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  #1  
Old December 30th, 2011, 10:56 AM
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Health EuroFlu - Weekly Electronic Bulletin - Week 51 : 19/12/2011-25/12/2011 - 30 December 2011, Issue N° 425 (edited): 91% of type A virus were H3N2 so far this season

[Source: EuroFlu, full page: (LINK). Edited.]

EuroFlu - Weekly Electronic Bulletin - Week 51 : 19/12/2011-25/12/2011 - 30 December 2011, Issue N° 425



Sporadic influenza detections in the WHO European Region
  • This issue is based on data for week 51/2011 reported by 44 Member States in the WHO European Region.
  • The levels of influenza activity in the Region were low.
  • Sixty-six sentinel specimens (8%) from patients with influenza-like illness (ILI) or acute respiratory infection (ARI) tested positive for influenza.
  • The percentage of sentinel samples that were positive has increased during the past two weeks and indicates the possible start of the influenza season.
  • Sporadic detections of influenza A(H3N2), influenza B and influenza A(H1N1)pdm09 have been reported since week 40/2011.
  • All 101 influenza A viruses subtyped in week 51/2011 were A(H3).

Current situation: week 51/2011

Consultation rates for ILI and ARI are at pre-season levels in most countries in the WHO European Region.

Of 35 countries reporting on trends in respiratory disease activity, 20 reported stable trends, 6 reported increasing trends and 9 reported decreasing trends.

Of the 35 countries reporting on the geographical distribution of influenza activity, 21 reported no activity, 1 reported local activity and 13 reported sporadic activity.

In week 51, data from sentinel hospital-based surveillance for severe acute respiratory infection (SARI) were reported by 10 countries: Albania, Armenia, Georgia, Kazakhstan, Kyrgyzstan, the Republic of Moldova, Romania, the Russian Federation, Serbia and Ukraine.

Although some countries have been reporting slight increases in SARI cases in recent weeks, none of the cases reported this week were associated with laboratory-confirmed influenza.

Further information on the sentinel SARI surveillance systems represented in the EuroFlu bulletin can be found in the overview of sentinel SARI systems in EuroFlu.



Virological situation: week 51/2011

Sentinel outpatient clinics collected 801 respiratory specimens, of which 66 (8%) tested positive for influenza viruses: 62 were type A and 4 were type B.

All 61 type A viruses subtyped were identified as influenza A(H3).

In the 11 countries testing 20 or more sentinel specimens, influenza positivity ranged from 0% to 24% (Turkey).

Among these countries, France, Germany, Italy, Spain and Turkey have observed slight increases in influenza activity in recent weeks.

Only in France has the rate for ARI exceeded the baseline level.

In addition, 97 non-sentinel specimens were reported positive for influenza: 86 as type A and 11 as type B.

Of the influenza A viruses, 40 were subtyped: all were A(H3).

Sentinel hospitals collected 81 respiratory specimens from patients with SARI, none of which tested positive for influenza virus.



Cumulative virological data: weeks 40-51/2011

During this period, 733 influenza virus detections were reported: 631 (86%) were influenza A and 102 (14%) were influenza B.

Of the influenza A viruses, 428 were subtyped: 389 (91%) as A(H3) and 39 (9%) as A(H1)pdm09.

Since week 40/2011, 19 influenza viruses have been characterized antigenically:
  • 2 were A(H1)pdm09 A/California/7/2009 (H1N1)–like,
  • 13 were A(H3) A/Perth/16/2009 (H3N2)–like,
  • 2 were B/Florida/4/2006-like (B/Yamagata/16/88 lineage),
  • 1 was B/Bangladesh/3333/2007-like (B/Yamagata/16/88 lineage) and
  • 1 was B/Brisbane/60/2008-like (B/Victoria/2/87 lineage).
Of 27 influenza viruses characterized genetically,
  • 3 belonged to the B/Bangladesh/3333/2007 clade (Yamagata lineage),
  • 1 belonged to the A(H1)pdm09 group represented by A/Astrakhan/1/2011,
  • 1 belonged to the B/Brisbane/60/2008 clade (Victoria lineage) and
  • 22 belonged to the A/Victoria/208/2009 A(H3) clade - 18 in the group represented by A/Stockholm/18/2011 and 4 in the group represented by A/Iowa/19/2010.

Comment

Influenza activity remains low throughout the WHO European Region.

For most countries, consultation rates for ILI and ARI in outpatient clinics and SARI admissions to hospitals are at pre-season levels.

Two countries (Spain and Turkey) reported increases in confirmed influenza cases among sentinel samples, with percentages of positive samples of 17% and 23% respectively, which could indicate that influenza activity is about to start in these countries.

Influenza has been detected sporadically during recent weeks, with 8% of sentinel samples collected across the WHO European Region testing positive for influenza in week 51/2011 – an increase from 5% in the previous week.

Sporadic detections of influenza A(H3N2), influenza B and influenza A(H1N1)pdm09 have been reported since week 40/2011.

Type A influenza has been dominant over type B, and in week 51/2011 all 101 type A viruses subtyped were A(H3).



Further information

The EuroFlu bulletin describes and comments on influenza activity in the 53 countries of the WHO European Region.

Further information can be obtained from the web sites of WHO/Europe, WHO headquarters and the European Centre for Disease Prevention and Control.

(…)



Country comments (where available)

Kazakhstan: In week 51/2011, 155 respiratory specimens were collected of which: 0 tested positive for influenza virus, 2 were adenoviruses, 3 respiratory syncytial viruses (RSV) and 3 parainfluenza-1.

Norway: Whereas the number of influenza virus detections in Norway remains comparably low, there has an increased number of influenza A detections in weeks 48 through 51. All except one out of 49 influenza A viruses subtyped in Norway so far this season have been of H3 subtype.

Romania: Laboratory investigations have been performed for 87% of SARI cases.

Detected pathogens were:
  • eleven parainfluenza virus type 1;
  • two parainfluenza virus type 2;
  • four parainfluenza virus type 4;
  • three RSV type B;
  • one untyped RSV;
  • two adenovirus;
  • two rhinovirus;
  • two bocavirus;
  • one Coronavirus 229E/NL63;
  • one H.influenzae;
  • seven Str.pneumoniae;
  • one Ps.aeruginosa + Klebsiella spp.
To date, the total positivity rate for SARI cases has been 52.2% and the positivity rate for influenza in SARI cases 0%.
In one of the two deaths registered in SARI cases, an adenovirus was detected.

For the second one, no samples have been prelevated (refusal of parents).

In the third death Pseudomonas aeruginosa and Klebsiella spp. have been isolated from tracheo-bronchial aspirate.
(…)

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  #2  
Old January 6th, 2012, 11:13 AM
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Health EuroFlu - Weekly Electronic Bulletin - Week 52 : 26/12/2011-01/01/2012 - 06 January 2012, Issue N° 426 (extracts)

[Source: EuroFlu, full page: (LINK). Extracts, edited.]

EuroFlu - Weekly Electronic Bulletin - Week 52 : 26/12/2011-01/01/2012 - 06 January 2012, Issue N° 426


Increasing influenza activity in the WHO European Region mainly due to influenza A(H3N2)
  • This issue is based on data for week 52/2011 reported by 43 Member States in the WHO European Region.
  • Clinical consultation rates in the Region were low.
  • 24% of sentinel specimens from patients with influenza-like illness (ILI) or acute respiratory infection (ARI) tested positive for influenza.
  • The percentage of sentinel samples that were influenza positive increased during the previous two weeks, which may indicate the start of the influenza season.
  • Sporadic detections of influenza A(H3N2), influenza B, and influenza A(H1N1)pdm09 have been reported, with A(H3N2) predominating.

