Announcement

**Giuseppe** · February 5, 2010, 12:15 PM

EuroFlu - Weekly Electronic Bulletin Week 4 : 25/01/2010-31/01/2010 - 05 February 2010, Issue N? 343 (edited)

EuroFlu - Weekly Electronic Bulletin Week 4 : 25/01/2010-31/01/2010 - 05 February 2010, Issue N? 343 (edited)

EuroFlu - Weekly Electronic Bulletin Week 4 : 25/01/2010-31/01/2010 - 05 February 2010, Issue N? 343

Initial pandemic wave of influenza coming to an end in Europe

This report is based on data received from 44 of the 53 Member States in the WHO European Region.
Nine per cent of specimens collected from sentinel sources tested positive for influenza virus.
All countries reported a low or medium intensity of influenza activity.
Pandemic influenza A(H1N1) 2009 accounted for 98% of influenza virus detections in sentinel specimens.
Countries have reported 3649 deaths associated with laboratory-confirmed pandemic A(H1N1) 2009 in the Region.

Current situation: week 04/2010

Current levels of clinical respiratory disease are only above levels observed during week 4/2009 in five countries, and reported levels in most countries are well below recent pandemic peak levels. Fifteen countries tested at least twenty sentinel specimens. For the first week since week 25/2009, all of these countries reported less than 20% influenza positivity. Although Latvia, the Russian Federation, Slovakia and Slovenia reported slight increases in clinical consultation rates this week, these are not associated with increases in virological confirmations of influenza and may be due to other respiratory viruses. In addition, the number of respiratory syncytial virus (RSV) detections is increasing in the European Region.

Twenty-seven countries reported that pandemic influenza A (H1N1) 2009 virus was the dominant virus in circulation. Five (Armenia, Croatia, Georgia, Greece and the Republic of Moldova) still reported widespread influenza activity but with low-to-medium intensity. Armenia, Kyrgyzstan, the Republic of Moldova, and Romania reported the impact of influenza on health care services to be moderate, while 22 countries reported low impact.

Reported numbers of severe acute respiratory infection (SARI) hospitalizations have declined from earlier peaks in Slovakia and Uzbekistan. Rates and proportions of hospitalizations due to SARI in Kyrgyzstan, the Republic of Moldova and Ukraine have also now declined to levels approximately half the peaks observed in weeks 47?52/2009. The single peak in sentinel SARI hospitalizations that was observed in Ukraine during week 52 can be contrasted with the two distinct peaks observed in Ukrainian ARI consultation rates in weeks 45 and 51.

During the period 25?31 January 2010, 43 reported deaths associated with laboratory-confirmed pandemic A(H1N1) 2009 were reported from 22 countries in Europe, making the total 3649 since the beginning of the pandemic.

Virological update: week 04/2010

Sentinel physicians collected 1037 respiratory specimens, of which 96 (9.3%) were positive for influenza virus; 94 were type A (89 were subtyped as pandemic A(H1), 5 were not subtyped) and 2 were influenza B. Of the 15 countries testing 20 or more sentinel specimens this week, influenza-positivity rates ranged from 0% in Italy to 14.3% in Romania (median 9.1%, mean 8.5%). A total of 559 specimens from non-sentinel sources were influenza positive: 542 type A (422 pandemic A(H1), 14 seasonal A(H1), 9 seasonal A(H3), 97 not subtyped) and 17 influenza B.

From week 40/2009 to week 04/2010, a total of 153 697 influenza virus detections were reported: 153 247 were influenza A (99.7%) and 450 (0.3%) were influenza B. Of the influenza A viruses, 140 168 (91.8%) were subtyped, with 138 757 being pandemic A(H1), 917 A(H1) and 494 A(H3).

For technical reasons, antigenic and genetic characterization data are not reported this week.

Comment

Although WHO is still receiving reports of widespread activity from some Member States in central and southern Europe, trends in clinical and virological data suggest that this winter wave of pandemic influenza is coming to an end. The winter peak of influenza occurred earlier this season than during any season since 2003/2004 (when the Fujian A(H3) variant emerged).

Further information

The EuroFlu bulletin describes and comments on influenza activity in the 53 countries in the WHO European Region. Further information can be obtained from the WHO/Europe and WHO headquarters web sites.
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<cite cite="http://www.euroflu.org/cgi-files/bulletin_v2.cgi">EuroFlu - Bulletin Review</cite>

**Giuseppe** · February 12, 2010, 12:02 PM

EuroFlu - Weekly Electronic Bulletin Week 5 : 01/02/2010-07/02/2010 - 12 February 2010, Issue N? 344 (edited)

EuroFlu - Weekly Electronic Bulletin Week 5 : 01/02/2010-07/02/2010 - 12 February 2010, Issue N? 344 (edited)

EuroFlu - Weekly Electronic Bulletin Week 5 : 01/02/2010-07/02/2010 - 12 February 2010, Issue N? 344

Low levels of pandemic influenza activity in Europe

This report is based on data received from 46 of the 53 Member States in the WHO European Region.
Eight per cent of specimens collected from sentinel sources tested positive for influenza virus.
All countries reported a low or medium intensity of influenza activity.
Pandemic influenza (H1N1) 2009 accounted for 98% of influenza virus detections in sentinel specimens.
Countries have reported 4057 deaths associated with laboratory-confirmed pandemic (H1N1) 2009 in the Region since April 2009.

Current situation: week 05/2010

Consultation rates have remained at low levels for most of the countries in Europe. Twelve countries tested at least twenty sentinel specimens, with only Hungary reporting over 20% influenza positivity. Although the Russian Federation and Slovakia reported slight increases in clinical consultation rates this week, these are not associated with increases in detection of influenza and may be due to other respiratory viruses. In addition, the number of respiratory syncytial virus (RSV) detections is increasing in the European Region; 22 countries reported that pandemic (H1N1) 2009 influenza virus was the dominant virus in circulation. Croatia and the Republic of Moldova continued to report widespread influenza activity, but with low-to-medium intensity. The Republic of Moldova reported the impact of influenza on health care services to be moderate, while 24 countries reported low impact.

Reported numbers of severe acute respiratory infection (SARI) hospitalizations have declined or stabilized from earlier peaks in Albania, Malta, the Republic of Moldova, Romania and Uzbekistan. In one of the sites in Ukraine, Kyiv city, SARI hospitalizations increased slightly from the previous week.

A total of 4057 deaths associated with laboratory-confirmed pandemic (H1N1) 2009 have been reported in the Region since April 2009.

Virological update: week 05/2010

Sentinel physicians collected 996 respiratory specimens, of which 81 (8%) were positive for influenza virus; 79 were type A (70 were subtyped as pandemic A(H1), 9 were not subtyped) and 2 were influenza B. Of the 12 countries testing 20 or more sentinel specimens this week, influenza-positivity rates ranged from 0% to 23% (median 5.5%; mean 8.0%). A total of 504 specimens from non-sentinel sources were influenza positive: 487 type A (408 pandemic A(H1), 12 seasonal A(H1), 4 seasonal A(H3), 63 not subtyped) and 17 influenza B.

