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Institute for Disease Control 2011-2012 weekly reports weeks 2-15

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  • Institute for Disease Control 2011-2012 weekly reports weeks 2-15

    Institute for Disease Control warns of flu epidemic
    Published: kl 18:14 , Radio Sweden Comment 3 gillar Share
    The Swedish Institute for Communicable Disease Control is warning that flu could be a serious problem this year.

    "We have seen an increase that indicates an epidemic is on the way," state epidemiologist Annika Linde tells TT.

    Cases of the virus took off after Christmas and have risen significantly because of the cold weather. Last week, 40 new cases were reported.
    ...
    http://sverigesradio.se/sida/artikel...rtikel=4934242

    Contents
    Influenza in Sweden

    After a few weeks of relatively low activity, the flu started to increase again. For three weeks reported 47 laboratory confirmed cases of influenza compared with 13 cases Week 2. 34 of these were seasonal influenza A and those that have been characterized as expected, were of subtype A (H3). Cases have been reported from laboratories in Skåne, Västra Götaland, Uppsala, Falun, Östersund and Umeå, and probably is the virus throughout the country. It is mainly young children and adults who have so far received influenza diagnosis verified. Often, usually older suffer slightly later than younger people, who have more contacts.

    We have also received reports of four cases of influenza B in week 3. Although this virus seems to get lost sporadic throughout the country. The pandemic flu A (H1N1) pdm09 has been verified in 1 patient from Stockholm.

    The increased activity is not yet visible in reporting of influenza-like illness from sentinel physicians, but in web searches and ill report has curves that indicate flu activity turned upward, and even phone calls to 1177 related to fever in children has increased.

    Most are talking to the spread of seasonal influenza A which we have long talked about now begun in earnest across the country, but we do not yet know when the peak is reached and the extent of the spread becomes. Once again, we urge those in risk groups for vaccination - and now is the time!

    Characterization for vaccine similarity and antiviral resistance

    As of week 40, a total of 29 A/H1 (2009), 62 A/H3, 2 B / Yam and a B / Vic sub / linjetypats at the SMI, Gothenburg and Umeå. (Table 4). Of these, 8 A/H1 (2009), 27 A/H3, 2 B / Yamagata and a B / Victoria characterized regarding, among other vaccine similarity and resistance to antiviral agents.

    Both influenza A/H1N1 (2009) and A/H3N2 has in recent years developed a number of different subgroups (clades; 8 for H1 and 10 for H3). They all have large antigenic similarity with the current vaccine strains, A/California/7/2009 (H1N1) and A/Perth/16/2009 (H3N2). The influenza A strains that SMI has characterized this season belong to different genotypes circulating even last season. No one is quite different from any of the vaccine strains, and all are sensitive to both neuraminidase inhibitors (Tamiflu and Relenza).

    The vaccine also includes B/Brisbane/60/2008 belonging B/Victoria/2/1987-linjen. The two influenza B strains SMI has characterized is B/Yamagata/16/1988-linjetyp, and thus does not give the vaccine strain protection. One of the strains have been characterized with respect to sensitivity to neuraminidase inhibitors, and it was sensitive to both.

    ...

    In-depth statistics
    Table 1. Number of laboratory confirmed influenza cases in Sweden, Week 3, and cumulatively since week 40/2011.
    Influensatyp Current week // Cumulative number of
    A (H1N1) pdm09 6 // 34
    Seasonal Influenza A 40 // 140
    Seasonal influenza B 1 // 13
    A total of 47 // 187
    Figure 1 and 2. Weekly incidence of laboratory-confirmed cases by county.
    Figure 1. Weekly incidence of all laboratory-confirmed cases by county, A (H1N1) pdm09, seasonal influenza A and B.
    ...
    http://www.smittskyddsinstitutet.se/...1---221--2012/
    Twitter: @RonanKelly13
    The views expressed are mine alone and do not represent the views of my employer or any other person or organization.

  • #2
    Re: Institute for Disease Control warns of flu epidemic

    Influenza Report, Week 5 (30/1 -5 / 2), 2012
    Report on the current flu situation

    Influenza in Sweden
    A total of 117 influenza cases have been reported during the week, 108 cases of seasonal influenza A, 7 A (H1N1) pdm, and 2 cases of influenza B. For week 4 were 51 reported cases of seasonal influenza A, and the number has thus more than doubled. 30 of the verified seasonal influenza cases in people over 65 years, and there is an increase in the elderly compared to previous weeks.

    The spread has thus taken off in earnest, and cases are reported from all over the country, with most cases of Stockholm and Gothenburg. A further sign of growing flu spread is that the number of influenza increases Vårdguiden home grown, and that 1177 has received an increased number of questions about fever, particularly in children. If the spread follows the pattern of previous years, we expect still to peak reached in early March. It is still too early to determine the extent of the epidemic will be.

    Week 5 was 13 of 49 (27&#37 sentinel samples analyzed at the SMI positive for influenza. The increasing proportion of positive is another sign of flu spread begun in earnest. A total of 12 influenza A (one subtypad to A/H3) and one influenza B / Yamagata detected. The positive samples came from Skåne and Stockholm. From week 40, 28 A/H3, 6 A/H1 (2009), 2 B / Victoria and 2 B / Yamagata identified in typing the submitted sentinel samples.

