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Ireland Influenza Surveillance 2015-2016

Ronan Kelly

Retired 2020
Link to 2014-15 thread: https://flutrackers.com/forum/forum/...ance-2014-2015
Link to Health Protection Surveillance Centre; http://www.hpsc.ie/A-Z/Respiratory/Influenza/SeasonalInfluenza/

Influenza Surveillance in Ireland – Weekly Report
Influenza Week 48 2015 (23rd – 29th November 2015)
Summary
All indicators of influenza activity in Ireland were at low levels during week 48 2015 (week ending
November 29, 2015), with sporadic influenza detections reported. Respiratory syncytial virus (RSV)
activity was at high levels during week 48 2015, as expected at this time of year.

 Influenza-like illness (ILI): The sentinel GP influenza-like illness (ILI) consultation rate was 8.0 per 100,000
population in week 48 2015, remaining low, and stable compared to the updated rate of 7.4 per 100,000
reported during week 47 2015.
o ILI rates remain below the Irish baseline ILI threshold (18 per 100,000 population)
o ILI rates remain at low levels in all age groups

 GP Out of Hours: The proportion of influenza–related calls to GP Out-of-Hours services was at low levels
during week 48 2015.

 National Virus Reference Laboratory (NVRL):

 Influenza positivity remained low during week 48 2015, with four (1.5%) influenza positive specimens
reported from the NVRL from sentinel and non-sentinel sources, all influenza B.
 Respiratory syncytial virus (RSV) positivity was at high levels during week 48 2015, as expected at this time
of year.
 Positive detections of parainfluenza viruses, adenovirus and human metapneumovirus have been reported
for the 2015/2016 season to date.
 Respiratory admissions: Respiratory admissions reported from a network of sentinel hospitals during week
47 2015 were at moderate levels and remained stable compared to the previous week.
 Hospitalisations: Eleven confirmed influenza hospitalised cases were notified to HPSC for the 2015/2016
season to date: two associated with influenza A(H3), one with A(H1)pdm09, four with influenza A (not
subtyped) and four with influenza B.
 Critical care admissions: Three confirmed influenza cases were admitted to critical care units and reported
to HPSC for the 2015/2016 season to date.
 Mortality: There were no reports of any influenza-associated deaths for the 2015/2016 season to date.
 Outbreaks: One influenza B outbreak in a school in HSE-S and one acute respiratory outbreak (associated
with an unidentified pathogen) in a community hospital/long stay unit in HSE-SE were reported to HPSC
during the week ending November 29, 2015.
 International: In the European Region, influenza activity remained at low levels, with sporadic influenza
detections reported.
...
http://www.hpsc.ie/A-Z/Respiratory/I...e,15488,en.pdf
 
Last edited:
Influenza Surveillance in Ireland ? Weekly Report
Influenza Week 49 2015 (30th November ? 6th December 2015)
http://www.hpsc.ie/A-Z/Respiratory/...lanceReports/20152016Season/File,15497,en.pdf

Summary
Influenza activity in Ireland is increasing slowly, however remained at low levels during week 49
2015 (week ending December 6, 2015). Respiratory syncytial virus (RSV) activity remained at high
levels during week 49 2015. Respiratory admissions reported from a network of sentinel hospitals
were also at high levels during week 49 2015.

 Influenza-like illness (ILI): The sentinel GP influenza-like illness (ILI) consultation rate was 9.6 per 100,000
population in week 49 2015, remaining low, however increased slightly compared to the updated rate of
7.3 per 100,000 reported during week 48 2015.
o ILI rates remain below the Irish baseline ILI threshold (18 per 100,000 population)
o ILI rates remain at low levels in all age groups

 GP Out of Hours: The proportion of influenza?related calls to GP Out-of-Hours services remained at low
levels during week 49 2015.

 National Virus Reference Laboratory (NVRL):

 Influenza positivity remained low during week 49 2015, with nine (4.0%) influenza positive specimens
reported from the NVRL from sentinel and non-sentinel source: 4 A(H1)pdm09 and 5 B.
 Respiratory syncytial virus (RSV) positivity remained at high levels during week 49 2015, as expected at this
time of year.
 Positive detections of parainfluenza viruses, adenovirus and human metapneumovirus have been reported
for the 2015/2016 season to date.
 Respiratory admissions: Respiratory admissions reported from a network of sentinel hospitals during week
49 2015 were at high levels.
 Hospitalisations: Fifteen confirmed influenza hospitalised cases were notified to HPSC for the 2015/2016
season to date: two associated with influenza A(H3), three with A(H1)pdm09, four with influenza A (not
subtyped) and six with influenza B.
 Critical care admissions: Three confirmed influenza cases were admitted to critical care units and reported
to HPSC for the 2015/2016 season to date.
 Mortality: One confirmed influenza B death was reported to HPSC for the 2015/2016 season to date.
 Outbreaks: One acute respiratory outbreak (associated with an unidentified pathogen) in a community
hospital/long stay unit in HSE-NW and one RSV outbreak in a nursing home in HSE-E were reported to
HPSC during the week ending December 06, 2015.  International: In the European Region, influenza activity remained at low levels, with sporadic influenza
detections reported.
...
 
Influenza Surveillance in Ireland ? Weekly Report
Influenza Week 50 2015 (7th ? 13th December 2015)
http://www.hpsc.ie/A-Z/Respiratory/...lanceReports/20152016Season/File,15504,en.pdf

Summary
Influenza activity in Ireland is increasing slowly, however remained at low levels during week 50
2015 (week ending December 13, 2015). Respiratory syncytial virus (RSV) activity remained at high
levels during week 50 2015, however has decreased over the past two weeks. The latest available
data on respiratory admissions reported from a network of sentinel hospitals were at high levels.

 Influenza-like illness (ILI): The sentinel GP influenza-like illness (ILI) consultation rate was 10.7 per 100,000
population in week 50 2015, remaining low, however increased slightly compared to the updated rate of
8.7 per 100,000 reported during week 49 2015.
o ILI rates remain below the Irish baseline ILI threshold (18 per 100,000 population)
o ILI rates remain at low levels in all age groups

 GP Out of Hours: The proportion of influenza?related calls to GP Out-of-Hours services remained at low
levels during week 50 2015, however have increased slightly over recent weeks.

 National Virus Reference Laboratory (NVRL):

 Influenza positivity remained low during week 50 2015, with six (2.2%) influenza positive specimens
reported from the NVRL from sentinel GP and non-sentinel sources: 1 A(H1)pdm09 and 5 B.

