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<TABLE cellSpacing=0 cellPadding=0 width=782 border=0><TBODY><TR><TD width=1 bgColor=#0063c8 height=3></TD><TD width=1 bgColor=black height=1></TD></TR><TR><TD width=1 bgColor=black height=1></TD><TD align=middle width=780 bgColor=#0063c8 height=1>EISS - Weekly Electronic Bulletin</TD><TD width=1 bgColor=black height=1></TD></TR><TR><TD width=1 bgColor=black height=1></TD><TD width=780 bgColor=#0063c8 height=1><TABLE border=0><TBODY><TR bgColor=white><TD noWrap width=254 bgColor=#0063c8>Week 42 : 13/10/2008-19/10/2008</TD><TD noWrap align=middle width=258 bgColor=#0063c8></TD><TD noWrap align=right width=254 bgColor=#0063c8>24 October 2008, Issue N? 276</TD></TR></TBODY></TABLE></TD><TD width=1 bgColor=black height=1></TD></TR><TR><TD width=1 bgColor=black height=1></TD><TD width=780 bgColor=black height=1></TD><TD width=1 bgColor=black height=1></TD></TR><TR><TD width=1 bgColor=black height=1></TD><TD width=780 bgColor=#1d92ff height=3></TD><TD width=1 bgColor=black height=1></TD></TR><TR><TD width=1 bgColor=black height=1></TD><TD width=780 bgColor=black height=1></TD><TD width=1 bgColor=black height=1></TD></TR><TR><TD width=1 bgColor=black height=1></TD><TD width=780 bgColor=white><TABLE><TBODY><TR><TD> Continuing low levels of influenza activity in Europe Summary: Levels of influenza activity in Europe are low, with all countries reporting no or only sporadic influenza activity in week 42/2008. Only a few laboratory confirmed cases of influenza have been reported during the weeks 40-42/2008.
Epidemiological situation - week 42/2008: For the intensity indicator, the national network levels of influenza-like illness (ILI) and/or acute respiratory infection (ARI) were low in all of the 23 countries providing these data. For the geographical spread indicator, sporadic influenza activity was reported in two countries (England and Ireland) and no activity in 21 countries. Definitions for the epidemiological indicators can be found here.
Cumulative epidemiological situation ? 2008-2009 season (weeks 40-42/2008): So far this season, the consultation rates for ILI and/or ARI are at levels usually seen outside the winter period (e.g. below the national baseline threshold).
Virological situation - week 42/2008: The total number of respiratory specimens collected by sentinel physicians in week 42/2008 was 199, of which four (2%) were influenza virus positive, two type A not subtyped in Ireland and two subtype A(H3N2), one each in The Netherlands and Sweden. In addition, six influenza virus detections were reported from non-sentinel sources (e.g. specimens collected for diagnostic purposes in hospitals), of which three were type A not subtyped,[two in England and one in Sweden], one subtype A(H1) in Germany, one A(H3N2) in Sweden and one was type B in England.
Cumulative virological situation ? 2008-2009 season (weeks 40-42/2008): During the first three weeks of the current season, 22 influenza viruses were detected in six countries: 11 type A not subtyped, three subtype A(H1), five A(H3) [of which three were A(H3N2)] and three type B. In addition to England, Spain and Sweden, virus has now also been detected in Germany, Ireland and The Netherlands.
Comment: There have only been a few sporadic laboratory confirmed cases of influenza reported to EISS in this surveillance season (the past three weeks). Hence, it is currently too early to comment on which virus type or subtype may become dominant in Europe this season.
Background: The Weekly Electronic Bulletin presents and comments on influenza activity in the 30 European countries that are members of EISS. In week 42/2008, 23 countries reported clinical data and 24 countries reported virological data to EISS. The spread of influenza virus strains and their epidemiological impact in Europe are being monitored by EISS under the responsibility of the European Centre for Disease Prevention and Control in Stockholm (Sweden) in collaboration with the WHO Collaborating Centre in London (United Kingdom).
Other bulletins: To view national/regional bulletins in Europe and other bulletins from around the world, please click here. </TD></TR></TBODY></TABLE></TD><TD width=1 bgColor=black height=1></TD></TR><TR><TD width=1 bgColor=black height=1></TD><TD width=780 bgColor=black height=1></TD><TD width=1 bgColor=black height=1></TD></TR></TBODY></TABLE><TABLE cellSpacing=0 cellPadding=0 width=782 border=0><TBODY><TR><TD width=1 bgColor=black height=1></TD><TD width=780 bgColor=#1d92ff height=5></TD><TD width=1 bgColor=black height=1></TD></TR><TR><TD width=1 bgColor=black height=1></TD><TD width=780 bgColor=black height=1></TD><TD width=1 bgColor=black height=1></TD></TR><TR><TD width=1 bgColor=black height=1></TD><TD width=780 bgColor=white><TABLE width=780 border=0><TBODY><TR><TD>Map
The map presents the intensity of influenza activity and the geographical spread as assessed by each of the networks in EISS.
