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Low seasonal influenza activity but just over 300 human infections with the new influenza A(H1N1) virus have now been reported in the Europe region (ECDC, 5/22/09, Edited)
Seasonal Influenza ? European Status - Low seasonal influenza activity but just over 300 human infections with the new influenza A(H1N1) virus have now been reported in the Europe region
Summary:
In week 20/2009, influenza activity remained at or below baseline levels in almost all of Europe. While the regular influenza season is virtually over, additional cases of new influenza A(H1N1) virus infections have been reported in countries in the European region bringing the total to just over 300.
Epidemiological situation - week 20/2009:
For the intensity indicator, the national network levels of influenza-like illness (ILI) and/or acute respiratory infection (ARI) were low in all countries that reported this indicator, with only one region (Urals) of the Russian Federation reporting medium intensity. For the geographical spread indicator, all countries reported sporadic or no activity. Definitions for the epidemiological indicators can be found here.
Cumulative epidemiological situation - 2008-2009 season (weeks 40/2008-20/2009):
Consultation rates for ILI and/or ARI rose above baseline levels as of week 49/2008 in most western and central European countries following a general west to east progression. High influenza intensity, with peak activity following a general west to east progression, has been reported in 15 countries since week 51/2008. Generally, the highest consultation rates have been in the 0-4 and 5-14 age groups, but Ireland, UK, Norway and Romania have reported their highest ILI consultation rates in the 15-64 age group. In most countries the seasonal epidemic appears to be over, with consultation rates for ILI and/or ARI having returned to baseline levels.
Virological situation - week 20/2009:
The total number of respiratory specimens collected by sentinel physicians in week 20/2009 was 547, of which 31 (5%) were positive for influenza virus: 12 type A (four subtype H3, one subtype H1, four subtype new H1 and two not subtyped) and 20 type B. In addition, 130 non-sentinel source specimens (e.g. specimens collected for diagnostic purposes in hospitals) were reported positive for influenza virus: 95 type A (13 subtype H3, four subtype H3N2, seven subtype H1, two subtype H1N1, 36 subtype new H1, three subtype new H1N1 and 31 not subtyped) and 34 type B.
Cumulative virological situation - 2008-2009 season (weeks 40/2008-20/2009):
Of 31059 virus detections (sentinel and non-sentinel) since week 40/2008, 25882 (83%) were type A (11652 subtype H3, 1417 subtype H1 and 12813 not subtyped) and 5177 (17%) were type B. Based on the antigenic and/or genetic characterisation of 3246 influenza viruses reported to EISS up to week 20/2009, 2163 (67%) were reported as A/Brisbane/10/2007 (H3N2)-like, 146 (4%) as A/Brisbane/59/2007 (H1N1)-like, 36 (1%) as B/Florida/4/2006-like (B/Yamagata/16/88 lineage), 900 (28%) as B/Malaysia/2506/2004-like (B/Victoria/2/87 lineage) and one as A/California/4/2009 (H1N1)swl-like (click here). More detailed antigenic and genetic analyses have shown that B/Victoria/2/87 lineage viruses resembled either B/Malaysia/2506/2004-like or B/Brisbane/60/2008-like, the prototype vaccine strain recommended by WHO for inclusion in the 2009-10 vaccine (WER 2009; 84(9): 65-76 (click here).
Influenza isolates from 20 countries were assessed for antiviral drug susceptibility. All influenza A(H3N2) viruses tested were sensitive to oseltamivir and zanamivir, but resistant to M2 inhibitors. Ninety-eight percent of influenza A(H1N1) viruses analysed were resistant to oseltamivir while all those tested against zanamivir were sensitive. One A(H1N1) virus was M2 inhibitor resistant, but sensitive to the neuraminidase inhibitors.
All new A(H1N1) viruses tested were sensitive to oseltamivir and zanamivir but resistant to M2 inhibitors.
The small number of influenza B viruses tested were sensitive to oseltamivir and zanamivir (click here).
Comment:
Seasonal influenza activity in Europe is coming to an end, with most influenza virus detections having occurred between weeks 48/2008 and 15/2009 (a 20-week period) (click here). However, a new A(H1N1) subtype influenza virus with pandemic potential has emerged in North America and spread to many countries. The World Health Organisation has raised the pandemic alert level to phase five. For further details please see the WHO website (click here).