    Published in the newsletter 2012-02-09

    Influenza in the world
    Reports from WHO and the ECDC is only week three. Then, activity in the temperate part of the Northern Hemisphere remained low, but it had begun to grow in Canada, China, parts of southern Europe and northern Africa. The percentage of positive samples in the sentinel sampling in Europe had also increased, which jars to be a pretty sure sign that influence the season has begun in earnest. From Mexico has reported an outbreak of A (H1N1) pdm with several deaths among young people. However, there are no reports of the virus has changed, and we are monitoring the situation, but now no need to worry.

    Published in the newsletter 2012-02-09

    In-depth statistics
    A (H1N1) pdm09Tabell first Number of laboratory confirmed influenza cases in Sweden, Week 3, and cumulatively since week 40/2011.
    Influenza type // Current Week // Cumulative number of
    A (H1N1) pdm09 // 7 // 53
    Seasonal influenza A // 108 // 313
    Seasonal influenza B // 2 // 19
    A total of 117 385
    ...
    http://www.smittskyddsinstitutet.se/...01--5-2--2012/
    Twitter: @RonanKelly13
    The views expressed are mine alone and do not represent the views of my employer or any other person or organization.

    Comment


    • #3
      Re: Institute for Disease Control warns of flu epidemic

      Influenza Report, Week 6 (6/2 -13 / 2), 2012
      Report on the current flu situation

      Influenza in Sweden
      Flu has now taken off in earnest in Sweden with a total of 190 laboratory-confirmed cases. Seasonal influenza A predominated, with 177 cases compared with 108 during week 5. Also reported four influenza A (H1N1) pdm and 9 influenza B. Sentinel reporting shows no clear increase in the number seeking treatment with flu-like symptoms, but the number who applied for influenza at Vårdguiden site has risen sharply and the number of calls to care inquiries on issues related to febrile children.

      There are always children and young people who get the greatest extent with the flu. The youngest can sometimes become so ill that they require hospitalization, but we have very rarely any deaths among children in seasonal flu. Severe illness, hospitalizations and deaths from influenza are most common in the elderly. To follow the development of different ages, we show fr.om this week chart (Figure 3) where the number of laboratory-reported cases of seasonal flu per 100 000 (incidence) for the seasons 2008-09, 2010-11 and 2011-12 are shown for five different age groups Week by Week. As can be seen dominating right now the group 15-39 years very rapidly, and groups 65 + and 0-4 comes next. Group 5-14 years, most affected by his own reporting sick report, manage flu good, and get in that age group have had to seek medical advice and sampled.

      Both the number of submissions and the proportion of sentinel specimens positive increased by week 6 compared to the earlier weeks of the season. Week 6 was 26 of 59 (44%) sentinel samples were analyzed at SMI positive for influenza. Total found 25 influenza A (of which 14 subtypade to A/H3) and influenza B. The positive samples come from all over the country. From week 40, 54 A/H3, 6 A/H1 (2009), 2 B / Victoria and 2 B / Yamagata identified in typing the submitted sentinel samples.

      Published in the newsletter 2012-02-09
      Click image for larger version

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      http://www.smittskyddsinstitutet.se/...-vecka-6-2012/
      Twitter: @RonanKelly13
      The views expressed are mine alone and do not represent the views of my employer or any other person or organization.

      Comment


      • #4
        Re: Institute for Disease Control warns of flu epidemic

        machine translated
        Influenza Report, Week 7 (13/2 -19 / 2), 2012

        Influenza in Sweden
        Influenza spread exploded during week 7. A total of reported 416 laboratory confirmed cases, including 405 seasonal influenza A. It is more a twofold increase compared with 177 cases in week 6, and this is the highest figure we've had over a week ago, the voluntary laboratory reporting began in autumn 1993. More sampling and more efficient analyzes in the 2000s may have contributed to it, but above all shows reporting that seasonal influenza A (H3N2) have now recovered after temporarily held back by the pandemic virus.

        The patients who sought outpatient care in sentinel reporting has not increased as much. This is probably partly because most are keeping flu at home - with the help of web information and medical information. The number who sought care at the guide's home with the flu as a keyword has increased in the same way as the laboratory confirmed cases, including fever questions to 1177th Exactly how many people are influenza illness in the community right now we do not know. They sampled the tip of the iceberg, and although we are working on there is still no reliable system for determining the extent of influenza illness in the population.

        Unfortunately, for technical reasons, the reporting of age of the patients during week 7 incomplete. We have data only for half of the reported, but the data we have seems to verify what we have long warned - that the elderly will be hit hard, especially since relatively few have been vaccinated. Week 6 had people between 15 and 39 the highest incidence (number fall/100000 inhabitants) in laboratory reporting, but already the high-incidence among persons over 65 years. . Probably also has health care is now a tough few weeks ahead.

