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Seasonal Flu 2008 - 2009

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  • Re: Seasonal Flu 2008 - 2009

    39 influenza viruses were isolated until the 49
    th week in 2008-2009 season.
    34 viruses were identified as A/H1 type and 5 viruses were identified as A/H3

    type.

    Influenza Weekly Report
    Week 49, 2008 – November 30, 2008 ~ December 6 , 2008
    1

    Korean Influenza Surveillance Scheme, Korea Center For Disease Control and Prevention

    Comment


    • Re: Seasonal Flu 2008 - 2009

      [Seasonal Human Influenza] Situation in Hong Kong (As of 29 Dec 2008)

      [Seasonal Human Influenza] Situation in Hong Kong (As of 29 Dec 2008)

      [Original full PDF Report at LINK. EDITED.]

      The influenza activity in Hong Kong remained at low level.

      For the week ending 20 Dec 2008 (week 51), the average consultation rates for ILI among sentinel private doctors ... and general outpatient clinics ... were 36.7 and 2.5 (per 1,000 consultations) respectively.

      In the same week, 0.70% of children in the sentinel child care centres ... and 0.15% of residents in the sentinel residential care homes for the elderly ... had fever.

      The consultation rate for ILI among chinese medicine practitioners ... was 6.11 per 1,000 consultations.

      Influenza detection was 16 in week 51.

      Laboratory surveillance detected 11 influenza A (H1N1) viruses, 3 influenza A (H3N2) viruses, 1 influenza B virus and 1 influenza C virus.

      In week 51 and 52, there were no confirmed influenza outbreaks.

      In week 51, hospital admission rate due to influenza for the elderly 65 years old or above was 0 (per 10,000 people in the age group) ... and that for children aged 0 to 4 years was 0.09 (per 10,000 people in the age group) ... .

      For the week ending 20 Dec 2008, no children aged 12 years or below were reported to have severe complications related to influenza.

      (...)
      -
      -----

      Comment


      • Re: Seasonal Flu 2008 - 2009

        Synopsis: December 14th - December 20th (51st week of 2008)

        For week December 14th – December 20th (Week 51) we continue to see sporadic influenza activity. Three influenza isolates have been cultured at our state laboratory so far this season. All three were characterized as influenza A (H1) and appear to match the vaccine.

        http://www.health.state.mn.us/divs/i...x.html#summary

        Comment


        • Re: Seasonal Flu 2008 - 2009

          Of the 558 specimens tested since the beginning of the 2008-09 flu season, 129 (23.0%) influenza isolates
          have been detected by SLD. Of these, 1 (1%) was influenza A (subtype unknown), 119 (92%) were
          influenza A(H1) and 5 (4%) were influenza A(H3). There have been 4 (3%) influenza B cases. Select
          isolates were sent to CDC for strain characterization.

          http://hawaii.gov/health/about/famil...050%202008.pdf

          Comment


          • Re: Seasonal Flu 2008 - 2009

            CDC has reported antigenic characterization results from 13 influenza isolates [5 influenza A/H1, 0 influenza A/H3, and 8 influenza B viruses] received from the DSHS Laboratory since the beginning of the 2008–09 flu season.


            Influenza A/H1 [5]
            • Five (100%) of the five viruses were characterized as A/Brisbane/59/2007, the influenza A/H1 component of the 2008–09 influenza vaccine for the Northern Hemisphere.
            Influenza A/H3 [0]
            • The DSHS Lab has not isolated influenza A/H3 from any specimens yet this season.
            Influenza B (B/Victoria/02/87 and B/Yamagata/16/88 lineages) [8]
            • Victoria lineage [8]
            • Two (25%) of the eight viruses were characterized as B/Ohio/01/2005-like viruses.
            • Six (75%) of the eight viruses showed somewhat reduced titers with antisera produced against B/Malaysia/2506/2004 and B/Ohio/01/2005.
              Yamagata lineage [0]
            • The influenza B component for the 2008-09 influenza vaccine is a B/Florida/4/2006-like virus, belonging to the B/Yamagata lineage.
            http://www.dshs.state.tx.us/idcu/dis...eillance/2009/

            Comment


            • Re: Seasonal Flu 2008 - 2009

              Five positive specimens
              have been reported by the
              state laboratory

              Influenza A (H1) 2

              Influenza A (H3) 3

              Influenza A (unknown) 0

              Influenza B 0

              http://www.idph.state.il.us/flu/08-09/12_20_08.pdf

              Comment


              • Re: Seasonal Flu 2008 - 2009

                As of week 49, six samples were found to be positive by viral culture for influenza AH1 and
                influenza B. Rapid and culture results by county are displayed below.
                Week 40 to Week 49 Week 47, 47, 49
                County
                A RapBid * A/ Culture* Rapid* Culture*

                B
                A
                H1
                A
                H3
                A
                UNK
                B A B A/B A H1 A
                H3
                A
                UNK
                B
                Atlantic County
                0 0 0 0 0 0 0 0 0 0 0 0 0 0

                Bergen County
                0 0 0 0 0 0 0 0 0 0 0 0 0 0

                Burlington County
                3 0 0 0 0 0 0 2 0 0 0 0 0 0

                Camden County
                0 0 0 0 0 0 0 0 0 0 0 0 0 0

                Cape May County
                0 0 0 0 0 0 0 0 0 0 0 0 0 0

                Cumberland County
                0 0 0 0 0 0 0 0 0 0 0 0 0 0

                Essex County
                9 4 3 0 0 0 0 4 3 2 0 0 0 0

                Gloucester County
                0 0 0 0 0 0 0 0 0 0 0 0 0 0

                Hudson County
                1 1 0 0 0 0 0 1 1 0 0 0 0 0

                Hunterdon County
                0 0 3 1 0 0 0 0 0 2 1 0 0 0

                Mercer County
                1 0 0 0 0 0 0 0 0 0 0 0 0 0

                Middlesex County
                1 0 0 3 0 0 0 1 0 0 3 0 0 0

                Monmouth County
                8 0 3 0 0 0 0 4 0 2 0 0 0 0

                Morris County
                0 0 0 0 0 0 0 0 0 0 0 0 0 0

                Ocean County
                0 0 0 0 0 0 0 0 0 0 0 0 0 0

                Passaic County
                3 0 0 0 0 0 0 3 0 0 0 0 0 0

                Salem County
                0 0 0 0 0 0 0 0 0 0 0 0 0 0

                Somerset County
                0 0 0 0 0 0 0 0 0 0 0 0 0 0

                Sussex County
                3 0 0 0 0 0 0 2 0 0 0 0 0 0

                Union County
                0 1 0 1 0 0 1 0 1 0 1 0 0 1

                Warren County
                0 0 0 0 0 0 0 0 0 0 0 0 0 0

                Unknown
                0 0 0 0 0 0 0 0 0 0 0 0 0 0

                State Total
                29 6 9 5 0 0 1 17 5 6 5 0 0 1
                *Rapid data is acquired from facilities reporting rapid influenza tests via NREVSS or CDRSS ILI module. Culture
                results are obtained from the LIMS system at PHEL, hospital viral culture laboratories via NREVSS or commercial
                laboratories reporting in CDRSS.