Current situation: week 52/2011

Consultation rates for ILI and ARI remain at low levels throughout the WHO European Region, as normally seen outside the peak period for seasonal influenza.

Only Spain reported ILI consultation rates above the national baseline level.

Out of 36 countries reporting on trends, 22 reported stable trends, while 4 reported increasing and 10 reported decreasing trends.

In general, consultation rates were highest in young children.

Of the 36 countries reporting on the geographical distribution of influenza activity, 19 reported no activity, 3 reported local activity and 14 reported sporadic activity.

All countries reported low intensity of influenza activity and low impact on their health care services.



Severe acute respiratory infection (SARI): week 52/2011

In week 52, 6 countries reported data from sentinel hospital-based surveillance for SARI: Georgia, Kazakhstan, the Republic of Moldova, Romania, Serbia and Ukraine.

A total of 30 respiratory specimens was collected from SARI patients.

Sentinel SARI hospitalizations in these countries are at out-of-season levels.

2 of the 10 cases reported by Romania were associated with laboratory-confirmed influenza A(H3N2).

Further information on the sentinel SARI surveillance systems represented in the EuroFlu bulletin can be found in “Overview of sentinel SARI systems in EuroFlu”.



Virological situation: week 52/2011

Sentinel outpatient clinics collected 554 respiratory specimens, 133 (24%) of which tested positive for influenza viruses: 131 were type A and 2 were type B.

Of the influenza A viruses, all 124 that were subtyped were influenza A(H3).

In the 6 countries (France, Israel, Italy, Spain, Turkey and the United Kingdom) testing 20 or more sentinel specimens, influenza positivity ranged from 7.8% to 43.2%, with a median of 25.7% (mean: 25.1%).

In addition, 162 non-sentinel specimens were reported positive for influenza: 155 type A and 7 type B.

Of the influenza A viruses, 36 were subtyped: 35 as A(H3) and 1 as A(H1)pdm09.



Cumulative virological data: weeks 40–52/2011

During this period, 1104 influenza virus detections were reported: 990 (90%) were influenza A and 114 (10%) were influenza B.

Of the influenza A viruses, 633 were subtyped: 594 (94%) as A(H3) and 39 (6%) as A(H1)pdm09.

Since week 40/2011, 24 influenza viruses have been characterized antigenically:
  • 2 were A(H1)pdm09 A/California/7/2009 (H1N1)-like;
  • 16 were A(H3) A/Perth/16/2009 (H3N2)-like;
  • 2 were B/Florida/4/2006-like (B/Yamagata/16/88 lineage),
  • 1 was B/Bangladesh/3333/2007-like (B/Yamagata/16/88 lineage) and
  • 3 were B/Brisbane/60/2008-like (B/Victoria/2/87 lineage).
Out of 17 influenza viruses characterized genetically,
  • 1 belonged to the B/Bangladesh/3333/2007 clade (Yamagata lineage),
  • 2 belonged to the B/Brisbane/60/2008 clade (Victoria lineage) and
  • 14 belonged to the A/Victoria/208/2009 A(H3) clade – 10 in the group represented by A/Stockholm/18/2011 (group 3) and 4 in the group represented by A/Iowa/19/2010 (group 6).

Comment

Consultation rates for ILI and ARI in outpatient clinics and hospitalizations due to SARI are at low levels throughout the WHO European Region.

Consultation rates for week 52/2011 should be interpreted with caution, however, since it spans a holiday period when use of primary care and collection of respiratory samples are usually low. This is reflected in the overall number of sentinel specimens collected for virological testing, which decreased from 801 in week 51 to 554 in week 52/2011.

The proportion of specimens testing positive for influenza virus increased from 8% in week 51 to 24% in week 52/2011.

With this increasing trend, the number of countries with consultations rates above their baseline thresholds is expected to increase over the coming weeks.

Influenza types A and B have continued to co-circulate, with type A viruses being in the great majority and A(H3N2) viruses representing 94% of the H-subtyped viruses.

Detections of respiratory syncytial virus (RSV), a respiratory virus with clinical symptoms similar to influenza, peaked in week 49/2011 and are now stable (see the graphs for Europe, season 2011/2012).



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, WHO headquarters and European Centre for Disease Prevention and Control web sites.

(…)



Country comments (where available)
  • Kazakhstan: In week 52/2011, 80 respiratory specimens were collected of which: 0 tested positive for influenza virus, 2 were adenoviruses, 1 respiratory syncytial viruses (RSV) and 3 parainfluenza-1, 1 parainfluenza-3.
  • Norway: The number of influenza A virus detections in Norway has increased during weeks 48 through 52. All except two out of 57 influenza A viruses subtyped in Norway so far this season have been of the H3 subtype.
  • Romania: Laboratory investigations have been performed for 89% of SARI cases. The first two influenza viruses (AH3) have been detected in SARI cases notified in Week 52. One of the patients is a 6 month old girl, with onset in 23/12/2011 and the other one is a 6 years old boy having the onset three days later. Both were reported by the same sentinel hospital and have the residence and the incubation in the same region of Romania. None of them has underlying risk conditions. To date, the total positivity rate for SARI cases has been 55.8% and the positivity rate for influenza in SARI cases 2.6%. The 4th death registered in SARI cases was negative for influenza, too and also for other etiologies (parainfluenza virus, hMPV, RSV, enterovirus, rhinovirus, coronaviruses).
  • Spain: In week 52/2011 ILI incidence rate has exceeded in Spain baseline level by first time in the season. Since week 48/2011 there has been an increase of influenza detections and the percentage of positive samples (from 4% to 40%). In week 52/2011 there has been identified 60 influenza A virus and two B virus, out of 53 influenza virus A subtyped 100% were AH3 resulting the predominant virus along the country.
(…)
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  #3  
Old January 12th, 2012, 04:31 AM
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Health EpiSouth Weekly Epi Bulletin – N°199 - 4th January 2012 – 10th January 2012 (extracts): H5N1 in Bhutan, India and Indonesia (human)

[Source: EpiSouth, full PDF document: (LINK). Extracts, edited.]


EpiSouth Weekly Epi Bulletin – N°199 - 4th January 2012 – 10th January 2012



The objective of the bulletin is to report new heath events occurring outside and inside EpiSouth area that have potential implications on EpiSouth population. It does not aim to provide an exhaustive review of international alerts. Since 2006, The French public health Institute (InVS, http://www.invs.sante.fr/ ) is issuing an online epidemic intelligence bulletin (Bulletin hebdomadaire International - BHI, http://www.invs.sante.fr/international/index.htm ). In order to limit duplication and to make this already verified information available to a larger audience, information relating to health events of interest for EpiSouth population are translated and integrated in the relevant e-web sections. Despite all verifications, WP6 team would not be responsible for potential errors. The recipient is responsible for the cautious use of this information. Neither the European Commission nor any person acting on behalf of the Commission is liable for the use that may be made of the information contained in this report. Data maps and commentary used in this document do not imply any opinion of EpiSouth countries or its partners on the legal status of the countries and territories shown or concerning their borders.

The EpiSouth-Plus Project is cofunded by the European Union DG-SANCO/EAHC and EuropeAid together with the participating national partner Institutions. The financial support of the Italian Ministry of Health and ECDC is also acknowledged. Yet, the contents of this bulletin can in no way be taken to reflect the views of the European Union.