From week 40/2009 to week 05/2010, a total of 154 280 influenza virus detections were reported: 153 811 were influenza A (99.7%) and 469 (0.3%) were influenza B. Of the influenza A viruses, 140 660 (91.4%) were subtyped, with 139 233 being pandemic A(H1), 929 A(H1) and 498 A(H3).

Based on the antigenic characterization of 1715 influenza viruses reported from week 40/2009 to week 05/2010, 1704 were A(H1) pandemic A/California/7/2009 (H1N1)-like, 2 were A(H3) A/Brisbane/10/2007 (H3N2)-like; 7 were A(H3) A/Perth/16/2009 (H3N2)-like, 1 was A(H1) A/Brisbane/59/2007 (H1N1)-like and 1 was B/Brisbane/60/2008-like. Genetic characterizations were available for 11 323 isolates; 11 317 belonged to the A/California/7/2009 A(H1N1) pandemic group; 1 belonged to the A/Perth/16/2009 (H3N2) group; 4 to the A/Victoria/208/2009 (H3N2) group and 1 to the B/England/393/2008 (Victoria lineage) group.

Comment

Most countries continue to report fewer detections than in recent weeks, and influenza positivity rates for the Region have decreased from 20% in week 1/2010 to 8% in week 5/2010. Although a few countries in central and southern Europe report regional or widespread activity, trends in clinical and virological data suggest that this winter wave of pandemic influenza is coming to an end.

Further information

The EuroFlu bulletin describes and comments on influenza activity in the 53 countries in the WHO European Region. Further information can be obtained from the WHO/Europe and WHO headquarters web sites.
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<cite cite="http://www.euroflu.org/cgi-files/bulletin_v2.cgi">EuroFlu - Bulletin Review</cite>

**Giuseppe** · February 19, 2010, 12:14 PM

EuroFlu - Weekly Electronic Bulletin Week 6 : 08/02/2010-14/02/2010 - 19 February 2010, Issue N? 345 (edited)

EuroFlu - Weekly Electronic Bulletin Week 6 : 08/02/2010-14/02/2010 - 19 February 2010, Issue N? 345 (edited)

EuroFlu - Weekly Electronic Bulletin Week 6 : 08/02/2010-14/02/2010 - 19 February 2010, Issue N? 345

Little evidence of any remaining pandemic influenza activity in western Europe

This report is based on data received from 42 of the 53 Member States in the WHO European Region.
Five per cent of specimens collected from sentinel sources tested positive for influenza virus.
All countries reported a low or medium intensity of influenza activity.
Pandemic influenza (H1N1) 2009 accounted for 94% of influenza virus detections in sentinel specimens.
Countries have reported 4267 deaths associated with laboratory-confirmed pandemic (H1N1) 2009 in the Region since April 2009.

Current situation: week 06/2010

Consultation rates have remained at low levels for most of the countries in Europe. Twelve countries tested at least twenty sentinel specimens, but none of these reported influenza positivity over 20%. Although Georgia, the Russian Federation (southern and northwestern regions) and Slovakia reported slight increases in clinical consultation rates, these are not associated with increases in detection of influenza and may be due to other respiratory viruses, such as respiratory syncytial virus (RSV). Sixteen countries reported that pandemic (H1N1) 2009 influenza virus was the dominant influenza virus in circulation. Armenia reported widespread influenza activity with medium intensity. Regional activity was reported in Austria, Georgia, Greece, the Republic of Moldova and Serbia.

Twenty-six countries reported the impact of influenza on health care services to be low, while Armenia and the Republic of Moldova reported moderate impact.

Reported numbers of severe acute respiratory infection (SARI) hospitalizations continue to decline or level off from earlier peaks in Albania, Malta, the Republic of Moldova and Romania. In Uzbekistan and one of the sites in Ukraine, Kyiv city, SARI hospitalizations increased slightly from the previous week.

A total of 4267 deaths associated with laboratory-confirmed pandemic (H1N1) 2009 have been reported in the Region since April 2009.

Virological update: week 06/2010

Sentinel physicians collected 1054 respiratory specimens, of which 57 (5%) were positive for influenza virus; 54 were type A (46 were subtyped as pandemic A(H1), 8 were not subtyped) and 3 were influenza B. Of the 12 countries testing 20 or more sentinel specimens this week, influenza-positivity rates ranged from 0% to 15% (median 3.4%; mean 5.3%). A total of 524 specimens from non-sentinel sources were influenza positive: 485 type A (380 pandemic A(H1), 33 seasonal A(H1), 15 seasonal A(H3), 57 not subtyped) and 39 influenza B.

From week 40/2009 to week 06/2010, a total of 155 231 influenza virus detections were reported: 154 720 were influenza A (99.7%) and 511 (0.3%) were influenza B. Of the influenza A viruses, 141 504 (91.5%) were subtyped, with 140 029 being pandemic A(H1), 962 A(H1) and 513 A(H3).

Based on the reported antigenic characterization of 1772 influenza viruses from week 40/2009 to week 06/2010: 1752 were A(H1) pandemic A/California/7/2009 (H1N1)-like, 17 were A(H3) A/Perth/16/2009 (H3N2)-like, 1 was A(H1) A/Brisbane/59/2007 (H1N1)-like and 2 were B/Brisbane/60/2008-like.

Genetic characterizations were available for 957 isolates; 938 belonged to the A/California/7/2009 A(H1N1) pandemic group; 1 belonged to the A/Brisbane/10/2007 (H3) group, 10 to the A/Perth/16/2009 (H3N2) group; 5 to the A/Victoria/208/2009 (H3N2) group and 3 to the B/England/393/2008 (Victoria lineage) group.

Comment

Most countries continue to report fewer detections than in recent weeks, and influenza positivity rates for the Region continue to decrease from 45% in week 45/2009 to 5% in week 06/2010. Pandemic influenza remains the dominant circulating influenza virus but trends in clinical and virological data suggest that pandemic influenza activity is coming to an end.

Further information

The EuroFlu bulletin describes and comments on influenza activity in the 53 countries in the WHO European Region. Further information can be obtained from the WHO/Europe and WHO headquarters web sites.
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<cite cite="http://www.euroflu.org/cgi-files/bulletin_v2.cgi">EuroFlu - Bulletin Review</cite>

**Giuseppe** · February 26, 2010, 12:39 PM

EuroFlu - Weekly Electronic Bulletin Week 7 : 15/02/2010-21/02/2010 - 26 February 2010, Issue N? 346 (edited)

EuroFlu - Weekly Electronic Bulletin Week 7 : 15/02/2010-21/02/2010 - 26 February 2010, Issue N? 346 (edited)

EuroFlu - Weekly Electronic Bulletin Week 7 : 15/02/2010-21/02/2010 - 26 February 2010, Issue N? 346

Pandemic influenza activity has ended in most parts of Europe

This report is based on data received from 45 of the 53 Member States in the WHO European Region.
3.3% of specimens collected from sentinel sources tested positive for influenza virus.
Most countries reported a low intensity of influenza activity.
Only 21 influenza virus detections in sentinel specimens were reported, of which 18 were pandemic (H1N1) 2009 influenza.
Countries have reported 4389 deaths associated with laboratory-confirmed pandemic (H1N1) 2009 in the Region since April 2009.

