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  • Archive. EuroFlu - Weekly Electronic Bulletin - Influenza Surveillance (at December 31, 2009)

    EISS - Weekly Electronic Bulletin Week 21 : 18/05/2009-24/05/2009 - 29 May 2009, Issue N° 307 (edited)
    EISS - Weekly Electronic Bulletin Week 21 : 18/05/2009-24/05/2009 - 29 May 2009, Issue N° 307 - Low seasonal influenza activity but substantial human infections with the influenza A(H1N1)v virus have now been reported in the European region


    Summary:

    In week 21/2009, influenza activity remained at or below baseline levels throughout Europe. While the regular influenza season is virtually over, additional cases of influenza A(H1N1)v virus infections have been reported in countries in the European region bringing the total to 471.


    Epidemiological situation - week 21/2009:

    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.

    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 40/2008-21/2009):

    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. The seasonal epidemic appears to be over.


    Virological situation - week 21/2009:

    The total number of respiratory specimens collected by sentinel physicians in week 21/2009 was 235 of which 8 (3.4%) were positive for influenza virus: one type A (subtype H1N1v) and seven type B.

    In addition, 146 non-sentinel source specimens (e.g. specimens collected for diagnostic purposes in hospitals) were reported positive for influenza virus: 117 type A (eight subtype H3, one subtype H3N2, five subtype H1, one subtype H1N1, three subtype H1v, 76 subtype H1N1v and 23 not subtyped) and 29 type B.


    Cumulative virological situation - 2008-2009 season (weeks 40/2008-21/2009):

    Of 31155 virus detections (sentinel and non-sentinel) since week 40/2008, 25928 (83%) were type A (11666 subtype H3, 1424 subtype H1 and 12838 not subtyped) and 5227 (17%) were type B. Based on the antigenic and/or genetic characterisation of 3397 influenza viruses reported to EISS up to week 21/2009, 2281 (67%) were reported as A/Brisbane/10/2007 (H3N2)-like, 162 (5%) as A/Brisbane/59/2007 (H1N1)-like, 30 (1%) as B/Florida/4/2006-like (B/Yamagata/16/88 lineage), 919 (27%) as B/Malaysia/2506/2004-like (B/Victoria/2/87 lineage) and five as A/California/4/2009 (H1N1)v-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 A(H1N1)v 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 28 May, 471 confirmed cases have been reported in 23 European region countries. For more information please go to the dedicated web pages of ECDC (click here) or WHO (click here). Outside of the United States and Mexico, no sustained community transmission has been recorded so far. 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 A(H1N1)v 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, 22 reported both clinical and virological data, three reported virological data only and three reported clinical data only to EISS in week 21/2009. 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.


    Network comments (where available)
    • Bulgaria. Since the 15-th of May 2009 CDC primers and probes have been used in the National Influenza Laboratory for detection of new influenza virus A/H1N1/. Till now a total of 13 samples obtained from probable cases were tested. No positive detections for new subtype were observed.
    • Italy. During this week further 13 novel A/H1N1 and 1 B influenza viruses have been detected.
    (...)
    -
    <cite cite="http://www.eiss.org/cgi-files/bulletin_v2.cgi">EISS - Bulletin Review</cite>

  • #2
    Re: EISS - Weekly Electronic Bulletin - Influenza Surveillance (seasonal and pandemic)

    Seasonal Influenza – European Status - Regular 2008-2009 influenza season over, but number of A(H1N1)v infections almost doubled over past seven days
    Seasonal Influenza – European Status - Regular 2008-2009 influenza season over, but number of A(H1N1)v infections almost doubled over past seven days


    Summary:

    In week 22/2009, the regular influenza season can be considered to be over, and this is the final bulletin summarising the 2008/09 data. Meanwhile, a 99% increase in recorded cases of influenza A(H1N1)v virus infections in the European region compared to the previous week has brought the total to 937 (as of 4 June).


    Epidemiological situation - week 22/2009:

    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. For the geographical spread indicator, all countries but Italy (local activity) reported sporadic or no activity. Definitions for the epidemiological indicators can be found here.


    Cumulative epidemiological situation - 2008-2009 season (weeks 40/2008-22/2009):

    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. By week 16, peak activity had been passed in all countries, and in most countries intensity had returned to the low levels typically seen outside the season. By then, the seasonal epidemic could be considered to be over. So far, there is no clear indication that the occurrence of A(H1N1)v infection has given rise to increased incidence of ILI or ARI in Europe.


    Virological situation - week 22/2009:

    The total number of respiratory specimens collected by sentinel physicians in week 22/2009 was 278 of which 10 (3.6%) were positive for influenza virus: six type A (one subtype H3, three subtype H1, one subtype H1N1 and two not subtyped) and four type B. In addition, 112 non-sentinel source specimens (e.g. specimens collected for diagnostic purposes in hospitals) were reported positive for influenza virus: 90 type A (six subtype H3, two subtype H1, 70 subtype H1v and 12 not subtyped) and 22 type B.


    Cumulative virological situation - 2008-2009 season (weeks 40/2008-22/2009):

    Of 31234 virus detections (sentinel and non-sentinel) since week 40/2008, 25968 (83%) were type A (11673 subtype H3, 1431 subtype H1 and 12864 not subtyped) and 5266 (17%) were type B. Based on the antigenic and/or genetic characterisation of 3539 influenza viruses reported up to week 22/2009, 2419 (68%) were reported as A/Brisbane/10/2007 (H3N2)-like, 153 (4%) as A/Brisbane/59/2007 (H1N1)-like, 25 (1%) as B/Florida/4/2006-like (B/Yamagata/16/88 lineage), 931 (26%) as B/Malaysia/2506/2004-like (B/Victoria/2/87 lineage) and 11 as A/California/4/2009 (H1N1)v-like (click here).

    All A(H1N1)v viruses tested were sensitive to oseltamivir and zanamivir (n=26) but resistant to M2 inhibitors (n=28).


    Comment:

    Seasonal influenza activity in Europe has come to an end, with most influenza virus detections having occurred between weeks 48/2008 and 15/2009 (click here ). The season was dominated by influenza A(H3N2), its peak in week 5 being followed by a smaller one of influenza B in week 11. All influenza A(H3N2) 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. Ninety-eight percent of influenza A(H1N1) viruses analysed were resistant to oseltamivir while all those tested against zanamivir were sensitive. (click here).

    In late April 2009, a new A(H1N1) subtype influenza virus with pandemic potential emerged in North America and has since spread to many countries around the world. The World Health Organization has raised the pandemic alert level to phase five. For further details please see the WHO website (click here). As of 4 June, 937 confirmed cases of influenza A(H1N1)v have been reported in 29 European region countries (877 in 25 EU/EEA countries and 60 in four non-EU/EEA countries). Cases in the UK and Spain amount to 69% of this total. Altogether, the current numbers represent an increase of 99% compared to the previous week. 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.