                3
                http://www.state.nj.us/health/flu/do...flummwr_50.pdf

                Comment


                • Re: Seasonal Flu 2008 - 2009

                  Italy. 2008/2009 Influenza Season. Influenza-like Illness Weekly Surveillance Report (data provided by CIRI, updated at Dec. 31 2008)

                  Global Trend for Influenza-like Illness and Acute Respiratory Illness Incidence among population.

                  Tables and Graphs are provided by CIRI (Centro Interuniversitario per lo Studio dell'Influenza). Please follow this LINK for further details about current week surveillance results.

                  Data reports ILI and ARI incidence for 1,000 inhabitants, as per class ages, season and surveillance week.

                  <table style="width: auto;"><tbody><tr><td></td></tr><tr><td style="font-family: arial,sans-serif; font-size: 11px; text-align: right;">From TABLES</td></tr></tbody></table>

                  <table style="width: auto;"><tbody><tr><td></td></tr><tr><td style="font-family: arial,sans-serif; font-size: 11px; text-align: right;">From TABLES</td></tr></tbody></table>
                  [Updated at 31-12-2008 9:24:45am GMT+1]

                  [SURVEILLANCE WEEK / Sentinel GPs / Outpatients / CASES: 0-4 / 5-14 / 15-65 / +65 / TOTAL INCIDENCE]

                  2008-42 / 391 / 510721 / 141 / 0,67 / 0,23 / 0,29 / 0,16 / 0,28
                  2008-43 / 386 / 509332 / 133 / 0,76 / 0,34 / 0,25 / 0,14 / 0,26
                  2008-44 / 405 / 535482 / 147 / 0,81 / 0,16 / 0,29 / 0,16 / 0,27
                  2008-45 / 408 / 536770 / 177 / 1,16 / 0,36 / 0,3 / 0,18 / 0,33
                  2008-46 / 394 / 516856 / 177 / 0,66 / 0,45 / 0,36 / 0,15 / 0,34
                  2008-47 / 411 / 541846 / 272 / 1,76 / 0,56 / 0,47 / 0,26 / 0,5
                  2008-48 / 420 / 554658 / 337 / 1,93 / 0,57 / 0,6 / 0,31 / 0,61
                  2008-49 / 414 / 547040 / 413 / 2,74 / 1,08 / 0,68 / 0,33 / 0,75
                  2008-50 / 416 / 547743 / 487 / 3,22 / 1,29 / 0,82 / 0,3 / 0,89
                  2008-51 / 393 / 520822 / 644 / 4,41 / 2,04 / 1,06 / 0,63 / 1,24
                  2008-52 / 316 / 420983 / 581 / 5,5 / 1,94 / 1,21 / 0,61 / 1,38

                  For the 52th week, there is an increasing incidence of ILI among 0-4 class-age population, that reaches 5,5 cases per 1,000 inhab. (or 550 x 100,000).

                  RED figures indicates an increased incidence, whereas BLUE figures a decreased incidence.
                  -
                  -----

                  Comment


                  • Re: Seasonal Flu 2008 - 2009

                    so, in Italy, we are slighly below the #cases from last season

                    last graphic is #cases per 1000 citizens from ILI(influenza-like-illness) by age-groups
                    in Italy 2008 ?
                    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


                    • Re: Seasonal Flu 2008 - 2009

                      Originally posted by gsgs View Post
                      so, in Italy, we are slighly below the #cases from last season

                      last graphic is #cases per 1000 citizens from ILI(influenza-like-illness) by age-groups
                      in Italy 2008 ?
                      Yes. It represents 2008/2009 class-aged tabulated ILI incidence per 1,000 inhab.

                      Comment


                      • Re: Seasonal Flu 2008 - 2009

                        dominant in Europe is H3N2 (Brisbane) so far,
                        in USA : H1N1 (Brisbane)
                        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


                        • Re: Seasonal Flu 2008 - 2009

                          Originally posted by gsgs View Post
                          dominant in Europe is H3N2 (Brisbane) so far,
                          in USA : H1N1 (Brisbane)
                          H3N2 is Brisbane/10
                          H1N1 is Brisbane/59

                          Comment


                          • Re: Seasonal Flu 2008 - 2009

                            Last week

                            HPA Weekly National Influenza Report
                            Summary of UK* surveillance of influenza and other seasonal respiratory illness
                            24 December 2008 (Week 52
                            )

                            Summary
                            Clinical indices of acute respiratory illness
                            (England, Wales, Scotland and Northern Ireland)

                            The overall influenza-like illness incidence rate**
                            increased from 39.5 per 100,000 in week 50/08 to 68.5
                            per 100,000 in week 51/08, this is well above the
                            baseline threshold of 30 per 100,000. The rate in the
                            northern region was lowest at 43.8 per 100,000, an
                            increase from 16.4 per 100,000 in week 50/08. The
                            *
                            Incorporating data from the Royal College of General Practitioners (RCGP) (England and Wales), The National Public Health
                            Service for Wales (NPHS), Health Protection Scotland (HPS), Communicable Disease Surveillance Centre Northern Ireland
                            (CDSC Northern Ireland), the Office for National Statistics (ONS) (England and Wales), Medical Officers of Schools Association
                            (MOSA) (England), NHS Direct (England and Wales) and Q Surveillance (England, Northern Ireland, Scotland and Wales).