Clicking on the map will, if available, take you through to the national web site. If 'regional' activity is reported, a pop-up text box will appear which describes the activity in greater detail.
Clicking on England and France will provide you with regional data.
</TD><TD></TD><TD vAlign=top>Low = no influenza activity or influenza at baseline levels Medium = usual levels of influenza activity High = higher than usual levels of influenza activity Very high = particularly severe levels of influenza activity
No activity = no evidence of influenza virus activity (clinical activity remains at baseline levels) Sporadic = isolated cases of laboratory confirmed influenza infection Local outbreak = increased influenza activity in local areas (e.g. a city) within a region,
or outbreaks in two or more institutions (e.g. schools) within a region. Laboratory confirmed. Regional activity = influenza activity above baseline levels in one or more regions with
a population comprising less than 50% of the country's total population. Laboratory confirmed. Widespread = influenza activity above baseline levels in one or more regions with a population
comprising 50% or more of the country's population. Laboratory confirmed.
Finland : Where available, the epidemiological data are provided by a health-care district in
South-Western Finland (the health-care district serves 54,000 inhabitants i.e. approximately one
percent of the Finnish population). </TD></TR></TBODY></TABLE></CENTER></TD></TR></TBODY></TABLE></TD><TD width=1 bgColor=black height=1></TD></TR><TR><TD width=1 bgColor=black height=1></TD><TD width=780 bgColor=black height=1></TD><TD width=1 bgColor=black height=1></TD></TR></TBODY></TABLE><TABLE cellSpacing=0 cellPadding=0 width=782 border=0><TBODY><TR><TD width=1 bgColor=black height=1></TD><TD width=780 bgColor=#1d92ff height=5></TD><TD width=1 bgColor=black height=1></TD></TR><TR><TD width=1 bgColor=black height=1></TD><TD width=780 bgColor=black height=1></TD><TD width=1 bgColor=black height=1></TD></TR><TR><TD width=1 bgColor=black height=1></TD><TD width=780 bgColor=white><TABLE><TBODY><TR><TD>Network comments (where available)
<TABLE><TBODY><TR><TD width=20> </TD><TD width=700>Netherlands
In week 42, a specimen from a sentinel boy patient of 3 years old with ILI was positive for infleunza virus A(H3N2). The patient got ill on the day of returning from Mexico. This is the first influenza virus positive sentinel patient this season in the Netherlands. </TD></TR></TBODY></TABLE></TD></TR></TBODY></TABLE></TD><TD width=1 bgColor=black height=1></TD></TR><TR><TD width=1 bgColor=black height=1></TD><TD width=780 bgColor=black height=1></TD><TD width=1 bgColor=black height=1></TD></TR></TBODY></TABLE><TABLE cellSpacing=0 cellPadding=0 width=782 border=0><TBODY><TR><TD width=1 bgColor=black height=1></TD><TD width=780 bgColor=#1d92ff height=5></TD><TD width=1 bgColor=black height=1></TD></TR><TR><TD width=1 bgColor=black height=1></TD><TD width=780 bgColor=black height=1></TD><TD width=1 bgColor=black height=1></TD></TR><TR><TD width=1 bgColor=black height=1></TD><TD width=780 bgColor=white><TABLE width=780><TBODY><TR><TD>Table and graphs (where available)
EISS is funded by the European Centre for Disease Prevention and Control. Specific projects within EISS are funded by F. Hofmann-La Roche Ltd. (Switzerland) and Sanofi Pasteur. Neither the European Centre for Disease Prevention and Control, F. Hofmann-La Roche Ltd. (Switzerland) or Sanofi Pasteur, nor any person acting on their behalf is liable for the use that may be made of the information contained in this bulletin. </TD></TR></TBODY></TABLE></TD></TR></TBODY></TABLE></TD><TD width=1 bgColor=black height=1></TD></TR><TR><TD width=1 bgColor=black height=1></TD><TD width=780 bgColor=black height=1></TD><TD width=1 bgColor=black height=1></TD></TR><TR><TD width=1 bgColor=black height=1></TD><TD align=middle width=780 bgColor=#0063c8>EISS : Weekly Electronic Bulletin</TD></TR></TBODY></TABLE>
Reporting date: 8 May 2008
Over the 2007-2008 influenza season in the northern hemisphere, a total of 476 H1N1 viruses
were tested for oseltamivir resistance (H274Y) in Canada, of which 123 viruses (26%) were
found to be resistant.
Table 1
Month of sampling Sept
07
Oct
07
Nov
07
Dec
07
Jan
08
Feb
08
Mar
08
Apr
08
No.of H1N1 isolates
tested 1 1 18 114 153 126 56 7
No. (%) of viruses
resistant to
oseltamivir
0
(0%)
0
(0%)
0
(0%)
16
(14%)
26
(17%)
37
(29%)
38
(68%)
6
(86%)
Influenza A(H3N2) viruses and B viruses have been also tested for oseltamivir susceptibility
Comment