        Sentinel Sampling
        During week 7, the number of submissions sentinel samples increased as the proportion of positive samples. Week 7 contained 40 of 104 (38%) sentinel samples were analyzed at SMI flu. Total found 39 influenza A of which one A/H1 (2009) pdm and 21 A/H3 and one influenza B Yam. The positive samples come from all over the country. From week 40, 89 A/H3, 7 A/H1 (2009) pdm, 3 B / Victoria and 3 B / Yamagata identified in typing the submitted sentinel samples.

        Characterization for vaccine similarities, and antiviral resistance
        of week 40, 14 A/H1 (2009) pdm, 39 A/H3, 3 B / Yamagata and 2 B / Victoria characterized the SMI regarding, among other vaccine likeness and / or resistance to antiviral agents. No one is quite different from any of the vaccine strains, and all are sensitive to both neuraminidase inhibitors (Tamiflu and Relenza).

        Both influenza A/H1N1 (2009) and A/H3N2 has in recent years developed a variety of subgroups (clader; 8 for H1 and 10 for H3). They all have large antigenic similarity with the current vaccine strains, A/California/7/2009 (H1N1) and A/Perth/16/2009 (H3N2). The influenza A strains that SMI has characterized this season belong to different genotypes were circulating even last season. The vaccine includes B/Brisbane/60/2008 belonging B/Victoria/2/1987-linjen. The three influenza B strains that SMI has characterized is B/Yamagata/16/1988-linjetyp, and thus does not give the vaccine strain of protection. Five influenza B strains have been characterized for susceptibility to neuraminidase inhibitors, and they were all vulnerable.

        A total of 44 influenza A or B strains isolated and the majority of these have been sent to the WHO laboratory in Britain for further analysis. Information from these strains and those available from other countries during this season is the basis for today's meeting at the WHO, where the vaccine strains for the 2013-2014 season are determined.

        Published in the newsletter 2012-02-23

        ...
        Click image for larger version

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        http://www.smittskyddsinstitutet.se/...-62--132-2012/
        Twitter: @RonanKelly13
        The views expressed are mine alone and do not represent the views of my employer or any other person or organization.

        Comment


        • #5
          Re: Institute for Disease Control warns of flu epidemic

          A comparison with the graph in the above post with the Google Flu trends picture (which measures the number of flu symptoms and treatment related searches on the interent) is interesting.

          http://www.google.org/flutrends/se/#SE

          Comment


          • #6
            Last week was quite ill. The highest figure since 1993.It's crazy.

            http://www.aftonbladet.se/nyheter/article14428080.ab
            Swedish-English translation


            Last week was quite ill. The highest figure since 1993.It's crazy.


            Annika Linde, state epidemiologist in the Infectious Diseases Institute.
            Photo: SMI
            The highest figure since 1993
            It's crazy.
            Last week was reported more than twice the number of flu cases as the week before - the highest figure since 1993.
            - We expected that it would take off this year, but we had not expected it would be this much, said Annika Linde, state epidemiologist in the Infectious Diseases Institute.
            Influenza spread exploded last week. In total, 416 laboratory-confirmed cases, more than doubling compared to the 177 cases reported during week 6. It is the highest figure for a week since the voluntary laboratory reporting began in autumn 1993, writes the Infectious Diseases Institute in a statement.
            - There is a substantial increase, which may partly be due to the lab takes more samples, but we also know that there are very many who are sick now, says Annika Linde, state epidemiologist in the Infectious Diseases Institute.
            Usually after a pandemic
            Because pandemics like swine flu two years ago, pushing back the normal seasonal influenza, it is usual with flu peaks when the pandemic is over.
            - We expected that it would take off this year, but we had not expected it would be this much, said Annika Linde, and continues:
            - We expected a peak as early as last year, but then it never came, so absolutely certain that it would come this year instead, we could not be.
            She points out that the laboratory confirmed cases are only the tip of an iceberg, most of those who get the flu stay at home without medical attention.
            - It is mainly the elderly and people with heart and lung diseases such as coal, and chronic diseases such as severe diabetes who are at risk of being seriously affected, and even death if they become infected. There are those belonging to risk groups and should be vaccinated, says Annika Linde.
            Stockholm and Gothenburg peaks
            For the rest of the population, she sees both the pros and cons of vaccination.
            - If you want to be sure to avoid the flu a specific year is good to get vaccinated, but otherwise, you may want to help and build a stronger immune system in the longer term. Generally, you may want to have exposed themselves to a flu to build up their defenses.
            According to SMI's statistics, it is mainly people in major cities of Stockholm and Gothenburg are now suffering the flu.
            - We believe this is because the sampling is greatest there, but also that there are lots of people who meet, and thus infect each other, said Annika Linde.
            On average you get flu every ten to twenty years. Above all, children who suffer.
            - However, children between five and fifteen are rarely seriously ill and therefore not evident in the statistics, said Annika Linde.

            Comment


            • #7
              Re: Last week was quite ill. The highest figure since 1993.It's crazy.

              See this thread http://www.flutrackers.com/forum/sho...d.php?t=180970
              or http://www.smittskyddsinstitutet.se/...ngen-20112012/ for weekly epidemiological reports.

