1 Division of Health Security and Emergencies (DSE) WHO Western Pacific Regional Office (WPRO) Fifth Meeting of National Influenza Centres in the Western.

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

25

26

27

28

29

30

31

32

33

34

35

36

37

38

39

40

41

42

43

44

45

46

47

48

49

50

51

52 1 2 3 4 5 6 7 8 9

10

11

12

13

14

15

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.