19.37.20903","article-title":"Burden of influenza B virus infections in Scotland in 2012\/13 and epidemiological investigations between 2000 and 2012","volume":"19","author":"Harvala","year":"2014","journal-title":"Euro Surveill"},{"key":"2020081005080500500_CIT0009","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1111\/irv.12319","article-title":"Epidemiological and virological characteristics of influenza B: results of the Global Influenza B Study","volume":"9","author":"Caini","year":"2015","journal-title":"Influenza Other Respir Viruses"},{"key":"2020081005080500500_CIT0010","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1080\/21645515.2017.1342907","article-title":"Trends of influenza B during the 2010-2016 seasons in 2 regions of North and South Italy: the impact of the vaccine mismatch on influenza immunisation strategy","volume":"14","author":"Orsi","year":"2018","journal-title":"Hum Vaccin Immunother"},{"key":"2020081005080500500_CIT0011","doi-asserted-by":"crossref","first-page":"2177","DOI":"10.2165\/11641110-000000000-00000","article-title":"The coming era of quadrivalent human influenza vaccines: who will benefit?","volume":"72","author":"Barr","year":"2012","journal-title":"Drugs"},{"key":"2020081005080500500_CIT0012","doi-asserted-by":"crossref","first-page":"D45","DOI":"10.1016\/j.vaccine.2010.08.028","article-title":"The need for quadrivalent vaccine against seasonal influenza","volume":"28","author":"Belshe","year":"2010","journal-title":"Vaccine"},{"key":"2020081005080500500_CIT0013","first-page":"1","article-title":"Prevention and control of seasonal influenza with vaccines. 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