    Background:

    The Weekly Electronic Bulletin presents and comments on influenza activity in the 53 countries that report to EISS. Of these countries, 23 reported both clinical and virological data, nine reported virological data only and four reported clinical data only in week 22/2009. 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.
    -
    <cite cite="http://www.ecdc.europa.eu/en/health_content/episu/090605_EISS.aspx">ECDC Health Content</cite>

    Comment


    • #3
      Re: EISS - Weekly Electronic Bulletin - Influenza Surveillance (seasonal and pandemic)

      Overall influenza activity remains low in the European region while A(H1N1)v detections again doubled over the past seven days (ECDC, June 12, 2009, edited)
      Overall influenza activity remains low in the European region while A(H1N1)v detections again doubled over the past seven days


      On 11 June, 2009, WHO raised the level of influenza A(H1N1) pandemic alert to phase 6, as sustained community-level transmission of the virus is taking place in more than one region of the world, heralding the start of the 2009 pandemic. The pandemic is characterized as of moderate severity.



      Summary:

      In week 23/2009, clinical and virological surveillance continued to operate. Low influenza activity was detected in all of the countries reporting data in the European region. Sporadic A(H1N1)v influenza virus infections have been reported from sentinel and non-sentinel specimens. This data indicates low circulation of A(H1N1)v at the community level. Despite this on 11 June, 2009, WHO raised the level of influenza A(H1N1) pandemic alert to phase 6, as sustained community-level transmission of the virus is taking place in more than one region of the world. The pandemic is characterized as of moderate severity.


      Epidemiological situation - week 23/2009:

      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. For the geographical spread indicator, all countries reported sporadic or no activity. Definitions for the epidemiological indicators can be found here.


      Cumulative epidemiological situation - (weeks 16-23/2009):

      By week 16/2009, seasonal peak activity had been passed in all countries, and in most countries intensity had returned to the low levels typically seen outside the season. As of 11 June, 1803 confirmed cases of influenza A(H1N1)v have been reported in 30 European region countries (1701 in 25 EU/EEA countries and 102 in five non-EU/EEA countries). To date, there is no indication that the occurrence of A(H1N1)v infection has given rise to increased levels of ILI or ARI in European seasonal influenza surveillance systems.


      Virological situation - week 23/2009:

      The total number of respiratory specimens collected by sentinel physicians in week 23/2009 was 544 of which 21 (3.9%) were positive for influenza virus: 18 type A (five H1v, four subtype H1N1, three subtype H3, two H3N2, four not subtyped) and three type B. In addition, 182 non-sentinel source specimens (e.g. specimens collected for diagnostic purposes in hospitals or from suspected cases of influenza A(H1N1)) were reported positive for influenza virus: 160 type A (117 subtype H1v, five subtype H3, four subtype H1N1, one subtype H1, three subtype H3N2, 30 not subtyped) and 22 type B.


      Cumulative virological situation - 2008-2009 season (weeks 40/2008-23/2009):

      Of 31331 virus detections (sentinel and non-sentinel) since week 40/2008, 26038 (83%) were type A (11690 subtype H3, 1442 subtype H1 and 12906 not subtyped) and 5293 (17%) were type B. Based on the antigenic and/or genetic characterisation of 3548 influenza viruses reported up to week 23/2009, 2388 (67%) were reported as A/Brisbane/10/2007 (H3N2)-like, 162 (5%) as A/Brisbane/59/2007 (H1N1)-like, 30 (1%) as B/Florida/4/2006-like (B/Yamagata/16/88 lineage), 950 (27%) as B/Malaysia/2506/2004-like (B/Victoria/2/87 lineage) and 18 as A/California/4/2009 (H1N1)v-like (click here).

      All A(H1N1)v viruses tested have been sensitive to oseltamivir and zanamivir but resistant to M2 inhibitors.


      Comment:

      Over the past week only sporadic influenza activity across Europe has been reported, as usually observed outside winter influenza seasons. Most of the Member States’ sentinel surveillance systems are functioning beyond week 20 to allow detection of community circulation of the A(H1N1)v influenza virus and monitoring of its virological characteristics.

      As of this week, 1803 A(H1N1)v virus detections have been made.

      Of the A(H1N1)V viral detections reported to the EISS platform in week 23, the majority have been from non sentinel specimens (117 versus 5 from sentinel sources).

      However, influenza activity has remained below baseline levels in all the countries reporting to EISS indicating that any circulation of A(H1N1)v at the community level must be at low incidence. For a detailed epidemiological description of the A(H1N1)v virus detections in the European region (April–May 2009), click here and in the EU/EFTA countries (April-8 June 2009) click here.

      Worldwide, 74 countries have now reported nearly 30000 cases of A(H1N1)v infection and on June 11, 2009 the WHO raised pandemic alert level to phase 6 (click here). 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.


      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, three reported virological data only and one reported clinical data only in week 23/2009. 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.
      -
      <cite cite="http://www.ecdc.europa.eu/en/health_content/episu/090612_EISS.aspx">ECDC Health Content</cite>

      Comment


      • #4
        Re: EISS - Weekly Electronic Bulletin - Influenza Surveillance (seasonal and pandemic)

        EISS - Influenza A(H1N1)v detections in the European region continue but influenza activity in the community remains at baseline levels (June 19, 2009, edited)
        EISS - Weekly Electronic Bulletin Week 24 : 08/06/2009-14/06/2009 - 19 June 2009, Issue N° 310

        Influenza A(H1N1)v detections in the European region continue but influenza activity in the community remains at baseline levels


        The 2008-2009 influenza season is now over and was described in the Weekly Electronic Bulletin of week 22/2009 (click here). As of week 24/2009, bulletins will also highlight developments regarding the influenza A(H1N1)v pandemic in the European region since week 16/2009.



        Summary:

        In week 24/2009, all countries reporting in the European region indicated low levels of influenza activity and 171 detections of influenza A(H1N1)v. This shows that despite a large number of influenza detections, not normally seen at this time of the year and due mainly to A(H1N1)v, influenza activity remains at or below baseline levels in Europe.


        Epidemiological situation - week 24/2009:

        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. For the geographical spread indicator, all countries reported sporadic or no activity. Definitions for the epidemiological indicators can be found here.


        Cumulative epidemiological situation - weeks 16-24/2009:

        Seasonal influenza activity was over in all countries in the European region by week 16/2009 and the intensity of activity returned to levels typically seen outside the winter season. To date, the occurrence of A(H1N1)v infection since week 16/2009 has not given rise to any increased levels of ILI or ARI, even in the UK and Spain, the two countries in Europe with the highest number of laboratory confirmed cases of influenza A(H1N1)v.


        Virological situation - week 24/2009:

        The total number of respiratory specimens collected by sentinel physicians in week 24/2009 was 194 of which 7 (4%) were positive for influenza virus: five type A (one H1v, one subtype H3 and three not subtyped) and two type B. In addition, 267 non-sentinel source specimens (e.g. specimens collected for diagnostic purposes in hospitals) were reported positive for influenza virus: 266 type A (170 subtype H1v, 18 subtype H3, nine subtype H1, 69 not subtyped) and 23 type B.