Current situation: week 07/2010

Consultation rates have remained at low levels for most of the countries in Europe. Eight countries tested at least twenty sentinel specimens, but none of these reported influenza positivity over 20%. Although parts of the Russian Federation (southern, Urals and far eastern regions) reported slight increases in clinical consultation rates, these were not associated with increases in detection of influenza, and may be due to other respiratory viruses, such as respiratory syncytial virus (RSV). Eighteen countries reported that pandemic (H1N1) 2009 was the dominant influenza virus in circulation. Regional activity was reported in Armenia, Austria and the Republic of Moldova.

Twenty-five countries reported the impact of influenza on health care services to be low, while Armenia and the Republic of Moldova reported moderate impact.

Reported numbers of severe acute respiratory infection (SARI) hospitalizations continued to decline or level off from earlier peaks in Armenia, Malta, Romania, Ukraine and Uzbekistan.

The Republic of Moldova reported a slight increase in hospitalizations.

A total of 4389 deaths associated with laboratory-confirmed pandemic (H1N1) 2009 has been reported in the Region since April 2009.

Virological update: week 07/2010

Sentinel physicians collected 635 respiratory specimens, of which 21 (3.3%) were positive for influenza virus; 19 were type A (18 were subtyped as pandemic A(H1); 1 was not subtyped) and 2 were influenza B. Of the 8 countries testing 20 or more sentinel specimens this week, influenza-positivity rates ranged from 0% to 10% (median 2.9%; mean 3.0%); 445 specimens from non-sentinel sources were influenza positive: 419 type A (326 pandemic A(H1), 33 seasonal A(H1), 5 seasonal A(H3), 55 not subtyped) and 26 influenza B.

From week 40/2009 to week 07/2010, a total of 156 039 influenza virus detections were reported: 155 500 were influenza A (99.7%) and 539 (0.3%) were influenza B. Of the influenza A viruses, 142 197(91.5%) were subtyped, with 140 684 being pandemic A(H1), 995 A(H1) and 518 A(H3).

Based on the reported antigenic characterization of 1777 influenza viruses from week 40/2009 to week 07/2010: 1758 were A(H1) pandemic A/California/7/2009 (H1N1)-like; 17 were A(H3) A/Perth/16/2009 (H3N2)-like; 1 was A(H1) A/Brisbane/59/2007 (H1N1)-like and 1 was B/Brisbane/60/2008-like (B/Victoria/2/87 lineage). Genetic characterizations were available for 995 isolates; 976 belonged to the A/California/7/2009 A(H1N1) pandemic group; 1 belonged to the A/Brisbane/10/2007 (H3) group; 10 to the A/Perth/16/2009 (H3N2) group; 5 to the A/Victoria/208/2009 (H3N2) group and 3 to the B/England/393/2008 (Victoria lineage) group.

Comment

Most countries have continued to report declining numbers of detections in recent weeks, and influenza positivity rates for the Region have continued to decrease, from 45% in week 45/2009 to 3.3% in week 07/2010. The viruses characterized to date correspond with the recommended viruses for influenza vaccines for use in the 2010?2011 northern hemisphere influenza season (click here). Pandemic influenza remains the dominant circulating influenza virus but trends in clinical and virological data suggest that pandemic influenza activity is coming to an end in the European Region. At the global level, however, the pandemic is not considered to have entered a post-peak phase (click here). WHO recommends that countries continue surveillance of influenza on a year-round basis.

Further information

The EuroFlu bulletin describes and comments on influenza activity in the 53 countries in the WHO European Region. Further information can be obtained from the WHO/Europe and WHO headquarters web sites.
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<cite cite="http://www.euroflu.org/cgi-files/bulletin_v2.cgi">EuroFlu - Bulletin Review</cite>

**Giuseppe** · March 5, 2010, 11:56 AM

EuroFlu - Weekly Electronic Bulletin Week 8 : 22/02/2010-28/02/2010 - 05 March 2010, Issue N? 347 (edited)

EuroFlu - Weekly Electronic Bulletin Week 8 : 22/02/2010-28/02/2010 - 05 March 2010, Issue N? 347 (edited)

EuroFlu - Weekly Electronic Bulletin Week 8 : 22/02/2010-28/02/2010 - 05 March 2010, Issue N? 347

Influenza activity low in most parts of Europe

This report is based on data received from 44 of the 53 Member States in the WHO European Region.
6.8% of specimens collected from sentinel sources tested positive for influenza.
Most countries reported a low intensity of influenza activity.
Pandemic (H1N1) 2009 is the dominant virus in 12 countries in Europe.
Countries have reported 4572 deaths associated with laboratory-confirmed pandemic (H1N1) 2009 influenza in the Region since April 2009.

Current situation: week 08/2010

Consultation rates have remained at low levels for most of the countries in Europe; 11 countries tested at least 20 sentinel specimens, but none reported influenza positivity over 20%. Most countries (N = 28) reported no dominant type of virus, indicating limited influenza activity. Twelve countries reported that pandemic (H1N1) 2009 was the dominant influenza virus in circulation. In two countries, the Russian Federation and Sweden, influenza B was reported as co-dominant or dominant.

Regional activity was reported in Armenia, Austria, Greece and Italy. Twenty-seven countries reported the impact of influenza on health care services to be low, while Armenia and Kyrgyzstan reported moderate impact.

Reported numbers of severe acute respiratory infection (SARI) hospitalizations continued to decline or level off from earlier peaks in Armenia, Malta, Romania, the Republic of Moldova, Ukraine and Uzbekistan.

A total of 4572 deaths associated with laboratory-confirmed pandemic (H1N1) 2009 has been reported in the Region since April 2009.

Virological update: week 08/2010

Sentinel physicians collected 652 respiratory specimens, of which 44 (6.8%) were positive for influenza virus; 36 were type A (26 were subtyped as pandemic A(H1); 9 were not subtyped; 1 was subtyped as H1) and 8 were influenza B. Of the 11 countries testing 20 or more sentinel specimens this week, influenza-positivity rates ranged from 0% to 19.2% (median. 4.4%; mean: 5.6%); 316 specimens from non-sentinel sources were influenza positive: 265 type A (194 pandemic A(H1), 15 seasonal A(H1), 11 seasonal A(H3), 45 not subtyped) and 51 influenza B.

