Friday 20 October 2006
Content
Seasonal Influenza – European Status
Week 41 (09/10/2006-15/10/2006
Avian Influenza - Country Update
Public Health Developments – Seasonal Influenza
Seasonal Influenza – European Status
Indonesia – WHO report on three additional cases in the country
European Influenza Surveillance Scheme (EISS) Weekly Electronic Bulletin
Issue 197, Week 41 (09/10/2006-15/10/2006)
Low levels of influenza activity in Europe
Summary: The intensity of clinical influenza activity in Europe is currently low. There have only been sporadic laboratory confirmed cases of influenza reported in the past seven weeks: 13 cases of influenza A and one case of influenza B.
Epidemiological situation - week 41/2006: The intensity of clinical activity was low in all 23 countries that reported clinical data to the European Influenza Surveillance Scheme (EISS). For the geographical spread of influenza, France reported sporadic activity (which means that isolated cases of laboratory confirmed influenza infection have been found) and all other countries reported no activity. Definitions for the epidemiological indicators can be found here.
Epidemiological situation - 2006-2007 season (week 35-41/2006): So far this season, the consultation rates for influenza-like illness ILI and / or acute respiratory infection ARI have been at baseline levels across the whole of Europe.
Virological situation - week 41/2006: The total number of respiratory specimens collected by sentinel physicians in week 41/2006 was 116, of which one (0.9%) was influenza virus positive (influenza A unsubtyped). In addition, 544 non-sentinel specimens (e.g. specimens collected in hospitals) were analyzed and four (0.7%) of these were positive (all influenza A unsubtyped).
Twenty countries reported no dominant influenza type in week 41/2006 and Sweden reported that influenza A was dominant.
Virological situation - 2006-2007 season (week 35-41/2006): Based on (sub)typing data of all influenza virus detections from week 35 to 41/2006 (N=14; sentinel and non-sentinel data), seven (50%) were A (not subtyped), three (21%) were A(H3), three (21%) were A(H1) and one (7%) was B. The influenza virus detections have been made in the following countries: France (4), Belgium (3), the Netherlands (2), England (1), Norway (1), Portugal (1), Sweden (1) and Switzerland (1).
No viruses have been antigenically and/or genically characterized since week 40/2006. Detailed virological surveillance data for weeks 23-39/2006 can be viewed here.
Comment: Influenza activity in Europe is currently low and there have only been sporadic laboratory confirmed cases of influenza. A number of these cases were infections acquired outside of Europe (e.g. a person returning from holiday in Asia). Over 90% of the laboratory confirmed cases since week 35/2006 (N=14) have been influenza A, but it is too early to say which virus type or subtype will become dominant in Europe this season.
Background: The Weekly Electronic Bulletin presents and comments influenza activity in 29 European countries. In week 41/2006, 21 countries reported clinical data and 21 countries reported virological data to EISS. The spread of influenza virus strains and their epidemiological impact in Europe are being monitored by EISS in collaboration with the WHO Collaborating Centre in London (United Kingdom) and the European Centre for Disease Prevention and Control in Stockholm (Sweden).
Other bulletins: To view national/regional bulletins in Europe and other bulletins from around the world, please click here.
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AVIAN INFLUENZA – COUNTRY UPDATE – HUMAN DISEASE AND RELATED POULTRY OUTBREAKS
Indonesia – WHO report on three additional cases in the country
As on 16 October 2006, WHO reported three additional human cases in the country, confirmed by the Ministry of Health in Indonesia. All cases reported were fatal.
The first newly confirmed case occurred in a 67year-old woman from West Java Province, known with previous chronic diseases. She developed symptoms on 3 October, was hospitalized on 7 October, and died on 15 October. There is reporting of dying chickens in her household and neighbourhood prior to symptom onset.
The second was an 11-year-old male from South Jakarta, Jakarta Province. He developed symptoms on 2 October, was hospitalized on 5 October, and died on 14 October. His recent history included exposure to dead chickens in his neighbourhood.
The third case was a 27-year-old female from Central Java Province. She developed symptoms on 8 October, was hospitalized on 12 October, and died on 13 October. The source of her exposure is currently under investigation.
Of the 72 cases confirmed to date in Indonesia, 55 have been fatal.
WHO: Disease outbreaks in Indonesia
OIE: Avian influenza update in Indonesia. Follow-up report no14
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PUBLIC HEALTH DEVELOPMENTS – PANDEMIC INFLUENZA – PERSONAL PROTECTION
Interim Guidance on Planning for the Use of Surgical Masks and Respirators in Health Care Settings during an Influenza Pandemic The United States Authorities have this week published on the pandemic influenza website new guidance on the use of masks in the health care setting.
These are available at www.pandemicflu.gov/plan/maskguidancehc.aspx
ECDC Interim Recommendations on non-pharmaceutical personal protective measures against influenza. These have been published and are available here, The Questions and Answers have been updated and there is an accompanying short article in Eurosurveilance.
Interim recommendations at ECDC website
Updated Questions & Answers
Priority Setting for Pandemic Influenza: An analysis of National Preparedness Plans Uscher-Pines L et al
PLoS Medicine 2006; 3(10):E436 (Published online October 2006 www.plosmedicine.og)
Overview: The authors reviewed fifty pandemic preparedness plans from different countries in the world, including three plans from non-developed nations. One important finding is that, regardless the WHO recommendations that nations set priority groups for both vaccine and antiviral distribution, only 30% prioritized neither of them. Besides, the vaccination was prioritized over the antivirals (62% vs 49%). Socio-cultural factors on prioritization decisions are not mentioned in the plans, but the authors suggest that they are actually considered when defining the tiered strategy. Ethics are seldom covered in the written plans. Among unresolved issues, the need of developing different antiviral strategies of treatment and postexposure prophylaxis is emphasized.
ECDC comment 2006-10-18: This is one of a number of academic comparisons that that have been made of published pandemic plans. Previous comparisons have been made within the European Union and between States in the United States.
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