              Edit: this is superfluous as the threads have been merged
              Last edited by Ronan Kelly; February 26th, 2012, 07:58 PM. Reason: see edit
              Twitter: @RonanKelly13
              The views expressed are mine alone and do not represent the views of my employer or any other person or organization.

              Comment


              • #8
                Re: Last week was quite ill. The highest figure since 1993.It's crazy.

                Source: http://www.thelocal.se/39336/20120226/

                Record high number of flu cases in Sweden

                Published: 26 Feb 12 11:24 CET | Double click on a word to get a translation
                Online: http://www.thelocal.se/39336/20120226/


                The number of flu cases reported in Sweden last week was at an all-time high, with some 100,000 simultaneous sufferers, according to estimates from the Swedish Institute for Communicable Disease Control (Smittskyddsinstitutet).

                As flu season spreads across Sweden, the number of cases is on a steady rise.

                Last week 416 lab-verified cases were reported, and 405 of these were seasonal flu A.

                The figure had more than doubled from the week before, and was the highest number in one week since the institute began keeping tabs in 1993.

                However, the verified cases are no more than a drop in the ocean compared to the real figure. Most people don't seek medical attention, choosing instead to simply remain at home...

                Comment


                • #9
                  Re: Institute for Disease Control warns of flu epidemic

                  Influenza Report, Week 8 (20/2 - 26/2), 2012
                  Report on the current flu situation

                  Influenza in Sweden
                  The number of laboratory confirmed cases of influenza have continued to rise over the previous weeks, but, possibly see the rate of increase appears to have subsided somewhat. Overall, 548 cases were reported for week 8 compared with 416 cases for week 7. Seasonal influenza A dominates with 526 cases reported from different parts of the country. This is the highest figure we've had over a week ago, the voluntary laboratory reporting began in autumn 1993. A total of 14 cases of A (H1N1) pdm 2009, the so-called swine flu, reported the highest number of cases from Umeå. Eight cases of influenza B has been diagnosed. It remains the highest incidence among those over 65 years, based on those cases for which the available age data. The data are not complete from all counties. We also see an increase in reported flu-like illness in sentinel reporting, with most cases reported from Skåne and Gothenburg, among people aged 15 to 65 years. The number of telephone calls to 1177 regarding fever in children has also increased, as did the number of people who applied with "flu" as a keyword care assistant ("Web Search").

                  Ang. Figure 3. As the incidence now risen to a level higher than we anticipated, we have now changed the color scheme for these maps, and therefore shows only the last 5 maps. Previous maps have shown a color scale where the darkest color meant a 10 per 100 000 inhabitants. On the new maps, the darkest color rather than 20 per 100 000 inhabitants.

                  Ang. Table 4. Starting at week 8, the test results from Kronoberg and Blekinge on the same line as all these samples are analyzed in Växjö (Kronoberg) and identification of the counties of each sample comes from missing. Previous weekly reports should be read so that the line of Kronoberg also contains the samples come from Blekinge.

                  Sentinel Sampling
                  The increase in the number of submitted samples and the proportion of positive continues during week 8. So far, SMI analyzed 119 samples taken from week 8. 62 (52%) are positive for influenza A and five (4%) are positive for influenza B. 30 of the influenza A positive samples have subtypats and 29 A/H3 and are subtype A (H1N1) pdm09. Of the influenza B positive specimens is a Yamagataliknande and Victoria are similar. Sub / linjetypningar has a certain delay, so the results are not complete yet. The flu-positive samples are submitted by reporters across the country.

                  Published in the newsletter 2012-03-01

                  Influenza in the world
                  Reports from WHO / Europe and ECDC are available only for week 7. They report increased influenza activity in most countries in Europe. According to the ECDC is near the top of the countries hit first. The predominant type continues to be A (H3N2), with only few cases of A (H1N1) pdm09 and influenza B reported. The circulating types have so far this season have been as the strains found in flu vaccine for this season.

                  From Canada reported local influenza activity in several regions. Of the sample typats was just under half the season, influenza A, more than 40 percent influenza B, and 10 percent influenza A (H1N1) pdm09. In the U.S., the activity on the rise and is dominated by A (H3N2), except in a region dominated by the A (H1N1) pdm09.

                  WHO has this week published recommendations for the composition of influenza vaccine for next flu season 2012-2013 for the northern hemisphere. It is recommended that two of the three vaccine strains is changed due to expected changes in circulating strains. The season 2012-2013, the vaccine contains:
                  - A/California/7/2009 (H1N1) pdm09, the influenza pandemic
                  - A/Victoria/361/2011 (H3N2), which replaces A/Perth/16/2009
                  - B/Wisconsin/1/2010, replacing B/Brisbane/60/2008 and is from Yamagatalinjen
                  Read more on the WHO website.

                  Published in the newsletter 2012-03-01
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                  http://www.smittskyddsinstitutet.se/...-vecka-8-2012/
                  Twitter: @RonanKelly13
                  The views expressed are mine alone and do not represent the views of my employer or any other person or organization.

