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Weekly influenza surveillance overview - 3 December 2010 (ECDC, extract, edited)
Weekly influenza surveillance overview - 3 December 2010 (ECDC, extract, edited)
[Source: European Centre for Diseases Prevention and Control (EDCD), full PDF document, (LINK). Extract, edited.]
SURVEILLANCE REPORT
Weekly influenza surveillance overview - 3 December 2010
Main surveillance developments in week 47/2010 (22 Nov 2010 ? 28 Nov 2010)
This first page contains the main developments of this week and can be printed separately or together with more detailed information following.
Sentinel surveillance of influenza-like illness (ILI)/ acute respiratory infection (ARI):
All reporting countries experienced low intensity influenza activity but, in comparison with the previous week, more countries reported sporadic activity.
Virological surveillance:
In week 47/2010, sentinel physicians collected 604 specimens of which 5.1% were positive for influenza. Of the 359 influenza detections in sentinel and non-sentinel specimens, 63% were influenza A and 37% influenza B viruses. Of 130 sub-typed influenza A viruses, 74.6% were A(H1N1) 2009, 24.6% were A(H3) and 0.8% was A(H1) virus.
Hospital surveillance of severe acute respiratory infection (SARI):
Since week 37/2010, 35 SARI cases have been reported by Romania, eight of which occurred during week 47/2010.
Sentinel surveillance (ILI/ARI) - Weekly analysis ? epidemiology
During week 47/2010, 24 of 29 countries reported epidemiological data. All reporting countries experienced low intensity influenza activity (Table 1 and map 1).
In comparison with the previous week, more sporadic activity was reported: 12 countries, including the UK (England, Scotland, Wales), reported sporadic activity and Malta reported local activity. No activity was reported by 13 countries and the UK (Northern Ireland) (Table 1 and Map 2). Five countries and the UK (Scotland) reported an increasing trend for clinical activity (Table 1, Map 2).
(...)
Table 1: Epidemiological and virological overview by country, week 47/2010
[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 47/2010, 23 countries and the UK (England, Northern Ireland and Scotland) reported virological data.
Sentinel physicians collected 604 specimens, 31 (5.1%) of which were positive for influenza virus (Tables 1 and 2).
In addition, 93 non-sentinel source specimens (i.e., specimens collected for diagnostic purpose in hospitals) were reported positive for influenza virus.
Of the 124 influenza viruses detected during week 47/2010, 68 (55%) were type A and 56 (45%) were type B.
Of the 31 influenza A viruses sub-typed, 26 (84%) were A(H1N1) 2009 and five (16%) were A(H3) (Table 2).
Since week 40/2010, of the 359 influenza detections in sentinel and non-sentinel specimens, 226 (63%) were influenza A and 133 (37%) influenza B viruses.
Additionally, of the 130 influenza A viruses have been sub-typed, 97 (74.6%) were A(H1N1) 2009, 32 (24.6%) were A(H3) and one (0.8%) was A(H1) virus (Table 2). Figures 1?3 show the trends of virological detections since week 40/2010. The percentage of positive sentinel swabs remained at a low level (5.1%, Figure 3).
Since week 40/2010, 39 influenza viruses from sentinel and non-sentinel specimens have been characterised antigenically (Table 3): 21 as A/California/7/2009 (H1N1)-like, seven as A(H3)/Perth/16/2009 (H3N2)-like, 10 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 47/2010, respiratory syncytial virus detections increased for the eighth consecutive week, with 12 countries reporting 661 detections (Figure 4).
Table 2: Weekly and cumulative influenza virus detections by type, subtype and surveillance system, weeks 40/2010?47/2010
[Virus Type/subtype - Current period: Sentinel - Non-sentinel / Season: Sentinel - Non-sentinel]
Note: A(pandemic H1), A(H3) and A(H1) includes 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?47/2010
[Strain name - Number of strains]
(...)
Country comments
The Netherlands: Since week 40/2010, four influenza B viruses and no influenza A viruses were detected in sentinel specimens. For two of the influenza B viruses, the lineage could be identified by PCR assay. Both were Victoria-like. In addition, the National Influenza Centre has so far received one influenza B virus and two influenza A(H1N1) 2009 viruses from non-sentinel sources.
Description of the system
According to the nationally defined sampling strategy, sentinel physicians take nasal or pharyngeal swabs from patients with influenza-like illness (ILI), acute respiratory infection (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
Since week 37/2010, Romania?which is the only country that has provided reports on SARI cases so far?has reported 35 cases representing a notification rate of 0.55 cases/105 inhabitants. During week 47/2010, eight SARI cases were reported, none of which were related to influenza infection.