(…)



Location: Bhutan, India - Event: A(H5N1) – Epizootic

BHUTAN
  • On 10th January 2012, the Ministry of Agriculture in Bhutan reported to OIE one outbreak of A(H5N1) in domestic poultry in Chukha district, in the South West of the country (cf. map 1).
  • Control measures including quarantine, movement control and culling of poultry have been implemented.
  • This is the second outbreak reported in the country. The last outbreak was reported in February 2010 in the same district, in wild birds (cf. eWEB n° 101).
Comments
  • To date, no human A(H5N1) case has ever been reported in the country.
  • The occurrence of A(H5N1) avian influenza epizootic in the area was not unexpected considering that Chukha district is located at the border with West Bengal, an enzootic state of India (cf. eWEB 183), and the country is surrounded by China and several other areas in India reported to be enzootic for A(H5N1) avian influenza (cf. eWEB n°198).
INDIA
  • On 11th January, the Ministry of Agriculture in India reported to OIE a new outbreak of A(H5N1) avian influenza in domestic poultry in Orissa state, in the North East of India (cf. map 2).
  • Surveillance and control measures have been strengthened, including culling, quarantine, and movement control in the country.
  • The last epizootic was reported in the North East of the country, in Jharkhand, (cf. eWEB n°195), one of Orissa’s neighbouring states.
Comments
  • To date, no human A(H5N1) case has ever been reported in India.
  • In the country, several states are already considered as enzootic with A(H5N1) avian influenza (cf. eWEB n°198): Jharkhand, West Bengal and the extreme North-East region of India (located between Bangladesh, Myanmar, China and Bhutan).
Location: Indonesia - Event: A(H5N1) – Human
  • On 11th January 2011, the Ministry of Health of Indonesia reported to WHO one new human case of A(H5N1) in Jakarta province (cf. map 3).
  • The case was:
    • a 23 years old male;
    • onset of symptoms on 31st December 2011;
    • he was hospitalised on 6th January 2012 and died on 7th January 2012;
    • exposure to infected domestic pigeons has been documented.
  • The last A(H5N1) human case in Indonesia was reported on 15th November 2011 (cf. eWEB n°191) in Bali.
  • To date, a total of 183 cases including 151 deaths have been reported in Indonesia.
(…)


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  #4  
Old January 13th, 2012, 11:24 AM
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Health EuroFlu - Weekly Electronic Bulletin - Week 1 : 02/01/2012-08/01/2012 - 13 January 2012, Issue N° 427 (Extracts)

[Source: EuroFlu, full page: (LINK). Extracts, edited.]
EuroFlu - Weekly Electronic Bulletin - Week 1 : 02/01/2012-08/01/2012 - 13 January 2012, Issue N° 427


Influenza activity remains low in the WHO European Region
  • This issue is based on data for week 1/2012 reported by 48 Member States in the WHO European Region.
  • Clinical consultation rates in the Region were low.
  • 16.3% of sentinel specimens from patients with influenza-like illness (ILI) or acute respiratory infection (ARI) tested positive for influenza.
  • Sporadic detections of influenza A(H3N2), influenza B, and influenza A(H1N1)pdm09 were reported, with A(H3N2) predominating.
  • All 130 influenza A viruses from sentinel sources that were subtyped in week 1/2012 were A(H3N2).

Current situation: week 1/2012

Consultation rates for ILI and ARI remained at low levels throughout the WHO European Region, as normally seen outside the peak period for seasonal influenza.

Out of 44 countries reporting on trends, 29 reported stable trends, while 11 reported increasing and 4 reported decreasing trends. In general, consultation rates were highest in young children.

Of the 44 countries reporting on the geographical distribution of influenza activity, 16 reported no activity; 4 reported local activity; 21 reported sporadic activity and 3 reported regional activity.

2 countries (Malta and Turkey) reported medium intensity of influenza activity and moderate impact on their health care services.



Severe acute respiratory infection (SARI): week 1/2012

9 countries reported data from sentinel hospital-based surveillance for SARI: Albania, Armenia, Georgia, Kazakhstan, the Republic of Moldova, Romania, the Russian Federation, Serbia and Ukraine.

A total of 36 respiratory specimens was collected from SARI patients.

Sentinel SARI hospitalizations in these countries were at out-of-season levels.

Of the 12 cases reported by Romania, 2 were associated with laboratory-confirmed influenza A(H3N2).

Further information on the sentinel SARI surveillance systems represented in the EuroFlu bulletin can be found in “Overview of sentinel SARI systems in EuroFlu”.



Virological situation: week 01/2012

Sentinel outpatient clinics collected 910 respiratory specimens, 148 (16%) of which tested positive for influenza viruses: 142 were type A and 6 were type B.

Of the influenza A viruses, all 130 that were subtyped were influenza A(H3).

In the 13 countries testing 20 or more sentinel specimens (Albania, Belarus, the Czech Republic, Finland, France, Germany, Israel, Italy, Romania, Spain, Sweden, Turkey and the United Kingdom), influenza positivity ranged from 0% to 53.3%, with a median of 9.1% (mean: 13.4%).

In addition, 317 non-sentinel specimens were reported positive for influenza: 306 type A and 11 type B.

Of the influenza A viruses, 106 were subtyped: 93 as A(H3) and 13 as A(H1)pdm09.



Cumulative virological data: weeks 40/2011–1/2012

During this period, 1722 influenza virus detections were reported: 1584 (92%) were influenza A and 138 (8%) were influenza B.

Of the influenza A viruses, 981 were subtyped: 915 (93%) as A(H3) and 66 (7%) as A(H1)pdm09.

In addition, 29 influenza viruses were characterized antigenically:
  • 2 were A(H1)pdm09 A/California/7/2009 (H1N1)-like;
  • 21 were A(H3) A/Perth/16/2009 (H3N2)-like;
  • 2 were B/Florida/4/2006-like (B/Yamagata/16/88 lineage);
  • 1 was B/Bangladesh/3333/2007-like (B/Yamagata/16/88 lineage) and
  • 3 were B/Brisbane/60/2008-like (B/Victoria/2/87 lineage).
Out of 48 influenza viruses characterized genetically,
  • 1 belonged to the A(H1)pdm09 group represented by A/Astrakhan/1/2011;
  • 1 belonged to the A(H1)pdm09 group represented by A/St Petersburg/100/2011;
  • 1 belonged to the B/Bangladesh/3333/2007 clade (Yamagata lineage);
  • 2 belonged to the B/Brisbane/60/2008 clade (Victoria lineage), and
  • 43 belonged to the A/Victoria/208/2009 A(H3) clade – 34 in the group represented by A/Stockholm/18/2011 (group 3), 4 in the group represented by A/Iowa/19/2010 (group 6) and 1 in the group represented by A/Johannesburg/114/2011 (group 7).

Comment

Consultation rates for ILI and ARI in outpatient clinics and hospitalizations due to SARI are at low levels throughout the WHO European Region.

Two countries (Malta and Turkey) now report influenza activity of medium intensity and moderate impact on their health care services.

Consultation rates for week 1/2011 should be interpreted with caution, however, as it spans a holiday period when use of primary care and collection of respiratory samples are usually low.

The proportion of sentinel specimens testing positive for influenza virus decreased from 24% in week 52/2011 to 16% in week 1/2012.

The highest percentages of sentinel specimens positive for influenza were seen in 3 countries in the southern part of the Region (Italy, Spain and Turkey).

Influenza types A and B have continued to co-circulate, with type A viruses in the great majority and A(H3N2) viruses representing 92% of the H-subtyped viruses.

Detections of respiratory syncytial virus (RSV), a respiratory virus with clinical symptoms similar to influenza, peaked in week 52/2011 and are now decreasing (see the graphs for Europe, season 2011/2012).



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, WHO headquarters and European Centre for Disease Prevention and Control web sites.