                  Comment


                  • #10
                    Re: Institute for Disease Control warns of continuing flu epidemic - Influenza reports weeks 2-8

                    Influenza Report, Week 9 (27/2 - 4/3), 2012
                    http://www.smittskyddsinstitutet.se/...02---262-2012/

                    Influenza in Sweden
                    The number of laboratory confirmed cases of influenza increased also in week 9, reaching a new record level. Total reported 815 laboratory confirmed influenza cases, including 792 seasonal influenza A, 14 A (H1N1) pdm09 and 9 influenza B. The increase was mainly outside metropolitan areas, while the Stockholm, Gothenburg and Malmö seems to have reached a plateau phase with largely steady or declining number of confirmed cases .

                    People over 65 had the highest incidence of laboratory-confirmed cases during the week, and the proportion of elderly sick has a weekly basis during the epidemic time (see Figure 4). This is typical of an outbreak of seasonal influenza A (H3). The fact that so many elderly people suffered because of course that we now have a strong outbreak of a flu that is always hit hard on the group, but the lack of vaccination will before the season has probably also contributed. According to statistics from the National Board has now also the death rate for people over 65 started to increase.

                    The sentinel reporting, the proportion of the population who are looking for flu-like symptoms have diminished somewhat, and the proportion of influenza positive samples in the sentinel sampling has also fallen, as the number of searchers vårguiden with flu questions and inquiries about fever in children of sjuvårdsrådgivningen 1177th This, along with the increase in confirmed cases stalled in the big cities, suggest that the epidemic probably peaked in week 9 in the country, but also the coming weeks, the activity remains fairly wide.

                    Sentinel Sampling

                    During week 9 were 122 samples in the sentinel sampling and in 43 of them (35%) had a flu. The number of samples analyzed was about the same as in week 8, but then, the proportion positive is significantly higher. The majority of the samples came from Stockholm, Västra Götaland and Skåne, but positive samples are submitted from across the country.

                    Published in the newsletter 2012-03-08
                    ...


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                    The views expressed are mine alone and do not represent the views of my employer or any other person or organization.

                    Comment


                    • #11
                      Re: Institute for Disease Control weekly reports weeks 2-9 - New record # of flu cases again

                      Influenza Report, week 10 (5/3 - 11/3), 2012
                      Report on the current flu situation

                      Influenza in Sweden
                      Everything indicates that the influenza peak was reached in week 9, but it was still high activity in week 10, and especially many elderly have received influenza diagnosis. Total reported 626 verified influenza cases compared with 815 weeks ninth 603 were seasonal influenza A, 15 A (H1N1) pdm09 and 26 influenza B. Most laboratories do not characterize seasonal influenza A, but so far all seasonal influenza investigated were influenza A (H3N2).

                      Seasonal influenza A declined in all age groups except among the very young, but still, the incidence in the elderly more than twice as high as in any other age group. Increased number of diagnoses reported from Gästrikland, Västmanland, Örebro and Kalmar, while the number remained steady or decreased in other parts of the country. All reporting shows for week 10 stationary or declining influenza activity, and confirms that the peak was reached in week 9.

                      It is likely that despite the decrease in the next few weeks many, particularly elderly, needing hospital treatment for influenza. It is important that the Board's recommendation for treatment and prophylaxis with antiviral agents for severe cases and persons at risk are followed (link below). It's been an unusually long time since the flu vaccine was given because we got a late flu peak, and the effect of administered vaccine has begun to decline. There are also indications that seasonal virus has begun to change (see link to ECDC and deepening text below). It was a year ago it was decided the vaccine composition, and the widespread deployment of the season has increased the virus's rate of change. This does not mean that the vaccine is completely ineffective, but such very old people and immunsuprimerade already due to its ground state are less protective of influenza vaccination. The combination of that it was a long time after the vaccine was given and that the flu has been partly changed thus enables one were needed extra focus on the complement of antiviral agents.

                      Sentinel Reporting and virus characterization

                      Both the sample inflow as the number of positive samples decreased during week 10. This is another very strong indication that the peak now passed. Total analyzed 99 samples. Twenty samples (20%) were positive for influenza, and all were subtype A/H3.

                      There have been reports of vaccine failure for people who have seasonal influenza vaccine. The protective effect of seasonal flu vaccine is usually only 60-80% and may be even worse for the elderly and the family infection (due to higher smittdos). Therefore, there will always be disease despite vaccination. We have no data mjöliggör analysis of vaccination failure was more common this year than other years, or if it is noted more as more disease total also gives more vaccination breakthrough in total.

                      The A (H3N2) strains that SMI has so far characterized are similar to large parts of them that circulated last year, but the proportion between the different genetic variants (clader) are slightly different. A/H3N2 influenza For circulates 10 different clader. This season's vaccine contains influenza strain A/Perth/16/2009 (H3N2). The share belonging to this clade has been reduced, and this season dominate clades A/Victoria/208/2009. In late February, it was also decided at the WHO A/H3N2 strain in the vaccine for 2012-2013 to be exchanged for ordinary A/Victoria/361/2011, belonging to just clade A/Victoria/208/2009. The hemagglutination assay (analysis of strain-specific antibodies to analyze the protective effect against other viruses and variants) is not much difference in the antibodies' ability to inhibit these strains, but these analyzes have become increasingly difficult to perform when the latter claderna of A (H3N2) has lost some of its ability to bind red blood cells.

