World Health Organization, Regional Office for The Western Pacific Regional Activities Report and Preparation for the Upcoming Influenza Seasons THE 3rd.

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


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


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


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


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


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


The WPRO Guidelines

• “A Practical Guide to Harmonizing Virological and Epidemiological Influenza Surveillance”

• “A Practical Guide for Designing and Conducting Influenza Disease Burden Studies”


ftp://ftp.wpro.who.int/Scratch/WproNic/


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


Influenza SurveillanceKey to Success

Influenza Virus

Outbreak Events

Influenza Disease

sARI


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


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


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


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


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?


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






Preparing for The Upcoming Influenza Seasons in The Middle of A Pandemic

Challenge and Opportunity

• Pandemic (H1N1) 2009

• Influenza A (H5N1)

• Seasonal Influenza

• Others?


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



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?



Response



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.


Thank Thank you!you!

Thank Thank you!you!