(…)



Country comments (where available)

Kazakhstan: In week 01/2012, 50 respiratory specimens were collected of which: 0 tested positive for influenza virus, 2 were adenoviruses, 1 parainfluenza-1.

(…)
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  #5  
Old January 20th, 2012, 11:42 AM
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Health EuroFlu - Weekly Electronic Bulletin - Week 2 : 09/01/2012-15/01/2012 - 20 January 2012, Issue N° 428 (edited): flu activity 9 times lower than last season this time

[Source: EuroFlu, full page: (LINK).]

EuroFlu - Weekly Electronic Bulletin - Week 2 : 09/01/2012-15/01/2012 - 20 January 2012, Issue N° 428



Influenza activity increasing slowly in the WHO European Region due to A(H3N2)
  • This issue is based on data for week 2/2012 reported by 47 Member States in the WHO European Region.
  • Consultation rates for influenza-like illness (ILI) and acute respiratory infection (ARI) continue to be low in most countries in the Region.
  • 21% of sentinel specimens tested positive for influenza: 95% of these were influenza A.
  • Of the 191 influenza A viruses from sentinel sources that were subtyped, 99% were A(H3N2).

Current situation: week 2/2012

Despite an overall increasing trend, ILI and ARI consultation rates remained at low levels in most countries in the WHO European Region.

In general, consultation rates were highest in young children.

Of the 42 countries reporting on the geographical spread of influenza: 13 reported no activity; 6, local activity; 22, sporadic activity; and 1 country (Italy), regional activity.

Intensity was reported to be low in most countries reporting on this indicator, except for Italy and Spain , where influenza activity was at medium levels.



Severe acute respiratory infection (SARI): week 2/2012

10 countries reported data from sentinel hospital-based surveillance for SARI: Albania, Armenia, Georgia, Kazakhstan, Kyrgyzstan, the Republic of Moldova, Romania, the Russian Federation, Serbia and Ukraine.

The number of SARI hospitalizations has decreased overall in the Region in the past weeks, in general owing to declining hospitalizations in children aged 0–4 years.

A total of 88 respiratory specimens was collected from SARI patients, of which 7 (8%) tested positive for influenza; all were subtyped as A(H3N2).

Only 3 countries (Kyrgyzstan, Romania and Ukraine) have reported influenza detections in SARI patients during the course of this influenza season.

Further information on the sentinel SARI surveillance systems represented in the EuroFlu bulletin can be found in “Overview of sentinel SARI systems in EuroFlu”.



Virological situation: week 2/2012

Sentinel outpatient clinics collected 1138 respiratory specimens, 242 (21%) of which tested positive for influenza viruses: 231 (95%) were type A and 11 (5%) were type B.

Of the 191 influenza A viruses subtyped, 189 (99%) were influenza A(H3N2) and 2 (1%) were A(H1N1)pdm09.

In the 16 countries testing 20 or more sentinel specimens, influenza positivity ranged from 0% to 60%, with a median of 16% (mean: 18%).

In addition, 365 non-sentinel specimens were reported positive for influenza: 353 (97%) type A and 12 (3%) type B.

Of the influenza A viruses, 158 were subtyped: 146 (92%) as A(H3N2) and 12 (8%) as A(H1N1)pdm09.



Cumulative virological data: weeks 40/2011 – 2/2012

During this period, 2388 influenza virus detections were reported: 2223 (93%) were influenza A and 165 (3%) were influenza B.

Of the influenza A viruses, 1402 were subtyped: 1320 (94%) as A(H3N2) and 82 (6%) as A(H1N1)pdm09.

In addition, 48 influenza viruses were characterized antigenically:
  • 39 were A(H3) A/Perth/16/2009 (H3N2)-like;
  • 2 were A(H1N1)pdm09 A/California/7/2009 (H1N1)-like;
  • 2 were B/Florida/4/2006-like (B/Yamagata/16/88 lineage);
  • 1 was B/Bangladesh/3333/2007-like (B/Yamagata/16/88 lineage) and
  • 4 were B/Brisbane/60/2008-like (B/Victoria/2/87 lineage).
Of 65 influenza viruses characterized genetically,
  • 1 belonged to the A(H1N1)pdm09 group represented by A/Astrakhan/1/2011;
  • 1 belonged to the A(H1N1)pdm09 group represented by A/St Petersburg/100/2011;
  • 3 belonged to the B/Bangladesh/3333/2007 clade (Yamagata lineage);
  • 3 belonged to the B/Brisbane/60/2008 clade (Victoria lineage), and
  • 57 belonged to the A/Victoria/208/2009 A(H3) clade – 44 in the group represented by A/Stockholm/18/2011 (group 3), 12 in the group represented by A/Iowa/19/2010 (group 6) and 1 in the group represented by A/Johannesburg/114/2011 (group 7).

Comment

Influenza activity has increased slowly but steadily over the past weeks, although remaining low compared to the same period of the 2010/2011 season, when detections were approximately 9 times higher and represented 50% of sentinel samples testing positive for influenza in the WHO European Region.

Influenza A and B viruses are co-circulating in the Region, with the vast majority of detections in outpatient clinics and hospitals being A(H3N2) – in contrast to the 2010/2011 season, when A(H1N1)pdm09 was the dominant virus at the beginning.



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, WHO headquarters and European Centre for Disease Prevention and Control web sites.

(…)



Country comments (where available)

Kazakhstan: In week 02/2012, 140 respiratory specimens were collected of which: 0 tested positive for influenza virus, 6 were adenoviruses, 2 parainfluenza-1, 1 parainfluenza-3, 3 respiratory syncytial viruses (RSV).

(…)

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Old January 27th, 2012, 10:57 AM
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Health EuroFlu - Weekly Electronic Bulletin - Week 3 : 16/01/2012-22/01/2012 - 27 January 2012, Issue N° 429 (edited)

[Source: EuroFlu, full page: (LINK). Extracts, edited.]

EuroFlu - Weekly Electronic Bulletin - Week 3 : 16/01/2012-22/01/2012 - 27 January 2012, Issue N° 429



Influenza activity continues to rise slowly in the WHO European Region due to A(H3N2)
  • This issue is based on data for week 3/2012 reported by 46 Member States in the WHO European Region.
  • Consultation rates for influenza-like illness (ILI) and acute respiratory infection (ARI) continue to be relatively low in most countries of the Region, but with many countries reporting increasing activity.
  • 29 % of sentinel specimens tested positive for influenza, which is an increase over last week: 95% of these were influenza A.
  • Of the 352 influenza A viruses from sentinel sources that were subtyped, 99 % were A(H3N2).

Current situation: week 3/2012

Trends in clinical activity were reported by 42 countries: 20 stable, 19 increasing and 3 decreasing.

At the same time, ILI and ARI consultation rates remained at low levels in most countries of the WHO European Region.

Similar to the previous week, consultation rates were highest in young children.

Of the 41 countries reporting on the geographical spread of influenza: 12 reported no activity; 7 local activity; 18 sporadic activity; and 4 countries (Finland, Iceland, Italy and Spain) regional activity.

Intensity was reported to be low in most countries reporting on this indicator, except for Bulgaria, Iceland, Italy and Spain, where influenza activity was at medium levels.



Severe acute respiratory infection (SARI): week 3/2012

11 countries reported data from sentinel hospital-based surveillance for SARI: Albania, Armenia, Belarus, Georgia, Kazakhstan, Kyrgyzstan, the Republic of Moldova, Romania, the Russian Federation, Serbia and Ukraine.

The number of SARI hospitalizations remained largely unchanged compared to the previous week, except in Kazakhstan, which reported increases in SARI hospitalization – mainly in children aged 0–4 years.

A total of 122 respiratory specimens was collected from SARI patients, of which 10 (8%) tested positive for influenza with 6 being subtyped, all as A(H3N2).

