Giuseppe
Emeritus
[Source: World Health Organization, Weekly Epidemiological Record, full PDF document: (LINK). Edited.]
Weekly epidemiological record / Relev? ?pid?miologique hebdomadaire
17 february 2012, 87th year / 17 f?vrier 2012, 87e ann?e - No. 7, 2012, 87, 61?64 - http://www.who.int/wer
Fifth meeting of National Influenza Centres ? WHO Western Pacific and South-East Asia Regions
The fifth meeting of the National Influenza Centres (NICs) in the WHO Western Pacific and South-East Asia Regions was held in Vientiane, Lao People?s Democratic Republic, on 7?10 June 2011. Representatives from 20 countries and areas reviewed the current capacity of the WHO Global Influenza Surveillance and Response System (GISRS) in the Regions and developed a biregional 5-year plan (2012?2016) for further strengthening national influenza surveillance. In addition, a draft summary of seasonal influenza in the Western Pacific Region was presented and discussed and a prioritized influenza research agenda was drafted for this Region.
Background
Influenza surveillance has been established in many countries in the WHO Western Pacific and South-East Asia Regions. The GISRS currently includes 21 NICs in 15 countries in the Western Pacific Region and 10 NICs in 8 countries in the South-East Asia Region. There are 3 WHO Collaborating Centres for Reference and Research on Influenza in the Western Pacific Region, 1 each in Australia, China, and Japan. The GISRS collects and collates data on circulating strains of influenza viruses that enable WHO to recommend twice annually the content of the influenza vaccine for the subsequent influenza season. GISRS also gathers and analyses information on the appearance of novel strains of influenza virus and human infections with non-human viruses, such as influenza A(H5N1), and reports to WHO to enable prompt and appropriate public health responses.
Since 2007, annual meetings have provided an opportunity for NIC staff, Ministry of Health officials, WHO staff, and partners to meet and share experiences, successes, and challenges. (1, 2) The first meeting was held in Melbourne, Australia, on 1?4 May 2007. A biregional 4-year workplan for strengthening national influenza surveillance capacity was developed and endorsed during that meeting. The second meeting was held in Tokyo, Japan on 21?24 April 2008.(2) Guidelines on comprehensive influenza surveillance and influenza disease burden studies were introduced, and a software database for NICs was presented. The third meeting was hosted by the China National Influenza Centre, Beijing, China, on 18?20 August 2009. Lessons learnt from the influenza A(H1N1) pdm09 pandemic response were reviewed and appropriate measures for mitigating the impact of the pandemic were agreed. The fourth meeting of NICs in the Western Pacific Region was held in Manila, Philippines on 3?6 May 2010. Participants shared experiences from the influenza A(H1N1)pdm09 pandemic to assist those countries developing preparedness plans and laboratory contingency plans.
Objectives
The objectives of the meeting were (i) to review current capacity of the network in the Regions and develop the next biregional 5-year plan (2012?2016) to further strengthen national influenza surveillance; (ii) to finalize a regional review of seasonal influenza; and (iii) to develop a prioritized Region-specific research agenda based on the WHO Public Health Research Agenda for Influenza.
Participants
The meeting was attended by 45 participants including directors of NICs, epidemiologists, public health officials and influenza researchers from 20 countries and areas, namely: Bangladesh, Cambodia, China, the Democratic People?s Republic of Korea, Fiji, Hong Kong Special Administrative Region of China (Hong Kong SAR), Indonesia, the Lao People?s Democratic Republic, Malaysia, Mongolia, Myanmar, Nepal, New Caledonia, New Zealand, the Philippines, the Republic of Korea, Singapore, Sri Lanka, Thailand, and Viet Nam.
The meeting also included 10 experts from 4 WHO Collaborating Centres for Reference and Research on Influenza (United States Centers for Disease Control and Prevention, Atlanta, United States of America; Victorian Infectious Diseases Reference Laboratory, Melbourne, Australia; National Institute of Infectious Diseases, Tokyo, Japan; Chinese National Influenza Center, National Institute for Viral Disease Control and Prevention, Beijing, China); 1 participant from the WHO reference laboratory for diagnosis of influenza A/H5 infection, National Influenza Centre, Centre for Health Protection, Hong Kong SAR, China, and 1 influenza expert from New Zealand. The WHO Secretariat consisted of 12 representatives from WHO Headquarters, the Western Pacific Regional Office, the South-East Asia Regional Office, and Country Offices.