Seven of the eight reported cases for week 47/2010 were in males, and six were in infants < 2 years old. Only one was vaccinated with the seasonal vaccine. All eight SARI cases needed oxygen support, with two being admitted to ICU. Of the six patients with available information, only one had a chronic lung disease (Tables 4?10).
As a complication, acute respiratory distress syndrome was observed in seven cases, of which five were infants <2 years old (Table 11).
Table 4: Cumulative number of SARI cases, week 40/2010?week 47/2010
[Country - Number of cases - Incidence of SARI cases per 100,000 population - Number of fatal cases reported - Incidence of fatal cases per 100,000 population - Estimated population covered]
(...)
Table 5: Number of SARI cases by age and gender, week 47/2010
[Age groups - Male - Female - Other (e.g., transsexual) - Unknown]
Table 6: Number of SARI cases by influenza type and subtype, week 47/2010
[Virus type/subtype - Number of cases during current week - Cumulative number of cases since the start of the season]
Table 7: Number of SARI cases by antiviral treatment, week 47/2010
[Antiviral treatment - Number of patients who received prophylaxis - Number of patients who received anti-viral treatment]
Table 8: Number of SARI cases by level of care and respiratory support, week 47/2010
[Respiratory support - ICU - Inpatient ward - Other - Unknown]
Table 9: Number of SARI cases by vaccination status, week 47/2010
[Vaccination Status - Number Of Cases - Percentage of cases]
Table 10: Number of underlying conditions in SARI cases by age group, week 47/2010
[Underlying condition/risk factor - Infant below 2 years - 2-17 years - 18-44 years - 45-59 years - >=60 years]
Table 11: Additional clinical complications in SARI cases by age group, week 47/2010
[Additional clinical complications - Infant below 2 years - 2-17 years - 18-44 years - 45-59 years - >=60 years]
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 Diseases Prevention and Control (EDCD), full PDF document, (LINK). Extract, edited.]
SURVEILLANCE REPORT
Weekly influenza surveillance overview - 3 December 2010
Main surveillance developments in week 47/2010 (22 Nov 2010 ? 28 Nov 2010)
This first page contains the main developments of this week and can be printed separately or together with more detailed information following.
- During week 47/2010, all reporting countries experienced low intensity influenza activity.
- Compared with the previous week, a greater number of countries (12 in week 47, six in week 46), reported sporadic activity.
- Malta reported local activity.
- Since week 40/2010, of the 359 typed influenza viruses, 63% were type A and 37% were type B.
- Of the sub-typed influenza A viruses, 75% were A(H1N1) 2009.
- The number of detected respiratory syncytial virus infections continued to show steady increase.
- Since week 37/2010, Romania has reported 35 SARI cases, none of which were related to influenza.
Sentinel surveillance of influenza-like illness (ILI)/ acute respiratory infection (ARI):
All reporting countries experienced low intensity influenza activity but, in comparison with the previous week, more countries reported sporadic activity.
Virological surveillance:
In week 47/2010, sentinel physicians collected 604 specimens of which 5.1% were positive for influenza. Of the 359 influenza detections in sentinel and non-sentinel specimens, 63% were influenza A and 37% influenza B viruses. Of 130 sub-typed influenza A viruses, 74.6% were A(H1N1) 2009, 24.6% were A(H3) and 0.8% was A(H1) virus.
Hospital surveillance of severe acute respiratory infection (SARI):
Since week 37/2010, 35 SARI cases have been reported by Romania, eight of which occurred during week 47/2010.
Sentinel surveillance (ILI/ARI) - Weekly analysis ? epidemiology
During week 47/2010, 24 of 29 countries reported epidemiological data. All reporting countries experienced low intensity influenza activity (Table 1 and map 1).
In comparison with the previous week, more sporadic activity was reported: 12 countries, including the UK (England, Scotland, Wales), reported sporadic activity and Malta reported local activity. No activity was reported by 13 countries and the UK (Northern Ireland) (Table 1 and Map 2). Five countries and the UK (Scotland) reported an increasing trend for clinical activity (Table 1, Map 2).
(...)
Table 1: Epidemiological and virological overview by country, week 47/2010
[Country - Intensity - Geographic spread - Trend - No. of sentinel swabs - Dominant type - Percentage positive* - ILI per 100.000 - ARI per 100.000]
- Austria - Low - No activity - Unknown (no information available) - 3 - None - 0.0 - ... - 22.6
- Belgium - Low - No activity - Stable - 14 - None - 7.1 - 36.4 - 1106.6
- Bulgaria - Low - No activity - Decreasing - 0 - None - 0.0 - ... - 889.4
- Cyprus - ... - ... - ... - ... - ... - 0.0 - ... - ...
