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1Division of Health Security and Emergencies (DSE)WHO Western Pacific Regional Office (WPRO)
Fifth Meeting of National Influenza Centres in the Western Pacific and South East Asia Regions
7 June 2011 Vientiane, Lao PDR
Summary of Influenza ActivityJune 2010 - May 2011
Dr Jeffrey Partridge (PhD)WHO/WPRO/ESR
2Division of Health Security and Emergencies (DSE)WHO Western Pacific Regional Office (WPRO)
Influenza Updates
Bi-weekly Influenza Updates for the Western Pacific Regionhttp://www.wpro.who.int/health_topics/influenza/
3Division of Health Security and Emergencies (DSE)WHO Western Pacific Regional Office (WPRO)
37 – Countries & Areas3 – WHO Collaborating Centers21 – National Influenza Centers in 15 countries
WHO CCs and NICs - WPR
4Division of Health Security and Emergencies (DSE)WHO Western Pacific Regional Office (WPRO)
0
2000
4000
6000
8000
10000
12000
14000
20 22 24 26 28 30 32 34 36 38 40 42 44 46 48 50 52 2 4 6 8 10 12 14 16 18
Weeks
No
of
spec
imen
s
Week 22 (2008) - Week 18 (2009) Week 22 (2009) - Week 18 (2010) Week 22 (2010) - Week 18 (2011)
Number of specimens processed by week by GISN(From 30 May 2010 to 8 May 2011)
379,514
215,35476,622
12,955September
Wk 35
12,313September
Wk 35
6073January
Wk 1
Data source: FluNet, Global Influenza Surveillance Network (GISN)
10 countries
12 countries
12 countries
5Division of Health Security and Emergencies (DSE)WHO Western Pacific Regional Office (WPRO)
Percentage of influenza viruses by subtypes(From 30 May 2010 to 8 May 2011)
A(H1)0.11%
A(H5)0.01%
B18.70%
A(not subtyped)6%
A(H1N1) 200941%
A(H3)34%
6Division of Health Security and Emergencies (DSE)WHO Western Pacific Regional Office (WPRO)
Number of specimens positive for influenza by subtypes (From 30 May 2010 to 8 May 2011)
Data source: FluNet, Global Influenza Surveillance Network (GISN)
0
500
1000
1500
2000
2500
3000
3500
4000
22
23
24
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26
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28
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32
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52 1 2 3 4 5 6 7 8 9
10
11
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13
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16
17
18
Epidemiological Week
No
of
infl
ue
nza
po
sit
ive
sp
ec
ime
ns
A(not subtyped) A(H1N1) 2009 A(H3) B
7Division of Health Security and Emergencies (DSE)WHO Western Pacific Regional Office (WPRO)
Avian Influenza H5N1• As of 3 June 2011, only Cambodia has reported cases in
2011—there have been 5 cases, all of which were fatal
C D C D C D C D C D C D C D C D C D
Cambodia 0 0 0 0 4 4 2 2 1 1 1 0 1 0 1 1 5 5
China 1 1 0 0 8 5 13 8 5 3 4 4 7 4 2 1 0 0
Lao PDR 0 0 0 0 0 0 0 0 2 2 0 0 0 0 0 0 0 0
Viet Nam 3 3 29 20 61 19 0 0 8 5 6 5 5 5 7 2 0 0
2010 2011
As of 3 June 2011
2006 2007 2008 20092003 2004 2005
8Division of Health Security and Emergencies (DSE)WHO Western Pacific Regional Office (WPRO)
Current situation(mid-April to mid-May 2011)
• ILI activity low in Northern Hemisphere, Tropics, and Southern Hemisphere
• Mix of influenza viruses reported from nine countries, but predominantly B viruses (>70% of positives) followed by A/H3 then A/H1N1
9Division of Health Security and Emergencies (DSE)WHO Western Pacific Regional Office (WPRO)
Epidemiological and Virological characteristics of influenza in the Western Pacific Region, 2008 - 2010
10Division of Health Security and Emergencies (DSE)WHO Western Pacific Regional Office (WPRO)
Aims
• To summarize the available epidemiological and virological data on influenza from the Western Pacific Region from 2008-2010
• Contribute to an improved understanding of disease burden in the Western Pacific Region
• Identify areas for improvement for surveillance and reporting
11Division of Health Security and Emergencies (DSE)WHO Western Pacific Regional Office (WPRO)
Methods
• Influenza disease data was collected via survey conducted by 16 countries or areas
• Requested each country's or area's weekly or monthly data by age group:– influenza-like illness (ILI)– acute respiratory infection (ARI)– severe acute respiratory infection (SARI)– all-cause outpatient visits or hospital admissions data
• Virological data extracted from the Global Influenza Surveillance Network (GISN) database, FluNet and validated and updated as required
12Division of Health Security and Emergencies (DSE)WHO Western Pacific Regional Office (WPRO)
Results
• All 16 countries or areas responded to the survey
• Surveillance systems and data collection methods, cases definitions, and age categorizations varied across the region
• ILI, SARI and ARI were reported from 14, 5, and 4 countries or areas, respectively
13Division of Health Security and Emergencies (DSE)WHO Western Pacific Regional Office (WPRO)
Challenges
• Many!• Data Collection
– Not easy to access for all countries or areas – Time-consuming
• Variations in collection methods– Different case definitions– Different methodology in collection/sampling– Age groups different
14Division of Health Security and Emergencies (DSE)WHO Western Pacific Regional Office (WPRO)
More Challenges• Missing data
– Denominator data– Some data not available e.g. missing years
• Interpretation issues– Changes to case definitions (within countries or areas)– Plausibility issues – some data doesn't make sense e.g.
ILI case number is higher than denominator data– Three years is a small time period to determine
patterns, particularly as this period included the 2009 pandemic
– Not enough data on ARI, SARI and age data to make any solid conclusions
15Division of Health Security and Emergencies (DSE)WHO Western Pacific Regional Office (WPRO)
Next steps
• Looking for guidance and advice from you tomorrow during Group Work 2
• Identify areas for improvement for surveillance and reporting
• Try this exercise again in 5 years??
16Division of Health Security and Emergencies (DSE)WHO Western Pacific Regional Office (WPRO)
Thank You
National Center for Laboratory and Epidemiology, Laos PDR, Became the newest NIC in the WPRon 16 August 2010.
On October 28, 2010 Chinese National Influenza Center, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention was officially designated a WHO Collaborating Center for Reference and Research on Influenza.