Global influenza surveillance and virus sharing
Over the past half century a global system, the Global Influenza Surveillance Network (GISN) has grown up under WHO. Through GISN virological and epidemiological surveillance for human influenza is undertaken internationally. This is vital for maintaining global and local health protection against seasonal, pandemic and avian influenza. It would for example be part of the process of detection of a novel human influenza and the next influenza pandemic and it is the way the antiviral resistance was detected in Europe in 2008. It is one of the tools which the International Health Regulations would use in an emergency using function Key to the surveillance of viruses are a limited number of high level WHO Collaborating Centres and Reference Laboratories involved in annual influenza vaccine composition recommendations and many more national influenza laboratories (National Influenza Centres). In Europe the Collaborating Centre and the Regulatory Laboratory - the National Institute for Biological Standards and Control are in the UK. They are supported by the virtual Community Network Reference Laboratory which works under contract from ECDC following an open competitive tender. The European Commission also supports the process for example through providing underpinning legal regulations in Europe and funding research under the Framework and public health Programmes. While the European Medicines Agency also provides an important regulatory role in preparing for the production of human avian influenza vaccines and specific pandemic vaccines ahead of a pandemic.
Functions and Benefits
This surveillance system supports multiple benefits and functions key to health security and risk assessment and the annual cycle of vaccine productions. These include:
surveillance for the seasonal human influenza A and B viruses including antigenic haracterisation and genetic sequencing
surveillance for novel emerging human and avian influenza A viruses
developing and improving diagnostic tests for influenza
reviewing and revising the composition of seasonal human influenza vaccines
- supporting complex trials of new vaccines
- supplying to manufacturers virus strains with the required growth and antigenic properties for seasonal influenza vaccine production along with reagents to support that production
- supplying to manufacturers carefully prepared safe influenza candidate vaccine viruses for pandemic vaccine production (both pre-pandemic planning and responding to emergencies). This is generally done by a sophisticated genetic engineering technique known as ‘reverse genetics’ – only three or four laboratories world-wide have the capability to do this
- maintaining safety and standards in the handling of what are inherently dangerous pathogens
There are essential links with industrial companies, both commercial and state-owned that produce and distribute influenza vaccines. In Europe these are organised under the European Vaccine Manufacturers EVM
The GISN grew up over time and by a series of informal relationships. Central to its functioning is the free, rapid and uninhibited sharing of influenza viruses, human and animal, and information between countries, as happened during the 2009 pandemic. Currently the system is undergoing reform and further regulation. This followed questions arising in late 2006 as to the sharing of the benefits of the system, especially with less resourced countries and the sharing of the human avian influenza viruses know as A(H5N1). This has been the subject of discussion at the World Health Assemblies in May 2007 and 2008 and three intervening global Intergovernmental Meetings in April 2007, November 2007, April 2008, December 2008 and May 2009.
ECDC has been issuing briefings on this for the European Union and its Member States. The latest briefing is available as an summary (July 2010). The complete document can be requested at email@example.com, please indicate ECDC EU Virus Sharing Briefing July 2010.