- Czech Republic - Low - Sporadic - Stable - 15 - None - 0.0 - 26.4 - 949.8
- Denmark - Low - No activity - Stable - 5 - None - 0.0 - 62.9 - ...
- Estonia - Low - Sporadic - Increasing - 14 - None - 7.1 - 5.1 - 304.4
- Finland - Low - Sporadic - Stable - 12 - None - 8.3 - ... - ...
- France - Low - Sporadic - Stable - 64 - None - 6.3 - ... - 1566.3
- Germany - Low - Sporadic - Stable - 36 - None - 5.6 - ... - 975.0
- Greece - Low - No activity - Stable - 1 - ... - 0.0 - 84.4 - ...
- Hungary - Low - No activity - Increasing - 42 - None - 0.0 - 85.9 - ...
- Iceland - ... - ... - ... - ... - ... - 0.0 - ... - ...
- Ireland - Low - No activity - Stable - 12 - None - 8.3 - 6.7 - ...
- Italy - Low - No activity - Stable - 19 - A - 5.3 - 110.3 - ...
- Latvia - Low - Sporadic - Increasing - ... - ... - 0.0 - 0.9 - 967.3
- Lithuania - Low - No activity - Increasing - ... - ... - 0.0 - 0.7 - 473.0
- Luxembourg - Low - No activity - Stable - 1 - None - 0.0 - ... * - ...*
- Malta - Low - Local - Stable - ... - ... - 0.0 - ... * - ... *
- Netherlands - Low - No activity - Stable - 13 - None - 7.7 - 31.9 - ...
- Norway - Low - Sporadic - Stable - 4 - None - 0.0 - 29.7 - ...
- Poland - Low - Sporadic - Stable - 18 - None - 0.0 - 43.1 - ...
- Portugal - Low - Sporadic - Stable - 6 - B - 50.0 - 9.7 - ...
- Romania - Low - No activity - Increasing - 47 - None - 0.0 - 16.6 - 785.8
- Slovakia - ... - ... - ... - 5 - None - 0.0 - ... - ...
- Slovenia - Low - Sporadic - Stable - 7 - None - 0.0 - 0.0 - 969.7
- Spain - Low - Sporadic - Stable - 99 - None - 3.0 - 20.1 - ...
- Sweden - Low - No activity - Stable - 12 - None - 0.0 - 4.3 - ...
- UK - England - Low - Sporadic - Stable - 123 - None - 9.8 - 11.8 - 462.4
- UK - Northern Ireland - Low - No activity - Stable - 7 - None - 0.0 - 25.4 - 341.1
- UK - Scotland - Low - Sporadic - Increasing - 25 - None - 4.0 - 2.1 - 287.0
- UK - Wales - Low - Sporadic - Stable - ... - ... - 0.0 - 7.7 - ...
- Europe - ... - ... - ... - 604 - ... - 5.1 - ... - ... - ...
(*) 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 47/2010, 23 countries and the UK (England, Northern Ireland and Scotland) reported virological data.
Sentinel physicians collected 604 specimens, 31 (5.1%) of which were positive for influenza virus (Tables 1 and 2).
In addition, 93 non-sentinel source specimens (i.e., specimens collected for diagnostic purpose in hospitals) were reported positive for influenza virus.
Of the 124 influenza viruses detected during week 47/2010, 68 (55%) were type A and 56 (45%) were type B.
Of the 31 influenza A viruses sub-typed, 26 (84%) were A(H1N1) 2009 and five (16%) were A(H3) (Table 2).
Since week 40/2010, of the 359 influenza detections in sentinel and non-sentinel specimens, 226 (63%) were influenza A and 133 (37%) influenza B viruses.
Additionally, of the 130 influenza A viruses have been sub-typed, 97 (74.6%) were A(H1N1) 2009, 32 (24.6%) were A(H3) and one (0.8%) was A(H1) virus (Table 2). Figures 1?3 show the trends of virological detections since week 40/2010. The percentage of positive sentinel swabs remained at a low level (5.1%, Figure 3).
Since week 40/2010, 39 influenza viruses from sentinel and non-sentinel specimens have been characterised antigenically (Table 3): 21 as A/California/7/2009 (H1N1)-like, seven as A(H3)/Perth/16/2009 (H3N2)-like, 10 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 47/2010, respiratory syncytial virus detections increased for the eighth consecutive week, with 12 countries reporting 661 detections (Figure 4).
