Thursday 2 August 2007
Epidemiological updates
Scientific Developments
Public health developments
Meetings and workshops
Epidemiological updates
Seasonal Influenza – European Status
During the inter-season period over the summer, EISS produces a bulletin every two weeks as a low-level monitoring of human influenza activity in Europe. The next inter-season bulletin will be published on 27th July 2007
Text updated from: European Influenza Surveillance Scheme (EISS) Inter-season Electronic Bulletin
Issue 230, Week 29 (16/07/2007-22/07/2007)
Sporadic laboratory confirmed cases of influenza in Europe in recent weeks
Summary: In week 28/2007 and 29/007 fourteen countries reported virological data to the European Influenza Surveillance Scheme (EISS). Three positive specimens were reported in week 28/2007 and two in week 29/2007. Ten countries reported an assessment of the geographical spread and all reported no influenza activity in week 29/2007.
Since week 21/2007, a total of 12 positive specimens - 10 influenza A viruses and 2 influenza B viruses - have been reported to EISS (see graph and table for further details). Additionally, Finland reported one positive specimen (influenza B) in week 21/2007.
There have been no reports of unusual influenza activity in humans since week 22/2007, when an outbreak of avian influenza A(H7N2) was reported in the United Kingdom.
Background: The Inter-season Electronic Bulletin presents and comments influenza activity based on virological data reported to EISS. The Inter-season Electronic Bulletin will be published between week 21/2007 and week 39/2007.
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).
Full interactive EISS bulletin including maps and graphs by country and informative links in the text
National/regional bulletins in Europe and other bulletins from around the world
Links to general information from EISS:
General information on EISS, including background, membership and information on citing the EISS bulletin
Definitions of epidemiological indicators used by EISS
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AVIAN INFLUENZA –HUMAN HEALTH – UPDATE
25th July 07
No new cases of human infections with H5N1 Influenza have been confirmed by WHO since the announcement of a case in Egypt. There are media reports of a case in Viet Nam but this has yet to be confirmed to WHO’s satisfaction
ECDC Travel Advice
WHO latest avian influenza update
WHO timeline of major events
Cumulative number of confirmed human cases of avian influenza A/(H5N1) reported to WHO (up to 25th July 2007)
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AVIAN INFLUENZA –ANIMAL HEALTH – INDIA
26th July 07
The World organisation for animal health (OIE) has reported one outbreak of HPAI/H5N1 affecting backyard poultry in the Manipur province, in India. This is the first outbreak in India since June 2006. Epidemiological investigations are ongoing while public health authorities are implementing control measures including stamping out of all domestic poultry within 5 Km radius zone around the outbreak. In addition, within a 10 Km radius zone, active surveillance was established. In the same area closure of poultry markets, prohibition to sell and transport poultry products, sealing up and disinfection of the premises have been implemented.
OIE official report
ECDC Travel Advice
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LOW PATHOGENIC AVIAN INFLUENZA –ANIMAL HEALTH – ITALY
1st August 07
An outbreak of Low Pathogenic Avian Influenza (LPAI) A/H7N1, has been confirmed by public health authorities in the Veneto Region, Italy. There are no reports of humans being infected. Genotyping of the virus NA and HA genes, showed only low homologies with the strain previously isolated in May in the same Region.
LPAI outbreaks are currently being reported in EU and US. For more information on public health implications of LPAI outbreaks see: Low Pathogenicity Avian Influenzas and human health. Influenza team (ECDC). Euro Surveill 2007;12(5).
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AVIAN INFLUENZA –ANIMAL HEALTH – FRANCE
31st July 07
French authorities have reported 2 cases of HPAI A/H5N1 isolated from wild birds (swans) found dead in Moselle Region.
OIE official report
See also:
ECDC influenza team. Highly pathogenic avian influenza A/H5N1 in birds within the EU - Implications for Public Health. Euro Surveill 2007;12(7):E070705.2. Available from: http://www.eurosurveillance.org/ew/2007/070705.asp#2
Relevant technical advice on the human aspects of highly pathogenic avian influenza A/H5N1 in humans (risk groups, risk assessments, advice to the public etc) is available through http://www.ecdc.europa.eu/Health_topics/Avian_Influenza/Guidance.aspx
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AVIAN INFLUENZA –ANIMAL HEALTH – UPDATE
Ongoing poultry outbreaks of HPAI/H5N1 are reported by OIE in Ghana and Myanmar.
