{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T17:04:08Z","timestamp":1789578248137,"version":"build-2803163510"},"reference-count":48,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:00Z","timestamp":1789516800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000030","name":"U.S. Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["NU2GGH002389"],"award-info":[{"award-number":["NU2GGH002389"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]},{"award":["NU2GGH002389"],"award-info":[{"award-number":["NU2GGH002389"]}],"id":[{"id":"https:\/\/ror.org\/042twtr12","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Biology"],"abstract":"<jats:p>Influenza viruses undergo continuous genetic and antigenic evolution, making sustained surveillance essential for monitoring changes in virus circulation and vaccine relevance. We analyzed influenza epidemiology and viral evolution in Kazakhstan across eight consecutive epidemic seasons (2017\/18\u20132024\/25) using data from the national influenza sentinel surveillance system, together with antigenic characterization, Sanger sequencing, whole-genome sequencing, and phylogenetic analysis. Influenza activity was almost undetectable during the 2020\/21 season, followed by the re-emergence of A(H3N2)-dominated circulation in 2021\/22. In 2022\/23, influenza B predominated initially, followed by A(H1N1)pdm09, whereas A(H3N2) predominated in 2023\/24. A total of 199 A(H1N1)pdm09, 157 A(H3N2), 105 B\/Victoria, and 16 B\/Yamagata viruses were genetically characterized. A(H1N1)pdm09 viruses showed successive replacement of 6B-derived lineages, with descendants of 6B.1A.5a.2a predominating in the post-pandemic period. A(H3N2) viruses showed substantial genetic diversification, progressing from 3C.2a descendants to 3C.2a1b-related viruses and subsequently to 2a.3a.1\/J.2 viruses. Among B\/Victoria viruses, V1A was successively replaced by V1A.3 and V1A.3a.2, with V1A.3a.2 accounting for 100% of genetically characterized viruses in 2023\/24 and 2024\/25. Antigenic analysis showed 16- to 32-fold lower HI titers for A(H1N1)pdm09 6B.1A.5a.2 viruses when tested against antisera to earlier vaccine\/reference strains, whereas no detectable antigenic differences were observed between 6B.1A.5a.2a and its recent descendants. These findings demonstrate substantial post-pandemic changes in influenza epidemic timing, subtype dominance, and genetic composition in Kazakhstan, while circulating viruses remained within globally recognized evolutionary lineages. Integrated epidemiological, genetic, and antigenic surveillance is important for detecting emerging variants, assessing vaccine relevance, and supporting timely influenza prevention and control measures.<\/jats:p>","DOI":"10.3390\/biology15181640","type":"journal-article","created":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T16:07:29Z","timestamp":1789574849000},"page":"1640","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Antigenic and Molecular Genetic Evolution of Influenza Viruses in Kazakhstan from 2017 to 2025"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2323-5043","authenticated-orcid":false,"given":"Altynay","family":"Gabiden","sequence":"first","affiliation":[{"name":"National Center of Public Health Care of the Ministry of Health of the Republic of Kazakhstan, Almaty 050000, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9608-4138","authenticated-orcid":false,"given":"Aknur","family":"Mutaliyeva","sequence":"additional","affiliation":[{"name":"National Center of Public Health Care of the Ministry of Health of the Republic of Kazakhstan, Almaty 050000, 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Global Mortality Associated with Seasonal Influenza Epidemics: New Burden Estimates and Predictors from the GLaMOR Project","volume":"9","author":"Paget","year":"2019","journal-title":"J. Glob. Health"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1038\/nrmicro.2017.118","article-title":"The Evolution of Seasonal Influenza Viruses","volume":"16","author":"Petrova","year":"2018","journal-title":"Nat. Rev. Microbiol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1038\/s41594-018-0025-9","article-title":"Structural Insights into the Design of Novel Anti-Influenza Therapies","volume":"25","author":"Wu","year":"2018","journal-title":"Nat. Struct. Mol. Biol."