                            Figure 1
                            : RCGP consultation rate for influenza – like illness, 2008/09 and recent years, England and Wales

                            Influenza activity is widespread across the UK and has continued to increase from week 50 to week 51/08. GP
                            consultation rates have increased and are exceeding threshold levels in England and Scotland, they have also
                            increased but remain within baseline in Wales. In Northern Ireland the consultation rate has greatly increased but
                            thresholds have not yet been set. Proportions of calls to NHS Direct in England and Wales relating to colds/flu and
                            fever have increased and remain above baseline levels. Calls to NHS 24 in Scotland are also increasing. Of the
                            samples referred to the Centre for Infections’ Respiratory Virus Unit (RVU) during week 51/08, 148 were positive for
                            influenza A; three A (H1) and 145 A (H3), and eight for influenza B. Other NHS and HPA laboratories in England and
                            Wales reported 131 influenza A and two influenza B positive specimens in week 51/08. Thirty-one Scottish and 20
                            Northern Irish influenza positive specimens were reported in week 51. Eleven outbreaks of respiratory illness were
                            reported recently from various areas of England in care homes, schools and a hospital. The proportion of people over
                            65 years who have received this season’s influenza vaccine was 72% in week 50/08, and 44.2% in those aged under
                            65 in risk groups. Characterisation of 200 influenza viruses since week 40/08 by RVU have shown that the majority of
                            circulating strains are well-matched by the current influenza vaccine. Influenza activity was increasing throughout the
                            rest of Europe with four countries reporting ‘medium’ levels and 11 reporting increasing activity in week 50/08.
                            England and Wales
                            Royal College of General Practitioners
                            (
                            http://www.rcgp.org.uk/bru/index.asp)

                            Covered in this report:
                            Data, except that from ONS, MOSA and non-UK sources: 15/12/08 - 21/12/08 (Week 51, 2008 )
                            Data from ONS, MOSA and non-UK sources: 08/12/08 - 14/12/08 (Week 50, 2008)
                            ** RCGP incidence rates in this report only refer to first or new episodes of infection diagnosed by a GP.
                            Neuraminidase inhibitor susceptibility testing on 73 A (H3) isolates since week 40/08 showed that all are sensitive to
                            oseltamivir and zanamivir but resistant to amantadine. Both of the two influenza B isolates tested since week 40/08
                            are sensitive to oseltamivir and zanamivir
                            . Twenty-nine of 30 A (H1) specimens tested in the same time frame are
                            resistant to oseltamivir but sensitive to zanamivir and amantadine. The majority of these oseltamivir-resistant viruses
                            come from the south west of England. Two influenza A (H1) isolates have been found to be resistant to oseltamivir in
                            Scotland this season, one of which has been confirmed by CfI.

                            Antiviral drug susceptibility testing
                            highest rate in week 51/08 was in the central region at
                            81.7 per 100,000 and in the south the rate was 67.8 per
                            100,000. The rates were highest in the 15-44 year age
                            group at 79.7 per 100,000 and in the 45-64 year age
                            group at 75.6 per 100,000 in week 51/08 (Figure 2).
                            The rate for acute bronchitis has been increasing steadily
                            over the season, it increased to 218.7 per 100,000 in
                            week 51/08. The highest rate is now in the over 75 year
                            group at 582.2 per 100,000 in week 51/08.
                            2
                            0
                            2 5
                            5 0
                            7 5
                            1 0 0
                            1 2 5
                            1 5 0
                            1 7 5
                            2 0 0
                            2 2 5
                            4 0 4 2 4 4 4 6 4 8 5 0 5 2 2 4 6 8 1 0 1 2 1 4 1 6 1 8 2 0
                            W e e k
                            Rate per 100 000 population
                            E n g l a n d ( R C G P )
                            S c o t l a n d ( H P S )
                            W a l e s ( N P H S )
                            N o r t h e r n I r e l a n d ( C D S C N I )
                            Figure 3
                            : GP Consultation rates for influenza/influenza-like illness in the U.K

                            QSurveillance
                            HPA and Nottingham University Division of Primary
                            Care.
                            (
                            http://www.qresearch.org)

                            Northern Ireland
                            CDSC Northern Ireland
                            (
                            http://www.cdscni.org.uk/)

                            The combined rate for influenza and influenza-like illness
                            increased from 124.3 (updated rate) per 100,000 in week
                            50/08 to 196.5 per 100,000 in week 51/08 (Figure 3).
                            The highest rate was 289.8 per 100,000 in the 45-64 year
                            age group. No threshold has been set for Northern Ireland.
                            This primary care surveillance system uses
                            QSurveillance, a database of general practice derived
                            data. During week 51/08, over 3200 practices reported
                            from England, Wales, Scotland and Northern Ireland
                            covering a population of over 22 million. The rate of
                            influenza-like illness increased from 28 per 100,000 in
                            week 50/08 to 42.7 per 100,000 in week 51/08. The
                            highest rates have consistently been in the 15-44 year
                            age group (50.6 per 100,000 in week 51/08). The rates
                            were highest in Northern Ireland and London.
                            NHS Direct total call activity
                            England and Wales
                            (
                            http://www.nhsdirect.nhs.uk/)

                            The proportions of cold/flu and fever calls are over the
                            baseline and are still increasing. The proportion of cold/
                            flu calls increased from 1.6% in week 50/08 to 2.1% in
                            week 51/08 (1.2% is the theshold). Fever calls in the 5-14
                            age group made up 12.3% of the total calls in week 51/
                            08, an increase from 11.5% in week 50/08 which exceeds
                            the threshold of 9%.
                            Wales
                            National Public Health Service
                            (
                            http://www.wales.nhs.uk/sites/home.cfm?OrgID=368)

                            GP consultation rates for influenza increased from 9.3
                            per 100,000 in week 50/08 to 15.6 per 100,000 in week
                            51/08. Both figures are well below the baseline threshold
                            of 25 consultations per 100,000 (Figure 3).
                            Figure 2
                            : RCGP Episode incidence rates for influenza-like illness (ILI) by age group, England and Wales.

                            0
                            1 0
                            2 0
                            3 0
                            4 0
                            5 0
                            6 0
                            7 0
                            8 0
                            9 0
                            1 0 0
                            4 0 4 2 4 4 4 6 4 8 5 0 5 2 2 4 6 8 1 0 1 2 1 4 1 6 1 8 2 0
                            W e e k
                            Rate per 100 000 population
                            0 - 1
                            1 - 4
                            5 - 1 4
                            1 5 - 4 4
                            4 5 - 6 4
                            6 5 - 7 4
                            > 7 5
                            Medical Officers of Schools Association
                            (MOSA)
                            There is no data for weeks 49 and 50/08 as the school
                            students are on holiday
                            Scotland
                            Health Protection Scotland
                            (
                            http://www.hps.scot.nhs.uk/)