 Respiratory syncytial virus (RSV) positivity remained at high levels during week 50 2015, however has
decreased over the last two weeks.

 Positive detections of parainfluenza viruses and human metapneumovirus were reported during week 50
2015.

 Respiratory admissions: Respiratory admissions reported from a network of sentinel hospitals during week
49 2015 were at high levels.

 Hospitalisations: Eighteen confirmed influenza hospitalised cases were notified to HPSC for the 2015/2016
season to date: two associated with influenza A(H3), four with A(H1)pdm09, four with influenza A (not
subtyped) and eight with influenza B.

 Critical care admissions: Three confirmed influenza cases were admitted to critical care units and reported
to HPSC for the 2015/2016 season to date.

 Mortality: One confirmed influenza B death was reported to HPSC for the 2015/2016 season to date.

 Outbreaks: No new acute respiratory infection/influenza outbreaks were reported to HPSC during the
week ending December 13, 2015.

 International: In the European Region, influenza activity remained at low levels, with sporadic influenza
detections reported.
...
 
Influenza Surveillance in Ireland – Weekly Report
Influenza Week 51 2015 (14th – 20th December 2015)
http://www.hpsc.ie/A-Z/Respiratory/I...e,15507,en.pdf

Summary
Influenza activity in Ireland is increasing slowly, however remained at low levels during week 51
2015 (week ending December 20, 2015). Sporadic influenza B hospitalisations increased during
week 51 2015. Respiratory syncytial virus (RSV) activity remained at high levels during this period.

 Influenza-like illness (ILI): The sentinel GP influenza-like illness (ILI) consultation rate was 14.7 per 100,000
population in week 51 2015, remaining low, however increased slightly compared to the updated rate of
10.7 per 100,000 reported during week 50 2015.
o ILI rates remain below the Irish baseline ILI threshold (18 per 100,000 population)
o ILI rates remain at low levels in all age groups

 GP Out of Hours: The proportion of influenza–related calls to GP Out-of-Hours services remained at low
levels during week 51 2015, however has increased slightly over recent weeks.

 National Virus Reference Laboratory (NVRL):

o Influenza positivity remained low during week 51 2015, with 16 (5.9%) influenza positive
specimens reported from the NVRL from sentinel GP and non-sentinel sources: 3 A(H1)pdm09, 1
A (not subtyped) and 12 B.
o Respiratory syncytial virus (RSV) positivity remained at high levels during week 51 2015.
o Positive detections of adenovirus, parainfluenza viruses and human metapneumovirus were
reported during week 51 2015.

 Respiratory admissions: Respiratory admissions reported from a network of sentinel hospitals during week
50 2015 were at high levels.

 Hospitalisations: 33 confirmed influenza hospitalised cases were notified to HPSC for the 2015/2016
season to date: two associated with influenza A(H3), four with A(H1)pdm09, seven with influenza A (not
subtyped) and 20 with influenza B.

 Critical care admissions: Three confirmed influenza cases were admitted to critical care units and reported
to HPSC for the 2015/2016 season to date.

 Mortality: One confirmed influenza B death was reported to HPSC for the 2015/2016 season to date.

 Outbreaks: One influenza-like illness (ILI) outbreak in a residential care facility in HSE-NE was reported to
HPSC during the week ending December 20, 2015.

 International: In the European Region, influenza activity remained at low levels, with sporadic influenza
detections reported.
 
Influenza Surveillance in Ireland ? Weekly Report
Influenza Weeks 52 and 53 2015 (21st December 2015 ? 3rd January 2016)
http://www.hpsc.ie/A-Z/Respiratory/...lanceReports/20152016Season/File,15533,en.pdf

Data for weeks 52 and 53 2015 should be interpreted with caution, as reporting levels are affected during the
Christmas/New Year Holiday period.

Summary
Influenza activity in Ireland is increasing slowly, however remained at low levels during weeks 52
2015 (week ending December 27, 2015) and 53 2015 (week ending January 3, 2016). Influenza B
hospitalisations increased during weeks 52 and 53 2015. Respiratory syncytial virus (RSV) activity
remained at high levels during this period.

 Influenza-like illness (ILI): The sentinel GP influenza-like illness (ILI) consultation rate was 12.0 per 100,000
population in week 53 2015, remaining low, however increased slightly compared to the rate of 7.3 per
100,000 reported during week 52 2015.
o ILI rates remain below the Irish baseline ILI threshold (18 per 100,000 population)
o ILI rates remain at low levels in all age groups

 GP Out of Hours: The proportion of influenza?related calls to GP Out-of-Hours services increased
significantly during week 53 2015.

 National Virus Reference Laboratory (NVRL):
o Influenza positivity remained low, however increased slightly during weeks 52 and 53 2015, with
33 (7.0%) influenza positive specimens reported from the NVRL: 13 A(H1)pdm09, 1 A (not
subtyped) and 19 B. Respiratory syncytial virus (RSV) positivity remained at high levels during
weeks 52 and 53 2015.
o Positive detections of adenovirus, parainfluenza viruses and human metapneumovirus were
reported during weeks 52 and 53 2015.  Respiratory admissions: Respiratory admissions reported from a network of sentinel hospitals were at high
levels during week 53 2015.

 Hospitalisations: 43 confirmed influenza hospitalised cases were notified to HPSC for the 2015/2016
season to date: two associated with influenza A(H3), six with A(H1)pdm09, eight with influenza A (not
subtyped) and 27 with influenza B.

 Critical care admissions: Seven confirmed influenza cases (one associated with influenza A(H1)pdm09,
three with influenza A-not subtyped and three with influenza B) were admitted to critical care units and
reported to HPSC for the 2015/2016 season to date.

 Mortality: One confirmed influenza B death was reported to HPSC for the 2015/2016 season to date.

 Outbreaks: One RSV outbreak in a residential care facility was reported from HSE-NE to HPSC during the
week ending January 3, 2016. No acute respiratory/influenza outbreaks were reported to HPSC during the
week ending December 27, 2016.

 International: Influenza activity remained low in most countries in the European Region, with sporadic
influenza viruses detected. The proportion of influenza virus-positive sentinel specimens was over 10% for
two consecutive weeks during weeks 50 and 51 2015, confirming the start of the influenza season in
Europe in week 51 2015.
...
 