From week 40/2009 to week 08/2010, 156 459 influenza virus detections were reported: 155 867 were influenza A (99.6%) and 592 (0.4%) were influenza B. Of the influenza A viruses, 142 466 (91.4%) were subtyped, with 140 926 being pandemic A(H1); 1011 A(H1), and 529 A(H3).

Based on the reported antigenic characterization of 1794 influenza viruses from week 40/2009 to week 08/2010: 1773 were A(H1) pandemic A/California/7/2009 (H1N1)-like; 17 were A(H3) A/Perth/16/2009 (H3N2)-like; 1 was A(H1) A/Brisbane/59/2007 (H1N1)-like and 3 were B/Brisbane/60/2008-like (B/Victoria/2/87 lineage).

Genetic characterizations were available for 1045 isolates; 1026 belonged to the A/California/7/2009 A(H1N1) pandemic group; 1 belonged to the A/Brisbane/10/2007 (H3) group; 10 to the A/Perth/16/2009 (H3N2) group; 5 to the A/Victoria/208/2009 (H3N2) group and 3 to the B/England/393/2008 (Victoria lineage) group.

Comment

Pandemic influenza activity has shown a decreasing or stable trend in recent weeks. Most countries have continued to report declining numbers of influenza detections. The current influenza positivity rate for the Region is low: 6.8%. The overall pattern indicates that pandemic influenza activity is over, particularly in the western part of Europe. The percentage of positive sentinel specimens is lower in European Union (EU)/ European Economic Area (EEA) countries (median: 0%; mean: 4.2%) than other countries (median: 6.5%; mean: 10.8%) in the Region.

The viruses characterized to date correspond with those recommended for influenza vaccines for use in the 2010?2011 northern hemisphere influenza season (see WHO headquarters web site). WHO recommends that countries continue surveillance of influenza on a year-round basis.

Further information

The EuroFlu bulletin describes and comments on influenza activity in the 53 countries in the WHO European Region. Further information can be obtained from the WHO/Europe and WHO headquarters web sites.
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<cite cite="http://www.euroflu.org/cgi-files/bulletin_v2.cgi">EuroFlu - Bulletin Review</cite>

**Giuseppe** · March 12, 2010, 11:54 AM

EuroFlu - Weekly Electronic Bulletin - Week 9 : 01/03/2010-07/03/2010 - 12 March 2010, Issue N? 348 (Extract, edited)

EuroFlu - Weekly Electronic Bulletin - Week 9 : 01/03/2010-07/03/2010 - 12 March 2010, Issue N? 348 (Extract, edited)

[Source: EuroFlu.org, extract, edited; full page: <cite cite="http://www.euroflu.org/cgi-files/bulletin_v2.cgi">EuroFlu - Bulletin Review ]
</cite>
EuroFlu - Weekly Electronic Bulletin - Week 9 : 01/03/2010-07/03/2010 - 12 March 2010, Issue N? 348

Influenza activity is low in most parts of the WHO European Region

This report is based on data received from 46 of the 53 Member States in the WHO European Region.
5.1% of specimens collected from sentinel sources tested positive for influenza.
Most countries reported a low intensity of influenza activity.
Pandemic (H1N1) 2009 is the dominant virus in 11 countries in Europe.
Countries in the Region have reported 4597 deaths associated with laboratory-confirmed pandemic (H1N1) 2009 since April 2009.

Current situation: week 09/2010

Consultation rates have remained at low levels for most of the countries in Europe; 11 countries tested at least 20 sentinel specimens, but none reported influenza positivity rates over 20%. Most countries (N = 27) reported no dominant type of virus, indicating limited influenza activity. Eleven countries reported that pandemic (H1N1) 2009 was the dominant influenza virus in circulation. Influenza B was reported as dominant in Sweden, and as co-dominant with influenza A in the Russian Federation.

Regional activity was reported in Armenia, Austria and Greece.

The impact of influenza on health care services was low in 28 countries, while Armenia reported moderate impact.

Low numbers of severe acute respiratory infection (SARI) hospitalizations were reported in Armenia, Kazakhstan, Malta, the Republic of Moldova, Romania, Ukraine and Uzbekistan.

A total of 4597 deaths associated with laboratory-confirmed pandemic (H1N1) 2009 has been reported in the Region since April 2009.

Virological update: week 09/2010

Sentinel physicians collected 552 respiratory specimens, of which 28 (5.1%) were positive for influenza virus; 17 were type A (15 were subtyped as pandemic A(H1); 2 were not subtyped) and 11 were influenza B. Of the 11 countries testing 20 or more sentinel specimens this week, influenza-positivity rates ranged from 0% to 10.7% (median: 3.9%; mean: 4.4%); 283 specimens from non-sentinel sources were influenza positive: 185 type A (119 pandemic A(H1), 10 seasonal A(H1), 9 seasonal A(H3), 47 not subtyped) and 98 influenza B.

From week 40/2009 to week 09/2010, 160 053 influenza virus detections were reported: 159 326 were influenza A (99.5%) and 727 (0.5%) were influenza B. Of the influenza A viruses, 146 219 (91.8%) were subtyped, with 144 637 being pandemic A(H1); 1023 A(H1), and 559 A(H3).

Based on the reported antigenic characterization of 1836 influenza viruses from week 40/2009 to week 09/2010: 1815 were A(H1) pandemic A/California/7/2009 (H1N1)-like; 17 were A(H3) A/Perth/16/2009 (H3N2)-like; 1 was A(H1) A/Brisbane/59/2007 (H1N1)-like and 3 were B/Brisbane/60/2008-like (B/Victoria/2/87 lineage).

Genetic characterizations were available for 1145 isolates; 1124 belonged to the A/California/7/2009 A(H1N1) pandemic group; 1 belonged to the A/Brisbane/10/2007 (H3) group; 12 to the A/Perth/16/2009 (H3N2) group; 5 to the A/Victoria/208/2009 (H3N2) group; and 3 to the B/England/393/2008 (Victoria lineage) group.

Comment

Pandemic influenza activity has shown a decreasing or stable trend in recent weeks. Most countries have continued to report declining numbers of influenza detections. The current influenza positivity rate for the Region is low at 5.1%. The overall pattern indicates that pandemic influenza activity is over, particularly in the western part of Europe. The viruses characterized to date correspond with those recommended for influenza vaccines for use in the 2010?2011 northern hemisphere influenza season (see WHO headquarters web site). WHO recommends that countries continue surveillance of influenza on a year-round basis.

Further information

The EuroFlu bulletin describes and comments on influenza activity in the 53 countries in the WHO European Region. Further information can be obtained from the WHO/Europe and WHO headquarters web sites.

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**Giuseppe** · March 19, 2010, 11:11 AM

EuroFlu - Weekly Electronic Bulletin - Week 10 : 08/03/2010-14/03/2010 - 19 March 2010, Issue N? 349 (Extracts, edited)

EuroFlu - Weekly Electronic Bulletin - Week 10 : 08/03/2010-14/03/2010 - 19 March 2010, Issue N? 349 (Extracts, edited)

[Source: EuroFLu, <cite cite="http://www.euroflu.org/cgi-files/bulletin_v2.cgi"></cite>EuroFlu - Bulletin Review. Extracts, edited.]