                            GP consultation rates for influenza increased from 33.0
                            per 100,000 in week 50/08 to 65.0 per 100,000 in week
                            51/08(Figure 3). This exceeds the Scottish baseline
                            threshold of 50 consultations per 100,000, suggesting
                            that influenza viruses are circulating in the community.
                            In accordance with NICE guidelines, physicians in
                            Scotland have been advised to prescribe anti-viral drugs
                            for treatment or prophylaxis of influenza in appropriate
                            cases.
                            3
                            Respiratory Virus Unit (RVU) Influenza Reference
                            Laboratory, CfI
                            One hundred and fifty-six specimens tested positive for
                            influenza in week 51/08 (Table 1). Since week 40/08 200
                            viruses have been characterised: 22 A (H1) Brisbane/59/
                            2007 (H1N1)-like, 174A (H3) A/Brisbane/10/2007 (H3N2)-
                            like, one B/Florida/4/2006-like which are all vaccine strains,
                            three A/Solomon Islands/3/2006 (H1)-like which is similar
                            to the vaccine strain,and eight B/Malaysia/2506/2004-like.
                            54.1% of specimens from the RCGP surveillance
                            scheme were positive for influenza in week 51/08, this
                            is above the threshold of 30% (figure 4).
                            Neuraminidase inhibitor susceptibility testing on 73 A
                            (H3) isolates since week 40/08 showed that all of them
                            are sensitive
                            to oseltamivir and zanamivir but resistant to
                            amantadine. Of the 30 A (H1) specimens received and
                            tested, 29 are resistant to oseltamivir but sensitive to
                            zanamivir and amantadine. These specimens are from

                            * RSV detection is by PCR only
                            Other NHS and HPA laboratories (England and
                            Wales)
                            The number of specimens positive for influenza A has
                            increased from 109 in week 50/08 to 131 in week 51/
                            08 and the number of RSV positives decreased (from
                            380 to 327) in the same time period. To date, a higher
                            number of influenza A positive specimens have come
                            from central and southen England. (Table 2).
                            Please note that these data are provisional.
                            Laboratory indices of acute respiratory illness
                            *
                            Detections of RSV by isolation are not included.

                            Table 1 “Detections” (PCR and isolation) of influenza and
                            RSV made by RVU (CfI) Reference Laboratory.
                            Samples from community and hospital sources,
                            by week of report.
                            6 96 7 2
                            5 150 2 5
                            24 293 9 22
                            1 2 0 0
                            1 3 0 0
                            0 5 0 0
                            37 549 18 29
                            Influenza Detections by
                            PCR and Isolation
                            A (H1) A (H3) B RSV*
                            Cumulative to date
                            Northern England
                            Central England
                            Southern England
                            Wales
                            Scotland
                            Northern Ireland
                            Cumulative Total
                            Influenza type ( subtype)
                            Week 50/08
                            Week 51/08
                            (week 40/08 – 51/08)
                            356 336 3922
                            Table 2 ‘‘Detections” (isolation, PCR, direct
                            immunofluorescence and paired sera tests) of
                            influenza and RSV reported to CfI by NHS and
                            HPA microbiology laboratories. Data for England
                            and Wales by RCGP region, by week of report
                            Week 50/08
                            Week 51/08
                            Cumulative to Date
                            (week 40/08 - 51/08)
                            Northern England
                            Central England
                            Southern England
                            Wales
                            Cumulative Total
                            Detection (isolates, DIF and PCR)
                            Influenza A Influenza B RSV*
                            109 2 380
                            131 2 327
                            95 4 1072
                            156 4 449
                            148 3 1326
                            13 0 182
                            414 11 3029
                            4 97 4 2
                            3 145 8 1
                            Figure 4 : Proportion of RCGP specimens positive for influenza detected (PCR and Isolation) by RVU,CfI, by week of
                            specimen
                            0
                            1 0
                            2 0
                            3 0
                            4 0
                            5 0
                            6 0
                            7 0
                            4 0 4 2 4 4 4 6 4 8 5 0 5 2 2 4 6 8 1 0 1 2 1 4 1 6 1 8 2 0
                            W e e k
                            Percentage positive
                            % I n f l u e n z a B
                            % I n f l u e n z a A ( H 1 )
                            % I n f l u e n z a A ( H 3 )
                            England, Scotland and Wales (table 1). Seven further
                            influenza A(H1) isolates are undergoing resistance
                            testing at the moment. Two influenza B isolates have
                            been tested and are both sensitive to oseltamivir and
                            zanamivir.
                            Please note that these data are provisional.
                            4
                            Avian Influenza
                            The WHO continues to monitor and report on new cases
                            of human infection with A(H5N1) avian influenza when
                            they occur. Since 16 December there have been no further
                            cases of avian influenza confirmed by WHO.
                            According to WHO, the total number of confirmed human
                            infections worldwide with H5N1, since December 2003,
                            is 391 of which 247 (63%) have died.
                            Useful links:
                            Situation updates from WHO (human):
                            Situation summary from the HPA (avian and human):
                            Virological data from Northern Ireland
                            (
                            http://www.cdscni.org.uk/)

                            Fourteen sentinel samples were tested in week 51/08
                            of which 13 (92.9%) were positive for influenza (12 A
                            and one B). Of the 80 non-sentinel samples tested,
                            seven (8.8%) were positive for influenza (six A and one
                            B) and 33 for RSV.
                            Flu Vaccination Campaign 2008/09 (England)
                            Data on influenza vaccination uptake is taken weekly from
                            a sample of GPs in England.
                            Steady increasing trends have been seen since since
                            the start of the campaign in September 2008. In week
                            50/08 the proportion vaccinated in the over 65 year age
                            group was 72% and in the under 65 years at risk group,
                            the proportion vaccinated was 44.2%.
                            No vaccine uptake data is available for week 51/08.
                            It should be noted that all data is provisional.
                            In week 51/08 this parallel GP sentinel scheme
                            reported 15 out of 29 (51.7%) influenza positive
                            specimens; 14 influenza A and one influenza B. One
                            specimen was positive for another virus in the same
                            time period. Since week 40/08 479 specimens have
                            been submitted and135 (28.2%) have been positive
                            for influenza; 125 influenza A and ten influenza B.
                            HPA CfI Virological Surveillance of Influenza
                            (England)
                            Outbreak Reports:
                            Eleven respiratory outbreaks have been reported recently;
                            six in schools or universities (south east and south west
                            England, Yorkshire and the Humber and London), four in
                            care homes (north west and south west England and
                            Yorkshire and the Humber) and one in a hospital in the
                            South East. Four of these have been confirmed as
                            influenza A and some are still be investigated.
                            CfI welcomes reports of respiratory illness outbreaks.
                            Please email any reports to
                            respdcsc@hpa.org.uk).

