Giuseppe
Emeritus
[Source: EuroFlu, full page: (LINK). Extracts.]
EuroFlu - Weekly Electronic Bulletin - Week 47 : 18/11/2013-24/11/2013 - 29 November 2013, Issue No. 506
Low levels of influenza activity with sporadic influenza detections in countries of the WHO European Region
Summary, week 47/2013
For a description of influenza surveillance in the WHO European Region see below.
Virological surveillance for influenza
For week 47/2013 the number of influenza detections in the Region remained low: cumulatively, 5984 specimens from sentinel and non-sentinel sources were tested for influenza, 45 (1%) of which were positive: 29 (64%) for influenza A and 16 (36%) for influenza B (Fig. 1 and 2).
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Of the 17 influenza A viruses that were subtyped for week 47/2013, 5 (29%) were A(H1N1)pdm09 and 12 (71%) A(H3N2) (Fig. 2a).
Since the beginning of the season (week 40/2013), 387 influenza viruses from sentinel and non-sentinel sources have been detected and typed, with influenza A being predominant: 277 (72%) viruses were influenza A and 110 (28%) influenza B.
Of the 169 influenza A viruses that have been subtyped, 82 (51%) were A(H1N1)pdm09 and 87 (49%) were A(H3N2) (Fig. 2b).
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Since the beginning of the season, the number of influenza detections in reporting countries has remained too low to allow inference of any dominant virus; consequently 38 countries reported ?none? in the dominant virus type category for week 47/2013 (Map 1).
Virus strain characterizations
Circulating influenza viruses are assessed each season for their antigenic and genetic characteristics, to determine the extent of their antigenic similarity to the viruses included in the seasonal influenza vaccine, and determine the prevalence of mutations that affect pathogenicity or are associated with susceptibility to antiviral drugs.
Since week 40/2013, one country (Germany) has characterized 2 influenza viruses antigenically: both were A(H1N1)pdm09 viruses (A/California/7/2009 (H1N1)-like).
4 countries (Denmark, Finland, Norway and Sweden) have characterized 26 influenza viruses genetically: 12 A(H3N2), 13 A(H1N1)pdm09 and 1 influenza B virus (Yamagata lineage).
All showed susceptibility to both drugs.
The 11 influenza A(H1N1)pdm09 and 7 influenza A(H3N2) viruses screened for susceptibility to adamantanes were found to be resistant.
For the 2013/2014 northern hemisphere influenza season, WHO recommended inclusion of A/California/7/2009 (H1N1)pdm09-like, A/Texas/50/2012 (H3N2)-like (an egg-adapted virus antigenically like the cell-propagated prototype virus A/Victoria/361/2011) and B/Massachusetts/2/2012-like (Yamagata lineage) viruses in vaccines (see the WHO headquarters web site).
Outpatient surveillance for influenza-like illness (ILI) and/or acute respiratory infection (ARI)
Similar to previous weeks, during week 47/2013 all reporting countries in the Region reported low influenza activity (Map 2), mainly stable trends (Map 4), with predominantly no or sporadic influenza activity (Map 3), which resembles the situation in previous seasons at this time of year.
Consultation rates for ILI and/or ARI remained below the national baselines or at pre-season levels in all countries reporting clinical data, for week 47/2013. Nevertheless, in several countries (Austria, Italy, Spain and the United Kingdom (England)) an increase in ILI or ARI consultation rates was observed in children aged 0?4 years.
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The number of ILI and ARI cases testing positive for influenza in the Region remained low. Six samples (1%) tested positive for influenza during week 47/2013.
Fig. 5 presents historical data on the weekly percentage of influenza positive sentinel ILI/ARI specimens from the previous 4 seasons; the percentage of sentinel ILI/ARI influenza positive samples was not calculated in weeks 40?47/2013, because there were fewer than 20 influenza-positive specimens per week.
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6 (1%) of the 763 specimens collected from sentinel sources tested positive for influenza A for week 47/2013. Click here for a detailed overview in a table format.