        Cumulative virological situation - weeks 16/2009-24/2009:

        Of 1777 virus detections (sentinel and non-sentinel) since week 16/2009, 1253 (70%) were type A (543 subtype H1v, 241 subtype H3, 101 subtype H1 and 368 not subtyped) and 524 (30%) were type B.

        Based on the antigenic and/or genetic characterisation of 3422 influenza viruses reported from week 20/2009 to week 24/2009, 2279 (67%) were reported as A/Brisbane/10/2007 (H3N2)-like, 165 (5%) as A/Brisbane/59/2007 (H1N1)-like, 30 (1%) as B/Florida/4/2006-like (B/Yamagata/16/88 lineage), 924 (27%) as B/Malaysia/2506/2004-like (B/Victoria/2/87 lineage) and 24 (1%) as A/California/4/2009 (H1N1)v-like (click here), the current virus strain recommended by WHO for vaccine preparation (click here).

        All A(H1N1)v viruses tested have been sensitive to oseltamivir and zanamivir but resistant to M2 inhibitors.


        Comment:

        In week 24/2009, 171 detections of the new pandemic influenza virus A(H1N1)v were reported. This does not reflect the total number of confirmed cases in the European Region reported on a daily basis during week 24/2009 to WHO through the IHR National Focal Points (click here) and to ECDC through the Early Warning Response System (click here) and efforts to harmonize this reporting are underway.

        Virus detections outside the winter season are usually highly sporadic in Europe, so these detections are unusual for this time of the year. However, influenza activity in the community remains low across all countries in the European region.

        As of 19 June 2009, there have been a total of 3308 laboratory confirmed cases and one death due to influenza A(H1N1)v reported in the European region: 3038 in 26 EU/EEA countries (including one death) and 188 in five non-EU/EEA countries).

        For a detailed epidemiological description of the A(H1N1)v virus detections in the European region (April–May 2009), click here, and in the EU/EFTA countries (April-8 June 2009), click here.

        Worldwide, 84 countries have now reported over 39000 cases of A(H1N1)v infection and on 11 June 2009 the WHO raised the pandemic alert level to phase 6 (click here). For more information, please go to the dedicated web pages of ECDC (click here) or WHO (click here).

        European countries have been requested to continue to perform seasonal influenza surveillance until further notice.


        Background:

        The Weekly Electronic Bulletin presents and comments on influenza activity in the 53 countries that report to EISS. Of these countries, 26 reported both clinical and virological data, four reported virological data only and six reported clinical data only in week 24/2009. 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.

        (...)
        -
        <cite cite="http://www.eiss.org/cgi-files/bulletin_v2.cgi">EISS - Bulletin Review</cite>

        Comment


        • #5
          Re: EISS - Weekly Electronic Bulletin - Influenza Surveillance (seasonal and pandemic)

          EISS - Bulletin Review: Influenza A(H1N1)v detections across the European region continue but influenza activity in the community remains at baseline levels (June 26, 2009, edited)
          EISS - Weekly Electronic Bulletin Week 25 : 15/06/2009-21/06/2009 - 26 June 2009, Issue N° 311

          Influenza A(H1N1)v detections across the European region continue but influenza activity in the community remains at baseline levels


          The 2008-2009 influenza season is over and was described in the Weekly Electronic Bulletin of week 22/2009. As of week 24/2009, bulletins present developments regarding the pandemic (H1N1) 2009 in the European region since week 16/2009.



          Summary:

          In week 25/2009, all countries reporting in the European region indicated low levels of influenza activity and 172 detections of influenza A(H1)v. Although a considerable number of influenza detections were reported, mainly due to pandemic (H1N1) 2009, influenza activity remains at or below baseline levels in Europe. The influenza A(H1)v was the dominant type reported in Belgium, Denmark, Hungary, Ireland, Italy, the Netherlands, Northern Ireland, Norway and Turkey.


          Epidemiological situation - week 25/2009:

          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. For the geographical spread indicator, all countries reported sporadic or no activity. Definitions for the epidemiological indicators can be found here.


          Cumulative epidemiological situation - weeks 16-25/2009:

          Seasonal influenza activity was over in almost all countries in the European region by week 16/2009 and the intensity of activity had returned to levels typically seen outside the winter season. To date, the occurrence of A(H1N1)v infection since week 16/2009 has not given rise to increased levels of ILI or ARI, although in England a slight increase can be observed in week 25/2009, see here.


          Virological situation - week 25/2009:

          The total number of respiratory specimens collected by sentinel physicians in week 25/2009 was 399 of which 33 (8.3%) were positive for influenza virus: 32 type A (22 H1v, two subtype H3, and eight A unsubtyped) and one type B. In addition, 286 non-sentinel source specimens (e.g. specimens collected for diagnostic purposes in hospitals) were reported positive for influenza virus: 266 type A (150 subtype H1v, 28 subtype H3, 10 subtype H1, 78 not subtyped) and 20 type B.


          Cumulative virological situation - weeks 16/2009-25/2009:

          Of 1993 virus detections
          (sentinel and non-sentinel) since week 16/2009, 1517 (76%) were type A (713 subtype H1v, 268 subtype H3, 111 subtype H1 and 425 not subtyped) and 476 (24%) were type B. The increase in detections of the influenza A(H1)v virus over the last weeks can be found (click here).

          Based on the antigenic and/or genetic characterisation of 3266 influenza viruses reported from week 20/2009 to week 25/2009, 2139 (65%) were reported as A/Brisbane/10/2007 (H3N2)-like, 151 (5%) as A/Brisbane/59/2007 (H1N1)-like, 30 (1%) as B/Florida/4/2006-like (B/Yamagata/16/88 lineage), 921 (28%) as B/Malaysia/2506/2004-like (B/Victoria/2/87 lineage) and 25 (1%) as A/California/4/2009 (H1N1)v-like (click here), the current virus strain recommended by WHO for vaccine preparation (click here).

          All A(H1N1)v viruses tested have been sensitive to oseltamivir and zanamivir but resistant to M2 inhibitors.


          Comment:


          In week 25/2009, 172 detections of the influenza A(H1)v were reported, similar to the previous week. However, the numbers do not reflect the total number of confirmed cases in the European Region reported on a daily basis during week 25/2009 (see below) to WHO through the IHR National Focal Points (click here) and to ECDC through the Early Warning Response System (click here) and efforts to harmonize this reporting are underway. Virus detections outside the winter season are usually highly sporadic in Europe, so these detections are unusual for this time of the year. However, influenza activity in the community remains low across all countries in the European region.

          As of 19 June 2009, there have been a total of 4888 laboratory confirmed cases and one death due to pandemic (H1N1) 2009 reported in the European region: 4482 in 26 EU/EEA countries (including one death) and 406 in five non-EU/EEA countries. For a detailed epidemiological description of the A(H1N1)v detections in the European region (April–May 2009), click here, and in the EU/EFTA countries (April-8 June 2009), click here.

          Worldwide, over 55000 cases of A(H1N1)v infection have been reported and on 11 June 2009 the WHO raised the pandemic alert level to phase 6 (click here). For more information, please go to the dedicated web pages of ECDC (click here) or WHO (click here). European countries have been requested to continue to report both clinical and virological data on influenza until further notice.