Table 2: Weekly and cumulative influenza virus detections by type, subtype and surveillance system, weeks 40/2010?47/2010
[Virus Type/subtype - Current period: Sentinel - Non-sentinel / Season: Sentinel - Non-sentinel]
- Influenza A - 15 - 53 / 75 - 151
- A (pandemic H1N1) - 14 -12 / 53 -44
- A (subtyping not performed) - 0 - 37 / 5 - 91
- A (not subtypable) - 0 - 0 / 0 - 0
- A (H3) - 1 - 4 / 16 - 16
- A (H1) - 0 - 0 / 1 - 0
- Influenza B - 16 - 40 / 56 - 77
- Total Influenza - 31 -93 / 131 - 228
Note: A(pandemic H1), A(H3) and A(H1) includes 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?47/2010
[Strain name - Number of strains]
- A(H1)v California/7/2009-like - 21
- A(H3) A/Brisbane/10/2007 (H3N2)-like - 0
- A(H3) A/Perth/16/2009 (H3N2)-like - 7
- B/Brisbane/60/2008-like (B/Victoria/2/87 lineage) - 10
- B/Florida/4/2006-like (B/Yamagata/16/88 lineage) - 1
(...)
Country comments
The Netherlands: Since week 40/2010, four influenza B viruses and no influenza A viruses were detected in sentinel specimens. For two of the influenza B viruses, the lineage could be identified by PCR assay. Both were Victoria-like. In addition, the National Influenza Centre has so far received one influenza B virus and two influenza A(H1N1) 2009 viruses from non-sentinel sources.
Description of the system
According to the nationally defined sampling strategy, sentinel physicians take nasal or pharyngeal swabs from patients with influenza-like illness (ILI), acute respiratory infection (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
Since week 37/2010, Romania?which is the only country that has provided reports on SARI cases so far?has reported 35 cases representing a notification rate of 0.55 cases/105 inhabitants. During week 47/2010, eight SARI cases were reported, none of which were related to influenza infection.
Seven of the eight reported cases for week 47/2010 were in males, and six were in infants < 2 years old. Only one was vaccinated with the seasonal vaccine. All eight SARI cases needed oxygen support, with two being admitted to ICU. Of the six patients with available information, only one had a chronic lung disease (Tables 4?10).
As a complication, acute respiratory distress syndrome was observed in seven cases, of which five were infants <2 years old (Table 11).
Table 4: Cumulative number of SARI cases, week 40/2010?week 47/2010
[Country - Number of cases - Incidence of SARI cases per 100,000 population - Number of fatal cases reported - Incidence of fatal cases per 100,000 population - Estimated population covered]
- Romania - 35 - 0.55 - ... - ... - 6.413.821
- Total - 35 - ... - 0 - ... - 6.413.821
(...)
Table 5: Number of SARI cases by age and gender, week 47/2010
[Age groups - Male - Female - Other (e.g., transsexual) - Unknown]
- Under 2 - 5 - 1 - ... - ...
- 2-17 - 1 - ... - ... - ...
- 18-44 - 1 - ... - ... - ...
- Total - 7 - 1 - ... - ...
Table 6: Number of SARI cases by influenza type and subtype, week 47/2010
[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 - 8 - 35
- Total - 8 - 35
Table 7: Number of SARI cases by antiviral treatment, week 47/2010
[Antiviral treatment - Number of patients who received prophylaxis - Number of patients who received anti-viral treatment]
- None - 8 - 8
- Total - 8 - 8
Table 8: Number of SARI cases by level of care and respiratory support, week 47/2010
[Respiratory support - ICU - Inpatient ward - Other - Unknown]
- Oxygen therapy - 2 - 6 - ... - ...
Table 9: Number of SARI cases by vaccination status, week 47/2010
[Vaccination Status - Number Of Cases - Percentage of cases]
- Not full pandemic vaccination - 0 - 0
- Not vaccinated - 7 - 88
- Seasonal vaccination - 1 - 12.5
- TOTAL - 8 - ...
Table 10: Number of underlying conditions in SARI cases by age group, week 47/2010
[Underlying condition/risk factor - Infant below 2 years - 2-17 years - 18-44 years - 45-59 years - >=60 years]
- Chronic lung disease - 1 - ... - ... - ... - ...
- No underlying condition - 5 - 1 - 1 - ... - ...
Table 11: Additional clinical complications in SARI cases by age group, week 47/2010
[Additional clinical complications - Infant below 2 years - 2-17 years - 18-44 years - 45-59 years - >=60 years]
- Acute respiratory distress syndrome - 5 - 1 - 1 - ... - ...
- None - 1 - ... - ... - ... - ...
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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