Influenza Surveillance in Ireland ? Weekly Report
Influenza Week 1 2016 (4th- 10th January 2016)
http://www.hpsc.ie/A-Z/Respiratory/...lanceReports/20152016Season/File,15537,en.pdf

Summary
All indicators of influenza activity in Ireland increased significantly during week 1 2016 (week
ending January 10, 2016), with activity at moderate levels. Influenza A(H1)pdm09 and influenza B
are co-circulating, with increasing hospitalisations and ICU admissions reported during this period.
It is now recommended that antivirals be considered for the treatment or prevention of influenza
in high risk groups.

 Influenza-like illness (ILI): The sentinel GP influenza-like illness (ILI) consultation rate was 48.5 per 100,000
population in week 1 2016, a significant increase compared to the rate 11.3 per 100,000 reported during
week 53 2015.
o ILI rates have increased above the Irish baseline ILI threshold (18 per 100,000 population), for the
first time this season.
o ILI rates increased in all age groups; with the highest rates reported in the 15-64 year age group.

 GP Out of Hours: The proportion of influenza?related calls to GP Out-of-Hours services remained elevated
during week 1 2016.

 National Virus Reference Laboratory (NVRL):
o Influenza positivity increased during week 1 2016, with 72 (18.6%) influenza positive specimens
reported from the NVRL: 31 A(H1)pdm09, 2 A (H3), 5 A (not subtyped) and 34 B.
o The predominant influenza viruses circulating are influenza A(H1)pdm09 and influenza B.
o Respiratory syncytial virus (RSV) positivity remained at high levels during week 1 2016. o Positive detections of adenovirus, parainfluenza viruses and human metapneumovirus were
reported during week 1 2016.

 Respiratory admissions: Respiratory admissions reported from a network of sentinel hospitals were at high
levels during week 53 2015.

 Hospitalisations: 76 confirmed influenza hospitalised cases were notified to HPSC for the 2015/2016
season to date: two associated with influenza A(H3), 16 with A(H1)pdm09, 16 with influenza A (not
subtyped) and 42 with influenza B.

 Critical care admissions: Six new confirmed influenza cases were admitted to critical care units and
reported to HPSC during the week ending January 10, 2016, bringing the season total to 13 cases.

 Mortality: Four confirmed influenza cases died and were reported to HPSC for the 2015/2016 season to
date.

 Outbreaks: Four acute respiratory/influenza outbreaks were reported to HPSC during the week ending
January 10, 2016, one in an acute hospital setting and three in residential care facilities.

 International: The 2015/16 influenza season has started in Europe; with the proportion of influenza virus- positive sentinel specimens over 10% for three consecutive weeks. The increase in influenza positivity in
recent weeks, is mainly associated with influenza A(H1)pdm09. Viruses characterised to date this season
in Europe are genetically similar to the strains recommended for inclusion in this winter?s trivalent or
quadrivalent vaccines for the northern hemisphere.
 
Influenza Surveillance in Ireland ? Weekly Report
Influenza Week 2 2016 (11th- 17th January 2016)
http://www.hpsc.ie/A-Z/Respiratory/...lanceReports/20152016Season/File,15543,en.pdf

Summary
Influenza activity in Ireland increased slightly during week 2 2016 (week ending January 17, 2016), with activity remaining at moderate levels. Influenza A(H1)pdm09 and influenza B are co- circulating, with increasing hospitalisations and ICU admissions reported during this period. It is now recommended that antivirals be considered for the treatment or prevention of influenza in
high risk groups.

 Influenza-like illness (ILI): The sentinel GP influenza-like illness (ILI) consultation rate was 52.4 per 100,000
population in week 2 2016, a slight increase compared to the updated rate of 46.3 per 100,000 reported
during week 1 2016.
o ILI rates remained above the Irish baseline ILI threshold (18 per 100,000 population).
o ILI age specific rates increased in 0-4 and 5-14 year olds and in those aged 65 years and older and
remained stable in the 15-64 year age group during week 2 2016, compared to the previous week.

 GP Out of Hours: The proportion of influenza?related calls to GP Out-of-Hours services remained elevated
during week 2 2016.

 National Virus Reference Laboratory (NVRL):
o Influenza positivity decreased slightly during week 2 2016, compared to the previous week, with
87 (20.8%) influenza positive specimens reported: 42 A(H1)pdm09, 5 A (not subtyped) and 40 B.
o The predominant influenza viruses circulating are influenza A(H1)pdm09 and influenza B.
o RSV continues to circulate at moderate to high levels, with positivity decreasing in recent weeks.
o Positive detections of parainfluenza viruses and human metapneumovirus were reported during
week 2 2016.

 Respiratory admissions: Respiratory admissions reported from a network of sentinel hospitals were at high
levels during weeks 1 and 2 2016.

 Hospitalisations: 137 confirmed influenza hospitalised cases were notified to HPSC for the 2015/2016
season to date: 46 associated with influenza A(H1)pdm09, 3 with A(H3), 22 with A-not subtyped and 66
with influenza B.

 Critical care admissions: Three new confirmed influenza cases were admitted to critical care units and
reported to HPSC during the week ending January 17, 2016, bringing the season total to 16 cases.

 Mortality: Five confirmed influenza cases died and were reported to HPSC for the 2015/2016 season to
date.

 Outbreaks: Eight acute respiratory/influenza outbreaks were reported to HPSC during the week ending
January 17, 2016.

 International: In Europe, influenza activity continued at low levels, except in some countries in Northern
and Eastern Europe where an increase in influenza activity was observed. The increase in influenza
positivity in recent weeks, is mainly associated with influenza A(H1)pdm09. Viruses characterised to date
this season in Europe are genetically similar to the strains recommended for inclusion in this winter?s
trivalent or quadrivalent vaccines for the northern hemisphere.
...
 
Influenza Surveillance in Ireland ? Weekly Report
Influenza Week 3 2016 (18th- 24th January 2016)
http://www.hpsc.ie/A-Z/Respiratory/...lanceReports/20152016Season/File,15554,en.pdf

Summary
Influenza activity in Ireland continued to increase during week 3 2016 (week ending January 24, 2016), with activity at moderately high levels. Influenza A(H1)pdm09 and influenza B are co- circulating, with increasing hospitalisations and ICU admissions reported during this period. It is
now recommended that antivirals be considered for the treatment or prevention of influenza in
high risk groups.