EuroFlu - Weekly Electronic Bulletin - Week 10 : 08/03/2010-14/03/2010 - 19 March 2010, Issue N? 349

Low levels of influenza activity continue to be reported in the WHO European Region

This report is based on data received from 45 of the 53 Member States in the WHO European Region.
6.5% of specimens collected from sentinel sources tested positive for influenza.
Most countries reported a low intensity of influenza activity.
Over 20% of sentinel specimens in Germany, Italy and the Russian Federation tested positive for influenza.
Countries in the Region have reported 4638 deaths associated with laboratory-confirmed pandemic (H1N1) 2009 since April 2009.

Current situation: week 10/2010

Clinical consultation rates for influenza-like illness (ILI) and acute respiratory infections (ARI) remain at low levels throughout the Region. While Romania has reported a recent increase in ARI consultations, this was not associated with an increase in influenza detections.

Nine countries tested at least 20 sentinel specimens. Of these countries, Germany, Italy, and the Russian Federation reported influenza positivity rates of over 20%. The six influenza detections from sentinel sites in Germany were all positive for pandemic (H1N1) 2009 viruses, and the 15 influenza detections from sentinel sites in Italy and the Russian Federation were all positive for influenza B viruses.

Portugal also reported 64 laboratory-confirmed cases of pandemic A(H1N1) 2009 (non-sentinel influenza detections) from the Azores during week 10/2010.

Most countries (N = 30) reported no dominant type of virus, indicating limited influenza activity overall.

The majority of countries reporting severe acute respiratory infection (SARI) hospitalizations reported lower numbers of such hospitalizations in week 10/2010 than in week 9/2010 (Albania, Kazakhstan, the Republic of Moldova, Ukraine and Uzbekistan). Only Malta reported a slight increase in the number of SARI hospitalizations, albeit still at low levels relative to their observed peak during week 1/2010.

A total of 4638 deaths associated with laboratory-confirmed pandemic (H1N1) 2009 has been reported in the Region since April 2009.

Virological update: week 10/2010

Sentinel physicians collected 573 respiratory specimens, of which 37 (6.5%) were positive for influenza virus; 17 were type A (15 were subtyped as pandemic A(H1); two were not subtyped) and 20 were influenza B. Of the nine countries testing 20 or more sentinel specimens this week, influenza-positivity rates ranged from 0% to 26.1% (median 5.3%; mean 10.1%); 276 specimens from non-sentinel sources were influenza positive: 188 type A (117 pandemic A(H1), 13 seasonal A(H1), 20 seasonal A(H3), 38 A not subtyped) and 88 influenza B.

From week 40/2009 to week 10/2010, 162 018 influenza virus detections were reported: 161 103 were influenza A (99.4%) and 915 (0.6%) were influenza B. Of the influenza A viruses, 147 972 (91.8%) were subtyped, with 146 345 being pandemic A(H1); 1036 A(H1), and 591 A(H3).

Based on the reported antigenic characterization of 2001 influenza viruses from week 40/2009 to week 10/2010: 1980 were A(H1) pandemic A/California/7/2009 (H1N1)-like; 17 were A(H3) A/Perth/16/2009 (H3N2)-like; 1 was A(H1) A/Brisbane/59/2007 (H1N1)-like and 3 were B/Brisbane/60/2008-like (B/Victoria/2/87 lineage).

Genetic characterizations were available for 1155 isolates; 1134 belonged to the A/California/7/2009 A(H1N1) pandemic group; 1 belonged to the A/Brisbane/10/2007 (H3) group; 12 to the A/Perth/16/2009 (H3N2) group; 5 to the A/Victoria/208/2009 (H3N2) group; and 3 to the B/England/393/2008 (Victoria lineage) group.

Comment

Pandemic influenza activity has shown a decreasing or stable trend in recent weeks. Although influenza B detections continue to be reported, there is not a strong indication of any absolute increase in influenza B circulation. The current influenza positivity rate for the Region is low at 6.5%. The viruses characterized to date correspond with those recommended for influenza vaccines for use in the 2010?2011 northern hemisphere influenza season (see WHO headquarters web site). WHO recommends that countries continue surveillance of influenza on a year-round basis.

Further information

The EuroFlu bulletin describes and comments on influenza activity in the 53 countries in the WHO European Region. Further information can be obtained from the WHO/Europe and WHO headquarters web sites.

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**Giuseppe** · April 2, 2010, 03:13 AM

EuroFlu - Weekly Electronic Bulletin - Week 12 : 22/03/2010-28/03/2010 - 31 March 2010, Issue N? 352 (edited)

EuroFlu - Weekly Electronic Bulletin - Week 12 : 22/03/2010-28/03/2010 - 31 March 2010, Issue N? 352 (edited)

[Source: EuroFlu.org, <cite cite="http://www.euroflu.org/cgi-files/bulletin_v2.cgi">EuroFlu - Bulletin Review</cite>. Edited.]

EuroFlu - Weekly Electronic Bulletin - Week 12 : 22/03/2010-28/03/2010 - 31 March 2010, Issue N? 352

Influenza activity remains at low levels in the WHO European Region

This report is based on data received from 41of the 53 Member States in the WHO European Region.
6.2% of specimens collected from sentinel sources tested positive for influenza.
Of the 4 countries testing 20 or more sentinel specimens, 1 reported an influenza positivity rate of over 20%.
A total of 4764 deaths associated with laboratory-confirmed pandemic (H1N1) 2009 has been reported in the Region since April 2009.

Current situation: week 12/2010

Clinical consultation rates for influenza-like illness (ILI) and acute respiratory infection (ARI) remain at low levels throughout the Region. Belarus, England (United Kingdom), Italy and Spain tested 20 or more sentinel specimens, but only Italy reported an influenza positivity rate over 20% (31%), of which all were influenza B viruses. England and Spain reported influenza positivity rates of 4.7% and 3.3%, respectively, of which all were pandemic (H1N1) 2009 viruses, and Belarus did not report the positivity rate.

Most countries (N = 24) reported no dominant type of virus, indicating limited influenza activity.

Four countries reported that pandemic (H1N1) 2009 was the dominant influenza virus in circulation.

Influenza B was reported as dominant in two: Italy and Sweden.

Eight countries ? Armenia, Kazakhstan, Kyrgyzstan, the Republic of Moldova, Romania, Switzerland, Ukraine and Uzbekistan ? reported low levels of hospitalizations for severe acute respiratory infection (SARI) compared to rates observed during the peak of the winter pandemic wave.

A total of 4764 deaths associated with laboratory-confirmed pandemic (H1N1) 2009 virus infection has been reported in the Region since April 2009.

