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Weekly influenza surveillance overview - 26 November 2010 (ECDC, 11/26/10, extract, edited): 27 SARI cases in Romania since the start of season.
Weekly influenza surveillance overview - 26 November 2010 (ECDC, 11/26/10, extract, edited)
[Source: European Centre for Disease Prevention and Control (ECDC), full PDF document (LINK). Extract, edited.]
SURVEILLANCE REPORT
Weekly influenza surveillance overview - 26 November 2010
Main surveillance developments in week 46/2010 (15 ? 21 Nov 2010)
This first page contains the main developments of this week and can be printed separately or together with the more detailed information following.
Sentinel surveillance of influenza-like illness (ILI)/ acute respiratory infection (ARI):
22 of 24 reporting countries continued to observe low activity.
Virological surveillance:
Sentinel physicians collected 485 specimens, 12 (2.5%) of which were positive for influenza virus. Of the 25 influenza viruses detected from sentinel and non-sentinel sources during week 46/2010, 15 (60%) were type A, and 10 (40%) were type B.
Hospital surveillance of severe acute respiratory infection (SARI):
During week 46/2010, nine SARI cases were reported.
Sentinel surveillance (ILI/ARI) - Weekly analysis ? epidemiology
During week 46/2010, 24 of 29 countries reported epidemiological data.
Twenty-two observed low intensity, and Finland had insufficient information to make an estimate.
Bulgaria remained the only country indicating medium intensity.
Compared with the previous week, Hungary, Lithuania and Poland reported an increase in ILI/ARI consultation rates, with Hungary and Lithuania doing so for the second consecutive week.
Slovakia reported a decrease while the remaining countries saw no change (Map 1, Table 1).
For the geographic spread indicator, the UK (Scotland) reported local activity, while Cyprus, France, Luxembourg, Norway, Portugal, Slovenia and the UK (England and Wales) reported sporadic activity. The remaining countries indicated no activity (Map 2).
(...)
Table 1: Epidemiological and virological overview by country, week 46/2010
[Country - Intensity - Geographic spread - Trend - No. of sentinel swabs - Dominant type - Percentage positive* ILI per 100.000 - ARI per 100.000]
(*) Incidence per 100 000 is not calculated for these countries as no population denominator is provided.
Note: Liechtenstein is not reporting to the European Influenza Surveillance Network
Description of the system
This surveillance is based on nationally organized sentinel networks of physicians, mostly general practitioners (GPs), covering at least 1?5% of the population in their countries. All EU/EEA Member States (except Liechtenstein) are participating. Depending on their country?s choice, each sentinel physician reports the weekly number of patients seen with influenza-like illness (ILI), acute respiratory infection (ARI) or both to a national focal point. From the national level, both numerator and denominator data are then reported to the European Surveillance System (TESSy) database. Additional semi-quantitative indicators of intensity, geographic spread and trend of influenza activity at the national level are also reported.
Virological surveillance - Weekly analysis ? virology
In week 46/2010, 24 countries reported virological data. Sentinel physicians collected 485 specimens, 12 (2.5%) of which were positive for influenza virus (Tables 1 and 2).
In addition, 13 non-sentinel source specimens (i.e., specimens collected for diagnostic purpose in hospitals) were reported positive for influenza virus.
Of the 25 influenza viruses detected from sentinel and non-sentinel sources during week 46/2010, 15 (60%) were type A, and 10 (40%) were type B; the latter being mainly reported by Spain and the UK (England).
Nine of the 15 influenza A viruses detected in week 46/2010 were subtyped: eight (89%) as A(H1N1) 2009 virus and one as A(H3).
Since week 40/2010, sentinel and non-sentinel specimens yielded 192 influenza detections, of which 133 (69%) were type A, and 59 (31%) were type B. Eighty-four of these influenza A viruses were subtyped: 65 (77%) as A(H1N1)2009 virus and 19 (23%) as A(H3).
Table 2 shows the distribution of both sentinel and non-sentinel specimens by type and subtype. Figures 1?3 show the trends of virological detections since week 40/2010.
