Influenza molecular surveillance strategy

Joint WHO/Europe & ECDC Annual Influenza Surveillance Meeting

Vienna, 11-13 June 2014

Eeva Broberg, ECDC

Rationale for influenza molecular surveillance at the global level

• Detection and monitoring of

• seasonal strains

• potential pandemic strains

ECDC. AF32/NMFP10 – The ECDC strategy and roadmap for integration of molecular typing into European level surveillance

and epidemic preparedness 2012.

• Outbreak detection including antiviral drug susceptibility monitoring

• Selection of vaccine strains

Objectives with European added value

Linking the virus sequence data of a global sequence database and virological and clinical data of TESSy for

Other objectives fulfilled by WHO Global Influenza Surveillance and Response System.

1. Enhanced understanding of the virological markers of severe infection

2. Detection of genetic markers associated with reduced

antiviral susceptibility

- To improve understanding of genetic markers

- To describe the prevalence of antiviral resistance

- To identify antiviral-resistant clusters

Proposed data flow

Benefits

Combining existing data resources of TESSy and GISAID, the proposed system would allow to

1. Identify strains causing severe infections. 2. Detect genetic markers associated with reduced antiviral

susceptibility - To have a more complete picture of genetic resistance markers in circulating strains - To be able to describe the prevalence of antiviral resistance in Europe - To make geospatial analysis of the strains at sequence level, e.g. EU-level resistance outbreak monitoring.

Challenges

TESSy can store sequence data, but

• not advisable to build “yet another sequence database” for influenza

• influenza requires global sequence data sharing

• with the proposed data flow, the Member States need to continue reporting to two databases

• GISAID has not agreed to the data flow from TESSy to GISAID

• in TESSy, clinical severe influenza and virological surveillance data are reported separately

ECDC Advisory Forum and National Microbiology Focal Points feedback

1. Do you agree with the objectives for molecular surveillance of influenza in EU/EEA countries?

- some questions in regard to the justification

- we can expand on the strain-based reporting pilot

2. Do you agree with the proposed principle of database interaction between TESSy and the Global Initiative on Sharing All Influenza Data (GISAID)?

- yes

Next steps

• Finalize agreements with GISAID

• Proceed with IT development at ECDC

• MS to proceed with preparing for strain-based reporting for 2014-2015

Questions to the working group

1. Do you agree with the objectives for molecular surveillance of influenza in EU/EEA countries? If not, what should be the objectives?

2. What are the best output formats? How do you want your data displayed and how often?