Virological update: week 12/2010

Sentinel physicians collected 322 respiratory specimens, of which 20 (6.2%) were positive for influenza virus; 9 were type A (9 were subtyped as pandemic A(H1)) and 11 were influenza B. Of the 4 countries testing 20 or more sentinel specimens this week, influenza-positivity rates ranged from 0% to 31.0% (median: 4.0%; mean: 9.8%). Specimens from non-sentinel sources yielded 66 influenza detections: 54 type A (36 pandemic A(H1), 18 not subtyped) and 12 influenza B.

From week 40/2009 to week 12/2010, 165 593 influenza virus detections were reported: 164 488 were influenza A (99.3%) and 1105 (0.7%) were influenza B. Of the influenza A viruses, 149 295 (90.8%) were subtyped, with 147 645 being pandemic A(H1), 1039 A(H1), and 611 A(H3).

Based on the reported antigenic characterization of 2055 influenza viruses from week 40/2009 to week 12/2010: 2030 were A(H1) pandemic A/California/7/2009 (H1N1)-like; 17 were A(H3) A/Perth/16/2009 (H3N2)-like; 1 was A(H1) A/Brisbane/59/2007 (H1N1)-like and 7 were B/Brisbane/60/2008-like (B/Victoria/2/87 lineage).

Genetic characterizations were available for 1196 isolates; 1169 belonged to the A/California/7/2009 A(H1N1) pandemic group; 1 belonged to the A/Brisbane/10/2007 (H3) group; 12 to the A/Perth/16/2009 (H3N2) group; 5 to the A/Victoria/208/2009 (H3N2) group; 2 to the B/Bangladesh/3333/2007 (Yamagata lineage) and 7 to the B/England/393/2008 (Victoria lineage) group.

Comment

Pandemic influenza activity has shown a decreasing or stable trend in recent weeks and the winter wave is effectively over in western Europe. The current influenza positivity rate for the Region is low (6.2%), and in week 12/2010 the total number of sentinel influenza B detections exceeded that of influenza A. The viruses characterized to date correspond to those recommended for influenza vaccines for use in the 2010?2011 northern hemisphere influenza season (see the WHO headquarters web site).

Further information

The EuroFlu bulletin describes and comments on influenza activity in the 53 countries in the WHO European Region. Further information can be obtained from the WHO/Europe and WHO headquarters web sites.

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**Giuseppe** · April 9, 2010, 10:37 AM

EuroFlu - Weekly Electronic Bulletin Week 13 : 29/03/2010-04/04/2010 - 09 April 2010, Issue N? 353 (Extracts, edited): Netherlands, H1N1v virus with reduced susceptibility to zanamivir and oseltamivir

EuroFlu - Weekly Electronic Bulletin Week 13 : 29/03/2010-04/04/2010 - 09 April 2010, Issue N? 353 (Extracts, edited)

[Source: EuroFlu.org, <cite cite="http://www.euroflu.org/cgi-files/bulletin_v2.cgi">EuroFlu - Bulletin Review</cite>. Extracts, edited.]

EuroFlu - Weekly Electronic Bulletin Week 13 : 29/03/2010-04/04/2010 - 09 April 2010, Issue N? 353

Influenza activity remains at low levels in the WHO European Region

This report is based on data received from 45 of the 53 Member States in the WHO European Region.
5.4% of specimens collected from sentinel sources tested positive for influenza.
Of the 6 countries testing 20 or more sentinel specimens, none reported an influenza positivity rate of over 20%.
A total of 4777 deaths associated with laboratory-confirmed pandemic (H1N1) 2009 has been reported in the Region since April 2009.
In the Netherlands, a mutation in the pandemic strain with reduced susceptibility to zanamivir and oseltamivir was identified in an immunocompromised child who subsequently died (see the virological comment below for further details).

Current situation: week 13/2010

Clinical consultation rates for influenza-like illness (ILI) and acute respiratory infection (ARI) remain at low levels throughout the Region. Belarus, England (United Kingdom), France, Georgia, Hungary, and Kazakhstan tested 20 or more sentinel specimens but only Belarus and Kazakhstan reported influenza positivity rates: 10% and 9.5% respectively.

Most countries (N = 36) reported no dominant type of virus, indicating limited influenza activity. Six countries reported that pandemic (H1N1) 2009 was the dominant influenza virus in circulation. Italy, Latvia, Norway, the Russian Federation and Sweden reported influenza B as the dominant type of virus.

Six countries ? Armenia, Kazakhstan, Malta, the Republic of Moldova, Ukraine and Uzbekistan ? reported hospitalizations for severe acute respiratory infection (SARI), at low levels compared to rates observed during the peak of the winter pandemic wave.

A total of 4777 deaths associated with laboratory-confirmed pandemic (H1N1) 2009 virus infection has been reported in the Region since April 2009.

Virological update: week 13/2010

Sentinel physicians collected 333 respiratory specimens, of which 18 (5.4%) were positive for influenza virus; 8 were type A (6 were subtyped as pandemic A(H1)) and 10 were influenza B. Of the 6 countries testing 20 or more sentinel specimens this week, influenza-positivity rates ranged from 0% to 10.0% (median: 0%; mean: 3.3%). Specimens from non-sentinel sources yielded 192 influenza detections: 68 type A (36 pandemic A(H1), 11 A(H3), and 21 not subtyped) and 124 influenza B.

From week 40/2009 to week 13/2010, 164 629 influenza virus detections were reported: 163 281 were influenza A (99.2%) and 1348 (0.8%) were influenza B. Of the influenza A viruses, 148 610 (91.0%) were subtyped, with 146 920 being pandemic A(H1), 1060 A(H1), and 630 A(H3).

Based on the reported antigenic characterization of 2073 influenza viruses from week 40/2009 to week 13/2010: 2047 were A(H1) pandemic A/California/7/2009 (H1N1)-like; 17 were A(H3) A/Perth/16/2009 (H3N2)-like; 1 was A(H1) A/Brisbane/59/2007 (H1N1)-like; 3 were B/Florida/4/2006-like (B/Yamagata/16/88 lineage) and 5 were B/Brisbane/60/2008-like (B/Victoria/2/87 lineage).

Genetic characterizations were available for 1238 isolates; 1209 belonged to the A/California/7/2009 A(H1N1) pandemic group; 1 belonged to the A/Brisbane/10/2007 (H3) group; 13 to the A/Perth/16/2009 (H3N2) group; 5 to the A/Victoria/208/2009 (H3N2) group; 2 to the B/Bangladesh/3333/2007 (Yamagata lineage) and 8 to the B/England/393/2008 (Victoria lineage) group.

Comment

Pandemic influenza activity has shown a decreasing or stable trend in recent weeks and the winter wave is effectively over in western Europe. The current influenza positivity rate for the Region is low (5.4%), and in week 13/2010 the total number of sentinel influenza B detections again exceeded that of influenza A. The viruses characterized to date correspond to those recommended for influenza vaccines for use in the 2010?2011 northern hemisphere influenza season (see the WHO headquarters web site).