6 countries so far (Albania, Belarus, Kazakhstan, Kyrgyzstan, Romania and Ukraine) have reported influenza detections in SARI patients during the course of this influenza season.

Further information on the sentinel SARI surveillance systems represented in the EuroFlu bulletin can be found in “Overview of sentinel SARI systems in EuroFlu”.



Virological situation: week 3/2012

Sentinel outpatient clinics collected 1469 respiratory specimens, 422 (29 %) of which tested positive for influenza viruses: 401 (95%) were type A and 21 (5%) were type B.

Of the 352 influenza A viruses subtyped, 349 (99%) were influenza A(H3N2) and 3 (1%) were A(H1N1)pdm09.

In the 18 countries testing 20 or more sentinel specimens, influenza positivity ranged from 0% to 85%, with a median of 22% (mean: 25%).

In addition, 525 non-sentinel specimens were reported positive for influenza: 504 (96%) type A and 21 (4%) type B.

Of the influenza A viruses, 189 were subtyped: 173 (92%) as A(H3N2) and 16 (8%) as A(H1N1)pdm09.



Cumulative virological data: weeks 40/2011 – 3/2012

During this period, 3436 influenza virus detections were reported: 3226 (94%) were influenza A and 210 (6%) were influenza B.

Of the influenza A viruses, 2099 were subtyped: 1985 (95%) as A(H3N2) and 114 (5%) as A(H1N1)pdm09.

In addition, 56 influenza viruses were characterized antigenically:
  • 46 were A(H3) A/Perth/16/2009 (H3N2)-like;
  • 2 were A(H1N1)pdm09 A/California/7/2009 (H1N1)-like;
  • 2 were B/Florida/4/2006-like (B/Yamagata/16/88 lineage);
  • 2 were B/Bangladesh/3333/2007-like (B/Yamagata/16/88 lineage); and
  • 4 were B/Brisbane/60/2008-like (B/Victoria/2/87 lineage).
Of 95 influenza viruses characterized genetically,
  • 1 belonged to the A(H1N1)pdm09 group represented by A/Astrakhan/1/2011;
  • 1 belonged to the A(H1N1)pdm09 group represented by A/St Petersburg/100/2011;
  • 5 belonged to the B/Bangladesh/3333/2007 clade (Yamagata lineage);
  • 2 belonged to the B/Brisbane/60/2008 clade (Victoria lineage); and
  • 86 belonged to the A/Victoria/208/2009 A(H3) clade – 63 in the group represented by A/Stockholm/18/2011 (group 3), 19 in the group represented by A/Iowa/19/2010 (group 6) and 1 in the group represented by A/Johannesburg/114/2011(group 7).

Comment

Influenza activity has increased consistently over the past several weeks, but influenza detections remain low compared to the same period of the 2010/2011 season.

Influenza A and B viruses are co-circulating in the Region, with the vast majority of detections in both outpatient clinics and hospitals being A(H3N2).



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, WHO headquarters and European Centre for Disease Prevention and Control web sites.

(…)



Country comments (where available)

Denmark: one H3N2 were detected in surveillance samples, recieved from other labs in Denmark

Kazakhstan: In week 03/2012, 185 respiratory specimens were collected of which: 0 tested positive for influenza virus, 5 were adenoviruses, 5 parainfluenza-1, 13 parainfluenza-3, 4 respiratory syncytial viruses (RSV)


(…)
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Old February 3rd, 2012, 11:48 AM
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Health EuroFlu - Weekly Electronic Bulletin - Week 4 : 23/01/2012-29/01/2012 - 03 February 2012, Issue N° 430 (edited)

[Source: EuroFlu, full page: (LINK). Extracts, edited.]
EuroFlu - Weekly Electronic Bulletin - Week 4 : 23/01/2012-29/01/2012 - 03 February 2012, Issue N° 430


Influenza activity remains at low levels in most countries in the WHO European Region
  • This issue is based on data for week 4/2012 reported by 49 Member States in the WHO European Region.
  • Consultation rates for influenza-like illness (ILI) and acute respiratory infection (ARI) remain low in most countries in the Region.
  • 29% of sentinel specimens tested positive for influenza: 95% of these were influenza A.
  • Influenza A(H3N2) continues to be the dominant virus in circulation throughout the Region, with relatively few A(H1N1)pdm09 and influenza B detections being reported.

Current situation: week 4/2012

ILI and ARI consultation rates continue to increase slowly but are at low levels in most countries in the WHO European Region, particularly in the north and west.

A few countries are reporting high and increasing ILI or ARI consultation rates, e.g. Bulgaria, Italy, Kyrgyzstan and Spain.

Of the 43 countries reporting on intensity of influenza activity, 38 reported low intensity and 5 reported medium intensity (Bulgaria, Iceland, Italy, Malta and Spain).

Geographic spread of influenza was reported by 43 countries: 8 reported no activity; 29 local or sporadic activity; 4 regional activity, and 2 widespread activity (Italy and Spain).



Severe acute respiratory infection (SARI): week 4/2012

11 countries reported data from sentinel hospital-based surveillance for SARI: Albania, Armenia, Belarus, Georgia, Kazakhstan, Kyrgyzstan, the Republic of Moldova, Romania, the Russian Federation, Serbia and Ukraine.

In most countries, hospitalizations due to SARI have either decreased or remained stable in the past weeks, except in Kazakhstan and Romania, where they have increased steadily.

A total of 120 respiratory specimens was collected from SARI patients, of which 11 (9%) tested positive for influenza A.
All 8 of the influenza A viruses subtyped were A(H3N2).

This week, 4 countries (Kazakhstan, Kyrgyzstan, Romania and the Russian Federation) reported influenza detections in SARI patients.

Further information on the sentinel SARI surveillance systems represented in the EuroFlu bulletin can be found in “Overview of sentinel SARI systems in EuroFlu”.



Virological situation: week 4/2012

Sentinel outpatient clinics collected 1506 respiratory specimens, 437 (29%) of which tested positive for influenza viruses: 414 (95%) were type A and 23 (5%) were type B.

Of the 352 influenza A viruses subtyped, 347 (99%) were influenza A(H3N2) and 5 (1%) were A(H1N1)pdm09.

In the 17 countries testing 20 or more sentinel specimens, influenza positivity ranged from 0% to 54%, with a median of 24% (mean: 23%).

In addition, 575 non-sentinel specimens were reported positive for influenza: 534 (93%) type A and 41 (7%) type B.

Of the influenza A viruses, 251 were subtyped: 222 (88%) as A(H3N2) and 29 (12%) as A(H1N1)pdm09.



Cumulative virological data: weeks 40/2011 – 4/2012

During this period, 4585 influenza virus detections were reported: 4305 (94%) were influenza A and 280 (4%) were influenza B.

Of the influenza A viruses, 2900 were subtyped: 2744 (95%) as A(H3N2) and 156 (5%) as A(H1N1)pdm09.

In addition, 76 influenza viruses were characterized antigenically:
  • 66 were A(H3) A/Perth/16/2009 (H3N2)-like;
  • 2 were A(H1N1)pdm09 A/California/7/2009 (H1N1)-like;
  • 2 were B/Florida/4/2006-like (B/Yamagata/16/88 lineage);
  • 2 were B/Bangladesh/3333/2007-like (B/Yamagata/16/88 lineage) and
  • 4 were B/Brisbane/60/2008-like (B/Victoria/2/87 lineage).
Of 151 influenza viruses characterized genetically,
  • 1 belonged to the A(H1N1)pdm09 group represented by A/Astrakhan/1/2011 (group 5);
  • 1 belonged to the A(H1N1)pdm09 group represented by A/St Petersburg/100/2011 (group 7);
  • 2 belonged to the A(H1N1)pdm09 group represented by A/St Petersburg/27/2011 (group 6);
  • 6 belonged to the B/Bangladesh/3333/2007 clade (Yamagata lineage);
  • 2 belonged to the B/Brisbane/60/2008 clade (Victoria lineage); and
  • 139 belonged to the A/Victoria/208/2009 A(H3) clade – 100 in the group represented by A/Stockholm/18/2011 (group 3), 33 in the group represented by A/Iowa/19/2010 (group 6) and 2 in the group represented by A/Johannesburg/114/2011(group 7).