                            Mortality Data
                            Office for National Statistics
                            (
                            http://www.statistics.gov.uk)

                            The number of deaths registered in England and Wales
                            increased from 10,258 in week 49/08 to 11,360 in week
                            50/08. The number of deaths due to all respiratory
                            diseases (as underlying cause) increased from1447
                            (14.1%) in week 49/08 to 1712 (15.1%). The weekly all
                            cause registered deaths are shown in Figure 5. In week
                            50/08 it is estimated that there were approximately 500
                            excess deaths reported compared to previous years.
                            Other Reports (UK)
                            During week 51/08, seven (20%) out of 35 sentinel
                            samples were positive for influenza A, two for RSV and
                            seven for other respiratory viruses. Fifty-two routine
                            samples reported from hospital and community
                            sources were also tested; 24 (46.2%) were positive for
                            influenza A (one A (H1) and 22 A (H3)) and 22 were
                            positive for RSV. Two influenza A (H1) isolates from
                            Scotland this season have been found to be resistant
                            to oseltamivir.
                            Virological data from Wales
                            )

                            To date this season one of 30 sentinel samples (week
                            45/08) and 16 non-sentinel samples have been
                            positive for influenza A. In week 50/08 two sentinel
                            samples were tested; neither were positive for
                            influenza.
                            Figure 5 : Weekly all cause registered deaths in England and Wales
                            0
                            2 0 0 0
                            4 0 0 0
                            6 0 0 0
                            8 0 0 0
                            1 0 0 0 0
                            1 2 0 0 0
                            1 4 0 0 0
                            1 6 0 0 0
                            4 0 4 2 4 4 4 6 4 8 5 0 5 2 2 4 6 8 1 0 1 2 1 4 1 6 1 8 2 0
                            W e e k N u m b e r
                            Number of Deaths
                            O b s e r v e d
                            E x p e c t e d
                            9 5 % U p p e r L i m i t
                            Data Source: The National Influenza Vaccine Uptake
                            Monitoring Programme (HPA/DH)
                            Virological data from Scotland
                            (
                            http://www.show.scot.nhs.uk/scieh/)

                            5
                            Data for this report were collated by the Influenza/
                            Respiratory Virus Team:
                            Estelle McLean, Joy Field and John Watson
                            Respiratory and Systemic Infections Department
                            HPA Centre for Infections, 61 Colindale Avenue
                            London NW9 5EQ, United Kingdom
                            Tel: (0)20 8327 7768; Fax: (0)20 8200 7868
                            E-mail:
                            respcdsc@hpa.org.uk

                            Maria Zambon, Joanna Ellis, Angie Lackenby, Alison
                            Bermingham and Praveen Sebastianpillai
                            Respiratory Virus Unit, Virus Reference Department
                            HPA Centre for Infections, 61 Colindale Avenue
                            London NW9 5HT, United Kingdom
                            Tel: (0)20 8327 6239; Fax: (0)20 8205 8195
                            E-mail:
                            ernvl@hpa.org.uk

                            If you wish to be included on our email notification list
                            please send your address to:
                            respcdsc@hpa.org.uk

                            Acknowledgements
                            Canada
                            Public Health Agency of Canada
                            (
                            http://www.phac-aspc.gc.ca/fluwatch/index.html)

                            During week 50/08, influenza activity remained low with
                            the majority of the influenza surveillance regions reporting
                            no activity and 15 regions reporting sporadic influenza
                            activity and one region reporting localised activity. Overall
                            there was a slight increase in the consultation rates. Thirty
                            of 1671 (1.8%) specimens tested positive for influenza in
                            week 50/08. One outbreak was reported in a school.
                            Since 1 September 2008, 16 influenza viruses have been
                            characterised: one influenza A/Brisbane/59/2007(H1N1)-
                            like, two A/Brisbane/10/2007 (H3N2)-like, three influenza
                            B/Florida/4/2006-like and 10 B/Malaysia/2506/2004-like,
                            the latter was a component of the 2007/08 vaccine. The
                            influenza A (H1N1) isolate has been found to be resistant
                            to oseltamivir.
                            Ireland
                            Health Protection Surveillance Centre (HPSC)
                            (
                            http://www.hpsc.ie/)

                            In week 51/08 the Irish ILI consultation rate was
                            61.6 per 100,000 which was a 50% increase from
                            the updated rate of 38.1 per 100,000 in week 50/08.
                            Both rates are well over the Irish baseline threshold
                            of 17.8 per 100,000.
                            In week 51/08 six of seven (85.7%) sentinel specimens
                            tested positive for influenza (five influenza A
                            and one influenza B) and five of 69 non-sentinel
                            specimens tested were positive for influenza A and
                            15 for RSV.
                            This season so far two viruses have been characterised
                            as A/Brisbane/10/2007 (H3N2)-like.
                            Other country reports can be obtained from the World
                            Health Organisation:
                            Europe
                            European Influenza Surveillance System (EISS)
                            (
                            www.eiss.org)

                            In week 50/08, four countries reported medium activity, a
                            further 11 reported increasing, but below baseline activity,
                            widespread activity was reported from England and
                            Portugal, regional activity in Northern Ireland, local activity
                            in Spain and France, sporadic activity in 11 countries and
                            12 reported no activity.
                            Out of the total 757 respiratory specimens collected by
                            sentinel physicians during week 50/08, 196 (25.9%)
                            specimens tested positive for influenza, 45 type A (not
                            subtyped), 135 A (H3), six A (H1) and ten type B. In addition,
                            159 non-sentinel specimens tested positive including
                            139 influenza A (not subtyped), 15 A (H3), one A (H1), and
                            four type B. These positive specimens were reported
                            from 15 countries.
                            Since week 40/08, 129 viruses have been characterised;
                            127 of these seem to be a good match to the strains
                            recommended for the 2008-09 vaccine, the remaining
                            two were B/Malaysia/2506/2004-like.
                            Influenza activity outside the UK
                            In week 50/08 WHO and NREVSS laboratories reported
                            2949 specimens tested for influenza viruses, 103 (3.5%)
                            of which were positive: 28 influenza A (H1), three A (H3),
                            48 A (not subtyped) and 24 influenza B.
                            Since week 40/08 69 influenza viruses have been
                            characterised; 49 A/Brisbane/59/2007 (H1N1)-like, 5 A/
                            Brisbane/10/2007 (H3N2)-like, four B/Florida/04/2006-
                            like, which are the components recommended for the
                            2008-09 vaccine, and nine from the B/Victoria lineage. Of
                            the 50 influenza A (H1) viruses tested this season, 49
                            have been found to be resistant to oseltamivir, but all are
                            sensitive to zanam

                            http://www.hpa.org.uk/web/HPAwebFile.../1230105661596

                            Comment


                            • Re: Seasonal Flu 2008 - 2009

                              Neuraminidase inhibitor susceptibility testing on 73 A (H3) isolates since week 40/08 showed that all are sensitive to
                              oseltamivir and zanamivir but resistant to amantadine. Both of the two influenza B isolates tested since week 40/08
                              are sensitive to oseltamivir and zanamivir
                              . Twenty-nine of 30 A (H1) specimens tested in the same time frame are
                              resistant to oseltamivir but sensitive to zanamivir and amantadine. The majority of these oseltamivir-resistant viruses
                              come from the south west of England. Two influenza A (H1) isolates have been found to be resistant to oseltamivir in

                              Scotland this season, one of which has been confirmed by CfI.