          Background:

          The Weekly Electronic Bulletin presents and comments on influenza activity in the 53 countries that report to EISS. Of these countries, 29 reported both clinical and virological data, two reported virological data only and four reported clinical data only in week 25/2009. 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.

          (...)
          -
          <cite cite="http://www.euroflu.org/cgi-files/bulletin_v2.cgi">EISS - Bulletin Review</cite>

          Comment


          • #6
            Re: EISS - Weekly Electronic Bulletin - Influenza Surveillance (seasonal and pandemic)

            what's H1N1v ? why the v ?
            is H1v also being used ?


            http://www.flutrackers.com/forum/sho...d.php?t=101180
            (thread closed)

            5 substrains by CDC : i,ii,iii,iv,v
            I'm interested in expert panflu damage estimates
            my current links: [url]http://bit.ly/hFI7H[/url] ILI-charts: [url]http://bit.ly/CcRgT[/url]

            Comment


            • #7
              Re: EISS - Weekly Electronic Bulletin - Influenza Surveillance (seasonal and pandemic)

              Originally posted by gsgs View Post
              what's H1N1v ? why the v ?
              is H1v also being used ?


              http://www.flutrackers.com/forum/sho...d.php?t=101180
              (thread closed)

              5 substrains by CDC : i,ii,iii,iv,v
              V=Variant?

              Comment


              • #8
                Re: EISS - Weekly Electronic Bulletin - Influenza Surveillance (seasonal and pandemic)

                how about H1N1n

                n for new or "novel" in Spanish?
                (...until there is a newer one...)

                v-flu
                I'm interested in expert panflu damage estimates
                my current links: [url]http://bit.ly/hFI7H[/url] ILI-charts: [url]http://bit.ly/CcRgT[/url]

                Comment


                • #9
                  Re: EISS - Weekly Electronic Bulletin - Influenza Surveillance (seasonal and pandemic)

                  EuroFlu - Continued pandemic H1N1 influenza detections in the European Region, with two countries reporting influenza activity above baseline levels (June 3, 2009, edited)
                  EuroFlu - Weekly Electronic Bulletin Week 26 : 22/06/2009-28/06/2009 03 July 2009, Issue N° 312

                  Continued pandemic H1N1 influenza detections in the European Region, with two countries reporting influenza activity above baseline levels


                  This is the first bulletin published by EuroFlu, the WHO/Euro platform for the surveillance of influenza in the 53 countries of the European Region.The 2008-2009 influenza season is considered to be over and was described in the EISS Bulletin of week 22/2009. Pandemic H1N1 influenza detections were first reported in the European Region in week 18/2009 and as of week 24/2009, bulletins present developments regarding this strain.



                  Summary:

                  In week 26/2009, most countries reporting in the European Region indicated low levels of influenza activity. For the first time this summer, England and Luxembourg reported ILI consultation rates above their national baselines and this highlights the need to carefully monitor the spread of pandemic H1N1 influenza in Europe in the coming weeks.


                  Epidemiological situation - week 26/2009:

                  For the intensity indicator, the national network levels of influenza-like illness (ILI) and/or acute respiratory infection (ARI) were medium in two countries (England and Luxembourg) and low in all other countries that reported this indicator. For the geographical spread indicator, England reported local activity and all other countries reported sporadic or no activity.


                  Cumulative epidemiological situation - weeks 16-26/2009:

                  Seasonal influenza activity was over in almost all countries in the European Region by week 16/2009, with the intensity returning to levels typically seen outside the winter season. Until this week, detections of pandemic H1N1 influenza have not caused increased levels of ILI or ARI in countries of the European Region. However, national baseline thresholds for ILI were reached in England) and Luxembourg in week 26/2009.


                  Virological situation - week 26/2009:


                  The total number of respiratory specimens collected by sentinel physicians in week 26/2009 was 574 of which 46 (8%) were positive for influenza virus: 38 type A (35 H1v and three A unsubtyped) and eight type B. In addition, 409 non-sentinel source specimens (e.g. specimens collected for diagnostic purposes in hospitals) were reported positive for influenza virus: 394 type A (246 subtype H1v, ten subtype H3 and 138 not subtyped) and 15 type B.


                  Cumulative virological situation - weeks 16/2009-26/2009:

                  Of 2037 virus detections (sentinel and non-sentinel) since week 16/2009, 1558 (76%) were type A (769 subtype H1v, 270 subtype H3, 113 subtype H1 and 406 not subtyped) and 479 (24%) were type B. The increasing trend for pandemic H1N1 influenza over these weeks is presented here.

                  Based on the antigenic and/or genetic characterisation of 2139 influenza viruses reported from week 40/2008 to week 26/2009, 1271 (59%) were A/Brisbane/10/2007 (H3N2)-like, 91 (4%) A/Brisbane/59/2007 (H1N1)-like, 18 (1%) B/Florida/4/2006-like (B/Yamagata/16/88 lineage) and 759 (35%) as B/Malaysia/2506/2004-/B/Brisbane/60/2008-like (B/Victoria/2/87 lineage) (click here).

                  No reports for pandemic H1N1 (A/California/7/2009-like, the current virus strain recommended by WHO for vaccine preparation (click here)) have been made in week 26/2009.

                  However, in previous weeks when the characterisation data was more complete, there have been reports of the pandemic H1N1 strain.

                  Antiviral susceptibility reports since week 40/2008 have shown all type B influenza viruses to be sensitive to oseltamivir and zanamivir, all A(H3N3) viruses to be susceptible to oseltamivir and zanamivir but resistant to M2 inhibitors, while for A(H1N1) viruses 98% were resistant to oseltamivir, 100% sensitive to zanamivir and 99% sensitive to M2 inhibitors.

                  All pandemic H1N1 viruses have been susceptible to zanamivir and resistant to M2 inhibitors, while only a single case of oseltamivir resistance has been reported in Denmark (click here).


                  Comment:

                  This is the first EuroFlu bulletin published by WHO Euro and data for a relatively large number of countries in the Region are missing. As of 3 July 2009, there have been a total of 10652 laboratory confirmed cases of pandemic H1N1 influenza and four associated deaths in the European Region. For a detailed epidemiological description of pandemic H1N1 detections in the European Region (April–May 2009), please click here. On 11 June 2009 WHO raised the pandemic alert level to phase 6 (click here) and worldwide 77201 cases of pandemic H1N1 infection have now been reported (1 July 2009). For more information, please go to the dedicated web pages of WHO (click here) and ECDC (click here).

                  Influenza activity in most countries in Europe remains at baseline levels, indicating that the pandemic virus is not spreading widely in the community. Of the two countries reporting ILI-levels above their national baselines, England has the highest number of laboratory confirmed cases of pandemic H1N1 influenza in the European Region (6929 confirmed cases, 65% of all confirmed cases in the region) so an increasing ILI consultation rate could be expected (click here). Luxembourg only has 4 confirmed cases of influenza A(H1N1)v and no virological detections since week 21/2009 (click here) so the increased ILI consultation rate (now reaching 2% of consultations) may be due to other respiratory pathogens which are currently not being tested for and a heightened awareness due to pandemic H1N1 influenza. It will be important to closely monitor these trends over the coming weeks to see if the increases are temporary or whether it represents the start of increased influenza activity in countries across the European Region.