Comment

Overall, influenza activity remains low in most countries in the WHO European Region.

In week 4/2012, 29% of sentinel samples tested positive for influenza, similar to the previous week.

At present, ILI and ARI consultations rates are stable in many countries and increasing slowly in others.

Influenza A(H3N2) accounts for the vast majority of influenza detections in outpatient clinics and hospitals, although sporadic detections of influenza A(H1N1)pdm09 and B viruses are also reported in the Region. Respiratory syncytial virus continues to circulate in some parts of the Region.



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, WHO headquarters and European Centre for Disease Prevention and Control web sites.


(…)
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Old February 10th, 2012, 11:27 AM
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Health EuroFlu - Weekly Electronic Bulletin - Week 5 : 30/01/2012-05/02/2012 - 10 February 2012, Issue N° 432 (Extracts)

[Source: EuroFlu, full text: (LINK). Extracts, edited.]


EuroFlu - Weekly Electronic Bulletin - Week 5 : 30/01/2012-05/02/2012 - 10 February 2012, Issue N° 432


Gradual increase of influenza activity in the WHO European Region


Current situation: week 5/2012
  • This issue is based on data for week 5/2012 reported by 46 Member States in the WHO European Region.
  • Consultation rates for influenza-like illness (ILI) and acute respiratory infection (ARI) are increasing in most countries in the Region. 37% of sentinel outpatient specimens tested positive for influenza, which is an increase over the previous week: 96% of these were influenza A.
  • Hospitalizations due to severe acute respiratory infection (SARI) continue to be relatively stable with most cases being in the group aged 0-4 years. 19% of sentinel SARI specimens tested positive for influenza, which is an increase over the previous week: all of these were influenza A.
  • By a large margin, influenza A(H3N2) continues to be the dominant virus in circulation in the Region, with relatively few A(H1N1)pdm09 and influenza B detections being reported.
  • Overall, influenza activity is heterogeneous, but with most countries reporting sporadic activity. In some countries (Italy, Kyrgyzstan and Spain), influenza activity may have peaked and be levelling off.

Outpatient surveillance for ILI and ARI

Trends in clinical activity were reported by 41 countries: 10 stable, 30 increasing and 1 decreasing.

At the same time, ILI and ARI consultation rates remained at low levels in most countries in the WHO European Region.

As in the previous week, consultation rates were highest in young children.

Of the 18 countries that report a threshold for the 2011/2012 season, the consultation rates exceeded the threshold in 8 (Albania, Belgium, France, Kyrgyzstan, the Russian Federation, Spain, Sweden and Switzerland) and were below but near the threshold in 3 (Estonia, Israel and Romania) in week 5/2012.

Of the 42 countries reporting on the geographical spread of influenza: 4 reported no activity; 19 sporadic activity; 11 local activity; 5 regional activity, and 3 (Belgium, Italy and Spain) widespread activity. Intensity was reported to be low in 28 countries reporting on this indicator, and medium in 14 others.

Sentinel outpatient clinics collected 1815 respiratory specimens, 676 (37%) of which tested positive for influenza viruses. Of these, 647 (96%) were influenza type A and 29 (4%) were influenza B (Table 1).

The percentage that was positive increased from 29% in week 4/2012 to 37% in week 5 (Figure 1). In the 22 countries testing 20 or more sentinel specimens, influenza positivity ranged from 0% to 84%, with a median of 28% (mean: 30%).




Hospital surveillance for SARI

11 countries reported data from sentinel hospital-based surveillance for SARI: Albania, Armenia, Belarus, Georgia, Kazakhstan, Kyrgyzstan, the Republic of Moldova, Romania, the Russian Federation, Serbia and Ukraine.

The number of SARI hospitalizations remained largely unchanged from the previous week, except in Kazakhstan, which reported a slight increase with 38% of specimens testing positive for influenza.

A total of 150 respiratory specimens was collected from SARI patients, of which 28 (19%) tested positive for influenza with 25 being subtyped: 20 as A(H3N2) and 5 as A(H1N1)pdm09 (Figure 2).

So far 7 countries (Albania, Belarus, Kazakhstan, Kyrgyzstan, the Russian Federation, Romania and Ukraine) have reported influenza detections in SARI patients during the course of this influenza season.
Further information on the sentinel SARI surveillance systems represented in the EuroFlu bulletin can be found in “Overview of sentinel SARI systems in EuroFlu”.



Virological overview

Sentinel detections

Table 1 provides an overview of the influenza virus detections by type and subtype in sentinel ILI/ARI and SARI surveillance, both for the current week and cumulative since week 40/2011. The dominant influenza type was A(H3) or A(H3N2) in 16 countries, influenza A in 4 countries, and type B and type A(H3N2) in 1 country.



Table 1. Virus detections in sentinel specimens

[ILI / ARI – SARI - Cumulative ILI/ARI from week 40 - Cumulative SARI from week 40]
  • Specimens tested – 1815 - 150 - 17319 - 2096
    • Influenza A + B - 676 (37.3%) - 28 (18.7%) – 2681 (15.5%) - 69 (3.3%)
    • Influenza A – 647 (95.7%) – 28 (100.0%) – 2535 (94.6%) – 69 (100.0%)
    • Influenza B – 29 (4.3%) – 0 (0.0%) – 146 (5.5%) – 0 (0.0%)
  • Influenza A sub-typed – 553 - 25 - 2305 - 59
    • A (H1N1)pdm09 – 10 (1.8%) - 5 (20.0%) - 34 (1.5%) - 6 (10.2%)
    • A (H3N2) – 543 (98.2%) - 20 (80.0%) - 2271 (98.5%) - 53 (89.8%)
    • A (H1N1) – 0 (0.0%) - 0 (0.0%) - 0 (0.0%) - 0 (0.0%)

Non-sentinel detections

During week 5/2012, 1064 specimens from non-sentinel sources were reported positive for influenza: 1016 (95%) type A and 48 (5%) type B.

Of the influenza A viruses, 368 were subtyped: 357 (97%) as A(H3N2) and 11 (3%) as A(H1N1)pdm09.

Since week 40/2011, a total of 6488 influenza virus detections from non-sentinel sources was reported: 6135 (95%) were influenza A and 353 (5%) were influenza B.

Of the influenza A viruses, 4056 were subtyped: 3884 (96%) as A(H3N2) and 172 (4%) as A(H1N1)pdm09.



Cumulative virological data: weeks 40/201-5/2012

Influenza viruses are monitored each season for antigenic and genetic characteristics, to determine the extent to which they correspond with the viruses included in the seasonal influenza vaccine (Figure 3). To date these viruses match those in the vaccine.



Cumulative influenza virus isolates strain characterisations - weeks 40/2011 - 05/2012

Since week 40/2011, 12 countries (Austria, Czech Republic, the United Kingdom (England), France, Germany, Latvia, Portugal, Romania, the Russian Federation, Slovenia, Sweden, Switzerland) have characterized 103 influenza viruses antigenically (figure 3). 11 countries (Austria, Denmark, Finland, France, Germany, Ireland, Norway, Portugal, Russian Federation, Spain, Sweden) have characterized 319 influenza viruses genetically (figure 4).