From week 40 to week 46/2010, 29 influenza viruses from sentinel and non-sentinel specimens were characterised antigenically (Table 3): 17 as A/California/7/2009 (H1N1)-like; four as A/Perth/16/2009 (H3N2)-like; seven as B/Brisbane/60/2008-like (Victoria lineage); and one as B/Florida/4/2006-like (Yamagata lineage).
More details on circulating viruses can be found in the report prepared by the Community Network of Reference Laboratories coordination team.
In week 46/2010, respiratory syncytial virus detections increased for the sixth consecutive week, with 13 countries reporting 289 detections (Figure 4).
Table 2: Weekly and cumulative influenza virus detections by type, subtype and surveillance system, weeks 40/2010?46/2010
[Virus Type / Subtype - Current Week: Sentinel - Non-Sentinel / Season: Sentinel - Non-Sentinel]
Note: A(pandemic H1) 2009, A(H3) and A(H1) include both N-subtyped and not N-subtyped viruses.
(...)
Table 3: Results of antigenic characterisations of sentinel and non-sentinel influenza virus isolates, weeks 40/2010?46/2010
[Strain name - Number of strains]
(...)
Description of the system
According to the nationally defined sampling strategy, sentinel physicians take nasal or pharyngeal swabs from patients with ILI, ARI or both and send the specimens to influenza-specific reference laboratories for virus detection, (sub-)typing, antigenic or genetic characterisation and antiviral susceptibility testing.
For details on the current virus strains recommended by WHO for vaccine preparation click here.
Hospital surveillance ? severe acute - respiratory infection (SARI) - Weekly analysis ? SARI
During week 46/2010, nine SARI cases were reported.
Since week 40/2010, a total of 27 SARI cases have been reported, all in Romania, representing a notification rate of 0.4 per 100000 population. Figure 5 displays the number of cases by week of onset.
Six of the nine cases reported for week 46/2010 were male, five of them less than two years old (Table 4). All cases presented with acute respiratory distress syndrome, but it is unknown if any of them were due to influenza (Table 5). One of the nine cases had previously been vaccinated against the pandemic A(H1N1) 2009 virus. Three elderly patients and one of the infants had underlying conditions.
Five cases, one having an underlying condition, were admitted to intensive care.
(...)
Table 4: Number of SARI cases by age and gender, week 46/2010
[Age groups - Male - Female]
Table 5: Number of SARI cases by influenza type and subtype, week 46/2010
[Virus Type / Subtype - Number of cases during current week / Cumulative Number of cases since the start of the season]
Note: A(pandemic H1) 2009, A(H3) and A(H1) include both N-subtyped and not N-subtyped viruses.
The report text was written by an editorial team at the European Centre for Disease Prevention and Control (ECDC): Eeva Broberg, Flaviu Plata, Phillip Zucs and Ren? Snacken. The bulletin text was reviewed by the Community Network of Reference Laboratories for Human Influenza in Europe (CNRL) coordination team: Adam Meijer, Rod Daniels, John McCauley and Maria Zambon. On behalf of the EISN members the bulletin text was reviewed by Bianca Snijders (RIVM Bilthoven, The Netherlands) and Thedi Ziegler (National Institute for Health and Welfare, Finland)
Maps and commentary used in this Weekly Influenza Surveillance Overview (WISO) 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.
All data published in the WISO are up-to-date on the day of publication. Past this date, however, published data should not be used for longitudinal comparisons as countries tend to retrospectively update their numbers in the database.
? European Centre for Disease Prevention and Control, Stockholm, 2010.
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[Source: European Centre for Disease Prevention and Control (ECDC), full PDF document (LINK). Extract, edited.]
SURVEILLANCE REPORT
Weekly influenza surveillance overview - 26 November 2010
Main surveillance developments in week 46/2010 (15 ? 21 Nov 2010)
This first page contains the main developments of this week and can be printed separately or together with the more detailed information following.
- Almost all countries reporting to EISN continue to experience low consultation rates for influenza-like illness and acute respiratory infection.