                              Comment


                              • Re: Seasonal Flu 2008 - 2009

                                HPA Weekly National Influenza Report
                                Summary of UK* surveillance of influenza and other seasonal respiratory illness
                                31 December 2008 (Week 01
                                )

                                Summary
                                Clinical indices of acute respiratory illness
                                (England, Wales, Scotland and Northern Ireland)

                                The overall influenza-like illness incidence rate**
                                decreased from 68.5 per 100,000 in week 51/08 to 41.3
                                per 100,000 in week 52/08. Although this week’s data
                                are incomplete due to the Christmas holiday, this rate is
                                still above the baseline threshold of 30 per 100,000.
                                The rates for all three regions decreased
                                correspondingly. The rate in the northern region was
                                *
                                Incorporating data from the Royal College of General Practitioners (RCGP) (England and Wales), The National Public Health
                                Service for Wales (NPHS), Health Protection Scotland (HPS), Communicable Disease Surveillance Centre Northern Ireland
                                (CDSC Northern Ireland), the Office for National Statistics (ONS) (England and Wales), Medical Officers of Schools Association
                                (MOSA) (England), NHS Direct (England and Wales) and Q Surveillance (England, Northern Ireland, Scotland and Wales).

                                Figure 1
                                : RCGP consultation rate for influenza – like illness, 2008/09 and recent years, England and Wales

                                Influenza activity continues to be widespread across the UK. GP consultation rates remained above the threshold
                                levels in England and Scotland in week 52/08. Rates decreased in England, which may be due to the incomplete data
                                during the Christmas holiday period, but increased in Scotland and Wales. In Northern Ireland the consultation rate
                                has decreased in week 52/08 compared to last week (week 51/08) but thresholds have not yet been set. Of the
                                samples referred to the Centre for Infections’ Respiratory Virus Unit (RVU) during week 51/08, 102 were positive for
                                influenza A; four A (H1) and 98 A (H3), and five for influenza B. Other NHS and HPA laboratories in England and Wales
                                reported 145 influenza A and ten influenza B positive specimens in week 52/08. Twenty-four Scottish and 14 Northern
                                Irish influenza positive specimens were reported in week 52. One outbreak of respiratory illness was reported
                                recently in a care home in England. The proportion of people over 65 years who have received this season’s influenza
                                vaccine was 72% in week 50/08, and 44.2% in those aged under 65 years in risk groups. Characterisation of 218
                                influenza viruses since week 40/08 by RVU have shown that the majority of circulating strains are well-matched by the
                                current influenza vaccine. Influenza activity is reported to be increasing throughout the rest of Europe with one country
                                reporting ‘ high’ level and four countries reporting ‘medium’ levels of influenza activity in week 51/08.
                                England and Wales
                                Royal College of General Practitioners
                                (
                                http://www.rcgp.org.uk/bru/index.asp)

                                Covered in this report:
                                Data, except that from ONS, MOSA and non-UK sources: 22/12/08 - 28/12/08 (Week 52, 2008 )
                                Data from ONS, MOSA and non-UK sources: 15/12/08 - 21/12/08 (Week 51, 2008)
                                ** RCGP incidence rates in this report only refer to first or new episodes of infection diagnosed by a GP.
                                Neuraminidase inhibitor susceptibility testing was not carried out during this Christmas - New Year holiday period.
                                Antiviral drug susceptibility testing
                                lowest at 21.4 per 100,000. The highest rate in week 52/
                                08 was in the south region at 46.7 per 100,000 and in
                                the central the rate was 43.7 per 100,000. The rates
                                were highest in the 15-44 year age group at 46.4 per
                                100,000 and in the 45-64 year age group at 43.3 per
                                100,000 in week 52/08 (Figure 2).
                                The rate for acute bronchitis decreased for this week
                                (52/08) as well to 133.7 compared to 218.7 per 100,000
                                in week 51/08. The highest rate is now in the under one
                                year group at 487.6 per 100,000 in week 52/08.
                                2
                                0
                                2 5
                                5 0
                                7 5
                                1 0 0
                                1 2 5
                                1 5 0
                                1 7 5
                                2 0 0
                                2 2 5
                                4 0 4 2 4 4 4 6 4 8 5 0 5 2 2 4 6 8 1 0 1 2 1 4 1 6 1 8 2 0
                                W e e k
                                Rate per 100 000 population
                                E n g l a n d ( R C G P )
                                S c o t l a n d ( H P S )
                                W a l e s ( N P H S )
                                N o r t h e r n I r e l a n d ( C D S C N I )
                                Figure 3
                                : GP Consultation rates for influenza/influenza-like illness in the U.K

                                QSurveillance
                                HPA and Nottingham University Division of Primary
                                Care.
                                (
                                http://www.qresearch.org)

                                Northern Ireland
                                CDSC Northern Ireland
                                (
                                http://www.cdscni.org.uk/)

                                The combined rate for influenza and influenza-like illness
                                decreased from 196.5 (updated rate) per 100,000 in week
                                51/08 to 136.3 per 100,000 in week 52/08 (Figure 3). No
                                threshold has been set for Northern Ireland.
                                This primary care surveillance system uses
                                QSurveillance, a database of general practice derived
                                data. During week 52/08, over 3200 practices reported
                                from England, Wales, Scotland and Northern Ireland
                                covering a population of over 21 million. The rate of
                                influenza-like illness decreased from 42.6 per 100,000
                                in week 51/08 to 25.0 per 100,000 in week 52/08. The
                                highest rates are in the 25-44 and 45-64 year age groups.
                                The rates were highest in Northern Ireland, London, S E
                                Coast and South West.
                                NHS Direct total call activity
                                England and Wales
                                (
                                http://www.nhsdirect.nhs.uk/)

                                The proportions of cold/flu and fever calls were over the
                                baseline and were still increasing in week 51/08. No data
                                available for week 52/08 due to technical problems.
                                Wales
                                National Public Health Service
                                (
                                http://www.wales.nhs.uk/sites/home.cfm?OrgID=368)

                                GP consultation rates for influenza increased from 15.6
                                per 100,000 in week 51/08 to 21.5 per 100,000 in week
                                52/08. Both figures are below the baseline threshold of
                                25 consultations per 100,000 (Figure 3).
                                Figure 2
                                : RCGP Episode incidence rates for influenza-like illness (ILI) by age group, England and Wales.