                  Background:

                  The EuroFlu Bulletin presents and comments on influenza activity in the 53 countries in the WHO European Region. Of these countries, 14 reported both clinical and virological data, six reported virological data only and five reported clinical data only in week 26/2009. The spread of influenza viruses and their epidemiological impact in Europe are being monitored by WHO Regional Office for Europe in Copenhagen (Denmark), in collaboration with the WHO Collaborating Centre for Reference and Research on Influenza in London (UK) and the European Centre for Disease Prevention and Control in Stockholm (Sweden).
                  (...)
                  -
                  -----
                  <cite cite="http://www.euroflu.org/cgi-files/bulletin_v2.cgi">EuroFlu - Bulletin Review</cite>

                  Comment


                  • #10
                    Re: EuroFlu - Weekly Electronic Bulletin - Influenza Surveillance

                    where is the page with the weekly ECDC flu-graphs ?

                    they used to have a page with curves for flu-A,RSV,
                    a colored cake showing the serotype-distribution
                    and other info on that page.

                    I used to have a link
                    http://www.eiss.org/cgi-files/figure...=Europe&type=v

                    but it no longer works


                    xttp://www.eiss.org/cgi-files/figures2002.cgi?year=2009&week=24&region=Europe&ty pe=v

                    (replace x with h)
                    I'm interested in expert panflu damage estimates
                    my current links: [url]http://bit.ly/hFI7H[/url] ILI-charts: [url]http://bit.ly/CcRgT[/url]

                    Comment


                    • #11
                      Re: EuroFlu - Weekly Electronic Bulletin - Influenza Surveillance

                      Influenza A(H1N1)v detections across the European Union continue with high influenza activity in the community in the UK and baseline level activity in the other reporting countries (ECDC, EuroFlu, July 10, 2009, edited)

                      EUROPEAN INFLUENZA SURVEILLANCE NETWORK [EUROFLU]

                      Weekly electronic bulletin - Week 27: 29 June 2009 - 05 July 2009 - 10 July 2009

                      Influenza A(H1N1)v detections across the European Union continue with high influenza activity in the community in the UK and baseline level activity in the other reporting countries

                      [Original Full Document: LINK. EDITED.]



                      The 2008-2009 influenza season is over and was described in the Weekly Electronic Bulletin of week 22/2009. As of week 24/2009, bulletins will present developments regarding the pandemic (H1N1) 2009 in the European Union and Norway since week 16/2009.



                      Summary:

                      In week 27/2009, all countries reporting indicated low levels of influenza activity except for the UK (England) who reported high levels of activity. A total of 301detections of A(H1N1)v influenza virus was reported. Although a large number of influenza detections were reported, mainly due to A(H1N1)v virus, influenza activity remains at or below baseline levels in Europe. A(H1N1)v was the dominant type reported in Denmark, Ireland, and the UK (England).


                      Epidemiological situation - week 27/2009:

                      The overall intensity of influenza-like illness
                      (ILI) and/or acute respiratory infection (ARI) was low in all countries that reported this indicator except for UK (England) where high intensity was reported. All countries reported sporadic or no activity but the UK(England) notified widespread activity.


                      Cumulative epidemiological situation - weeks 16-27/2009

                      To date, the occurrence of A(H1N1)v influenza virus infection since week 16/2009 has not given rise to increased levels of ILI or ARI, although in a part of England an increase can be observed starting in week 25 and continuing to week 27/2009. There is also an increase in the percentage of positive sentinel samples in Spain and the UK (England).


                      Virological situation - week 27/2009:

                      The total number of respiratory specimens collected by sentinel physicians in week 27/2009 was 471 of which 88 (19 %) were positive for influenza virus: 86 type A (79 subtype (H1N1)v, two subtype (H1)v, one subtype H1 and four A unsubtyped) and two type B. In addition, 2488 non-sentinel source specimens (e.g. specimens collected for diagnostic purposes in hospitals) were reported positive for influenza virus: 2479 type A (163 subtype (H1N1)v, 57 subtype (H1)v, seven subtype H3, one subtype H3N2, and 2251 not subtyped) and nine type B.


                      Cumulative virological situation - weeks 16/2009-27/2009:

                      Of 5440 virus detections (sentinel and non-sentinel) since week 16/2009, 5020 (92%) were type A (498 subtype (H1)v, 1243 subtype (H1N1)v, 124 subtype H3, 85 subtype H3N2, 38 subtype H1, 37 subtype H1N1 and 2995 not subtyped) and 420 (8%) were type B.

                      Based on the antigenic and/or genetic characterisation of 6616 influenza viruses reported from week 40/2008 to week 27/2009, 4867 (73%) were reported as A/Brisbane/10/2007 (H3N2)-like, 266 (4%) as A/Brisbane/59/2007 (H1N1)-like, 52 (1 %) as B/Florida /4/2006-like (B/Yamagata/16/88 lineage), 1377 (21%) as B/Malaysia/2506/2004-like or B/Brisbane/60/2008-like (B/Victoria/2/87 lineage) and 54 (1%) as A/California/4/2009 (H1N1)v-like.

                      For the current virus strains recommended by WHO for vaccine preparation click here

                      All A(H1N1)v viruses tested have been resistant to M2 inhibitors and sensitive to oseltamivir and zanamivir, but for one oseltamivir-resistant specimen isolated in Denmark, for ECDC a threat assessment on this click here.


                      Comment:

                      In week 27/2009 one EU Member State (UK) reported high activity in one of its regions. In total, 301 detections of the A(H1N1)v influenza virus were reported. However, the numbers do not reflect the total number of confirmed cases in the European Union and Norway reported on a daily basis during week 27/2009 to ECDC through the Early Warning Response System (click here). However, influenza activity in the community remains low across all countries in the European Union and Norway except UK (England). As of 09 July 2009, there have been a total of 11020 laboratory confirmed cases and four deaths due to A(H1N1)v influenza virus reported in the EU and EFTA countries. For a detailed epidemiological description of the A(H1N1)v virus detections in the EU/EFTA countries (April-8 June 2009), click here.

                      Worldwide, over 104000 cases and 470 deaths due to A(H1N1)v influenza virus infections have been reported and on 11 June 2009 the WHO raised the pandemic alert level to phase 6 (click here). For more information, please go to the dedicated web pages of ECDC (click here) or WHO (click here). European countries have been requested to continue to report both clinical and virological data on influenza until further notice.


                      Background:

                      The Weekly Electronic Bulletin presents and comments on influenza activity in the European Union and Norway. Of these countries, 12 reported both clinical and virological data, one reported virological data only and three reported clinical data only in week 27/2009. 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) in collaboration with the WHO collaborating Centre for Reference and Research on Influenza in London (UK).