- The very low proportion of sentinel clinical specimens testing positive for influenza virus (2.5%) supports the evidence from syndromic surveillance that there is currently very little influenza virus circulating in Europe.
- Almost 70% of influenza viruses detected since week 40/2010 have been type A, and 77% of the type A viruses subtyped were A(H1N1) 2009.
- At present, only one country (Romania) is reporting SARI cases, with nine cases in week 46/2010.
- Rare detections of influenza virus along with steadily increasing detections of respiratory syncytial virus in a number of European countries suggest that the low influenza-like illness and acute respiratory infection activity currently observed is likely due to other respiratory pathogens (including respiratory syncytial virus) rather than influenza virus.
Sentinel surveillance of influenza-like illness (ILI)/ acute respiratory infection (ARI):
22 of 24 reporting countries continued to observe low activity.
Virological surveillance:
Sentinel physicians collected 485 specimens, 12 (2.5%) of which were positive for influenza virus. Of the 25 influenza viruses detected from sentinel and non-sentinel sources during week 46/2010, 15 (60%) were type A, and 10 (40%) were type B.
Hospital surveillance of severe acute respiratory infection (SARI):
During week 46/2010, nine SARI cases were reported.
Sentinel surveillance (ILI/ARI) - Weekly analysis ? epidemiology
During week 46/2010, 24 of 29 countries reported epidemiological data.
Twenty-two observed low intensity, and Finland had insufficient information to make an estimate.
Bulgaria remained the only country indicating medium intensity.
Compared with the previous week, Hungary, Lithuania and Poland reported an increase in ILI/ARI consultation rates, with Hungary and Lithuania doing so for the second consecutive week.
Slovakia reported a decrease while the remaining countries saw no change (Map 1, Table 1).
For the geographic spread indicator, the UK (Scotland) reported local activity, while Cyprus, France, Luxembourg, Norway, Portugal, Slovenia and the UK (England and Wales) reported sporadic activity. The remaining countries indicated no activity (Map 2).
(...)
Table 1: Epidemiological and virological overview by country, week 46/2010
[Country - Intensity - Geographic spread - Trend - No. of sentinel swabs - Dominant type - Percentage positive* ILI per 100.000 - ARI per 100.000]
- Austria - ... - ... - ... - 0 - None - 0.0 - ... - ...
- Belgium - Low - No activity - Stable - 19 - None - 5.3 - 31.5 - 855.6
- Bulgaria - Medium - No activity - Stable - ... - None - 0.0 - ... - 900.7
- Cyprus - ... - Sporadic - Stable - ... - ... - 0.0 - ...* - ...*
- Czech Republic - ... - ... - ... - ... - ... - 0.0 - ... - ...
- Denmark - Low - No activity - Stable - 7 - None - 14.3 - 58.4 - ...
- Estonia - Low - No activity - Stable - 10 - None - 0.0 - 4.7 - 276.9
- Finland - Unknown (no information available) - No activity - Stable - 24 - None - 0.0 - ... - ...
- France - Low - Sporadic - Stable - 41 - None - 0.0 - ... - 1357.2
- Germany - Low - No activity - Stable - 21 - None - 0.0 - ... - 873.0
- Greece - Low - No activity - Stable - 1 - None - 0.0 - 58.6 - ...
- Hungary - Low - No activity - Increasing - 41 - None - 0.0 - 80.3 - ...
- Iceland - ... - ... - ... - ... - ... - 0.0 - ... - ...
- Ireland - Low - No activity - Stable - 13 - None - 0.0 - 9.4 - ...
- Italy - Low - No activity - Stable - ... - ... - 0.0 - 90.7 - ...
- Latvia - ... - ... - ... - 0 - None - 0.0 - ... - ...
- Lithuania - Low - No activity - Increasing - ... - ... - 0.0 - 0.5 - 426.8
- Luxembourg - Low - Sporadic - Stable - 3 - None - 33.3 - ...* - ...*
- Malta - ... - ... - ... - ... - ... - 0.0 - ... - ...