},{"key":"ref_5","unstructured":"World Health Organization (2026, July 01). Global Influenza Strategy 2019\u20132030, Available online: https:\/\/www.who.int\/publications\/i\/item\/9789241515320."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1146\/annurev-virology-101416-041726","article-title":"Constraints, Drivers, and Implications of Influenza A Virus Reassortment","volume":"4","author":"Lowen","year":"2017","journal-title":"Annu. Rev. Virol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e00480-18","DOI":"10.1128\/JCM.00480-18","article-title":"Real-Time Analysis and Visualization of Pathogen Sequence Data","volume":"56","author":"Neher","year":"2018","journal-title":"J. Clin. Microbiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1126\/science.1090727","article-title":"Unifying the Epidemiological and Evolutionary Dynamics of Pathogens","volume":"303","author":"Grenfell","year":"2004","journal-title":"Science"},{"key":"ref_9","unstructured":"Centers for Disease Control and Prevention (CDC) (2026, May 15). Seasonal Influenza (Flu), Available online: https:\/\/www.cdc.gov\/flu."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"119","DOI":"10.2217\/fmb.15.120","article-title":"Knowns and unknowns of influenza B viruses","volume":"11","author":"Koutsakos","year":"2016","journal-title":"Future Microbiol."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Espinar-Garc\u00eda, M., Vallejo-Berm\u00fadez, I.M., Onieva-Garc\u00eda, M.\u00c1., Reina-Alfonso, I., Llapa-Chino, L., \u00c1lvarez-Heredia, P., Salcedo, I., Solana, R., Pera, A., and Batista-Duharte, A. (2025). Epitope Variation in Hemagglutinin and Antibody Responses to Successive A\/Victoria A(H1N1) Strains in Young and Older Adults Following Seasonal Influenza Vaccination: A Pilot Study. Vaccines, 13.","DOI":"10.3390\/vaccines13070774"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"741","DOI":"10.1038\/s41579-021-00642-4","article-title":"Influenza Lineage Extinction during the COVID-19 Pandemic?","volume":"21","author":"Koutsakos","year":"2021","journal-title":"Nat. Rev. Microbiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"4121","DOI":"10.1093\/bioinformatics\/bty407","article-title":"Nextstrain: Real-Time Tracking of Pathogen Evolution","volume":"34","author":"Hadfield","year":"2018","journal-title":"Bioinformatics"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1038\/nature14460","article-title":"Global Circulation Patterns of Seasonal Influenza Viruses Vary with Antigenic Drift","volume":"523","author":"Bedford","year":"2015","journal-title":"Nature"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Glebova, T., Klivleyeva, N., Baimukhametova, A., Lukmanova, G., Saktaganov, N., Ongarbayeva, N., Baimakhanova, B., Kassymova, G., Sagatova, M., and Rachimbayeva, A. (2025). Acute Respiratory and Influenza Viruses Circulating in Kazakhstan during 2018\u20132024. Pathogens, 14.","DOI":"10.3390\/pathogens14050493"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"80","DOI":"10.20953\/1729-9225-2023-1-80-94","article-title":"Epidemiological Characteristics of Acute Respiratory Viral Infections and Influenza in Kazakhstan during Epidemic Seasons from 2018 to 2022","volume":"21","author":"Kuatbaeva","year":"2023","journal-title":"Infektsionnye Bolezn."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1305","DOI":"10.15585\/mmwr.mm6937a6","article-title":"Decreased Influenza Activity during the COVID-19 Pandemic\u2014United States, Australia, Chile, and South Africa, 2020","volume":"69","author":"Olsen","year":"2020","journal-title":"MMWR Morb. Mortal. Wkly. Rep."},{"key":"ref_18","unstructured":"Garza, Z.C.F., de Jong, S.P., Gibson, J., Han, A.X., van Leeuwen, S., de Vries, R.P., Russell, C.A., Boons, G., van Hoesel, M., and de Haan, K. (2022). Impacts of the COVID-19 Pandemic on Future Seasonal Influenza Epidemics. medRxiv."},{"key":"ref_19","unstructured":"World Health Organization (2026, May 01). Global Epidemiological Surveillance Standards for Influenza, Available online: https:\/\/www.who.int\/publications\/i\/item\/9789241506601."},{"key":"ref_20","unstructured":"World Health Organization Regional Office for Europe (2011). WHO Regional Office for Europe Guidance for Sentinel Influenza Surveillance in Humans, WHO Regional Office for Europe. Available online: https:\/\/iris.who.int\/handle\/10665\/349780."