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World Health Organization, Regional Office for The Western Pacific
Regional Activities Report Regional Activities Report and Preparation for the and Preparation for the
Upcoming Influenza SeasonsUpcoming Influenza Seasons
THE 3rd MEETING OF NATIONAL INFLUENZA CENTRES IN THE WESTERN PACIFIC AND SOUTH EAST ASIA REGIONS
18 - 20 AUGUST 2009, BEIJING, CHINA
World Health Organization, Regional Office for The Western Pacific
The 1st NIC meeting of WPR and SEAR
• The 1st NIC meeting of WPR and SEAR was hosted by WHO CC in Melbourne, Australia on 1 – 4 May 2007– 45 participants (Public Health Officials and NIC
directors) from 19 countries in the two regions– Identified the gap, the need, and the way forward– A workplan for establishing/strengthening a
comprehensive National Influenza Surveillance System was developed
WER, 2007; 82 (45): 389-400; http://www.who.int/wer
World Health Organization, Regional Office for The Western Pacific
The Gap
• Great contribution of influenza viruses to the Global Influenza Surveillance Network without understanding of influenza disease in most of the developing countries in the region
World Health Organization, Regional Office for The Western Pacific
The Need
• Not only contribute the virus
• But also understand the disease
• Provide essential information for the development of national control policy
• Contribute to national pandemic preparedness
World Health Organization, Regional Office for The Western Pacific
The Way Forward: Workplan for Building Capacity for A Comprehensive
National Influenza Surveillance System (NISS)
Goals of the Workplan by 2010:• to develop and sustain comprehensive
National Influenza Surveillance Systems through enhancing / strengthening the capacities of the National Influenza Centers and associated epidemiology programmes
• to have preliminary understanding of influenza disease burden in countries in Asia Pacific
World Health Organization, Regional Office for The Western Pacific
Building Capacity For Comprehensive National Influenza Surveillance Systems (NISS):
Workplan and Expected Outcomes by 2010
1. Improving virological testing capacity in the National Influenza Centres
2. Better understanding the epidemiology of influenza through link of virological and epidemiological surveillance for influenza
3. Improving the early warning function of national influenza surveillance
4. Contributing to the national rapid response and containment and pandemic preparedness
World Health Organization, Regional Office for The Western Pacific
The WPRO Guidelines
• “A Practical Guide to Harmonizing Virological and Epidemiological Influenza Surveillance”
• “A Practical Guide for Designing and Conducting Influenza Disease Burden Studies”
World Health Organization, Regional Office for The Western Pacific
ftp://ftp.wpro.who.int/Scratch/WproNic/
World Health Organization, Regional Office for The Western Pacific
The 2nd Bi-regional NIC meeting
• The 2nd bi-regional NIC meeting of WPR and SEAR was hosted by WHO CC in NIID, Tokyo, Japan on 21 – 24 April 2008– 59 participants (Public Health Officials, NIC
directors, and epidemiologists) from 21 countries in WPR and SEAR
– The meeting reviewed and commented the two guidelines and the NIC laboratory database software and outlined the next steps
WER, 2008; 83 (29): 253-260; http://www.who.int/wer
World Health Organization, Regional Office for The Western Pacific
Influenza SurveillanceKey to Success
Influenza Virus
Outbreak Events
Influenza Disease
sARI
World Health Organization, Regional Office for The Western Pacific
The WPRO Surveillance Guideline
SECTION 2: Event-Based Surveillance as Early Warning System
• Introduction• Event Definitions• Minimum Requirements• Reporting Sources• Reporting methods• Minimum Information from Reporting• Confirmation and Assessment• Routine Feedback• Monitoring and Evaluation
World Health Organization, Regional Office for The Western Pacific
Surveillance for Pandemic Influenza:Outcome of the regional workshop on WHO revised
pandemic influenza preparedness guidance 3-6 March 2009, Fukuoka, Japan