As of 21 May, 305 confirmed cases have been reported in 19 European region countries (296 in 17 EU/EEA countries and 9 in two non-EU/EEA countries). Outside of the United States and Mexico, no sustained community transmission has been recorded so far. For more information please go to the dedicated web pages of ECDC (click here) or WHO (click here). European Member States have been requested to continue to perform seasonal influenza surveillance until further notice. As of week 18/2009, countries are able to report detections of the new virus to the EISS platform.
Influenza A has been the dominant virus type circulating in Europe, mostly characterised antigenically and/or genetically as A(H3N2). Of the influenza B viruses that were characterised, the majority were B/Victoria lineage. With the exception of these B/Victoria lineage viruses, the viruses circulating are similar to the three components - A(H1N1), A(H3N2) and B/Yamagata lineage - included in the 2008/2009 Northern Hemisphere influenza vaccine. The mismatch of these B/Victoria/2/87 lineage viruses with the current vaccine is unlikely to be of public health significance because of limited circulation of influenza B viruses and the dominant circulation of influenza A(H3N2) viruses which matched the strain included in the vaccine. From a public health perspective, the vaccine used this season is therefore expected to have been effective.
Background:
The Weekly Electronic Bulletin presents and comments on influenza activity in the 53 countries that report to EISS. Of these countries, 27 reported both clinical and virological data, five reported virological data only and six reported clinical data only to EISS in week 20/2009. The spread of influenza viruses and their epidemiological impact in Europe are being monitored by the network under the aegis of the European Centre for Disease Prevention and Control in Stockholm (Sweden) and the WHO Regional Office for Europe in Copenhagen (Denmark), in collaboration with the WHO Collaborating Centre for Reference and Research on Influenza in London (UK).
Other bulletins:
The EISS bulletin is prepared using reports from GP consultations and other sources, depending on individual country arrangements. It is important to recognise that different health care systems and types of measurement should also be considered when assessing the impact of influenza. To view national/regional bulletins in Europe and other bulletins from around the world, please click here.
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<cite cite="http://www.ecdc.europa.eu/en/health_content/episu/090522_EISS.aspx">ECDC Health Content</cite>
Summary:
In week 20/2009, influenza activity remained at or below baseline levels in almost all of Europe. While the regular influenza season is virtually over, additional cases of new influenza A(H1N1) virus infections have been reported in countries in the European region bringing the total to just over 300.
Epidemiological situation - week 20/2009:
For the intensity indicator, the national network levels of influenza-like illness (ILI) and/or acute respiratory infection (ARI) were low in all countries that reported this indicator, with only one region (Urals) of the Russian Federation reporting medium intensity. For the geographical spread indicator, all countries reported sporadic or no activity. Definitions for the epidemiological indicators can be found here.
Cumulative epidemiological situation - 2008-2009 season (weeks 40/2008-20/2009):
Consultation rates for ILI and/or ARI rose above baseline levels as of week 49/2008 in most western and central European countries following a general west to east progression. High influenza intensity, with peak activity following a general west to east progression, has been reported in 15 countries since week 51/2008. Generally, the highest consultation rates have been in the 0-4 and 5-14 age groups, but Ireland, UK, Norway and Romania have reported their highest ILI consultation rates in the 15-64 age group. In most countries the seasonal epidemic appears to be over, with consultation rates for ILI and/or ARI having returned to baseline levels.
Virological situation - week 20/2009:
The total number of respiratory specimens collected by sentinel physicians in week 20/2009 was 547, of which 31 (5%) were positive for influenza virus: 12 type A (four subtype H3, one subtype H1, four subtype new H1 and two not subtyped) and 20 type B. In addition, 130 non-sentinel source specimens (e.g. specimens collected for diagnostic purposes in hospitals) were reported positive for influenza virus: 95 type A (13 subtype H3, four subtype H3N2, seven subtype H1, two subtype H1N1, 36 subtype new H1, three subtype new H1N1 and 31 not subtyped) and 34 type B.