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2856","DOI":"10.1093\/bioinformatics\/bty1057","article-title":"MMseqs2 desktop and local web server app for fast, interactive sequence searches","volume":"35","author":"Mirdita","year":"2019","journal-title":"Bioinformatics"},{"key":"ref_22","unstructured":"World Health Organization (2026, June 02). In WHO Global Pulse Survey, 90% of Countries Report Disruptions to Essential Health Services Since COVID-19 Pandemic, Available online: https:\/\/www.who.int\/news\/item\/31-08-2020-in-who-global-pulse-survey-90-of-countries-report-disruptions-to-essential-health-services-since-covid-19-pandemic."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"2100221","DOI":"10.2807\/1560-7917.ES.2021.26.11.2100221","article-title":"European Influenza Surveillance Network. Very Little Influenza in the WHO European Region during the 2020\/21 Season, Weeks 40 2020 to 8 2021","volume":"26","author":"Adlhoch","year":"2021","journal-title":"Eurosurveillance"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1111\/joim.70051","article-title":"Change in Healthcare Utilization before and after COVID-19 Using Data from 1.5 Million Individuals","volume":"299","author":"Bygdell","year":"2026","journal-title":"J. Intern. Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"987","DOI":"10.1093\/eurpub\/ckad136","article-title":"Changes in Public Health-Seeking Behaviours for Self-Limiting Respiratory Tract Infections across England during the COVID-19 Pandemic","volume":"33","author":"Read","year":"2023","journal-title":"Eur. J. Public Health"},{"key":"ref_26","first-page":"e49280","article-title":"A Comparison of the Epidemiological Characteristics Between Influenza and COVID-19 Patients: A Retrospective, Observational Cohort Study","volume":"15","author":"Naji","year":"2023","journal-title":"Cureus"},{"key":"ref_27","unstructured":"European Centre for Disease Prevention and Control (2018). Seasonal influenza, Annual Epidemiological Report for 2017."},{"key":"ref_28","unstructured":"European Centre for Disease Prevention and Control (2019). Seasonal influenza 2018\u20132019, Annual Epidemiological Report for 2018."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"5707","DOI":"10.1016\/j.vaccine.2020.06.031","article-title":"European Region Influenza Surveillance Network. Predominance of Influenza Virus A(H3N2) 3C.2a1b and A(H1N1)pdm09 6B.1A5A Genetic Subclades in the WHO European Region, 2018\u20132019","volume":"38","author":"Melidou","year":"2020","journal-title":"Vaccine"},{"key":"ref_30","unstructured":"European Centre for Disease Prevention and Control (2021). Seasonal influenza, Annual Epidemiological Report 2020."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"2200255","DOI":"10.2807\/1560-7917.ES.2022.27.15.2200255","article-title":"Influenza Returns with a Season Dominated by Clade 3C.2a1b.2a.2 A(H3N2) Viruses, WHO European Region, 2021\/22","volume":"27","author":"Melidou","year":"2022","journal-title":"Eurosurveillance"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Kolosova, N.P., Ilyicheva, T.N., Unguryan, V.V., Danilenko, A.V., Svyatchenko, S.V., Onhonova, G.S., Goncharova, N.I., Kosenko, M.N., Gudymo, A.S., and Marchenko, V.Y. (2022). Re-Emergence of Circulation of Seasonal Influenza during COVID-19 Pandemic in Russia and Receptor Specificity of New and Dominant Clade 3C.2a1b.2a.2 A(H3N2) Viruses in 2021\u20132022. Pathogens, 11.","DOI":"10.3390\/pathogens11111388"},{"key":"ref_33","unstructured":"European Centre for Disease Prevention and Control (2022). Seasonal influenza 2021\u20132022, Annual Epidemiological Report for 2021."},{"key":"ref_34","unstructured":"European Centre for Disease Prevention and Control (2023). Seasonal influenza 2022\u22122023, Annual Epidemiological Report for 2023."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"2500011","DOI":"10.2807\/1560-7917.ES.2025.30.23.2500011","article-title":"Influenza Vaccine Effectiveness in Europe and the Birth Cohort Effect against Influenza A(H1N1)pdm09: VEBIS Primary Care Multicentre Study, 2023\/24","volume":"30","author":"Kissling","year":"2025","journal-title":"Eurosurveillance"},{"key":"ref_36","unstructured":"European Centre for Disease Prevention and Control (2024). Seasonal influenza, 2023\u22122024, Annual Epidemiological Report for 2023."