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Hospital surveillance for SARI
The number of SARI hospitalizations in week 47/2013 was similar to that reported in previous weeks, and remained at inter-season levels in reporting countries participating in hospital surveillance for SARI in the WHO European Region (Fig. 7).
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Similarly to previous weeks, none of the 73 SARI samples collected in Belarus, Georgia, Kyrgyzstan, the Republic of Moldova, Romania, the Russian Federation, Serbia, Slovakia and Ukraine tested positive for influenza in week 47/2013.
Click here for a detailed overview in table format.
(?)
Since week 40/2013, Ireland, Sweden and the United Kingdom reported 15 hospitalized laboratory-confirmed influenza cases, with 7 of them being influenza B, 3 A(H1N1)pdm09 and 5 A not subtyped. For more information on surveillance of confirmed hospitalized influenza, please see ECDC?s Weekly Influenza Surveillance Overview (WISO) at European Centre for Disease Prevention and Control web site.
EuroMOMO (European Mortality Monitoring Project)
EuroMOMO is a project set up to develop and operate a routine public health mortality monitoring system to detect and measure, on a real-time basis, excess deaths related to influenza and other possible public health threats across 20 European Union (EU) countries.
Pooled analysis of week data for 46/2013 showed that all-cause mortality was within the normal range for all reporting countries. Results of pooled analysis may vary, depending on which countries are included in the weekly analysis. For more information about the EUROMOMO mortality monitoring system please click here).
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Country comments (where available)
Republic of Moldova: 21 samples were tested for Influenza A and B - none of them were positive. 2 samples were positive for RNA hRSV, 1 sample - positive for RNA Rhinovirus and RNA Adenovirus and 4 - positive for RNA Rhinovirus.
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EuroFlu - Weekly Electronic Bulletin - Week 47 : 18/11/2013-24/11/2013 - 29 November 2013, Issue No. 506
Low levels of influenza activity with sporadic influenza detections in countries of the WHO European Region
Summary, week 47/2013
- Levels of influenza activity in the Region remain low, with co-circulation of influenza A(H1N1)pdm09, A(H3N2) and type B viruses reported by countries for this week.
- The number of specimens testing positive for influenza is low, quite typical for this time of the year and comparable with previous seasons.
- The number of hospitalizations due to severe acute respiratory infection (SARI) is similar to that in the previous week, with none of the cases testing positive for influenza
For a description of influenza surveillance in the WHO European Region see below.
Virological surveillance for influenza
For week 47/2013 the number of influenza detections in the Region remained low: cumulatively, 5984 specimens from sentinel and non-sentinel sources were tested for influenza, 45 (1%) of which were positive: 29 (64%) for influenza A and 16 (36%) for influenza B (Fig. 1 and 2).
_________
_________
Of the 17 influenza A viruses that were subtyped for week 47/2013, 5 (29%) were A(H1N1)pdm09 and 12 (71%) A(H3N2) (Fig. 2a).
Since the beginning of the season (week 40/2013), 387 influenza viruses from sentinel and non-sentinel sources have been detected and typed, with influenza A being predominant: 277 (72%) viruses were influenza A and 110 (28%) influenza B.
Of the 169 influenza A viruses that have been subtyped, 82 (51%) were A(H1N1)pdm09 and 87 (49%) were A(H3N2) (Fig. 2b).
_________
_________
(?)
Since the beginning of the season, the number of influenza detections in reporting countries has remained too low to allow inference of any dominant virus; consequently 38 countries reported ?none? in the dominant virus type category for week 47/2013 (Map 1).
Virus strain characterizations
Circulating influenza viruses are assessed each season for their antigenic and genetic characteristics, to determine the extent of their antigenic similarity to the viruses included in the seasonal influenza vaccine, and determine the prevalence of mutations that affect pathogenicity or are associated with susceptibility to antiviral drugs.
Since week 40/2013, one country (Germany) has characterized 2 influenza viruses antigenically: both were A(H1N1)pdm09 viruses (A/California/7/2009 (H1N1)-like).
4 countries (Denmark, Finland, Norway and Sweden) have characterized 26 influenza viruses genetically: 12 A(H3N2), 13 A(H1N1)pdm09 and 1 influenza B virus (Yamagata lineage).