Cumulative virological situation - 2008-2009 season (weeks 40/2008-20/2009):
Of 31059 virus detections (sentinel and non-sentinel) since week 40/2008, 25882 (83%) were type A (11652 subtype H3, 1417 subtype H1 and 12813 not subtyped) and 5177 (17%) were type B. Based on the antigenic and/or genetic characterisation of 3246 influenza viruses reported to EISS up to week 20/2009, 2163 (67%) were reported as A/Brisbane/10/2007 (H3N2)-like, 146 (4%) as A/Brisbane/59/2007 (H1N1)-like, 36 (1%) as B/Florida/4/2006-like (B/Yamagata/16/88 lineage), 900 (28%) as B/Malaysia/2506/2004-like (B/Victoria/2/87 lineage) and one as A/California/4/2009 (H1N1)swl-like (click here). More detailed antigenic and genetic analyses have shown that B/Victoria/2/87 lineage viruses resembled either B/Malaysia/2506/2004-like or B/Brisbane/60/2008-like, the prototype vaccine strain recommended by WHO for inclusion in the 2009-10 vaccine (WER 2009; 84(9): 65-76 (click here).
Influenza isolates from 20 countries were assessed for antiviral drug susceptibility. All influenza A(H3N2) viruses tested were sensitive to oseltamivir and zanamivir, but resistant to M2 inhibitors. Ninety-eight percent of influenza A(H1N1) viruses analysed were resistant to oseltamivir while all those tested against zanamivir were sensitive. One A(H1N1) virus was M2 inhibitor resistant, but sensitive to the neuraminidase inhibitors.
All new A(H1N1) viruses tested were sensitive to oseltamivir and zanamivir but resistant to M2 inhibitors.
The small number of influenza B viruses tested were sensitive to oseltamivir and zanamivir (click here).
Comment:
Seasonal influenza activity in Europe is coming to an end, with most influenza virus detections having occurred between weeks 48/2008 and 15/2009 (a 20-week period) (click here). However, a new A(H1N1) subtype influenza virus with pandemic potential has emerged in North America and spread to many countries. The World Health Organisation has raised the pandemic alert level to phase five. For further details please see the WHO website (click here).
As of 21 May, 305 confirmed cases have been reported in 19 European region countries (296 in 17 EU/EEA countries and 9 in two non-EU/EEA countries). Outside of the United States and Mexico, no sustained community transmission has been recorded so far. For more information please go to the dedicated web pages of ECDC (click here) or WHO (click here). European Member States have been requested to continue to perform seasonal influenza surveillance until further notice. As of week 18/2009, countries are able to report detections of the new virus to the EISS platform.
Influenza A has been the dominant virus type circulating in Europe, mostly characterised antigenically and/or genetically as A(H3N2). Of the influenza B viruses that were characterised, the majority were B/Victoria lineage. With the exception of these B/Victoria lineage viruses, the viruses circulating are similar to the three components - A(H1N1), A(H3N2) and B/Yamagata lineage - included in the 2008/2009 Northern Hemisphere influenza vaccine. The mismatch of these B/Victoria/2/87 lineage viruses with the current vaccine is unlikely to be of public health significance because of limited circulation of influenza B viruses and the dominant circulation of influenza A(H3N2) viruses which matched the strain included in the vaccine. From a public health perspective, the vaccine used this season is therefore expected to have been effective.
Background:
The Weekly Electronic Bulletin presents and comments on influenza activity in the 53 countries that report to EISS. Of these countries, 27 reported both clinical and virological data, five reported virological data only and six reported clinical data only to EISS in week 20/2009. The spread of influenza viruses and their epidemiological impact in Europe are being monitored by the network under the aegis of the European Centre for Disease Prevention and Control in Stockholm (Sweden) and the WHO Regional Office for Europe in Copenhagen (Denmark), in collaboration with the WHO Collaborating Centre for Reference and Research on Influenza in London (UK).
Other bulletins:
The EISS bulletin is prepared using reports from GP consultations and other sources, depending on individual country arrangements. It is important to recognise that different health care systems and types of measurement should also be considered when assessing the impact of influenza. To view national/regional bulletins in Europe and other bulletins from around the world, please click here.
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