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Glebova, T., Klivleyeva, N., Ongarbayeva, N., Baimukhametova, A., Saktaganov, N., Kalkozhayeva, M., Karamendin, K., Ibragimova, I., Sagatova, M., and Mutaliyeva, A. (2026). Surveillance of Seasonal Influenza Viruses in Kazakhstan (2020\u20132025). Viruses, 18.","DOI":"10.3390\/v18040441"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"e01914","DOI":"10.7554\/eLife.01914","article-title":"Integrating Influenza Antigenic Dynamics with Molecular Evolution","volume":"3","author":"Bedford","year":"2014","journal-title":"eLife"},{"key":"ref_39","first-page":"335","article-title":"Peculiarities of the influenza and ARVI viruses circulation during epidemic season 2019\u20132020 in some regions of Russia","volume":"65","author":"Burtseva","year":"2020","journal-title":"Probl. Virol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"2400020","DOI":"10.2807\/1560-7917.ES.2024.29.39.2400020","article-title":"Members of the European Reference Laboratory Network for Human Influenza (ERLI-Net). Co-Circulation of Seasonal Influenza A(H1N1)pdm09, A(H3N2) and B\/Victoria Lineage Viruses with Further Genetic Diversification, EU\/EEA, 2022\/23 Influenza Season","volume":"29","author":"Broberg","year":"2024","journal-title":"Eurosurveillance"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"100851","DOI":"10.1016\/S2666-5247(24)00066-1","article-title":"Probable Extinction of Influenza B\/Yamagata and Its Public Health Implications: A Systematic Literature Review and Assessment of Global Surveillance Databases","volume":"5","author":"Caini","year":"2024","journal-title":"Lancet Microbe"},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Nelson, M.I., Simonsen, L., Viboud, C., Miller, M.A., and Holmes, E.C. (2007). Phylogenetic Analysis Reveals the Global Migration of Seasonal Influenza A Viruses. PLoS Pathog., 3.","DOI":"10.1371\/journal.ppat.0030131"},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Kolosova, N.P., Boldyrev, N.D., Svyatchenko, S.V., Danilenko, A.V., Goncharova, N.I., Shadrinova, K.N., Danilenko, E.I., Onkhonova, G.S., Kosenko, M.N., and Antonets, M.E. (2023). An Investigation of Severe Influenza Cases in Russia during the 2022\u20132023 Epidemic Season and an Analysis of HA-D222G\/N Polymorphism in Newly Emerged and Dominant Clade 6B.1A.5a.2a A(H1N1)pdm09 Viruses. Pathogens, 13.","DOI":"10.3390\/pathogens13010001"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"e01040-24","DOI":"10.1128\/mra.01040-24","article-title":"Complete genome sequence of a human influenza a virus (H1N1) detected in Kazakhstan in the fall of 2022","volume":"14","author":"Sarsenov","year":"2025","journal-title":"Microbiol. Resour. Announc."},{"key":"ref_45","unstructured":"World Health Organization (2023). Influenza Update No. 435."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Lemey, P., Rambaut, A., Bedford, T., Faria, N., Bielejec, F., Baele, G., Russell, C.A., Smith, D.J., Pybus, O.G., and Brockmann, D. (2014). Unifying Viral Genetics and Human Transportation Data to Predict the Global Transmission Dynamics of Human Influenza H3N2. PLoS Pathog., 10.","DOI":"10.1371\/journal.ppat.1003932"},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Zinder, D., Bedford, T., Baskerville, E.B., Woods, R.J., Roy, M., and Pascual, M. (2014). Seasonality in the migration and establishment of H3N2 Influenza lineages with epidemic growth and decline. BMC Evol. Biol., 14.","DOI":"10.1186\/s12862-014-0272-2"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"20161312","DOI":"10.1098\/rspb.2016.1312","article-title":"Explaining the geographical origins of seasonal influenza A (H3N2)","volume":"283","author":"Wen","year":"2016","journal-title":"Proc. R. Soc. B Biol. Sci."}],"container-title":["Biology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-7737\/15\/18\/1640\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T16:32:10Z","timestamp":1789576330000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-7737\/15\/18\/1640"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,16]]},"references-count":48,"journal-issue":{"issue":"18","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["biology15181640"],"URL":"https:\/\/doi.org\/10.3390\/biology15181640","relation":{},"ISSN":["2079-7737"],"issn-type":[{"value":"2079-7737","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,16]]}}}