                      For the A (H1N1) pdm09 there are 8 different genetic clader which all show a great similarity in the hemagglutination assay. This year's vaccine strain (A/Califorinia/7/2009) remains why the vaccine strain for next season.

                      Both line types of influenza B is circulating and the vaccine does not protect against line type B/Yamagata/16/1988. Influenza B strain is the next season to be replaced by B/Brisbane/60/2008 belonging B/Victoria/2/1987-linjen to B/Wisconsin/1/2010 belonging B/Yamagata/16/1988-linjen.

                      ...
                      Figure 1. Weekly reported laboratory confirmed cases of seasonal influenza A in week 40, 2006 to the current week, 2012.
                      Click image for larger version

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                      ...
                      http://www.smittskyddsinstitutet.se/...53---113-2012/
                      Twitter: @RonanKelly13
                      The views expressed are mine alone and do not represent the views of my employer or any other person or organization.

                      Comment


                      • #12
                        Re: Institute for Disease Control weekly reports weeks 2-10

                        Influenza Report, week 11 (12/3 - 18/3), 2012
                        Report on the current flu situation

                        Influenza in Sweden
                        All reporting shows for week 11 declining influenza activity. When systems shown steady or declining activity two consecutive weeks, they suggest that this year's flu peak was reached in week 9.

                        The number of laboratory confirmed cases of influenza, however, remains high. Overall, 558 laboratory confirmed influenza cases reported in week 11 compared with 666 cases for week 10. Seasonal influenza A predominated with 536 cases reported from different parts of the country.

                        A total of 13 cases of A (H1N1) pdm 2009, the so-called swine flu, reported the highest number of cases from Umeå. Nine cases of influenza B has been diagnosed. Seasonal influenza A reduction of all ages. It remains the highest incidence among those over 65 years. We also see a reduction of reported influenza-like illness in sentinel reporting. Altogether 114 cases were reported during week 11 compared with 149 cases during week 10 with most cases reported from Skåne Uppsala, Karlstad and Gothenburg and, among people aged 15 to 65 years. The number of telephone calls to 1177 regarding fever in children has also declined slightly over the past week, and the number of people who have sought to "flu" as a keyword care assistant ("Web Search").

                        Sentinel Sampling

                        Despite a lag in reporting, we see that the sample number decreases. Of 93 samples taken during vecka11 is 27 (29%) were positive for influenza A. Two samples could not be subtyped due to their low viral load in the original sample, the remaining 25 are subtype A/H3. The majority of influenza A positive samples were taken in Stockholm, Skåne, Västra Götaland, Dalarna and Västmanland. In addition to these influenza A positive specimens also lodged an influenza B positive specimens from the Stockholm region.

                        Published in the newsletter 2012-03-22

                        Influenza in the world

                        European

                        Recent reports from ECDC and WHO / Europe is for week 10. Then it was reported that flu peak has passed at the European level, although several countries still reported high or intermediate activity. Only three countries (Lithuania, Netherlands, and Romania) reported increasing influenza activity, while ten countries reported a decline.

                        The season has generally been relatively mild in Europe as a whole, although the spread has been geographically widespread in most countries. In Europe, only Sweden, Portugal, and Greece, who reported high or very high activity during weeks 9 and 10. Besides these three, only Austria previously reported high activity in 2012 (weeks 7-8). The percentage of positive tests among the European sentinel samples fell for the second week in a row - a clear sign that the peak has passed - but remained high with 43.2% of samples positive for influenza during week 10. Of these positive samples was 85.1% for influenza A and 14.9% influenza B. It is the highest proportion of influenza B for the season.

                        For week 11 reports Norway a further decline in influenza activity after the peak week 8, but continued widespread epidemic activity throughout the country. Influenza activity remains unusually low in Denmark.


                        Rest of world

                        WHO flu update for week 9 has now been published. It is reported that influenza activity continued to increase in Canada and the U.S. in week 9, while it declined in Mexico. Similar to developments in Europe were reported from Canada, a higher proportion of samples as influenza B, although the influenza A (H3N2) dominated in both the U.S. and Canada. In Mexico and Central America dominates the influenza A (H1N1) pdm09. Even in northern China and Mongolia increased influenza activity in week 9, while it declined in southern China, Japan and Korea. Most countries in the tropical parts of South America and North Africa reported low activity.

                        Published in the newsletter 2012-03-22

                        ...
                        http://www.smittskyddsinstitutet.se/...vecka-11-2012/
                        Twitter: @RonanKelly13
                        The views expressed are mine alone and do not represent the views of my employer or any other person or organization.