- The 12 A(H3N2) viruses belonged to subgroup 3C, represented by A/Texas/50/2012 in the A/Perth/16/2009, A(H3) clade;
- 13 A(H1N1)pdm09 viruses belonged to genetic group 6, represented by A/St Petersburg/27/2011;
- the influenza B virus belonged to clade 2 represented by B/Massachusetts/02/2012 in the Yamagata lineage.
All showed susceptibility to both drugs.
The 11 influenza A(H1N1)pdm09 and 7 influenza A(H3N2) viruses screened for susceptibility to adamantanes were found to be resistant.
For the 2013/2014 northern hemisphere influenza season, WHO recommended inclusion of A/California/7/2009 (H1N1)pdm09-like, A/Texas/50/2012 (H3N2)-like (an egg-adapted virus antigenically like the cell-propagated prototype virus A/Victoria/361/2011) and B/Massachusetts/2/2012-like (Yamagata lineage) viruses in vaccines (see the WHO headquarters web site).
Outpatient surveillance for influenza-like illness (ILI) and/or acute respiratory infection (ARI)
Similar to previous weeks, during week 47/2013 all reporting countries in the Region reported low influenza activity (Map 2), mainly stable trends (Map 4), with predominantly no or sporadic influenza activity (Map 3), which resembles the situation in previous seasons at this time of year.
Consultation rates for ILI and/or ARI remained below the national baselines or at pre-season levels in all countries reporting clinical data, for week 47/2013. Nevertheless, in several countries (Austria, Italy, Spain and the United Kingdom (England)) an increase in ILI or ARI consultation rates was observed in children aged 0?4 years.
(?)
The number of ILI and ARI cases testing positive for influenza in the Region remained low. Six samples (1%) tested positive for influenza during week 47/2013.
Fig. 5 presents historical data on the weekly percentage of influenza positive sentinel ILI/ARI specimens from the previous 4 seasons; the percentage of sentinel ILI/ARI influenza positive samples was not calculated in weeks 40?47/2013, because there were fewer than 20 influenza-positive specimens per week.
_________
________
6 (1%) of the 763 specimens collected from sentinel sources tested positive for influenza A for week 47/2013. Click here for a detailed overview in a table format.
________
Hospital surveillance for SARI
The number of SARI hospitalizations in week 47/2013 was similar to that reported in previous weeks, and remained at inter-season levels in reporting countries participating in hospital surveillance for SARI in the WHO European Region (Fig. 7).
_________
_________
Similarly to previous weeks, none of the 73 SARI samples collected in Belarus, Georgia, Kyrgyzstan, the Republic of Moldova, Romania, the Russian Federation, Serbia, Slovakia and Ukraine tested positive for influenza in week 47/2013.
Click here for a detailed overview in table format.
(?)
Since week 40/2013, Ireland, Sweden and the United Kingdom reported 15 hospitalized laboratory-confirmed influenza cases, with 7 of them being influenza B, 3 A(H1N1)pdm09 and 5 A not subtyped. For more information on surveillance of confirmed hospitalized influenza, please see ECDC?s Weekly Influenza Surveillance Overview (WISO) at European Centre for Disease Prevention and Control web site.
EuroMOMO (European Mortality Monitoring Project)
EuroMOMO is a project set up to develop and operate a routine public health mortality monitoring system to detect and measure, on a real-time basis, excess deaths related to influenza and other possible public health threats across 20 European Union (EU) countries.
Pooled analysis of week data for 46/2013 showed that all-cause mortality was within the normal range for all reporting countries. Results of pooled analysis may vary, depending on which countries are included in the weekly analysis. For more information about the EUROMOMO mortality monitoring system please click here).
(?)
Country comments (where available)
Republic of Moldova: 21 samples were tested for Influenza A and B - none of them were positive. 2 samples were positive for RNA hRSV, 1 sample - positive for RNA Rhinovirus and RNA Adenovirus and 4 - positive for RNA Rhinovirus.
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