• A well established comprehensive national influenza surveillance system is the key to success for pandemic influenza surveillance
• The National pandemic preparedness process should facilitate strengthening or establishing the comprehensive national influenza surveillance system
World Health Organization, Regional Office for The Western Pacific
Regional Trainings Since the 2nd NIC Meeting
• Hands-on Influenza laboratory PCR training, 6 – 10 Oct 2008, Singapore– Organized by REDI Centre in collaboration with WPRO and
SEARO– Singapore Public Health Laboratory/Singapore MoH,
Singapore NIC, Singapore Polytechnic Institute • Hands-on NIC laboratory database software training,
19 – 21 Nov 2008, WPRO, Manila, Philippines• Hands-on Influenza Virus Isolation & Characterization
Workshop, 30 March - 3 April 2009, Singapore– Organized by REDI Centre in collaboration with WPRO and
SEARO– Singapore Public Health Laboratory/Singapore MoH,
Singapore NIC, Singapore Polytechnic Institute– WHO CCs in Australia, Japan, USA– China NIC
World Health Organization, Regional Office for The Western Pacific
Regional EQAP Progresses
0
20
40
60
80
100
Panel 1 Panel 2 Panel 3 Panel 4 Panel 5
EGAP Panels
% o
f All
Cor
rect
World Health Organization, Regional Office for The Western Pacific
Regional Trainings Planned in The Second Half of 2009
• Hands-on Influenza Virus Isolation & Characterization Workshop, October 2009, Singapore
• Hands-on Antiviral Resistance Monitoring Workshop, November, 2009, Melbourne, Australia
• Others?
World Health Organization, Regional Office for The Western Pacific
Guiding Documents Developed by WPRO for Pandemic Surveillance and Response
• Surveillance– Options for influenza A(H1N1) surveillance strategies in response to
evolving in-country situations– Options for laboratory testing strategies in response to the emergence of
influenza A(H1N1) virus– Pandemic (H1N1) 2009 Surveillance and Reporting Guide in the WHO
Western Pacific Region• Response
– Preparing Responses to the 2009 Influenza A(H1N1) Pandemic– Responding to New Influenza A(H1N1): A framework for action for the next
five months– Mitigating the impact of the new influenza A(H1N1): options for public health
measures– Responding to New Influenza A(H1N1): Options for interventions at
international points of entry– Options for use of antivirals for influenza A(H1N1) cases
http://www.wpro.who.int/health_topics/h1n1/tech/tech_guidance.htm
World Health Organization, Regional Office for The Western Pacific
Preparing for The Upcoming Influenza Seasons in The Middle of A Pandemic
Challenge and Opportunity
• Pandemic (H1N1) 2009
• Influenza A (H5N1)
• Seasonal Influenza
• Others?
World Health Organization, Regional Office for The Western Pacific
Framework for Action
SURVEILLANCE
COMMAND
PUBLIC HEALTH INTERVENTIONS
COMMUNICATIONHEALTH CARE
RESPONSEHEALTH SECTOR
How to slow down transmission
How to minimize preventable deaths
Laboratory
PA
RT
NE
RS
INDIVIDUAL LEVEL SOCIETAL LEVEL
World Health Organization, Regional Office for The Western Pacific
Preparing for The Upcoming Influenza Seasons in The Middle of A Pandemic
Surveillance• Strengthen/establish Comprehensive Influenza
Surveillance– Influenza Disease– Influenza virus– Outbreak events– SARI
• NIC contingency plan• Regional Surveillance Information Sharing
Mechanism– Pandemic (H1N1) 2009– Seasonal Influenza– Influenza A(H5N1)– Others?
• Regional Surveillance Summary?
World Health Organization, Regional Office for The Western Pacific
Preparing for The Upcoming Influenza Seasons in The Middle of A Pandemic
Response
World Health Organization, Regional Office for The Western Pacific
Preparing for The Upcoming Influenza Seasons in The Middle of A Pandemic
Response
Public health interventions
• Prepare for rational public health actions, especially implementation options of nonpharmaceutical interventions based on assessed situations and country context. Advance planning is the key to smooth implementation.
• Implement individual and household public health measures, including hand and respiratory hygiene, to protect individuals from infection.
• Implement societal measures such as social distancing when necessary, to slow down or reduce transmission at population level.