 Influenza-like illness (ILI): The sentinel GP influenza-like illness (ILI) consultation rate was 76.5 per 100,000
population in week 3 2016, an increase compared to the updated rate of 50.6 per 100,000 reported
during week 2 2016.
o ILI rates remained above the Irish baseline ILI threshold (18 per 100,000 population).
o During week 3 2016, ILI age specific rates increased in all age groups, with the highest age specific
rates in the 5-14 year age group.

 GP Out of Hours: The proportion of influenza?related calls to GP Out-of-Hours services remained elevated
during week 3 2016.

 National Virus Reference Laboratory (NVRL):
o Influenza positivity increased during week 3 2016, compared to the previous week, with 114
(23.6%) influenza positive specimens reported: 68 A(H1)pdm09, 5 A (not subtyped) and 41 B.
o The predominant influenza viruses circulating are influenza A(H1)pdm09 and influenza B.
o Influenza B positivity peaked during week 53 2015 and has declined in recent weeks; while
influenza A(H1)pdm09 positivity continues to increase.
o RSV positive detections continue to decrease. o Positive detections of human metapneumovirus and parainfluenza viruses were reported during
week 3 2016.

 Respiratory admissions: Respiratory admissions reported from a network of sentinel hospitals were at high
levels during week 3 2016.

 Hospitalisations: 219 confirmed influenza hospitalised cases were notified to HPSC for the 2015/2016
season to date: 88 were associated with influenza A(H1)pdm09, 3 with A(H3), 37 with A (not subtyped)
and 91 with influenza B.

 Critical care admissions: 11 confirmed influenza cases admitted to critical care units were reported to HPSC
during the week ending January 24, 2016, bringing the season total to 27 cases.

 Mortality: Seven confirmed influenza cases died and were reported to HPSC for the 2015/2016 season to
date.

 Outbreaks: One RSV outbreak in a nursing home in HSE-SE was reported to HPSC during week 3 2016.

 International: Influenza activity is increasing in Europe, with influenza A(H1N1)pdm09 viruses
predominating this season to date.
...
 
[h=1]Swine flu virus killed four people in Ireland this winter[/h] [h=2][/h] News emerged yesterday that a pregnant mother was hospitalised having being diagnosed with the H1N1 virus.
It has now been confirmed that the same virus caused the death of four people in the country over the course of the winter.
This news has prompted doctors to promote the benefits of the flu vaccine to the general public.

Dr Darina O' Flanagan, head of the HSE's Health Protection Surveillance Centre (HSPC), said the current flu vaccine offered protection against the virus.
This is in contrast to the winter of 2009, when swine flu reached pandemic levels because there was initially no vaccine against it.

https://www.sundayworld.com/news/swine-flu-virus-killed-four-people-in-ireland-this-winter
 
[h=1]Swine flu: Pregnant woman among two in hospital with influenza strain responsible[/h] It is understood that one of the patients, thought to be a paramedic, began receiving treatment for a ?strain of H1N1? at the south-eastern hospital last week.

A second person was brought in shortly afterwards and, according to local reports, is a patient who was collected by ambulance from an address in Wexford town.
Neither patients? condition is believed to be life threatening, and the woman, who is a mother-of-two, is believed to be responding well to treatment after being transferred from intensive care.
A spokesman for Wexford General Hospital confirmed the ?influenza-like illness? was the swine flu strain.

http://www.independent.ie/irish-new...th-influenza-strain-responsible-34404046.html
 
Influenza Surveillance in Ireland ? Weekly Report
Influenza Week 4 2016 (25th ? 31st January 2016)
http://www.hpsc.ie/A-Z/Respiratory/...lanceReports/20152016Season/File,15569,en.pdf

Summary
Most indicators of influenza activity in Ireland continued to increase during week 4 2016 (week ending
January 31, 2016), with activity at high levels. Influenza A(H1)pdm09 is the predominant virus circulating. Reports of hospitalisations and ICU admissions have continued to increase. It is recommended that
antivirals be considered for the treatment and prevention of influenza in high risk groups.

 Influenza-like illness (ILI): The sentinel GP influenza-like illness (ILI) consultation rate was 88.3 per 100,000
population in week 4 2016, an increase compared to the updated rate of 75.3 per 100,000 reported
during week 3 2016.
o ILI rates remained above the Irish baseline ILI threshold (18 per 100,000 population).
o ILI age specific rates were highest in the 5-14 year age group.

 GP Out of Hours: The proportion of influenza?related calls to GP Out-of-Hours services remained elevated.

 National Virus Reference Laboratory (NVRL): Influenza positivity reported from the NVRL increased slightly
to 28% during week 4 2016, compared to 26% during the previous week. 131 influenza positive specimens
were reported during week 4 2016: 97 A(H1)pdm09, 1 A (H3), 4 A (not subtyped) and 29 B.
o The predominant influenza virus circulating is influenza A(H1)pdm09.
o Influenza B positivity peaked during week 53 2015 and has declined in recent weeks; while
influenza A(H1)pdm09 positivity continues to increase.
o RSV positive detections continued to decrease. o Human metapneumovirus, adenovirus and parainfluenza viruses were detected in week 4 2016.

 All influenza A(H1)pdm09 and A(H3) viruses characterised in Ireland this season, are genetically similar to
the strains recommended for inclusion in the 2015/2016 trivalent influenza vaccines. Influenza B viruses
characterised this season in Ireland, belong to the B/Victoria lineage, these viruses are not present in the
2015/2016 trivalent vaccine used in Ireland. Trivalent vaccines are the most widely used influenza
vaccines in Europe.

 Respiratory admissions: Respiratory admissions reported from a network of sentinel hospitals were at
high levels during week 4 2016.

 Hospitalisations: 344 confirmed influenza hospitalised cases were notified to HPSC for the 2015/2016
season to date: 164 were associated with influenza A(H1)pdm09, 3 with A(H3), 44 with A (not subtyped)
and 133 with influenza B.

 Critical care admissions: 18 confirmed influenza cases admitted to critical care units were reported to
HPSC since the last surveillance report, bringing the season total to 45 cases.

 Mortality: Nine confirmed influenza cases died and were reported to HPSC for the 2015/2016 season.

 Outbreaks: One RSV and one acute respiratory (associated with an unknown pathogen) outbreaks in
community hospitals in HSE-NW were notified to HPSC during week 4 2016.