Further information

The EuroFlu bulletin describes and comments on influenza activity in the 53 countries in the WHO European Region. Further information can be obtained from the WHO/Europe and WHO headquarters web sites.

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Network comments (where available)

Malta
- situation stable
Netherlands
- In the Netherlands, a case of pandemic A(H1N1) 2009 developed in an immunocompromised child with reduced susceptibility to zanamivir and oseltamivir due to an amino-acid mutation at position 223 in the neuraminidase. The child with an underlying condition that rendered him susceptible to infection died due to deterioration of pulmonary problems. No onward transmission of this variant was detected.
- Previously, amino-acid mutations at the 223 (n1 numbering) or 222 (n2 numbering) position in the neuraminidase have been reported in A(H5N1) and seasonal influenza viruses associated with reduced susceptibility or an enhanced level of resistance in combination with other resistance mutations (e.g. H275Y), for oseltamivir only or for both oseltamivir and zanamivir [Hurt, AC et al. Antimicrobial agents and chemotherapy 2009; 53: 4433-40].
- Therefore, inclusion of screening for variation of amino-acids at this position is warranted.
- The clinical implications of this A(H1N1) 2009 variant are being assessed and a publication is expected.

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**Giuseppe** · April 16, 2010, 12:01 PM

EuroFlu - Weekly Electronic Bulletin - Week 14 : 05/04/2010-11/04/2010 - 16 April 2010, Issue N? 354 (Excerpts, edited)

EuroFlu - Weekly Electronic Bulletin - Week 14 : 05/04/2010-11/04/2010 - 16 April 2010, Issue N? 354 (Excerpts, edited)

[Source: EuroFlu.org, <cite cite="http://www.euroflu.org/cgi-files/bulletin_v2.cgi">EuroFlu - Bulletin Review</cite>. Excerpts, edited.]

EuroFlu - Weekly Electronic Bulletin - Week 14 : 05/04/2010-11/04/2010 - 16 April 2010, Issue N? 354

Influenza activity in Europe is at a low level typical for this time of year

This report is based on data received from 46 of the 53 Member States in the WHO European Region.
6.9% of specimens collected from sentinel sources tested positive for influenza.
A total of 4784 deaths associated with laboratory-confirmed pandemic (H1N1) 2009 has been reported in the Region since April 2009.

Current situation: week 14/2010

Clinical consultation rates for influenza-like illness (ILI) and acute respiratory infection (ARI) remain at low levels throughout the Region. No countries tested 20 or more sentinel specimens. Overall 6.9% percent of sentinel specimens tested positive across the Region. Most countries (N = 38) reported no dominant type of virus, indicating limited influenza activity. Of the 10 countries that reported a dominant virus, 5 reported pandemic (H1N1) 2009, 4 reported influenza B and 1 reported influenza type A.

Virological update: week 14/2010

Sentinel physicians collected 175 respiratory specimens, of which 12 (6.9%) were positive for influenza virus; 3 were type A (2 were subtyped as pandemic A(H1), and 1 was not subtyped) and 9 were influenza B. Specimens from non-sentinel sources yielded 164 influenza detections: 36 type A (21 pandemic A(H1), 7 A(H3), 4 A (H1) and 4 not subtyped) and 128 influenza B.

From week 40/2009 to week 14/2010, 163 013 influenza virus detections were reported: 161 541 were influenza A (99.1%) and 1472 (0.9%) were influenza B. Of the influenza A viruses, 148 302 (91.8%) were subtyped, with 146 603 being pandemic A(H1), 1063 A(H1), and 636 A(H3).

Based on the reported antigenic characterization of 2300 influenza viruses from week 40/2009 to week 14/2010: 2277 were A(H1) pandemic A/California/7/2009 (H1N1)-like; 17 were A(H3) A/Perth/16/2009 (H3N2)-like; 1 was A(H1) A/Brisbane/59/2007 (H1N1)-like; and 5 were B/Brisbane/60/2008-like (B/Victoria/2/87 lineage).

Genetic characterizations were available for 1243 isolates; 1214 belonged to the A/California/7/2009 A(H1N1) pandemic group; 1 belonged to the A/Brisbane/10/2007 (H3) group; 13 to the A/Perth/16/2009 (H3N2) group; 5 to the A/Victoria/208/2009 (H3N2) group; 2 to the B/Bangladesh/3333/2007 (Yamagata lineage) and 8 to the B/England/393/2008 (Victoria lineage) group.

Comment

Influenza activity is low throughout the Region, and pandemic (H1N1) 2009 winter activity has run its course. The current influenza positivity rate for the Region is low (6.9%), and in week 14/2010 the total number of sentinel influenza B detections clearly exceeded that of influenza A. The viruses characterized to date correspond to those recommended for influenza vaccines for use in the 2010?2011 northern hemisphere influenza season.

Further information

The EuroFlu bulletin describes and comments on influenza activity in the 53 countries in the WHO European Region. Further information can be obtained from the WHO/Europe and WHO headquarters web sites.

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**Giuseppe** · April 23, 2010, 10:37 AM

EuroFlu - Weekly Electronic Bulletin Week 15 : 12/04/2010-18/04/2010 - 23 April 2010, Issue N? 355 (Extract, edited)

EuroFlu - Weekly Electronic Bulletin Week 15 : 12/04/2010-18/04/2010 - 23 April 2010, Issue N? 355 (Extract, edited)

[Source: EuroFlu.org, <cite cite="http://www.euroflu.org/cgi-files/bulletin_v2.cgi">EuroFlu - Bulletin Review</cite>. Extract, edited.]

EuroFlu - Weekly Electronic Bulletin Week 15 : 12/04/2010-18/04/2010 - 23 April 2010, Issue N? 355

Winter pandemic influenza activity in Europe has run its course

This report is based on data received from 44 of the 53 Member States in the WHO European Region.
Most countries reported a low intensity of influenza activity.
4.5% of specimens collected from sentinel sources tested positive for influenza.
A total of 4836 deaths associated with laboratory-confirmed pandemic (H1N1) 2009 has been reported in the Region since April 2009.

Current situation: week 15/2010

Clinical consultation rates for influenza-like illness (ILI) and acute respiratory infection (ARI) remain at low levels throughout the Region. In the Region, 4.5% of sentinel specimens tested positive. Most countries (N = 30) did not report a dominant virus, indicating limited influenza activity overall.

Virological update: week 15/2010

Sentinel physicians collected 311 respiratory specimens, of which 14 (4.5%) were positive for influenza virus; 8 were type A (2 were subtyped as pandemic A(H1), and 6 were not subtyped) and 6 were influenza B. Of the 27 countries testing sentinel specimens this week, influenza-positivity rates ranged from 0% to 46.2 % (median: 0.0 %; mean: 4.1 %). Specimens from non-sentinel sources yielded 197 influenza detections: 58 type A (15 pandemic A(H1), 23 A(H3), 15 A(H1) and 5 not subtyped) and 139 influenza B.