                      The EISN 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.

                      The bulletin text was written by an editorial team at the European Centre for Disease Prevention and Control (ECDC): Flaviu Plata, Phillip Zucs and Bruno Ciancio. The bulletin text was reviewed by the Community Network of Reference Laboratories for Human Influenza in Europe (CNRL) coordination team: Adam Meijer, Rod Daniels, Alan Hay and Maria Zambon. On behalf of the EISN members the bulletin text was reviewed by Joan O’Donnell (Health Protection Surveillance Centre, Ireland) and Katarina Prosenc (National Institute of Public Health, Slovenia).

                      Maps and commentary used in this Bulletin do not imply any opinions whatsoever of ECDC or its partners on the legal status of the countries and territories shown or concerning their borders.
                      (...)

                      -
                      ------

                      Comment


                      • #12
                        Re: EuroFlu - Weekly Electronic Bulletin - Influenza Surveillance

                        EuroFlu - Weekly Electronic Bulletin Week 28 : 06/07/2009-12/07/2009 17 July 2009, Issue N° 314 (Edited)
                        EuroFlu - Weekly Electronic Bulletin Week 28 : 06/07/2009-12/07/2009 17 July 2009, Issue N° 314

                        High influenza activity in England and continued pandemic H1N1 influenza detections in the European Region


                        The 2008-2009 influenza season is considered to be over and was described in the EISS Bulletin of week 22/2009. Pandemic H1N1 influenza detections were first reported in the European Region in week 18/2009 and as of week 24/2009 bulletins present developments involving this strain.


                        Summary:

                        In week 28/2009, most countries reporting in the European Region indicated low levels of influenza activity. A total of 468 detections of A(H1N1)v influenza were reported and eight countries (Austria, Denmark, England, Hungary, Italy, Luxembourg, Serbia and Turkey) now report A(H1N1)v as the dominant virus. Four countries have reported an intensity above the baseline in the past three weeks: England, Luxembourg, Turkey and Wales. England has reported a high intensity of influenza activity since week 27/2009.


                        Epidemiological situation - week 28/2009:

                        For the intensity indicator, the national network levels of influenza-like illness (ILI) and/or acute respiratory infection (ARI) were high in one country (England) and low in all other countries that reported this indicator. For the geographical spread indicator, England reported widespread activity while all other countries reported sporadic or no activity.


                        Cumulative epidemiological situation - weeks 16-28/2009:

                        Seasonal influenza activity was effectively over in the European Region by week 16/2009, with the intensity returning to levels typically seen outside the winter season. Until week 25/2009, detections of pandemic H1N1 influenza had not caused increased levels of ILI or ARI in countries of the European Region. However, national baseline thresholds for ILI were reached in England (in week 26/2009), Luxembourg (26/2007), Turkey (26/2009) and Wales (27/2009). England is the only country to have reported a high intensity of influenza activity (since week 27/2009).


                        Virological situation - week 28/2009:

                        The total number of respiratory specimens collected by sentinel physicians in week 28/2009 was 647 of which 45 (7%) were positive for influenza virus: 43 type A (38 subtype H1v, one subtype H1 and four not subtyped) and two type B. In addition, 978 non-sentinel source specimens (e.g. specimens collected for diagnostic purposes in hospitals) were reported positive for influenza virus: 965 type A (430 subtype H1v, 87 subtype H1, five subtype H3 and 443 not subtyped) and 13 type B. Therefore, of the total influenza A virus detections that were subtyped in week 28/2009 (N=561), 83% were the pandemic H1N1 virus: 97% in sentinel specimens (N=39) and 82% in non-sentinel specimens (N=522).


                        Cumulative virological situation - weeks 16/2009-28/2009:

                        Of 2055 virus detections (sentinel and non-sentinel) since week 16/2009, 1574 (77%) were type A (782 subtype H1v, 276 subtype H3, 106 subtype H1 and 410 not subtyped) and 481 (23%) were type B. The increasing trend for pandemic H1N1 influenza over these weeks is presented here.

                        Based on the antigenic and/or genetic characterisation of 3498 influenza viruses reported from week 40/2008 to week 28/2009, 2326 (67%) were A/Brisbane/10/2007 (H3N2)-like, 150 (4%) A/Brisbane/59/2007 (H1N1)-like, 28 (1%) B/Florida/4/2006-like (B/Yamagata/16/88 lineage) and 937 (27%) as B/Malaysia/2506/2004 or /B/Brisbane/60/2008-like (B/Victoria/2/87 lineage) (click here). Fifty-seven (2%) were pandemic H1N1, A/California/7/2009-like, the current virus strain recommended by WHO for vaccine preparation (click here).

                        Antiviral susceptibility reports from week 40/2008 to 26/2009 have shown all type B influenza viruses to be sensitive to oseltamivir and zanamivir, all A(H3N3) viruses to be susceptible to oseltamivir and zanamivir but resistant to M2 inhibitors, while for A(H1N1) viruses 98% were resistant to oseltamivir, 100% sensitive to zanamivir and 99% sensitive to M2 inhibitors.

                        All pandemic H1N1 viruses have been susceptible to zanamivir and resistant to M2 inhibitors, while only a single case of oseltamivir resistance has been reported in Denmark (click here).


                        Comment:

                        As of 8 July 2009, there have been a total of 11497 laboratory confirmed cases of pandemic H1N1 influenza and four associated deaths in two countries in the European Region. For a detailed epidemiological description of pandemic H1N1 detections in the European Region (April–May 2009), please click here.

                        On 11 June 2009 WHO raised the pandemic alert level to phase 6 (click here) and worldwide 94512 cases of pandemic H1N1 infection including 429 deaths have now been reported (6 July 2009). For more information, please go to the dedicated web pages of WHO (click here) and ECDC (click here).

                        Influenza activity reported in this bulletin is based on data reported in week 28/2009. In most countries in Europe influenza activity remains at baseline levels, indicating that, with the exception of a few countries, the pandemic H1N1 virus is not spreading widely in the community. However, 468 detections of the A(H1N1)v influenza virus were reported in week 28/2009, which is unusual for this time of year. These do not reflect the total number of confirmed cases in the European Region reported during week 28/2009 to WHO through the IHR National Focal Points and efforts to harmonize this reporting are underway.

                        England reported ILI consultation rates in week 28/2009 that exceeded the peak rates seen during the previous eight seasons (click here). The high consultation rates in England are reflected in the very large number of laboratory confirmed cases of pandemic H1N1 influenza reported in the United Kingdom (7447 or 65% of total cases in the European Region). Other countries with a high number of laboratory confirmed cases are Spain (870; 8%), Israel (727; 6%) and Germany (548; 5%), but all of them report ILI or ARI consultation rates at baseline levels. It will be important to closely monitor these trends over the coming weeks to determine if the increases are temporary or whether they represent the start of increased influenza activity in countries across the European Region.