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                        • #13
                          Re: Institute for Disease Control weekly reports weeks 2-10

                          Influenza Report, week 12 (19/3 - 25/3) 2012
                          Report on the current flu situation

                          Influenza in Sweden
                          All reporting shows for week 12 declining influenza activity for the third consecutive week. The number of laboratory confirmed cases of influenza have continued to decrease over the previous weeks. Overall, 407 cases were reported for week 12 compared with 558 cases in week 11. As usual during this season dominates the seasonal influenza A, with 385 cases reported from different parts of the country and most cases occurred in Gothenburg. A total of 15 cases of A (H1N1) pdm 2009, the so-called swine flu, reported the highest number of cases from Umeå. Seven cases of influenza B has been diagnosed. Since week 40, a total of 3893 cases of seasonal influenza A, 85 cases of influenza B and 129 cases of A (H1N1) pdm 2009 reported. Seasonal influenza A declined in all age groups during week 12. It is still higher incidence among those over 65 years than other age groups. See below for results of genetic analysis of vaccination breakthrough and virus characterization.

                          We also see a sharp decline in reported flu-like illness in sentinel reporting, with most cases reported from Umeå and among people aged 15 to 65 years. Altogether 41 cases were reported during week 12 compared with 114 cases during week 11.

                          The sentinel sampling, we have seen a halving of the number of samples compared to the previous week. The number of positive tests has decreased from 30% to 13%. The positive samples are sent in from Stockholm, Skåne and Västra Götaland.

                          The number of telephone calls to 1177 regarding fever in children has also decreased slightly compared to previous week, and the number of people who have sought to "flu" as a keyword care assistant ("Web Search").

                          Published in the newsletter 2012-03-29

                          Influenza in the world
                          European

                          The latest report from ECDC is for week 11. As reported 15 out of 27 countries a declining influenza activity. Sweden was the only country that reported high influenza activity in week 11. Most countries reported a medium level of activity. The percentage of positive tests among the European sentinel samples fell for the third week in a row to 40.7%. Of these positive samples was 82.9% influenza A and 17.1% were influenza B. The proportion of influenza B has steadily increased during the season.

                          ECDC writes again to a variety of A/H3N2 viruses circulating during the season, matching the rate for the vaccine strain is not perfect. All strains in Europe as characterized for susceptibility to antivirals have been susceptible.

                          For week 12, reports Norway a further decline in influenza activity after the peak weeks 8 and 9. In two regions, the activity has now fallen below the threshold level of the epidemic in terms of reports of flu illness (ILS) from sentinel physicians. Influenza activity remains low in Denmark.

                          Link to ECDC's weekly report

                          WHO / Europe weekly report

                          Rest of world

                          Influenza activity was at week 11 remained low, but increasing in North America. In Canada , more than half of laboratory-reported cases, influenza B (57.3%). In the U.S. , the proportion of patients who visited sentinel physicians for the first time this season reached the threshold level for epidemic activity. Most states reported regional or widespread influenza activity. The highest activity was reported from the southern Midwest.

                          WHO's next report on influenza activity in the world is expected on March 30. It can then be read here .

                          Published in the newsletter 2012-03-29

                          Analysis of vaccine breakthrough
                          During this season it is mostly influenza A/H3N2 that has been circulating (95% of all reported laboratory cases). Each access usually come in reports of vaccine breakthrough for people who have seasonal influenza vaccine, and so have made this year. SMI has gone through the patients' vaccination status of all the samples submitted by sentinel sampling for the three peak weeks 7, 8, and 9. During these weeks, A/H3N2 was detected in 138 sentinel specimens and of these 17 (12%) samples from patients who were vaccinated. The average age of patients with vaccine breakthrough was 75 years (58-91 years, median 72 years). For the seasons 2006-2009 was 10% (8-11%) of the positive samples from vaccinated patients. I just do not support large enough for reliable analysis of the effect of vaccination.

                          For genetic analysis, we found strains that caused the vaccination breakthroughs in three of the four variants (clader) of A/H3N2 circulating this year (see phylogenetic tree for A/H3N2 in which sequences from vaccination breakthroughs are highlighted in bold green text imprinted with "Vacc" before the strain name, see also below). The tribes that have caused vaccination breakthrough differs not from the others. It is important to consider that the protective effect of seasonal flu vaccine is normally only 60-80% and may be even worse for the elderly. The vaccination breakthrough that we are seeing is probably due to a combination of the flu peak came late (long time since vaccination) and because there are many elderly victims who often have poorer vaccine.

                          Since vaccination protection of seasonal influenza vaccination is not 100%, it is important that the Board's recommendations for treatment and prophylaxis with antiviral agents for severe cases and persons at risk are followed. All the strains have been characterized for susceptibility to antivirals is sensitive (see full report below).

                          Virus Characterization

                          The 59 A (H3N2) strains that SMI has characterized this season is similar to a large extent those that circulated last year, but the proportion between the different genetic variants (clader) are slightly different. For influenza A/H3N2 circulating 10 different clader in the world, including viruses from four of these clader have been found in Sweden during this season (see phylogenetic tree for A/H3).