                                0
                                1 0
                                2 0
                                3 0
                                4 0
                                5 0
                                6 0
                                7 0
                                8 0
                                9 0
                                1 0 0
                                4 0 4 2 4 4 4 6 4 8 5 0 5 2 2 4 6 8 1 0 1 2 1 4 1 6 1 8 2 0
                                W e e k
                                Rate per 100 000 population
                                0 - 1
                                1 - 4
                                5 - 1 4
                                1 5 - 4 4
                                4 5 - 6 4
                                6 5 - 7 4
                                > 7 5
                                Medical Officers of Schools Association
                                (MOSA)
                                There is no data for weeks 49, 50, 51 and 52/08 as the
                                school students are on holiday
                                Scotland
                                Health Protection Scotland
                                (
                                http://www.hps.scot.nhs.uk/)

                                GP consultation rates for influenza increased from 65.0
                                per 100,000 in week 51/08 to 73.0 per 100,000 in week
                                52/08(Figure 3). This exceeds the Scottish baseline
                                threshold of 50 consultations per 100,000.
                                3
                                Respiratory Virus Unit (RVU) Influenza Reference
                                Laboratory, CfI
                                One hundred and nine specimens tested positive for
                                influenza in week 52/08 (Table 1). Since week 40/08 218
                                viruses have been characterised: 26 A (H1) Brisbane/59/
                                2007 (H1N1)-like, 183 A (H3) A/Brisbane/10/2007 (H3N2)-
                                like, one B/Florida/4/2006-like which are all vaccine strains,
                                and eight B/Malaysia/2506/2004-like.
                                70.7% of
                                specimens from the RCGP surveillance scheme were
                                positive for influenza in week 52/08, this is above the
                                threshold of 30% (figure 4).

                                Neuraminidase inhibitor susceptibility testing was not
                                carried out during this Christmas - New Year holiday period
                                and this work will resume next week. Results between
                                week 40/08 - 51/08 were summarized in our last week’s
                                report.
                                * RSV detection is by PCR only
                                Other NHS and HPA laboratories (England and
                                Wales)
                                The number of specimens positive for influenza A has
                                increased from 131 in week 51/08 to 145 in week 52/
                                08 and the number of influenza B positives increased
                                from 2 in week 51/08 to 10 in week 52/08, and the
                                number of RSV positives slightly increased (from 327
                                to 333) in the same time period. To date, a higher
                                number of influenza A positive specimens have come
                                from central and southen England. (Table 2).
                                Please note that these data are provisional.
                                Laboratory indices of acute respiratory illness
                                *
                                Detections of RSV by isolation are not included.

                                Table 1 “Detections” (PCR and isolation) of influenza and
                                RSV made by RVU (CfI) Reference Laboratory.
                                Samples from community and hospital sources,
                                by week of report.
                                7 109 8 2
                                7 182 2 7
                                28 357 13 23
                                2 3 0 0
                                1 2 0 0
                                0 5 0 0
                                45 658 23 32
                                Influenza Detections by
                                PCR and Isolation
                                A (H1) A (H3) B RSV*
                                Cumulative to date
                                Northern England
                                Central England
                                Southern England
                                Wales
                                Scotland
                                Northern Ireland
                                Cumulative Total
                                Influenza type ( subtype)
                                Week 51/08
                                Week 52/08
                                (week 40/08 – 52/08) 356 336 3922
                                Table 2 ‘‘Detections” (isolation, PCR, direct
                                immunofluorescence and paired sera tests) of
                                influenza and RSV reported to CfI by NHS and
                                HPA microbiology laboratories. Data for England
                                and Wales by RCGP region, by week of report
                                Week 51/08
                                Week 52/08
                                Cumulative to Date
                                (week 40/08 - 52/08)
                                Northern England
                                Central England
                                Southern England
                                Wales
                                Cumulative Total
                                Detection (isolates, DIF and PCR)
                                Influenza A Influenza B RSV*
                                131 2 327
                                145 10 333
                                167 13 1183
                                179 4 469
                                184 4 1473
                                28 0 235
                                558 21 3360
                                3 145 8 1
                                4 98 5 2
                                Figure 4 : Proportion of RCGP specimens positive for influenza detected (PCR and Isolation) by RVU,CfI, by week of
                                specimen
                                0
                                1 0
                                2 0
                                3 0
                                4 0
                                5 0
                                6 0
                                7 0
                                4 0 4 2 4 4 4 6 4 8 5 0 5 2 2 4 6 8 1 0 1 2 1 4 1 6 1 8 2 0
                                W e e k
                                Percentage positive
                                % I n f l u e n z a B
                                % I n f l u e n z a A ( H 1 )
                                % I n f l u e n z a A ( H 3 )
                                4
                                Avian Influenza
                                The WHO continues to monitor and report on new cases
                                of human infection with A(H5N1) avian influenza when
                                they occur. Since 16 December there have been no further
                                cases of avian influenza confirmed by WHO.
                                According to WHO, the total number of confirmed human
                                infections worldwide with H5N1, since December 2003,
                                is 391 of which 247 (63%) have died.
                                Useful links:
                                Situation updates from WHO (human):
                                Situation summary from the HPA (avian and human):
                                Virological data from Northern Ireland
                                (
                                http://www.cdscni.org.uk/)

                                Twenty-five sentinel samples were tested in week 52/
                                08 of which 14 (56%) were positive for influenza (13 A
                                and one B). Of the 44 non-sentinel samples tested,
                                six (18.2%) were positive for influenza (five A and one
                                B) and 21 for RSV.
                                Flu Vaccination Campaign 2008/09 (England)
                                Data on influenza vaccination uptake is taken weekly from
                                a sample of GPs in England.
                                Steady increasing trends have been seen since since
                                the start of the campaign in September 2008. In week
                                50/08 the proportion vaccinated in the over 65 year age
                                group was 72% and in the under 65 years at risk group,
                                the proportion vaccinated was 44.2%.
                                No vaccine uptake data is available for weeks 51 and 52/
                                08. It should be noted that all data is provisional.
                                No data available for week 52/08 from this parallel GP
                                sentinel scheme. Week 51/08 data were reported in
                                our last week’s report. Between week 40/08 and 51/
                                08, 479 specimens have been submitted and135
                                (28.2%) have been positive for influenza; 125 influenza
                                A and ten influenza B.
                                HPA CfI Virological Surveillance of Influenza
                                (England)
                                Outbreak Reports:
                                One respiratory outbreak has been reported recently
                                which occurred in a care home in West Yorkshire,
                                England and laboratory testing results for this outbreak
                                are still awaited.
                                CfI welcomes reports of respiratory illness outbreaks.
                                Please email any reports to
                                respdcsc@hpa.org.uk).