- Netherlands - Low - No activity - Stable - 5 - None - 0.0 - 19.0 - ...
- Norway - Low - Sporadic - Stable - 5 - None - 0.0 - 28.5 - ...
- Poland - Low - No activity - Increasing - 14 - None - 0.0 - 50.1 - ...
- Portugal - Low - Sporadic - Stable - 1 - None - 0.0 - 15.2 - ...
- Romania - Low - No activity - Stable - 28 - None - 0.0 - 14.4 - 712.2
- Slovakia - Low - No activity - Decreasing - 0 - None - 0.0 - 142.7 - 1320.3
- Slovenia - Low - Sporadic - Stable - 6 - None - 0.0 - 0.0 - 855.3
- Spain - Low - No activity - Stable - 86 - None - 2.3 - 17.6 - ...
- Sweden - Low - No activity - Stable - 23 - None - 0.0 - 5.0 - ...
- UK - England - Low - Sporadic - Stable - 111 - None - 4.5 -8.3 - 414.1
- UK - Northern Ireland - Low - No activity - Stable - 8 - None - 0.0 - 18.9 - 335.3
- UK - Scotland - Low - Local - Stable - 18 - ... - 11.1 - 1.0 - 281.8
- UK - Wales - Low - Sporadic - Stable - ... - ... - 0.0 - 8.1 - ...
- Europe - ... - ... - ... - 485 - ... - 2.5 - ... - ... - ...
(*) Incidence per 100 000 is not calculated for these countries as no population denominator is provided.
Note: Liechtenstein is not reporting to the European Influenza Surveillance Network
Description of the system
This surveillance is based on nationally organized sentinel networks of physicians, mostly general practitioners (GPs), covering at least 1?5% of the population in their countries. All EU/EEA Member States (except Liechtenstein) are participating. Depending on their country?s choice, each sentinel physician reports the weekly number of patients seen with influenza-like illness (ILI), acute respiratory infection (ARI) or both to a national focal point. From the national level, both numerator and denominator data are then reported to the European Surveillance System (TESSy) database. Additional semi-quantitative indicators of intensity, geographic spread and trend of influenza activity at the national level are also reported.
Virological surveillance - Weekly analysis ? virology
In week 46/2010, 24 countries reported virological data. Sentinel physicians collected 485 specimens, 12 (2.5%) of which were positive for influenza virus (Tables 1 and 2).
In addition, 13 non-sentinel source specimens (i.e., specimens collected for diagnostic purpose in hospitals) were reported positive for influenza virus.
Of the 25 influenza viruses detected from sentinel and non-sentinel sources during week 46/2010, 15 (60%) were type A, and 10 (40%) were type B; the latter being mainly reported by Spain and the UK (England).
Nine of the 15 influenza A viruses detected in week 46/2010 were subtyped: eight (89%) as A(H1N1) 2009 virus and one as A(H3).
Since week 40/2010, sentinel and non-sentinel specimens yielded 192 influenza detections, of which 133 (69%) were type A, and 59 (31%) were type B. Eighty-four of these influenza A viruses were subtyped: 65 (77%) as A(H1N1)2009 virus and 19 (23%) as A(H3).
Table 2 shows the distribution of both sentinel and non-sentinel specimens by type and subtype. Figures 1?3 show the trends of virological detections since week 40/2010.
From week 40 to week 46/2010, 29 influenza viruses from sentinel and non-sentinel specimens were characterised antigenically (Table 3): 17 as A/California/7/2009 (H1N1)-like; four as A/Perth/16/2009 (H3N2)-like; seven as B/Brisbane/60/2008-like (Victoria lineage); and one as B/Florida/4/2006-like (Yamagata lineage).
More details on circulating viruses can be found in the report prepared by the Community Network of Reference Laboratories coordination team.
In week 46/2010, respiratory syncytial virus detections increased for the sixth consecutive week, with 13 countries reporting 289 detections (Figure 4).