                          This season's vaccine contains influenza strain A/Perth/16/2009 (H3N2). The proportion of strains belonging to this variant (clade 1-2) has decreased, and this season dominates A/Victoria/208/2009-lika strains (clade 3-8). In late February, it was also decided at the WHO A/H3N2 strain in the vaccine for 2012-2013 to be exchanged for ordinary A/Victoria/361/2011, which belongs to at A/Victoria/208/2009 (clade 3C). The hemagglutination assay (assay strain-specific antibodies to analyze the efficacy against other viral variants) will be little difference in the ability of the antibodies to inhibit the strains from the different claderna. Strains that have caused vaccination breakthrough in clade 3B, 3C and 6, which is the most common variants of this year. For 22 A/H3N2 strains have genotypic determination of antiviral susceptibility made and all strains were sensitive to the two approved antiviral engines.

                          For the A (H1N1) pdm09 there are eight different genetic clader which all show a great similarity in the hemagglutination assay. A total of 12 pieces of A (H1N1) pdm09 strains characterized from this season and they are found in three different clader (clade 5-7, see phylogenetic tree for A/H1). All these strains are sensitive to the antiviral were approved.

                          For influenza B, two line types, B/Yamagata/16/1988 (B-Yam) and B/Victoria/2/1987 (B Vic). Both line types of influenza B is circulating and the vaccine does not protect against the type of the line B-Yam. A total of 18 influenza B strains linjetypats and ten of them belong to the B Vic while eight member of the B-Yam. For influenza B are four different clader (one for the B-Vic and three B-Yam). A total of eight influenza B strains characterized, three similar vaccines (clade V1) belonging to five clades Y3 (see phylogenetic tree for B). The influenza B strain in the vaccine to be for next season to be replaced by B/Brisbane/60/2008 belonging to B-Vic to B/Wisconsin/1/2010 belonging to B-Yam. A total of 10 influenza B strains (five B Vic and five B-Yam) have been analyzed with respect to antiviral susceptibility, and all were sensitive.

                          Links to phylogenetic trees:

                          Trees for influenza (H3N2)

                          Trees for influenza B

                          Trees for influenza A (H1N1) pdm09

                          How are phylogenetic trees?

                          In the phylogenetic tree ("family tree") is the external part of hemagglutininets amino acid sequence was compared against other tribes. It is against this part of the protein that the neutralizing antibodies obtained from the vaccination / infection are directed.

                          How to read the tree?

                          To get an idea of how big the difference is between the two strains should you add up the lengths of all horizontal lines between tribes. The total length will then be compared with the longitudinal dimension which is under the tree. Read more ...

                          The vaccine strains are highlighted in bold black text on all trees, the seasons, the strain included in the vaccine is given in brackets. This season characterized strains are shown in green. Tribal clader displayed to the right by vertical lines with numbers.

                          Published in the newsletter 2012-03-29

                          ...
                          http://www.smittskyddsinstitutet.se/...vecka-12-2012/
                          Twitter: @RonanKelly13
                          The views expressed are mine alone and do not represent the views of my employer or any other person or organization.

                          Comment


                          • #14
                            Re: Institute for Disease Control weekly reports weeks 2-12

                            Influenza Report, week 13 (26/3 - 1/4), 2012
                            Influenza in Sweden
                            Influenza activity has now slowed down properly, and by week 13, a total of 213 laboratory-confirmed cases compared to 429 at week 12. 198 were seasonal influenza A, 7 A (H1N1) pdm, and 8 seasonal influenza B. Seasonal influenza have been reported from most of the country's laboratories. 1-2 cases of A (H1N1) pdm each were reported from Malmo, Gothenburg, Falun, Sundsvall and Umeå. Further, it is mainly older people diagnosed with seasonal flu.

                            All reporting systems within the influenza surveillance shows downward curves except the sentinel sampling, where the percentage of positive samples increased slightly, but the number of samples decreased.

                            198 laboratory-confirmed cases is a high figure compared with previous years, but the overall impression is that this year's unusually widespread outbreaks now nearing its end.

                            Sentinel Sampling

                            During the week 36 samples analyzed in the context of sentinel sampling. Five (13%) were positive for influenza A. Three of the positive samples were taken in the Västra Götaland Region, the other in Västerbotten, Dalarna and Västmanland.

                            Published in the newsletter 2012-04-04
                            ...
                            http://www.smittskyddsinstitutet.se/...vecka-13-2012/
                            Twitter: @RonanKelly13
                            The views expressed are mine alone and do not represent the views of my employer or any other person or organization.

                            Comment


                            • #15
                              Re: Institute for Disease Control weekly reports weeks 2-12

                              Influenza Report, week 14 (2/4 - 8/4), 2012
                              Report on the current flu situation

                              Influenza in Sweden
                              Almost all reporting shows that influenza activity is declining, but at week 14 still reported 128 laboratory confirmed influenza cases compared with 217 at week 13. Seasonal influenza A predominated with 112 cases, 7 were influenza A (H1N1) pdm09 and 9 influenza B. The number of cases per 100 000 population is highest among people over 65 years. Further cases were reported from most parts of the country but Västernorrland and Örebro County had the highest number per capita.

                              Published in the newsletter 2012-04-12
                              ...
                              http://www.smittskyddsinstitutet.se/...vecka-14-2012/
                              Twitter: @RonanKelly13
                              The views expressed are mine alone and do not represent the views of my employer or any other person or organization.

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