From week 40/2009 to week 15/2010, 163 187 influenza virus detections were reported: 161 644 were influenza A (99.1%) and 1543 (0.9%) were influenza B. Of the influenza A viruses, 148 419 (91.8%) were subtyped, with 146 715 being pandemic A(H1), 1066 A(H1), and 638 A(H3).

Based on the reported antigenic characterization of 2305 influenza viruses from week 40/2009 to week 15/2010: 2277 were A(H1) pandemic A/California/7/2009 (H1N1)-like; 17 were A(H3) A/Perth/16/2009 (H3N2)-like; 1 was A(H1) A/Brisbane/59/2007 (H1N1)-like; 5 were B/Florida/4/2006-like (B/Yamagata/16/88 lineage) and 5 were B/Brisbane/60/2008-like (B/Victoria/2/87 lineage).

Genetic characterizations were available for 1249 isolates: 1214 belonged to the A/California/7/2009 A(H1N1) pandemic group; 1 belonged to the A/Brisbane/10/2007 (H3) group; 13 to the A/Perth/16/2009 (H3N2) group; 5 to the A/Victoria/208/2009 (H3) group; 2 to the B/Bangladesh/3333/2007 (Yamagata lineage) and 14 to the B/England/393/2008 (Victoria lineage) group.

Comment

Influenza activity throughout Europe is at a low level. The current influenza positivity rate for the Region is low (4.5%), and in week 15/2010 the total number of influenza B detections exceeded that of influenza A and most were reported in the eastern part of the Region (Central, Siberian and Far Eastern regions of the Russian Federation). The viruses characterized to date correspond to those recommended for influenza vaccines for use in the 2010?2011 northern hemisphere influenza season.

Further information

The EuroFlu bulletin describes and comments on influenza activity in the 53 countries in the WHO European Region. Further information can be obtained from the WHO/Europe and WHO headquarters web sites.

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**Giuseppe** · April 30, 2010, 11:03 AM

EuroFlu - Weekly Electronic Bulletin - Week 16 : 19/04/2010-25/04/2010 - 30 April 2010, Issue N? 356 (EuroFlu, extracts, edited)

EuroFlu - Weekly Electronic Bulletin - Week 16 : 19/04/2010-25/04/2010 - 30 April 2010, Issue N? 356 (EuroFlu, extracts, edited)

[Source: EuroFlu.org, <cite cite="http://www.euroflu.org/cgi-files/bulletin_v2.cgi">EuroFlu - Bulletin Review</cite>. Extracts, edited.]

EuroFlu - Weekly Electronic Bulletin - Week 16 : 19/04/2010-25/04/2010 - 30 April 2010, Issue N? 356

Influenza activity in Europe is at a low level

This report is based on data received from 42 of the 53 Member States in the WHO European Region.
Most countries reported a low intensity of influenza activity.
5.3% of specimens collected from sentinel sources tested positive for influenza.
A total of 4861 deaths associated with laboratory-confirmed pandemic (H1N1) 2009 has been reported in the Region since April 2009.

Current situation: week 16/2010

Clinical consultation rates for influenza-like illness (ILI) and acute respiratory infection (ARI) remain at low levels throughout the Region. Most countries (N = 29) did not report a dominant virus, indicating limited influenza activity overall.

Virological update: week 16/2010

Sentinel physicians collected 282 respiratory specimens, of which 15 (5.3%) were positive for influenza virus; 5 were type A (1 was subtyped as pandemic A(H1), and 4 were not subtyped) and 10 were influenza B. Specimens from non-sentinel sources yielded 200 influenza detections: 40 type A (12 pandemic A(H1), 9 A(H3), 17 A(H1) and 2 not subtyped) and 160 influenza B.

From week 40/2009 to week 16/2010, 163 432 influenza virus detections were reported: 161 717 were influenza A (99.0%) and 1715 (1.0%) were influenza B. Of the influenza A viruses, 148 486 (91.8%) were subtyped, with 146 754 being pandemic A(H1), 1083 A(H1), and 649 A(H3).

Based on the reported antigenic characterization of 3048 influenza viruses from week 40/2009 to week 16/2010: 3005 were A(H1) pandemic A/California/7/2009 (H1N1)-like; 17 were A(H3) A/Perth/16/2009 (H3N2)-like; 8 were A(H3) A/ Brisbane/10/2007 (H3N2)-like; 2 were A(H1) A/Brisbane/59/2007 (H1N1)-like; 5 were B/Florida/4/2006-like (B/Yamagata/16/88 lineage) and 11 were B/Brisbane/60/2008-like (B/Victoria/2/87 lineage).

Genetic characterizations were available for 1262 isolates: 1223 belonged to the A/California/7/2009 A(H1N1) pandemic group; 1 belonged to the A/Brisbane/10/2007 (H3) group; 13 to the A/Perth/16/2009 (H3N2) group; 5 to the A/Victoria/208/2009 (H3) group; 2 to the B/Bangladesh/3333/2007 (Yamagata lineage) and 18 to the B/England/393/2008 (Victoria lineage) group.

Comment

Influenza activity throughout the European Region is at a low level. The current influenza positivity rate for the Region is low (5.3%), and in week 16/2010 the total number of sentinel and non-sentinel influenza B detections (79.1%) exceeded that of influenza A (20.9%) with seven counties reporting influenza B as a dominant type. The viruses characterized to date correspond to those recommended for influenza vaccines for use in the 2010?2011 northern hemisphere influenza season.

Further information

The EuroFlu bulletin describes and comments on influenza activity in the 53 countries in the WHO European Region. Further information can be obtained from the WHO/Europe and WHO headquarters web sites.

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Network comments (where available)

Greece
- A non-sentinel source swab, collected in Athens during week 16, was confirmed by real time PCR to be positive for influenza virus type A (subtype H1N1). Concerning antiviral susceptibility this seasonal influenza isolate (the first detected in 2010) was found by NA activity determination (MUNANA assay) to be oseltamivir resistant. The mutation responsible for oseltamivir resistance was confirmed by neuraminidase gene sequencing.
Netherlands
- In week 15 a cluster of nosocomial spread involving three cases of pandemic A(H1N1) 2009 occurred on a hospital ward in the Netherlands. The initial case was hospitalised with pneumonia and in second instance diagnosed for viral infection. When found positive for pandemic A(H1N1) 2009 virus four days after admission all patients in the same room were put into isolation. Two out of three patients in the same room became subsequently positive for pandemic A(H1N1) 2009 virus. By direct sequencing it was confirmed that the viruses of the index case and one of the contacts were identical but unique in the Dutch background set of A(H1N1) 2009 sequences. The viral load of the other contact was too low for direct sequencing. Investigations are ongoing.

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**Giuseppe** · May 14, 2010, 11:45 AM

Archive. EuroFlu - Weekly Electronic Bulletin (January-April 2010)

Container of recent EuroFlu surveillance bulletins.