 International: Influenza activity is increasing in Europe, with influenza A(H1N1)pdm09 viruses
predominating this season to date.
...
 Nine confirmed influenza cases (six associated with influenza A(H1)pdm09, one with influenza A-not
subtyped and two with influenza B) died and were reported to HPSC for the 2015/2016 season to date.

 No excess all-cause mortality was reported in Ireland for the 2015/2016 season to date, after correcting
GRO data for reporting delays with the standardised EuroMOMO algorithm.
...
 
[h=1]Young child dies of swine flu in Dublin hospital[/h] [h=2]A young child is believed to have died from the H1N1 strain of influenza at a Dublin hospital this week.[/h] The child is thought to be from the west of Ireland and had been transferred to Dublin for treatment.
The H1N1 virus was responsible for the 2009 swine flu outbreak in Ireland.
The latest HSE flu report claimed that consultations with GPs in relation to flu like illness had increased across the country in recent days.

It said there were 124 confirmed hospitalised cases of flu in the past week, bringing to 344 the total number of hospitalised cases notified in the 2015/2016 flu season.
So far 45 patients have been admitted to intensive care units.


Nine people have been killed by the flu this winter.

http://www.sundayworld.com/news/young-child-dies-of-swine-flu-in-dublin-hospital
 
Influenza Surveillance in Ireland ? Weekly Report
Influenza Week 5 2016 (1st ? 7th February 2016)
http://www.hpsc.ie/A-Z/Respiratory/...lanceReports/20152016Season/File,15574,en.pdf

Most indicators of influenza activity in Ireland stabilised during week 5 2016 (week ending February 7, 2016), with activity remaining at high levels. Influenza A(H1)pdm09 is the predominant virus circulating. Reports of hospitalisations/ICU admissions associated with influenza remain elevated. It is recommended
that antivirals be considered for the treatment and prevention of influenza in high risk groups.

 Influenza-like illness (ILI): The sentinel GP influenza-like illness (ILI) consultation rate was 84.9 per 100,000
population in week 5 2016, similar to the updated rate of 84.8 per 100,000 reported during week 4 2016.
o ILI rates remained above the Irish baseline ILI threshold (18 per 100,000 population).
o ILI age specific rates were highest in the 5-14 year age group.

 GP Out of Hours: The proportion of influenza?related calls to GP Out-of-Hours services remained elevated.

 National Virus Reference Laboratory (NVRL): Influenza positivity reported from the NVRL for all respiratory
specimens (sentinel and non-sentinel) remained stable at 32.5% during week 5 2016, compared to 33.8%
during the previous week. Of 560 sentinel and non-sentinel specimens tested, 182 were influenza
positive: 125 A(H1)pdm09, 5 A (not subtyped) and 52 B.
o The predominant influenza virus circulating is influenza A(H1)pdm09; co-circulating with influenza
B.
o Influenza A(H1)pdm09 positivity remains high; influenza B positivity peaked during week 53 2015.
o RSV positive detections continued to decrease.
o Sporadic cases of human metapneumovirus and adenovirus were reported in week 5 2016.

 All influenza A(H1)pdm09 and A(H3) viruses characterised in Ireland this season, belong to genetic groups
that are antigenically similar to the strains recommended for inclusion in the 2015/2016 trivalent
influenza vaccines. Influenza B viruses characterised this season in Ireland, belong to the B/Victoria
lineage, these viruses are not present in the 2015/2016 trivalent vaccine used in Ireland. Trivalent
vaccines are the most widely used influenza vaccines in Europe.

 Respiratory admissions: Respiratory admissions reported from a network of sentinel hospitals were at
high levels during week 5 2016.

 Hospitalisations: 460 confirmed influenza hospitalised cases were notified to HPSC for the 2015/2016
season to date: 240 were associated with influenza A(H1)pdm09, 3 with A(H3), 57 with A (not subtyped)
and 160 with influenza B.

 Critical care admissions: 10 confirmed influenza cases admitted to critical care units were reported to
HPSC since the last surveillance report, bringing the season total to 55 cases.

 Mortality: 15 confirmed influenza cases died and were reported to HPSC for the 2015/2016 season.

 Outbreaks: Five influenza A(H1)pdm09 outbreaks and four acute respiratory outbreaks (associated with
unknown pathogens) were notified to HPSC during week 5 2016.

 International: Overall, influenza activity has continued to increase in Europe, with influenza
A(H1N1)pdm09 viruses predominating this season to date.
...
 Fifteen confirmed influenza cases (11 associated with influenza A(H1)pdm09, one with influenza A-not
subtyped and three with influenza B) died and were reported to HPSC for the 2015/2016 season to date.
The median age of confirmed influenza cases who died this season is 63 years.
 No excess all-cause mortality was reported in Ireland for the 2015/2016 season to date, after correcting
GRO data for reporting delays with the standardised EuroMOMO algorithm.
...
 
Influenza Surveillance in Ireland ? Weekly Report
Influenza Week 6 2016 (8th ? 14th February 2016)
http://www.hpsc.ie/A-Z/Respiratory/...lanceReports/20152016Season/File,15580,en.pdf

Summary
Most indicators of influenza activity in Ireland decreased during week 6 2016 (week ending February 14, 2016), with activity remaining at high levels. Influenza A(H1)pdm09 is the predominant virus circulating. Reports of hospitalisations/ICU admissions associated with influenza remain elevated. It is recommended
that antivirals be considered for the treatment and prevention of influenza in high risk groups.

 Influenza-like illness (ILI): The sentinel GP influenza-like illness (ILI) consultation rate was 73.4 per 100,000
population in week 6 2016, a slight decrease compared to the updated rate of 79.5 per 100,000 reported
during week 5 2016.
o ILI rates remained above the Irish baseline ILI threshold (18 per 100,000 population).
o ILI age specific rates were highest in the 0-4 year age group.

 GP Out of Hours: The proportion of influenza?related calls to GP Out-of-Hours services remained elevated.

 National Virus Reference Laboratory (NVRL): Influenza positivity reported from the NVRL for all respiratory
specimens (sentinel and non-sentinel) decreased to 27.7% during week 6 2016, compared to 32.8% during
the previous week. Of 661 sentinel and non-sentinel specimens tested, 183 were influenza positive: 119
A(H1)pdm09, 3 A (not subtyped) and 61 B.
o Influenza A(H1)pdm09 is the predominant virus circulating; co-circulating with influenza B.
o Influenza A(H1)pdm09 positivity remains high; influenza B positivity peaked during December
2015.
o RSV activity remains at low levels.
o Increased positive detections of adenovirus were reported in week 6 2016.

