Understanding the Natural History, Treatment, Resistance and Therapies for Influenza B Virus

Rebecca Barley^*
*Correspondence: Rebecca Barley, Department of Ecology and Evolutionary Biology, Brown University, Providence RI 02906, USA, Email:

Keywords

Influenza • Pandemic • Virology

Introduction

Influenza B virus belongs to the Orthomyxoviridae family and is enveloped with a segmented, negative-sense RNA genome. Unlike Influenza A, which infects various animal species, Influenza B primarily infects humans and seals. The virus is responsible for seasonal outbreaks, contributing to significant morbidity and mortality, particularly among vulnerable populations such as the elderly, young children, and individuals with underlying health conditions. Influenza B exhibits a seasonal pattern, typically peaking during colder months in temperate regions, although it can circulate year-round in tropical regions. The virus spreads via respiratory droplets, with symptoms ranging from mild respiratory illness to severe pneumonia and even death in vulnerable individuals. Influenza B shares clinical manifestations with Influenza A, including fever, cough, sore throat, fatigue, muscle aches, and respiratory distress [1].

Literature Review

The cornerstone of managing influenza infections involves both antiviral treatment and supportive care. Antiviral medications target viral replication and can reduce the severity and duration of symptoms, as well as the risk of complications. The two main classes of antiviral drugs used against influenza viruses are adamantanes amantadine and rimantadine and neuraminidase inhibitors oseltamivir, zanamivir, and peramivir. However, adamantanes are no longer recommended for the treatment of influenza due to widespread resistance among circulating strains of both Influenza A and B viruses. Neuraminidase inhibitors, particularly oseltamivir and zanamivir, remain the primary treatment options for Influenza B. These drugs inhibit the viral neuraminidase enzyme, preventing the release of new virus particles from infected cells and thereby reducing viral spread. In recent years, the availability of newer antiviral agents targeting different stages of the viral replication cycle has expanded. Baloxavir marboxil, a cap-dependent endonuclease inhibitor, was approved for the treatment of influenza in several countries. This novel drug disrupts viral mRNA synthesis, effectively inhibiting viral replication. While baloxavir marboxil demonstrates potent activity against both Influenza A and B viruses, concerns regarding the emergence of resistance have been raised [2].

Discussion

Antiviral resistance presents a significant challenge in the management of influenza infections. Resistance to adamantanes among Influenza B viruses emerged rapidly, rendering these drugs ineffective. Neuraminidase inhibitor resistance, although less common, has also been documented, particularly in the context of prolonged treatment or prophylaxis. Resistance to oseltamivir, the most widely used neuraminidase inhibitor, is primarily mediated by mutations in the neuraminidase gene, affecting drug binding and efficacy. Monitoring for antiviral resistance through surveillance programs is essential for guiding treatment recommendations and informing public health strategies. Furthermore, the potential for cross-resistance between different antiviral agents underscores the importance of judicious antiviral use. Beyond antiviral medications, supportive care plays a crucial role in managing influenza B infections, particularly in severe cases. This includes hydration, fever reduction, and respiratory support as needed. Vaccination remains the most effective strategy for preventing influenza infections and reducing disease burden. Seasonal influenza vaccines are formulated to include strains predicted to be circulating during the upcoming season, including both Influenza A and B components [3-5].

In recent years, efforts to improve influenza vaccine efficacy and coverage have focused on the development of universal vaccines capable of providing broader and longer-lasting protection against diverse influenza strains. Additionally, non-pharmaceutical interventions such as hand hygiene, respiratory etiquette, and social distancing measures can help limit viral transmission, particularly during outbreaks and pandemics [6].

Conclusion

Influenza B virus poses a significant public health threat, causing seasonal epidemics and contributing to considerable morbidity and mortality worldwide. Understanding the natural history of the virus, available treatment options, the emergence of antiviral resistance, and prevention strategies is essential for mitigating the impact of influenza infections. Continued research into novel antiviral agents, improved vaccines, and enhanced surveillance efforts will be crucial in the ongoing battle against influenza. Effective collaboration between healthcare providers, public health agencies, and researchers is essential to address the evolving challenges posed by influenza B and other respiratory viruses.

Acknowledgement

Not applicable.

Conflict of Interest

There is no conflict of interest by author.

References

1. Chen, Rubing and Edward C. Holmes. "The evolutionary dynamics of human influenza B virus." J Mol Evol 66 (2008): 655-663.

Google Scholar, Crossref, Indexed at

2. Koutsakos, Marios, Thi HO Nguyen, Wendy S. Barclay and Katherine Kedzierska. "Knowns and unknowns of influenza B viruses." Future Microbiol 11 (2016): 119-135.

Google Scholar, Indexed at

3. Osterhaus, A. D. M. E., G. F. Rimmelzwaan, B. E. E. Martina and T. M. Bestebroer, et al. "Influenza B virus in seals." Sci 288 (2000): 1051-1053.

Google Scholar, Crossref, Indexed at

4. Jackson, David, Ruth A. Elderfield and Wendy S. Barclay. "Molecular studies of influenza B virus in the reverse genetics era." J Gen Virol 92 (2011): 1-17.

Google Scholar, Crossref, Indexed at

5. Caini, Saverio, Gabriela Kusznierz, Verònica Vera Garate and Sonam Wangchuk, et al. "The epidemiological signature of influenza B virus and its B/Victoria and B/Yamagata lineages in the 21st century." PloS one 14 (2019): e0222381.

Google Scholar, Crossref, Indexed at

6. Zaraket, Hassan, Aeron C. Hurt, Barry Clinch and Ian Barr, et al. "Burden of influenza B virus infection and considerations for clinical management." Antivir Res 185 (2021): 104970.

Google Scholar, Crossref, Indexed at