# Included in the WHO recommended composition of influenza virus vaccines for use in the 2011-2012 northern hemisphere influenza season.
* Included in the WHO recommended composition of influenza virus vaccines for use in the 2012 southern 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, WHO headquarters and European Centre for Disease Prevention and Control web sites.


(…)


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Old February 17th, 2012, 11:19 AM
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Health EuroFlu - Weekly Electronic Bulletin - Week 6 : 06/02/2012-12/02/2012 - 17 February 2012, Issue N° 433 (edited)

[Source: EuroFlu.org, full page: (LINK). Extracts, edited.]

EuroFlu - Weekly Electronic Bulletin - Week 6 : 06/02/2012-12/02/2012 - 17 February 2012, Issue N° 433


Influenza activity increasing slowly across the WHO European Region



Current situation: week 6/2012
  • This issue is based on data for week 6/2012 reported by 47 Member States in the WHO European Region.
  • Consultation rates for influenza-like illness (ILI) and acute respiratory infection (ARI) are increasing in 27 out of 42 countries in the Region. 42% of sentinel outpatient specimens tested positive for influenza, which is an increase over the previous week; 92% of these were influenza A.
  • Overall, influenza activity is higher in some countries in the western part of the Region than in the east. For most countries, influenza activity is low and in general has not reached the peak levels of ILI and/or ARI consultation rates seen in 2011.
  • Hospitalizations due to severe acute respiratory infection (SARI) continue to be relatively stable, with most cases being in the group aged 0–4 years. 14% of sentinel SARI specimens tested positive for influenza, which is a decrease over the previous week; all were influenza A.
  • Influenza A(H3N2) continues to be the dominant virus circulating in the Region, with relatively few A(H1N1)pdm09 and influenza B detections being reported.
  • To date, antigenic and genetic characterization of viruses have shown them to be similar to those recommended for inclusion in the 2011/2012 northern hemisphere vaccine.

Outpatient surveillance for ILI and ARI

Trends in clinical activity were reported by 42 countries: 11 stable, 27 increasing and 4 decreasing. As in the previous week, consultation rates were highest in young children. Although many countries reported an increase in ILI and ARI consultation rates, in general influenza activity is increasing slowly.

Azerbaijan, Belarus, the Czech Republic, Denmark, Montenegro, Poland, the Republic of Moldova, Serbia and Ukraine have reported no influenza activity or only sporadic detections to date. Of the 18 countries that reported a threshold for the 2011/2012 season, the consultation rates exceeded the threshold in 9 (Albania, Belgium, France, Kyrgyzstan, the Russian Federation, Romania, Spain, Sweden and Switzerland) and were below but near the threshold in 4 (Estonia, Ireland, Israel and the Netherlands).

Of the 42 countries reporting on the geographical spread of influenza, 6 reported no activity; 12 sporadic activity; 8 local activity; 8 regional activity, and 8 widespread activity. Intensity was reported to be low in 27 countries reporting on this indicator, and medium in 15 others.

Sentinel outpatient clinics collected 2081 respiratory specimens during week 6/2012, of which 872 (42%) tested positive for influenza viruses, a slight decrease compared to week 5/2012.

Of these, 805 (92%) were influenza type A and 67 (8%) were influenza B (Table 1, Fig. 1).

Percentage positivity in previous seasons peaked between weeks 44 and 6, indicating that influenza activity in the 2011/2012 season is relatively late. In the 24 countries testing 20 or more sentinel specimens, influenza positivity ranged from 0% to 84%, with a median of 43% (mean: 39%).

Hospital surveillance for SARI

11 countries reported data from hospital-based sentinel surveillance for SARI: Albania, Armenia, Belarus, Georgia, Kazakhstan, Kyrgyzstan, the Republic of Moldova, Romania, the Russian Federation, Serbia and Ukraine.

The number of SARI hospitalizations remained largely unchanged from the previous week. A total of 167 respiratory specimens was collected from SARI patients, of which 24 (14%) tested positive for influenza A, all of which were subtyped: 21 as A(H3N2) and 3 as A(H1N1)pdm09 (Fig. 2).

So far, 8 countries (Albania, Belarus, Georgia, Kazakhstan, Kyrgyzstan, the Russian Federation, Romania and Ukraine) have reported influenza detections in SARI patients during the course of the current influenza season.

Further information on the sentinel SARI surveillance systems represented in the EuroFlu bulletin can be found in “Overview of sentinel SARI systems in EuroFlu”.



Virological overview

During week 6/2012, 41 countries reported a dominant virus type and/or subtype; 21 reported influenza A as the dominant virus.

Of these, 18 reported A(H3N2) and 3 reported influenza A not subtyped. In addition, 1 country reported influenza B and 1 reported co-dominance of influenza B and A(H3N2).



Influenza virus type and subtype detections

Table 1 provides an overview of the influenza virus detections by type and subtype in sentinel ILI/ARI and SARI surveillance for both the current week and the period since week 40/2011.



Table 1. Influenza virus detections in sentinel specimens

[ILI/ARI current week – SARI current week - ILI/ARI cumulative since week 40 – SARI cumulative since week 40]
  • Specimens tested: 2081 - 167 - 19965 - 2294
    • Influenza A + B – 872 (41.9%) - 24 (14.4%) - 3973 (19.9%) - 139 (6.1%)
    • Influenza A – 805 (92.3%) - 24 (100.0%) - 3755 (94.5%) - 139 (100.0%)
    • Influenza B - 67 (7.7%) - 0 (0.0%) - 218 (5.5%) - 0 (0.0%)
  • Influenza A subtyped - 688 - 24 - 3434 – 131
    • A (H1N1)pdm09 – 4 (0.6%) - 3 (12.5%) - 42 (1.2%) - 37 (28.2%)
    • A (H3N2) - 684 (99.4%) - 21 (87.5%) - 3392 (98.8%) - 94 (71.8%)
    • A (H1N1) - 0 (0.0%) - 0 (0.0%) - 0 (0.0%) - 0 (0.0%)
During week 6/2012, 1417 specimens from non-sentinel sources were reported positive for influenza: 1345 (95%) type A and 72 (5%) type B.

Of the influenza A viruses, 499 were subtyped: 487 (98%) as A(H3N2) and 12 (2%) as A(H1N1)pdm09. Since week 40/2011, a total of 9440 influenza virus detections from non-sentinel sources was reported: 8951 (95%) were influenza A and 489 (5%) were influenza B. Of the influenza A viruses, 5905 were subtyped: 5698 (96%) as A(H3N2) and 207 (4%) as A(H1N1)pdm09.



Virus strain characterizations

Influenza viruses are monitored each season for antigenic and genetic characteristics, to determine the extent to which they correspond with the viruses included in the seasonal influenza vaccine as well as the occurrence of mutations that affect pathogenicity or that are associated with susceptibility to antiviral drugs.

Since week 40/2011, 13 countries (Austria, the Czech Republic, Denmark, the United Kingdom (England), France, Germany, Latvia, Portugal, Romania, the Russian Federation, Slovenia, Sweden, Switzerland) have characterized 146 influenza viruses antigenically (Fig. 3).

13 countries (Austria, Denmark, Finland, France, Germany, Ireland, Italy, Latvia, Norway, Portugal, the Russian Federation, Spain, Sweden) have characterized 421 influenza viruses genetically (Fig. 4).