 All influenza A(H1)pdm09 and A(H3) viruses characterised in Ireland this season, belong to genetic groups
that are antigenically similar to the strains recommended for inclusion in the 2015/2016 trivalent
influenza vaccines. Influenza B viruses characterised this season in Ireland, belong to the B/Victoria
lineage, these viruses are not present in the 2015/2016 trivalent vaccine used in Ireland. Trivalent
vaccines are the most widely used influenza vaccines in Europe.

 Respiratory admissions: Respiratory admissions reported from a network of sentinel hospitals decreased
during week 6 2016, however remained at elevated levels.

 Hospitalisations: 665 confirmed influenza hospitalised cases were notified to HPSC for the 2015/2016
season to date: 341 were associated with influenza A(H1)pdm09, 3 with A(H3), 96 with A (not subtyped)
and 225 with influenza B.

 Critical care admissions: 15 confirmed influenza cases admitted to critical care units were reported to
HPSC since the last surveillance report, bringing the season total to 70 cases.

 Mortality: 16 confirmed influenza cases died and were reported to HPSC for the 2015/2016 season.  Outbreaks: One influenza A(H1)pdm09 school outbreak in HSE-NE was notified to HPSC during week 6
2016.

 International: Overall, influenza activity has continued to increase in Europe, with influenza
A(H1N1)pdm09 viruses predominating this season to date.
...
 Sixteen confirmed influenza cases (12 associated with influenza A(H1)pdm09, one with influenza A-not
subtyped and three with influenza B) died and were reported to HPSC for the 2015/2016 season to date.
The median age of confirmed influenza cases who died this season is 63 years.

 No excess all-cause mortality was reported in Ireland for the 2015/2016 season to date, after correcting
GRO data for reporting delays with the standardised EuroMOMO algorithm.
...
http://www.hpsc.ie/A-Z/Respiratory/...lanceReports/20152016Season/File,15580,en.pdf
 
Influenza Surveillance in Ireland ? Weekly Report
Influenza Week 7 2016 (15th ? 21st February 2016)
http://www.hpsc.ie/A-Z/Respiratory/...lanceReports/20152016Season/File,15584,en.pdf

Summary
Influenza activity in Ireland was at moderate to high levels during week 7 2016 (week ending February 21, 2016). Influenza A(H1)pdm09 is the predominant virus circulating. Reports of hospitalisations/ICU
admissions associated with influenza and influenza outbreaks remain elevated. It is recommended that
antivirals be considered for the treatment and prevention of influenza in high risk groups.

 Influenza-like illness (ILI): The sentinel GP influenza-like illness (ILI) consultation rate was 71.1 per 100,000
population in week 7 2016, remaining stable compared to the updated rate of 72.0 per 100,000 reported
during week 6 2016.
o ILI rates remained above the Irish baseline ILI threshold (18 per 100,000 population).
o ILI age specific rates were highest in the 5-14 year age group.

 GP Out of Hours: The proportion of influenza?related calls to GP Out-of-Hours services decreased, however remained elevated.

 National Virus Reference Laboratory (NVRL): Influenza positivity reported from the NVRL for all respiratory
specimens (sentinel and non-sentinel) remained elevated at 29.4% during week 7 2016, compared to
30.3% during the previous week. Of 561 sentinel and non-sentinel specimens tested, 165 were influenza
positive: 103 A(H1)pdm09, 1 A(H3), 7 A(not subtyped) and 54 B.
o Influenza A(H1)pdm09 is the predominant virus circulating; co-circulating with influenza B.
o Influenza A(H1)pdm09 positivity remains high, accounting for 62.4% of all flu positive specimens.
o RSV activity has continued to decline and remains at low levels.

 All influenza A(H1)pdm09 and A(H3) viruses characterised in Ireland this season, belong to genetic groups
that are antigenically similar to the strains recommended for inclusion in the 2015/2016 trivalent
influenza vaccines. Influenza B viruses characterised this season in Ireland, belong to the B/Victoria
lineage, these viruses are not present in the 2015/2016 trivalent vaccine used in Ireland. Trivalent
vaccines are the most widely used influenza vaccines in Europe.

 Respiratory admissions: Respiratory admissions reported from a network of sentinel hospitals decreased
for the fourth consecutive week during week 7 2016.

 Hospitalisations: 886 confirmed influenza hospitalised cases were notified to HPSC for the 2015/2016
season to date: 460 were associated with influenza A(H1)pdm09, 3 with A(H3), 136 with A (not subtyped)
and 287 with influenza B.

 Critical care admissions: 15 confirmed influenza cases admitted to critical care units were reported to
HPSC since the last surveillance report, bringing the season total to 85 cases.

 Mortality: 25 confirmed influenza cases died and were reported to HPSC for the 2015/2016 season.

 Outbreaks: Six confirmed influenza outbreaks were notified to HPSC during week 7 2016, two in HSE-E
and one in each of the following: HSE-MW, -NW, -SE and -S.

 International: Overall, influenza activity has continued to increase in Europe, with influenza
A(H1N1)pdm09 viruses predominating this season to date.
...
 Twenty-five confirmed influenza cases (19 associated with influenza A(H1)pdm09, two with influenza A- not subtyped and four with influenza B) died and were reported to HPSC for the 2015/2016 season to
date. The median age of confirmed influenza cases who died this season is 64 years.
 No excess all-cause mortality was reported in Ireland during week 7 2016. For the 2015/2016 season to
date, excess all-cause mortality was reported during week 1 2016, after correcting GRO data for
reporting delays with the standardised EuroMOMO algorithm. Please note these data are provisional
...

due to the time delay in deaths? registration in Ireland.
 
Swine flu death toll increases to 20 this winter

Eilish O'Regan T
The official death toll from swine flu this winter has risen to 20, with doctors and hospitals continuing to report outbreaks of the illness.