Summary of activities
The first 3 days of the meeting consisted of 4 plenary sessions covering (i) regional and global updates; (ii) reports on influenza activity in the northern and southern hemispheres; (iii) information on influenza surveillance and reporting systems including examples from China, Mongolia, and Sri Lanka; and (iv) a comprehensive discussion on antiviral resistance surveillance. In addition, the meeting included 4 workshop sessions focusing on (i) quality assurance programmes; (ii) a summary of seasonal influenza in the Western Pacific Region; (iii) development of the biregional influenza surveillance 5-year workplan; and (iv) a review of the current surveillance and laboratory capacity in the South-East Asia Region and identification of gaps to be addressed in the coming year. A poster session was held for participants to present how their influenza research or surveillance data is used to inform public health practice. A total of 14 posters were presented and discussed.
On the 4th day parallel meetings were held. One meeting had a research-specific agenda consisting of 3 working modules aiming to facilitate discussion about research activities that would augment a 5-year vaccine policy development plan: (i) disease burden, vaccine target and effectiveness; (ii) vaccine selection, deployment, and regulation; and (iii) design of research agendas for vaccine policy and development. The parallel meeting included technical presentations from and discussions with WHO Collaborating Centres.
Conclusions, recommendations and actions
The availability of epidemiological and virological data during the influenza A(H1N1)pdm09 pandemic testifies to the great strides that have been made by countries and areas in the 2 Regions in terms of strengthening surveillance systems, including establishment of laboratory facilities for case confirmation.
The draft Biregional Plan for Further Strengthening National Influenza Surveillance: Guiding the Way towards Influenza Control Policy and Regional Surveillance was developed during the meeting.(3) It was agreed that countries and areas should develop workplans and monitor progress in three areas of work: (1) defining the epidemiology and burden of influenza; (2) improving virological testing capacity; and (3) improving communication and reporting through the development or strengthening of regional and global networks.
The collaborative effort to summarize epidemiological and virological characteristics of influenza in the Westdental ern Pacific Region was instructive, but challenging. Challenges included data collection and comparison issues across countries and areas (timely and difficult collection of historical data, different case definitions, different methodologies in collection and sampling, and missing data) and interpretation issues associated with non-standardized data. In addition, the time period for the summary (2008?2010) included the recent pandemic, which also made it difficult to summarize seasonal influenza epidemiological patterns. However, it was agreed that the presentation of regional data was valuable. Collection of data for 2 additional years was recommended to improve the understanding of disease burden in the Western Pacific Region and to identify areas for improvement in surveillance and reporting.
Integration of epidemiological and laboratory data was identified as an important task for the NICs in the South-East Asia Region. Participants from the South-East Asia Region agreed that developing a summary of the epidemiology of influenza in their region would be beneficial.
The research agenda meeting highlighted areas that need further research to better inform influenza vaccine introduction policy. It was recommended that research should begin with a literature review, followed by identification of the core data required and special studies to fill knowledge gaps. To move forward with the research agenda, a regional approach to obtaining data was suggested. A validated ?simplified? method to define disease burden with the available surveillance systems was also recommended, while countries and areas that have the capacity could conduct special studies to collect more detailed data.
Work continues on several activities endorsed by the meeting; examples are listed below.
1) The 5-year Biregional Plan for Further Strengthening National Influenza Surveillance: Guiding the Way towards Influenza Control Policy and Regional Surveillance was finalized and disseminated.
2) Work on the summary of epidemiological and virological characteristics of influenza in the Western Pacific Region has continued with collection of additional data from participating countries and areas. A report is being prepared. In addition, the South-East Asia Region may consider the development of a similar summary.
3) A regional influenza research agenda for the Western Pacific Region, based on the deliberations of the meeting, is being developed.
(1) See No. 45, 2007, pp. 389?395.
(2) See No. 29, 2008, pp. 253?256.
(3) Biregional Plan for Further Strengthening National Influenza Surveillance: Guiding the Way towards Influenza Control Policy and Regional Surveillance. Geneva, World Health Organization, 2011 (LINK), accessed February 2011).