Table 2: Weekly and cumulative influenza virus detections by type, subtype and surveillance system, weeks 40/2010?46/2010
[Virus Type / Subtype - Current Week: Sentinel - Non-Sentinel / Season: Sentinel - Non-Sentinel]
- Influenza A
- A (pandemic H1N1) - 5 - 10 / 51 - 82
- A (subtyping not performed) - 5 -3 / 36 -29
- A (not subtypable) - 0 - 0 / 0 - 0
- A (H3) - 0 - 1 / 12 - 7
- A (H1) - 0 - 0 / 0 - 0
- Influenza B - 7 - 3 / 29 - 30
- Total Influenza - 12 - 13 / 80 - 112
Note: A(pandemic H1) 2009, A(H3) and A(H1) include both N-subtyped and not N-subtyped viruses.
(...)
Table 3: Results of antigenic characterisations of sentinel and non-sentinel influenza virus isolates, weeks 40/2010?46/2010
[Strain name - Number of strains]
- A(H1)v California/7/2009-like - 17
- A(H3) A/Brisbane/10/2007 (H3N2)-like - 0
- A(H3) A/Perth/16/2009 (H3N2)-like - 4
- B/Brisbane/60/2008-like (B/Victoria/2/87 lineage) - 7
- B/Florida/4/2006-like (B/Yamagata/16/88 lineage) - 1
(...)
Description of the system
According to the nationally defined sampling strategy, sentinel physicians take nasal or pharyngeal swabs from patients with ILI, ARI or both and send the specimens to influenza-specific reference laboratories for virus detection, (sub-)typing, antigenic or genetic characterisation and antiviral susceptibility testing.
For details on the current virus strains recommended by WHO for vaccine preparation click here.
Hospital surveillance ? severe acute - respiratory infection (SARI) - Weekly analysis ? SARI
During week 46/2010, nine SARI cases were reported.
Since week 40/2010, a total of 27 SARI cases have been reported, all in Romania, representing a notification rate of 0.4 per 100000 population. Figure 5 displays the number of cases by week of onset.
Six of the nine cases reported for week 46/2010 were male, five of them less than two years old (Table 4). All cases presented with acute respiratory distress syndrome, but it is unknown if any of them were due to influenza (Table 5). One of the nine cases had previously been vaccinated against the pandemic A(H1N1) 2009 virus. Three elderly patients and one of the infants had underlying conditions.
Five cases, one having an underlying condition, were admitted to intensive care.
(...)
Table 4: Number of SARI cases by age and gender, week 46/2010
[Age groups - Male - Female]
- Under 2 - 5 - ...
- 2-17 - ... - 1
- >=60 - 1 - 2
- Total - 6 - 3
Table 5: Number of SARI cases by influenza type and subtype, week 46/2010
[Virus Type / Subtype - Number of cases during current week / Cumulative Number of cases since the start of the season]
- Influenza A
- A (pandemic H1N1) - ... - ...
- A (subtyping not performed) - ... - ...
- A (H3) - ... - ...
- A (H1) - ... - ...
- A (H5) - ... - ...
- Influenza B - ... - ...
- Unknown - 9 - 27
- Total - 9 - 27
Note: A(pandemic H1) 2009, A(H3) and A(H1) include both N-subtyped and not N-subtyped viruses.
The report text was written by an editorial team at the European Centre for Disease Prevention and Control (ECDC): Eeva Broberg, Flaviu Plata, Phillip Zucs and Ren? Snacken. The bulletin text was reviewed by the Community Network of Reference Laboratories for Human Influenza in Europe (CNRL) coordination team: Adam Meijer, Rod Daniels, John McCauley and Maria Zambon. On behalf of the EISN members the bulletin text was reviewed by Bianca Snijders (RIVM Bilthoven, The Netherlands) and Thedi Ziegler (National Institute for Health and Welfare, Finland)
Maps and commentary used in this Weekly Influenza Surveillance Overview (WISO) 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.
All data published in the WISO are up-to-date on the day of publication. Past this date, however, published data should not be used for longitudinal comparisons as countries tend to retrospectively update their numbers in the database.
? European Centre for Disease Prevention and Control, Stockholm, 2010.
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