OIE official report – Ghana
OIE official report - Myanmar
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Scientific Developments
SCIENTIFIC DEVELOPMENTS - PANMEDIC INFLUENZA - VACCINES
Vaccines for an influenza pandemic: scientific and political challenges (review) Haaheim LR
Influenza and Other Respiratory Viruses 1 (2), 55–60
This is a useful current review of the options for producing and delivering vaccines against pandemic influenza: sub-virion vaccines, adjuvanted vaccines, intradermal and intranasal dosing, DNA vaccines and ‘universal’ vaccines for example based on immunity against the highly conserved trans-membrane M2 protein in the virus. There is an especially useful table of trials registered with the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA) which maintains a database of registered trials.
IFPMA Influenza Trial Database (it must be noted that not all clinical trials are registered with this database)
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Public Health Developments
PUBLIC HEALTH DEVELOPMENTS– PANDEMIC INFLUENZA – PREPAREDNESS
United Nations Development Group: 75 things governments and their partners sould do to prepare for an influenza pandemic The United Nation Development Group (UNDG) has published guidance in the form of a check-list with a number of recommendations to increase pandemic preparedness of Governments and their partners. The document addresses several aspects of preparedness and goes from giving advice on more general aspects related to planning and coordination to more specific issues like implementation of public health measures and business continuity planning. The list is divided into 10 categories from Government Planning, through Coordination, IEC (Information, Education & Communication), Social Distancing, Transport Movement and Borders, Macroeconomic handling of the economy, Maintenance of Essential Services, Business Continuity Planning, Handling of Mass Casualties to Recovery.
ECDC comment (1/08/2007): The document represents a quick starting point and check-list and guidance for preparing for a pandemic where governments will have to take important decisions. Such a check list is highly welcome as a complementary list to that of WHO’s 2005 Pandemic Planning Checklist which according to that body’s remit has to focus primarily on the health sector. The main advice is to make plans in advance on how to implement those decisions. The document is somewhat ‘raw’ there is no pre-amble and will be daunting for some governments especially those in the lowest resourced sectors who may not feel that they need another seventy five things to do and it would be useful to have prioritised.
Although the aim of the guidance is to mitigate the economic, governance, humanitarian and social impacts of an influenza pandemic, the document seems to emphasize that this can be better achieved through a multisectoral coordinated approach involving policy makers at different levels and public health officers. Therefore many of the recommended actions suggested in this document would need to be triggered through systems that could brief governments with essential epidemiological information on severity of the pandemic, case fatality rate, most affected population segments, effectiveness of vaccines and other pharmaceutical and non pharmaceutical measures, etc. This is also an area of work that ECDC is developing in conjunction with MS, the WHO-Euro and the EMEA as part of the “Surveillance in a Pandemic” project. It is expected that relevant information like vaccine effectiveness, case fatality rate, by age and risk group, as well as other data, are produced and shared in a timely way within Europe.
See full text: http://www.undg.org/index.cfm?P=522
Potential Multi-sectoral Planning Topics for European Union Member States
Comment to
influenza@ecdc.europa.eu.
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Meetings and workshops
4th European Pandemic Preparedness Workshop, Luxembourg Sept 25th-27th 2007.
The fourth Europe-wide workshop is being organised by the European Commission, ECDC and WHO European Region with for this workshop the Commission taking the lead. It will be open to a limited number of senior officials from countries of the WHO Europe region including the EU Member States. These will be those with expertise in influenza pandemic preparedness that are either invited by the organisers or identified by the national authorities.
The report on the Third Joint Meeting in Uppsala in May is available at Third joint EC/ECDC/WHO Workshop on Pandemic Influenza Preparedness
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Perspectives in Interpandemic Influenza, Madrid, 12-14 October 2007.
The inaugural Congress on Perspectives in Interpandemic Influenza will take place 12-14 October 2007 in Madrid, Spain. This Congress aim’s to provide an update on the latest treatment and management options available for seasonal influenza. The agenda is focused on therapeutic approaches to patient care, and is targeted at health care professionals in the primary care sector.
Conference website: Perspectives in Interpandemic Influenza
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3rd ESWI European Influenza Conference, Vilamoura, Portugal, 14-17 September 2008.
The European Scientific Working group on Influenza (EWSI) - an independent group of European scientists promoting the study of influenza – will hold its third European Influenza Conference in the Autumn of 2008.
Preliminary conference information can be found at: http://www.eswi.org/Events.cfm
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