-
------
Weekly epidemiological record / Relev? ?pid?miologique hebdomadaire
17 february 2012, 87th year / 17 f?vrier 2012, 87e ann?e - No. 7, 2012, 87, 61?64 - http://www.who.int/wer
Fifth meeting of National Influenza Centres ? WHO Western Pacific and South-East Asia Regions
The fifth meeting of the National Influenza Centres (NICs) in the WHO Western Pacific and South-East Asia Regions was held in Vientiane, Lao People?s Democratic Republic, on 7?10 June 2011. Representatives from 20 countries and areas reviewed the current capacity of the WHO Global Influenza Surveillance and Response System (GISRS) in the Regions and developed a biregional 5-year plan (2012?2016) for further strengthening national influenza surveillance. In addition, a draft summary of seasonal influenza in the Western Pacific Region was presented and discussed and a prioritized influenza research agenda was drafted for this Region.
Background
Influenza surveillance has been established in many countries in the WHO Western Pacific and South-East Asia Regions. The GISRS currently includes 21 NICs in 15 countries in the Western Pacific Region and 10 NICs in 8 countries in the South-East Asia Region. There are 3 WHO Collaborating Centres for Reference and Research on Influenza in the Western Pacific Region, 1 each in Australia, China, and Japan. The GISRS collects and collates data on circulating strains of influenza viruses that enable WHO to recommend twice annually the content of the influenza vaccine for the subsequent influenza season. GISRS also gathers and analyses information on the appearance of novel strains of influenza virus and human infections with non-human viruses, such as influenza A(H5N1), and reports to WHO to enable prompt and appropriate public health responses.
Since 2007, annual meetings have provided an opportunity for NIC staff, Ministry of Health officials, WHO staff, and partners to meet and share experiences, successes, and challenges. (1, 2) The first meeting was held in Melbourne, Australia, on 1?4 May 2007. A biregional 4-year workplan for strengthening national influenza surveillance capacity was developed and endorsed during that meeting. The second meeting was held in Tokyo, Japan on 21?24 April 2008.(2) Guidelines on comprehensive influenza surveillance and influenza disease burden studies were introduced, and a software database for NICs was presented. The third meeting was hosted by the China National Influenza Centre, Beijing, China, on 18?20 August 2009. Lessons learnt from the influenza A(H1N1) pdm09 pandemic response were reviewed and appropriate measures for mitigating the impact of the pandemic were agreed. The fourth meeting of NICs in the Western Pacific Region was held in Manila, Philippines on 3?6 May 2010. Participants shared experiences from the influenza A(H1N1)pdm09 pandemic to assist those countries developing preparedness plans and laboratory contingency plans.
Objectives
The objectives of the meeting were (i) to review current capacity of the network in the Regions and develop the next biregional 5-year plan (2012?2016) to further strengthen national influenza surveillance; (ii) to finalize a regional review of seasonal influenza; and (iii) to develop a prioritized Region-specific research agenda based on the WHO Public Health Research Agenda for Influenza.
Participants
The meeting was attended by 45 participants including directors of NICs, epidemiologists, public health officials and influenza researchers from 20 countries and areas, namely: Bangladesh, Cambodia, China, the Democratic People?s Republic of Korea, Fiji, Hong Kong Special Administrative Region of China (Hong Kong SAR), Indonesia, the Lao People?s Democratic Republic, Malaysia, Mongolia, Myanmar, Nepal, New Caledonia, New Zealand, the Philippines, the Republic of Korea, Singapore, Sri Lanka, Thailand, and Viet Nam.
The meeting also included 10 experts from 4 WHO Collaborating Centres for Reference and Research on Influenza (United States Centers for Disease Control and Prevention, Atlanta, United States of America; Victorian Infectious Diseases Reference Laboratory, Melbourne, Australia; National Institute of Infectious Diseases, Tokyo, Japan; Chinese National Influenza Center, National Institute for Viral Disease Control and Prevention, Beijing, China); 1 participant from the WHO reference laboratory for diagnosis of influenza A/H5 infection, National Influenza Centre, Centre for Health Protection, Hong Kong SAR, China, and 1 influenza expert from New Zealand. The WHO Secretariat consisted of 12 representatives from WHO Headquarters, the Western Pacific Regional Office, the South-East Asia Regional Office, and Country Offices.