There have been 32 laboratory-confirmed deaths from the flu virus so far this winter, with most other patients dying from the B strain.
However, the true number of flu-related deaths is believed to be much higher as not everyone that dies with a flu-like illness is tested. They are also often a result of complications secondary to the patient's main underlying illness.
The flu is continuing to lead to hospitalisations and intensive care admissions, contributing to emergency-department overcrowding. It also contributed to higher than normal numbers dying in the first and last weeks of January.
...
http://www.independent.ie/irish-new...oll-increases-to-20-this-winter-34516880.html

Influenza Surveillance in Ireland ? Weekly Report
Influenza Week 8 2016 (22nd ? 28th February 2016)
http://www.hpsc.ie/A-Z/Respiratory/...lanceReports/20152016Season/File,15589,en.pdf

Summary
Influenza activity in Ireland was at moderate levels during week 8 2016 (week ending February 28, 2016).
Influenza A(H1)pdm09 is the predominant virus circulating. Reports of hospitalisations/ICU admissions
associated with influenza and influenza outbreaks remain elevated. It is recommended that antivirals be
considered for the treatment and prevention of influenza in high risk groups.

 Influenza-like illness (ILI): The sentinel GP influenza-like illness (ILI) consultation rate was 59.7 per 100,000
population in week 8 2016, a decrease compared to the updated rate of 71.1 per 100,000 reported during
week 7 2016.
o ILI rates remained above the Irish baseline ILI threshold (18 per 100,000 population).
o ILI age specific rates were highest in the 5-14 year age group.


 GP Out of Hours: The proportion of influenza?related calls to GP Out-of-Hours services decreased during
week 8 2016, however remained elevated.

 National Virus Reference Laboratory (NVRL): Influenza positivity reported from the NVRL for all respiratory
specimens (sentinel and non-sentinel) remained elevated at 32% during week 8 2016. Of 582 sentinel and
non-sentinel specimens tested, 186 were influenza positive: 115 A(H1)pdm09, 9 A(H3), 5 A (not subtyped)
and 57 B.
o Influenza A(H1)pdm09 is the predominant virus circulating; co-circulating with influenza B.
o Influenza A(H1)pdm09 positivity remains high, accounting for 62% of all flu positive specimens.
o RSV activity remains at low levels.

 All influenza A(H1)pdm09 and A(H3) viruses characterised in Ireland this season, belong to genetic groups
that are antigenically similar to the strains recommended for inclusion in the 2015/2016 trivalent
influenza vaccines. Influenza B viruses characterised this season in Ireland, belong to the B/Victoria
lineage, these viruses are not present in the 2015/2016 trivalent vaccine used in Ireland. Trivalent
vaccines are the most widely used influenza vaccines in Europe.

 Respiratory admissions: Respiratory admissions reported from a network of sentinel hospitals decreased
for the fifth consecutive week during week 8 2016.

 Hospitalisations: 1065 confirmed influenza hospitalised cases were notified to HPSC for the 2015/2016
season to date: 566 were associated with influenza A(H1)pdm09, 4 with A(H3), 153 with A (not subtyped)
and 342 with influenza B.

 Critical care admissions: 18 confirmed influenza cases admitted to critical care units were reported to
HPSC since the last surveillance report, bringing the season total to 103 cases.

 Mortality: 32 confirmed influenza cases died and were reported to HPSC for the 2015/2016 season.

 Outbreaks: Three influenza outbreaks in community hospitals/residential care facilities were notified to
HPSC during week 8 2016: one in HSE-E, one in HSE-NW and one in HSE-S.

 International: Overall, influenza activity remained widespread in Europe, with the majority of countries
reporting decreasing trends. Influenza A(H1N1)pdm09 viruses predominated this season to date.
...
 Thirty-two confirmed influenza cases (20 associated with influenza A(H1)pdm09, five with influenza A- not subtyped and seven with influenza B) died and were reported to HPSC for the 2015/2016 season to
date. The median age of confirmed influenza cases who died this season is 64 years.
 No excess all-cause mortality was reported in Ireland during week 8 2016. For the 2015/2016 season to
date, excess all-cause mortality was reported during weeks 1 and 4 2016, after correcting GRO data for
reporting delays with the standardised EuroMOMO algorithm. Please note these data are provisional
due to the time delay in deaths? registration in Ireland.
...
 
[h=1]Mayo man dies from swine flu[/h]
A man from the east Mayo region has died from the swine flu virus in the Mayo University Hospital, Castlebar. The HSE is encouraging people in the at-risk age groups to avail of the flu vaccine, as cases of swine flu have significantly increased in recent months.
?Deaths from swine flu are still very rare, but give cause for concern when they happen. Any virus can be dangerous, and the swine flu is contagious. We would encourage people to get the vaccinations at their local GPs,? said a GP in the south east Mayo region. ?It only takes a very short time to administer the vaccine,? he added.
Swine flu is now a ?seasonal? virus that circulates worldwide. The H1N1 flu strain, which causes the virus, has been included in the seasonal flu vaccine in Ireland since the 2010/11 influenza season.

http://www.mayonews.ie/news/27434-mayo-man-dies-from-swine-flu
 
[h=1]Number of swine flu deaths in winter season rises to 26[/h] Six more people died from swine flu in the first week of March, bringing the 2015/2016 seasonal total to 26.
Overall, 38 people have died from various strains of influenza. The six deaths recorded between February 29th and March 6th were all associated with the H1N1 strain, also known as swine flu.
There has been a downward trend in weekly flu detection rates, which stood at 42.9 per 100,000 population on March 6th compared to 60.8 the previous week. These figures are substantially above the national baseline figure of 18 per 100,000 which indicates the flu season is ongoing.
Latest figures from the Health Protection Surveillance Centre (HPSC) show there have been 1,258 confirmed cases of hospitalisation caused by influenza during the 2015/2016 season, with swine flu accounting for the highest number of these.

http://www.irishtimes.com/news/heal...deaths-in-winter-season-rises-to-26-1.2569879
 
Influenza Surveillance in Ireland – Weekly Report
Influenza Week 9 2016 (29th February – 6th March 2016)
http://www.hpsc.ie/A-Z/Respiratory/I...e,15593,en.pdf

Summary
Influenza activity in Ireland decreased significantly during week 9 2016 (week ending March 6, 2016).
Influenza A(H1)pdm09 is the predominant virus circulating. Reports of hospitalisations/ICU admissions
associated with influenza and influenza outbreaks continue to be reported. It is recommended that
antivirals be considered for the treatment and prevention of influenza in high risk groups.


 Influenza-like illness (ILI): The sentinel GP influenza-like illness (ILI) consultation rate was 42.9 per 100,000
population in week 9 2016, a decrease compared to the updated rate of 60.8 per 100,000 reported during
week 8 2016.
o ILI rates remained above the Irish baseline ILI threshold (18 per 100,000 population).
o ILI age specific rates decreased in the 0-4, 5-14 and 15-64 year age groups and increased slightly
in those aged 65 years and older during week 9 2016, compared to the previous week.