                        Background:

                        The EuroFlu Bulletin presents and comments on influenza activity in the 53 countries in the WHO European Region. Of these countries, 24 reported both clinical and virological data, five reported clinical data only and four reported virological data only in week 28/2009. The spread of influenza viruses and their epidemiological impact in Europe are being monitored by WHO Regional Office for Europe in Copenhagen (Denmark), in collaboration with the WHO Collaborating Centre for Reference and Research on Influenza in London (UK).
                        -
                        <cite cite="http://www.euroflu.org/cgi-files/bulletin_v2.cgi">EuroFlu - Bulletin Review</cite>

                        Comment


                        • #13
                          Re: EuroFlu - Weekly Electronic Bulletin - Influenza Surveillance

                          EuroFlu - High influenza activity in England and increasing pandemic H1N1 influenza detections in the European Region (July 24, 2009, edited)
                          EuroFlu - Weekly Electronic Bulletin Week 29 : 13/07/2009-19/07/2009

                          24 July 2009, Issue N° 315

                          High influenza activity in England and increasing pandemic H1N1 influenza detections in the European Region

                          The 2008-2009 influenza season is considered to be over and was described in the EISS Bulletin of week 22/2009 (click here). Pandemic H1N1 influenza detections were first reported in the European Region in week 18/2009 and as of week 24/2009 bulletins present developments involving this strain.


                          Summary:

                          In week 29/2009, most countries reporting in the European Region indicated low levels of influenza activity. However, a total of 980 detections of A(H1N1)v influenza were reported in week 29/2009 and 18 countries now report A(H1N1)v is the dominant virus. So far this season, five countries have reported an intensity above the baseline (England, Luxembourg, Northern Ireland, Turkey and Wales) and England has reported a high intensity of influenza activity since week 27/2009.


                          Epidemiological situation - week 29/2009:

                          For the intensity indicator, the national network levels of influenza-like illness (ILI) and/or acute respiratory infection (ARI) were high in one country (England), medium in two countries (Northern Ireland and Wales) and low in all other countries that reported this indicator.

                          For the geographical spread indicator, England reported widespread activity and Italy reported regional activity, while all other countries reported, local sporadic or no activity*.


                          Cumulative epidemiological situation - weeks 16-29/2009:

                          Until week 25/2009, detections of pandemic H1N1 influenza had not caused increased levels of ILI or ARI in countries of the European Region. However, national baseline thresholds for ILI were reached in England (in week 26/2009), Luxembourg (26/2007), Turkey (26/2009), Wales (27/2009) and Northern Ireland (29/2009). England is the only country in the European Region to have reported a high intensity of influenza activity (since week 27/2009).


                          Virological situation - week 29/2009:

                          The total number of respiratory specimens collected by sentinel physicians in week 29/2009 was 611 of which 61 (10%) were positive for influenza virus: all 61 were type A (50 subtype H1v and eleven not subtyped). In addition, 1427 non-sentinel source specimens (e.g. specimens collected for diagnostic purposes in hospitals) were reported positive for influenza virus: 1420 type A (980 subtype H1v, 29 subtype H1, four subtype H3 and 407 not subtyped) and seven type B. Therefore, of the total influenza A virus detections that were subtyped in week 29/2009 (N=1013), 97% were the pandemic H1N1 virus: 100% in sentinel specimens (N=50) and 97% in non-sentinel specimens (N=963).


                          Cumulative virological situation - weeks 16/2009-29/2009:

                          Of 2054 virus detections (sentinel and non-sentinel) since week 16/2009, 1573 (77%) were type A (782 subtype H1v, 276 subtype H3, 106 subtype H1 and 409 not subtyped) and 481 (23%) were type B. The increasing trend for pandemic H1N1 influenza over these weeks is presented here.

                          Based on the antigenic and/or genetic characterisation of 3719 influenza viruses reported from week 40/2008 to week 28/2009, 2366 (64%) were A/Brisbane/10/2007 (H3N2)-like, 154 (4%) A/Brisbane/59/2007 (H1N1)-like, 30 (1%) B/Florida/4/2006-like (B/Yamagata/16/88 lineage) and 947 (25%) as B/Malaysia/2506/2004 or /B/Brisbane/60/2008-like (B/Victoria/2/87 lineage) (click here). A total of 222 (6%) were pandemic H1N1, A/California/7/2009-like, the current virus strain recommended by WHO for vaccine preparation (click here).

                          Antiviral susceptibility reports from week 40/2008 to 26/2009 have shown all type B influenza viruses to be sensitive to oseltamivir and zanamivir, all A(H3N2) viruses to be susceptible to oseltamivir and zanamivir but resistant to M2 inhibitors, while for A(H1N1) viruses 98% were resistant to oseltamivir, 100% sensitive to zanamivir and 99% sensitive to M2 inhibitors.

                          All pandemic H1N1 viruses have been susceptible to zanamivir and resistant to M2 inhibitors, while only a single case of oseltamivir resistance has been reported in Denmark (click here).


                          Comment:

                          On 16 July 2009, WHO changed the reporting requirements for pandemic (H1N1) 2009 virus infections. The increasing number of cases in many countries with sustained community transmission made it extremely difficult, if not impossible, for these countries to confirm cases through laboratory testing and continue counting individual cases. WHO has therefore stopped the collection and publication of the total number of laboratory confirmed cases and the WHO Interim guidance for the surveillance of human infection with influenza A(H1N1) virus outlines a number of initiatives to enhance national and regional surveillance systems. The EuroFlu surveillance platform has been adapted to these new guidelines.

                          Influenza activity reported in this bulletin is based on data reported in week 29/2009. In most countries in Europe influenza activity remains at baseline levels, indicating that, with the exception of a few countries, the pandemic H1N1 virus is not spreading widely in the community. However, 980 detections of the A(H1N1)v influenza virus were reported in week 29/2009 and influenza A(H1N1)v is now the dominant virus in 18 of the 33 countries that reported this indicator to EuroFlu. This virological data indicates that the influenza A(H1N1)v is establishing itself in Europe.

                          England, Northern Ireland and Wales reported ILI consultation rates above the baseline level
                          in week 29/2209, with England reporting levels that exceeded the peak rates seen during the previous eight seasons (click here). The high consultation rates in England are reflected in the very large number of laboratory confirmed cases of pandemic H1N1 influenza reported in the United Kingdom (7447 or 65% of total cases in the European Region [data reported until 8 July 2009 (click here]).

                          For more information about the situation in Europe, please go to the dedicated web pages of WHO (click here) and ECDC (click here).


                          Background:

                          The EuroFlu Bulletin presents and comments on influenza activity in the 53 countries in the WHO European Region. Of these countries, 24 reported both clinical and virological data, nine reported virological data only and five reported clinical data only in week 29/2009. The spread of influenza viruses and their epidemiological impact in Europe are being monitored by WHO Regional Office for Europe in Copenhagen (Denmark), in collaboration with the WHO Collaborating Centre for Reference and Research on Influenza in London (UK).