                                Mortality Data
                                Office for National Statistics
                                (
                                http://www.statistics.gov.uk)

                                The data for the number of deaths registered in England
                                and Wales for week 51 are not available during the
                                Christmas - New Year period. Previous data up to week
                                50/08 were summarised in our last week’s report. The
                                weekly all cause registered deaths up to week 50/08
                                are shown in Figure 5.
                                Other Reports (UK)
                                During week 52/08, twenty three (47%) out of 49
                                sentinel samples were positive for influenza A including
                                17 A(H3) and three of the influenza A (H3) cases were
                                also positive for other respiratory viruses. One influenza
                                B positive case was also infected with corona virus;
                                two further samples were positive for RSV; three
                                samples were positive for rhinovirus. Seventy-seven
                                routine samples reported from hospital and community
                                sources were also tested; 31 (40.3%) were positive for
                                influenza A (four A (H1) and 27 A (H3)), one influenza B
                                and 55 were positive for RSV.
                                Virological data from Wales
                                )

                                To date this season seven of 44 sentinel samples and
                                28 non-sentinel samples have been positive for
                                influenza A. In week 51/08 12 sentinel samples were
                                tested and five of these were positive for influenza.
                                Figure 5 : Weekly all cause registered deaths in England and Wales
                                0
                                2 0 0 0
                                4 0 0 0
                                6 0 0 0
                                8 0 0 0
                                1 0 0 0 0
                                1 2 0 0 0
                                1 4 0 0 0
                                1 6 0 0 0
                                4 0 4 2 4 4 4 6 4 8 5 0 5 2 2 4 6 8 1 0 1 2 1 4 1 6 1 8 2 0
                                W e e k N u m b e r
                                Number of Deaths
                                O b s e r v e d
                                E x p e c t e d
                                9 5 % U p p e r L i m i t
                                Data Source: The National Influenza Vaccine Uptake
                                Monitoring Programme (HPA/DH)
                                Virological data from Scotland
                                (
                                http://www.show.scot.nhs.uk/scieh/)

                                5
                                Data for this report were collated by the Influenza/
                                Respiratory Virus Team:
                                Hongxin Zhao, Joy Field and John Watson
                                Respiratory and Systemic Infections Department
                                HPA Centre for Infections, 61 Colindale Avenue
                                London NW9 5EQ, United Kingdom
                                Tel: (0)20 8327 7768; Fax: (0)20 8200 7868
                                E-mail:
                                respcdsc@hpa.org.uk

                                Maria Zambon, Joanna Ellis, Angie Lackenby, Alison
                                Bermingham and Praveen Sebastianpillai
                                Respiratory Virus Unit, Virus Reference Department
                                HPA Centre for Infections, 61 Colindale Avenue
                                London NW9 5HT, United Kingdom
                                Tel: (0)20 8327 6239; Fax: (0)20 8205 8195
                                E-mail:
                                ernvl@hpa.org.uk

                                If you wish to be included on our email notification list
                                please send your address to:
                                respcdsc@hpa.org.uk

                                Acknowledgements
                                Canada
                                Public Health Agency of Canada
                                (
                                http://www.phac-aspc.gc.ca/fluwatch/index.html)

                                During week 51/08, influenza activity remained low with
                                the majority of the influenza surveillance regions reporting
                                no activity and 11 regions reporting sporadic influenza
                                activity. Overall there was a slight increase in the
                                consultation rates. Thirty two of 2383 (1.3%) specimens
                                tested positive for influenza in week 51/08. No outbreak
                                was reported in week 51/08.
                                Since 1 September 2008, 20 influenza viruses have been
                                characterised: three influenza A/Brisbane/59/
                                2007(H1N1)-like, two A/Brisbane/10/2007 (H3N2)-like,
                                three influenza B/Florida/4/2006-like and 12 B/Malaysia/
                                2506/2004-like, the latter was a component of the 2007/
                                08 vaccine. Six influenza A (H1N1) isolates have been
                                tested and found to be resistant to oseltamivir.
                                Ireland
                                Health Protection Surveillance Centre (HPSC)
                                (
                                http://www.hpsc.ie/)

                                In week 52/08 the Irish ILI consultation rate increased
                                to 72.8 from the updated rate of 61 per
                                00,000 population in week 51/08. Both rates are
                                well above the Irish baseline threshold of 17.8 per
                                100,000 population.
                                No virological data for week 52/08 are available as
                                yet.
                                Other country reports can be obtained from the World
                                Health Organisation:
                                Europe
                                European Influenza Surveillance System (EISS)
                                (
                                www.eiss.org)

                                In week 51/08,
                                influenza activity reached high intensity
                                in Portugal and medium intensity in Bulgaria, Ireland,
                                Spain and the UK (England and Northern Ireland).
                                Geographical spread was reported as local in France
                                and Switzerland, regional in Spain and Wales, and
                                widespread in England, Northern Ireland and Portugal.
                                Given the current epidemiological and virological
                                situation it is anticipated that in the coming weeks
                                seasonal influenza activity will increase in a number
                                of European countries.

                                Out of the total 1062 respiratory specimens collected by
                                sentinel physicians during week 51/08, 346 (32.6%)
                                specimens tested positive for influenza, 105 type A (not
                                subtyped), 223 A (H3), six A (H1) and 12 type B. In addition,
                                354 non-sentinel specimens tested positive including
                                310 influenza A (not subtyped), 27 A (H3), four A (H1), and
                                13 type B. These positive specimens were reported from
                                21countries.
                                Since week 40/08, 234 viruses have been characterised;
                                226 of these seem to be a good match to the strains
                                recommended for the 2008-09 vaccine, the remaining
                                eight were B/Malaysia/2506/2004-like.
                                Influenza activity outside the UK
                                In week 51/08 WHO and NREVSS laboratories reported
                                3035 specimens tested for influenza viruses, 103 (3.4%)
                                of which were positive: 22 influenza A (H1), three A (H3),
                                55 A (not subtyped) and 23 influenza B.
                                Since week 40/08 85 influenza viruses have been
                                characterised; 49 A/Brisbane/59/2007 (H1N1)-like, seven
                                A/Brisbane/10/2007 (H3N2)-like, nine B/Florida/04/2006-
                                like, which are the components recommended for the
                                2008-09 vaccine, and 20 from the B/Victoria lineage. Of
                                the 65 influenza A (H1) viruses tested this season, 64
                                have been found to be resistant to oseltamivir, but all are
                                sensitive to zanamivir


                                http://www.hpa.org.uk/web/HPAwebFile.../1230713150603

                                Comment

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