 GP Out of Hours: The proportion of influenza–related calls to GP Out-of-Hours services decreased further
during week 9 2016.

 National Virus Reference Laboratory (NVRL): Influenza positivity reported from the NVRL for all respiratory
specimens (sentinel and non-sentinel) decreased to 22% during week 9 2016. Of 503 sentinel and non- sentinel specimens tested, 111 were influenza positive: 71 A(H1)pdm09, 2 A (H3), 2 A (not subtyped) and 36 B.
o Influenza A(H1)pdm09 is the predominant virus circulating; co-circulating with influenza B.
o Positive detections of influenza A(H1)pdm09 and influenza B decreased significantly during week
9 2016, compared to the previous week.
o RSV activity remains at low levels.

 All influenza A(H1)pdm09 and A(H3) viruses characterised in Ireland this season, belong to genetic groups
that are antigenically similar to the strains recommended for inclusion in the 2015/2016 trivalent
influenza vaccines. Influenza B viruses characterised this season in Ireland, belong to the B/Victoria
lineage, these viruses are not present in the 2015/2016 trivalent vaccine used in Ireland. Trivalent
vaccines are the most widely used influenza vaccines in Europe.

 Respiratory admissions: Respiratory admissions reported from a network of sentinel hospitals increased
slightly during week 9 2016, compared to the previous week.

 Hospitalisations: 1258 confirmed influenza hospitalised cases were notified to HPSC for the 2015/2016
season to date: 671 were associated with influenza A(H1)pdm09, 5 with A(H3), 170 with A (not subtyped)
and 412 with influenza B.

 Critical care admissions: Seven confirmed influenza cases admitted to critical care units were reported to
HPSC since the last surveillance report, bringing the season total to 110 cases.

 Mortality: 38 confirmed influenza cases died and were reported to HPSC for the 2015/2016 season.

 Outbreaks: Five acute respiratory/influenza outbreaks were notified to HPSC during week 9 2016.

 International: Overall, influenza activity remained widespread in Europe, with the majority of countries
reporting decreasing trends. Influenza A(H1N1)pdm09 viruses predominated this season to date.
...
 Thirty-eight confirmed influenza cases (26 associated with influenza A(H1)pdm09, five with influenza A- not subtyped and seven with influenza B) died and were reported to HPSC for the 2015/2016 season to
date. The median age of confirmed influenza cases who died this season is 64 years.

 No excess all-cause mortality was reported in Ireland during week 9 2016. For the 2015/2016 season to
date, excess all-cause mortality was reported during weeks 1 and 4 2016, after correcting GRO data for
reporting delays with the standardised EuroMOMO algorithm. Please note these data are provisional
due to the time delay in deaths’ registration in Ireland.
...
 
Influenza Week 10 2016 (7th ? 13th March 2016)
http://www.hpsc.ie/A-Z/Respiratory/...lanceReports/20152016Season/File,15598,en.pdf

Summary
Influenza activity in Ireland continued to decrease during week 10 2016 (week ending March 13, 2016).
Influenza A(H1)pdm09 is the predominant virus circulating. Reports of hospitalisations/ICU admissions
associated with influenza and influenza outbreaks continue to be reported. It is recommended that
antivirals be considered for the treatment and prevention of influenza in high risk groups.

 Influenza-like illness (ILI): The sentinel GP influenza-like illness (ILI) consultation rate was 29.2 per 100,000
population in week 10 2016, a decrease compared to the updated rate of 40.7 per 100,000 reported
during week 9 2016.
o ILI rates remained above the Irish baseline ILI threshold (18 per 100,000 population).
o ILI age specific rates remained stable in the 0-4 year age group and decreased in all other age
groups.

 GP Out of Hours: The proportion of influenza?related calls to GP Out-of-Hours services decreased further.

 National Virus Reference Laboratory (NVRL): Influenza positivity reported from the NVRL for all respiratory
specimens (sentinel and non-sentinel) remained stable at 25% during week 10 2016. Of 486 sentinel and
non-sentinel specimens tested, 121 were influenza positive: 85 A(H1)pdm09, 2 A(H3), 4 A (not subtyped)
and 30 B.
o Influenza A(H1)pdm09 is the predominant virus circulating; co-circulating with influenza B. Overall, positive detections of influenza A(H1)pdm09 and influenza B have decreased each week
for four consecutive weeks.
o Sporadic detections of RSV, adenovirus and human metapneumovirus were reported during week
10 2016. RSV activity remains at low levels.

 All influenza A(H1)pdm09 and A(H3) viruses characterised in Ireland this season, belong to genetic groups
that are antigenically similar to the strains recommended for inclusion in the 2015/2016 trivalent
influenza vaccines. Influenza B viruses characterised this season in Ireland, belong to the B/Victoria
lineage, these viruses are not present in the 2015/2016 trivalent vaccine used in Ireland. Trivalent
vaccines are the most widely used influenza vaccines in Europe.

 Hospitalisations: 1393 confirmed influenza hospitalised cases were notified to HPSC for the 2015/2016
season to date: 738 were associated with influenza A(H1)pdm09, 6 with A(H3), 194 with A (not subtyped)
and 455 with influenza B.

 Critical care admissions: One confirmed influenza case admitted to a critical care unit was reported to
HPSC since the last surveillance report, bringing the season total to 111 cases.

 Mortality: 40 confirmed influenza cases died and were reported to HPSC for the 2015/2016 season.

 Outbreaks: Four acute respiratory/influenza outbreaks were notified to HPSC during week 10 2016.

 International: Overall, influenza activity remained widespread in Europe, with the majority of countries
reporting decreasing trends.
...
 Forty confirmed influenza cases (26 associated with influenza A(H1)pdm09, seven with influenza A-not
subtyped and seven with influenza B) died and were reported to HPSC for the 2015/2016 season to date.
The median age of confirmed influenza cases who died this season is 64 years.

 No excess all-cause mortality was reported in Ireland during week 10 2016. For the 2015/2016 season to
date, excess all-cause mortality was reported during weeks 1, 3 and 4 2016, after correcting GRO data for
reporting delays with the standardised EuroMOMO algorithm. Please note these data are provisional
due to the time delay in deaths? registration in Ireland.
...
 
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