                          * Erratum:
                          Portugal reported ‘Sporadic’ activity and not ‘Widespread’ activity (the Geographical spread indicator) in week 29/2009.
                          -
                          <cite cite="http://www.euroflu.org/cgi-files/bulletin_v2.cgi">EuroFlu - Bulletin Review</cite>

                          Comment


                          • #14
                            Re: EuroFlu - Weekly Electronic Bulletin - Influenza Surveillance

                            EuroFlu - 31 July 2009, Issue N° 316 - Influenza activity above the baseline in Ireland, Norway, Malta and the United Kingdom
                            EuroFlu - Weekly Electronic Bulletin Week 30 : 20/07/2009-26/07/2009

                            31 July 2009, Issue N° 316 - Influenza activity above the baseline in Ireland, Norway, Malta and the United Kingdom


                            Pandemic (H1N1) 2009 virus detections were first reported in the European Region in week 18/2009 and as of week 24/2009 bulletins present developments involving this strain. As of 31 July 2009, 46 of the 53 countries in the WHO European Region have reported to WHO confirmed cases of pandemic (H1N1) 2009 virus infection, in compliance with their obligations under the International Health Regulations. Forty-one fatalities associated with pandemic (H1N1) 2009 virus infections were reported in six countries.



                            Summary:

                            In week 30/2009, most countries reporting in the European Region indicated low levels of influenza activity. However, a total of 1599 detections of A(H1N1)v influenza were reported in week 30/2009 and 16 countries reported that A(H1N1)v is the dominant virus. Three new countries (Ireland, Malta and Norway) reported influenza activity above the baseline in week 30/2009. This means that eight countries (England, Ireland, Malta, Luxembourg, Northern Ireland, Norway, Turkey and Wales) have now reported an intensity above the baseline in the last four weeks.


                            Epidemiological situation - week 30/2009:

                            For the intensity indicator, the national network levels of influenza-like illness (ILI) and/or acute respiratory infection (ARI) were high in England and Malta, medium in Ireland, Luxembourg, Northern Ireland, Norway and Wales and low in all other countries that reported this indicator. For the geographical spread indicator, England and Norway reported widespread activity, Malta and Italy reported regional activity, and all other countries reported local, sporadic or no activity.


                            Cumulative epidemiological situation - weeks 16-30/2009:


                            Until week 25/2009, detections of pandemic H1N1 influenza had not caused increased levels of ILI or ARI in countries of the European Region. However, national baseline thresholds for ILI were reached in England (in week 26/2009), Luxembourg (26/2007), Turkey (26/2009), Wales (27/2009), Northern Ireland (29/2009), Malta (30/2009), Norway (30/2009) and Ireland (30/2009). Malta has reported a high intensity of influenza activity in week 30/2009, with 11% of sentinel GP consultations due to ILI. In most countries the highest consultation rates are seen in children (0-4 and 5-14).


                            Virological situation - week 30/2009:

                            The total number of respiratory specimens collected by sentinel physicians in week 30/2009 was 700 of which 84 (12%) were positive for influenza virus: all 84 were type A (79 subtype H1v, 3 subtype H1 and 2 not subtyped). In addition, 2220 non-sentinel source specimens (e.g. specimens collected for diagnostic purposes in hospitals) were reported positive for influenza virus: 2212 type A (1520 subtype H1v, 151 subtype H1, six subtype H3 and 535 not subtyped) and eight type B. Therefore, of the total influenza A virus detections that were subtyped in week 30/2009 (N=1759), 91% were the pandemic (H1N1) 2009 virus.


                            Cumulative virological situation - weeks 16/2009-30/2009:

                            Of 9596 virus detections (sentinel and non-sentinel) since week 16/2009, 9008 (94%) were type A (5098 subtype H1v, 407 subtype H3, 460 subtype H1 and 3043 not subtyped) and 588 (6%) were type B. A general increasing trend for pandemic (H1N1) 2009 virus over the past weeks is presented here.

                            Based on the antigenic and/or genetic characterisation of 3714 influenza viruses reported from week 40/2008 to week 30/2009, 2329 (63%) were A/Brisbane/10/2007 (H3N2)-like, 153 (4%) A/Brisbane/59/2007 (H1N1)-like, 29 (1%) B/Florida/4/2006-like (B/Yamagata/16/88 lineage) and 913 (25%) as B/Malaysia/2506/2004 or /B/Brisbane/60/2008-like (B/Victoria/2/87 lineage) (click here). A total of 290 (8%) were pandemic H1N1, A/California/7/2009-like, the current virus strain recommended by WHO for vaccine preparation (click here).

                            Antiviral susceptibility reports from week 40/2008 to 26/2009 have shown all type B influenza viruses to be sensitive to oseltamivir and zanamivir, all A(H3N3) viruses to be susceptible to oseltamivir and zanamivir but resistant to M2 inhibitors, while for A(H1N1) viruses 98% were resistant to oseltamivir, 100% sensitive to zanamivir and 99% sensitive to M2 inhibitors.

                            All pandemic (H1N1) 2009 viruses have been susceptible to zanamivir and resistant to M2 inhibitors, while only a single case of oseltamivir resistance has been reported in Denmark (click here).


                            Comment:

                            Influenza activity reported in this bulletin is based on data reported in week 30/2009. The reporting platform was modified this week and this probably explains why many countries did not provide clinical data to EuroFlu. In most countries in Europe influenza activity remains at baseline levels, however is the number of countries with ILI/ARI rates above the baseline is increasing. In week 29/2009 England reported levels that exceeded the peak rates seen during the previous eight seasons (click here), but the rates are levelling off or slightly decreasing in week 30/2009. This coincides with the start of school holidays and the introduction of the National Pandemic Flu Service, click here).

                            For more information about the situation in Europe, please go to the dedicated web pages of WHO (click here) and ECDC (click here).


                            Background:

                            The EuroFlu Bulletin presents and comments on influenza activity in the 53 countries in the WHO European Region. Of these countries, 23 reported both clinical and virological data, four reported virological data only and five reported clinical data only in week 30/2009. The spread of influenza viruses and their epidemiological impact in Europe are being monitored by WHO Regional Office for Europe in Copenhagen (Denmark), in collaboration with the WHO Collaborating Centre for Reference and Research on Influenza in London (UK).
                            -
                            <cite cite="http://www.euroflu.org/cgi-files/bulletin_v2.cgi">EuroFlu - Bulletin Review</cite>

                            Comment


                            • #15
                              Re: EuroFlu - Weekly Electronic Bulletin - Influenza Surveillance

                              Originally posted by ironorehopper View Post
                              This means that eight countries (England, Ireland, Malta, Luxembourg, Northern Ireland, Norway, Turkey and Wales) have now reported an intensity above the baseline in the last four weeks.
                              Interesting that Scotland is not included. According to the UK HPA latest update ili rate in Scotland is estimated at 33 per 100,000 with a baseline threshold of 50 - baseline is 30 everywhere else in the UK. However the much more detailed NHS Scotland update puts the current rate at 55 (up from 47 last week). See http://www.documents.hps.scot.nhs.uk...2009-07-30.pdf

                              On this basis Scotland has now reported above baseline but the UK report is only showing a little over half that rate and thus the European report also omits Scotland.

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