Summary of activities
The first 3 days of the meeting consisted of 4 plenary sessions covering (i) regional and global updates; (ii) reports on influenza activity in the northern and southern hemispheres; (iii) information on influenza surveillance and reporting systems including examples from China, Mongolia, and Sri Lanka; and (iv) a comprehensive discussion on antiviral resistance surveillance. In addition, the meeting included 4 workshop sessions focusing on (i) quality assurance programmes; (ii) a summary of seasonal influenza in the Western Pacific Region; (iii) development of the biregional influenza surveillance 5-year workplan; and (iv) a review of the current surveillance and laboratory capacity in the South-East Asia Region and identification of gaps to be addressed in the coming year. A poster session was held for participants to present how their influenza research or surveillance data is used to inform public health practice. A total of 14 posters were presented and discussed.
On the 4th day parallel meetings were held. One meeting had a research-specific agenda consisting of 3 working modules aiming to facilitate discussion about research activities that would augment a 5-year vaccine policy development plan: (i) disease burden, vaccine target and effectiveness; (ii) vaccine selection, deployment, and regulation; and (iii) design of research agendas for vaccine policy and development. The parallel meeting included technical presentations from and discussions with WHO Collaborating Centres.
Conclusions, recommendations and actions
The availability of epidemiological and virological data during the influenza A(H1N1)pdm09 pandemic testifies to the great strides that have been made by countries and areas in the 2 Regions in terms of strengthening surveillance systems, including establishment of laboratory facilities for case confirmation.
The draft Biregional Plan for Further Strengthening National Influenza Surveillance: Guiding the Way towards Influenza Control Policy and Regional Surveillance was developed during the meeting.(3) It was agreed that countries and areas should develop workplans and monitor progress in three areas of work: (1) defining the epidemiology and burden of influenza; (2) improving virological testing capacity; and (3) improving communication and reporting through the development or strengthening of regional and global networks.
The collaborative effort to summarize epidemiological and virological characteristics of influenza in the Westdental ern Pacific Region was instructive, but challenging. Challenges included data collection and comparison issues across countries and areas (timely and difficult collection of historical data, different case definitions, different methodologies in collection and sampling, and missing data) and interpretation issues associated with non-standardized data. In addition, the time period for the summary (2008?2010) included the recent pandemic, which also made it difficult to summarize seasonal influenza epidemiological patterns. However, it was agreed that the presentation of regional data was valuable. Collection of data for 2 additional years was recommended to improve the understanding of disease burden in the Western Pacific Region and to identify areas for improvement in surveillance and reporting.
Integration of epidemiological and laboratory data was identified as an important task for the NICs in the South-East Asia Region. Participants from the South-East Asia Region agreed that developing a summary of the epidemiology of influenza in their region would be beneficial.
The research agenda meeting highlighted areas that need further research to better inform influenza vaccine introduction policy. It was recommended that research should begin with a literature review, followed by identification of the core data required and special studies to fill knowledge gaps. To move forward with the research agenda, a regional approach to obtaining data was suggested. A validated ?simplified? method to define disease burden with the available surveillance systems was also recommended, while countries and areas that have the capacity could conduct special studies to collect more detailed data.
Work continues on several activities endorsed by the meeting; examples are listed below.
1) The 5-year Biregional Plan for Further Strengthening National Influenza Surveillance: Guiding the Way towards Influenza Control Policy and Regional Surveillance was finalized and disseminated.
2) Work on the summary of epidemiological and virological characteristics of influenza in the Western Pacific Region has continued with collection of additional data from participating countries and areas. A report is being prepared. In addition, the South-East Asia Region may consider the development of a similar summary.
3) A regional influenza research agenda for the Western Pacific Region, based on the deliberations of the meeting, is being developed.
(1) See No. 45, 2007, pp. 389?395.
(2) See No. 29, 2008, pp. 253?256.
(3) Biregional Plan for Further Strengthening National Influenza Surveillance: Guiding the Way towards Influenza Control Policy and Regional Surveillance. Geneva, World Health Organization, 2011 (LINK), accessed February 2011).
-
------