# Included in the WHO-recommended composition of influenza virus vaccines for use in the 2011/2012 northern hemisphere influenza season. * Included in the WHO-recommended composition of influenza virus vaccines for use in the 2012 southern 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, WHO headquarters and European Centre for Disease Prevention and Control web sites.

(…)



Country comments (where available)

Republic of Moldova: This week were tested 20 samples from sentinel surveillance system and only in one of them was detected DNA of Adenovirus by classic PCR.

Romania: By now, 38.7% from all SARI cases had underlying risk conditions, and 44.4% from confirmed SARI cases (AH3). The number of deaths in SARI cases (4) has been unchanged since Week 52, none of them being caused by influenza. Laboratory investigations have been performed for 87.7% of SARI cases. The first two influenza viruses (AH3) have been detected in SARI cases notified in Week 52. To date, the total positivity rate for SARI cases has been 66% and the positivity rate for influenza in SARI cases 19.4%. The most frequently detected etiologies were influenza AH3 (36 cases), RSV (26), PIV (22) and Str. pneumoniae (14). In 8 out of 36 confirmed (AH3) SARI cases, AH3N2 has been isolated. One of them was also tested for antiviral resistance, with negative result, both for Oseltamivir and Zanamivir.Following the declaration, on 08/02/2012, of Week 5 as week of onset of influenza season in Romania ('week with 10% positive samples for the same subtype/variant from the total number of tested samples in that week'), we passed to the sampling protocol specific to this new period of ILI and SARI Surveillance. Therefore, SARI samples received in the National Reference Laboratory starting from 10/02/2012 will be tested only for influenza.

(…)


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Old February 24th, 2012, 10:45 AM
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Health EuroFlu - Weekly Electronic Bulletin - Week 7 : 13/02/2012-19/02/2012 - 24 February 2012, Issue N° 434 (Extracts, edited)

[Source: EuroFlu.org, full page: (LINK). Extracts, edited.]
EuroFlu - Weekly Electronic Bulletin - Week 7 : 13/02/2012-19/02/2012 - 24 February 2012, Issue N° 434


Influenza activity continues to increase in most of the countries in the WHO European Region



Current situation: week 7/2012
  • This issue is based on data for week 7/2012 reported by 47 Member States in the WHO European Region.
  • Influenza activity is increasing in 27 countries. In general, the situation in the Region is rather diverse, with about half the countries experiencing low influenza activity and half, medium activity. 13 countries did not detect any influenza viruses in specimens from sentinel outpatient surveillance this week.
  • This season is starting somewhat later than previous seasons.
  • The number of hospitalizations due to severe acute respiratory infection (SARI) continues to be relatively stable, with 12% of sentinel SARI specimens testing positive for influenza.
  • Circulation of influenza A(H3N2)virus is still prevalent, with some A(H1N1)pdm09 and influenza B detections reported.
  • To date, circulating virus strains are similar to those that were recommended for inclusion in the current northern hemisphere vaccine for 2011/2012.

Outpatient surveillance for influenza-like illness (ILI) and acute respiratory infection (ARI)

42 countries reported on trends in clinical activity: 11 stable, 27 increasing and 4 decreasing trends.

Similarly to several previous weeks, consultation rates were highest in young children.

Of the 18 countries that reported a threshold for the 2011/2012 season, the consultation rates were below the threshold in 7: the Czech Republic, the United Kingdom (England), Estonia, Latvia, the Netherlands, the Republic of Moldova, and Ukraine.

Israel and Ireland just reached their threshold in week 7/2012.

Of the 42 countries reporting on the geographical spread of influenza, 4 reported no activity; 13, sporadic activity; 4, local activity; 7, regional activity; and 14, widespread activity.

Low intensity was reported by 22 countries, medium by 18 and high by 2.

Sentinel outpatient clinics collected 2240 respiratory specimens during week 7/2012, of which 1024 (46%) tested positive for influenza viruses, slightly more than in week 6/2012.

Of these, 930 (91%) were influenza type A and 94 (9%) were influenza B (Table 1, Fig. 1).

In the 26 countries testing 20 or more sentinel specimens, influenza positivity ranged from 0% to 77%, with a median of 47% (mean: 41%).


Hospital surveillance for SARI

11 countries reported data from hospital-based sentinel surveillance for SARI: Albania, Armenia, Belarus, Georgia, Kazakhstan, Kyrgyzstan, the Republic of Moldova, Romania, the Russian Federation, Serbia and Ukraine.

The number of SARI hospitalizations remained similar to the previous week, but with a slight decrease in the percentage of influenza-positive cases.

A total of 169 respiratory specimens was collected from SARI patients, of which 21 (12%) were influenza A positive, all of which were typed/subtyped: 17 as A(H3N2), 1 as A(H1N1)pdm09 and 3 as influenza B. (Fig. 2).

So far, 8 countries (Albania, Belarus, Georgia, Kazakhstan, Kyrgyzstan, the Russian Federation, Romania and Ukraine) have reported influenza detections in SARI patients during the current influenza season.




Further information on the sentinel SARI surveillance systems represented in the EuroFlu bulletin can be found in “Overview of sentinel SARI systems in EuroFlu”.



Virological overview

During week 7/2012, 45 countries reported a dominant virus type and/or subtype; 25 reported influenza A as the dominant virus, and 2 reported co-dominance of influenza B with A(H3)/A(H3N2. The remaining 18 reported no dominant virus.



Influenza virus type and subtype detections

Table 1 provides an overview of the influenza virus detections by type and subtype in sentinel ILI/ARI and SARI surveillance for both the current week and the period from week 40/2011.



Table 1. Influenza virus detections in sentinel specimens

[ILI/ARI current week – SARI current week - ILI/ARI cumulative since week 40 – SARI cumulative since week 40]
  • Specimens tested – 2240 - 169 - 22545 - 2559
  • Influenza A + B - 1024 (45.7%) - 21 (12.4%) – 5241 (23.3%) – 172 (6.7%)
  • Influenza A – 930 (90.8%) – 18 (85.7%) – 4906 (93.6%) – 168 (97.7%)
  • Influenza B - 94 (9.2%) – 3 (14.3%) - 335 (6.4%) - 4 (2.3%)
  • Influenza A subtyped - 671 - 18 - 4395 - 160
  • A (H1N1)pdm09 – 8 (1.2%) - 1 (5.6%) - 53 (1.2%) - 45 (28.1%)
  • A (H3N2) - 663 (98.8%) - 17 (94.4%) - 4342 (98.8%) - 115 (71.9%)
  • A (H1N1) - 0 (0.0%) - 0 (0.0%) - 0 (0.0%) - 0 (0.0%)
During week 7/2012, 2232 specimens from non-sentinel sources were reported positive for influenza: 2135 (96%) type A and 97 (4%) type B.

Of the influenza A viruses, 671 were subtyped: 663 (99%) as A(H3N2) and 8 (1%) as A(H1N1)pdm09.

Since week 40/2011, 13 117 specimens of influenza viruses from sentinel and non-sentinel sources have been typed and subtyped: 12 421(95%) were influenza A and 696 (5%) were influenza B.

Of the influenza A viruses 7616 were subtyped: 7347 (96%) as A (H3N2) and 269(4%) as A(H1N1)pdm09.



Virus strain characterizations

Influenza viruses are monitored each season for antigenic and genetic characteristics, to determine the extent to which they correspond with the viruses included in the seasonal influenza vaccine as well as the occurrence of mutations that affect pathogenicity or that are associated with susceptibility to antiviral drugs.

Since week 40/2011, 14 countries (Austria, the Czech Republic, Denmark, the United Kingdom (England), France, Germany, Greece, Latvia, Portugal, Romania, the Russian Federation, Slovenia, Sweden, Switzerland) have characterized 219 influenza viruses antigenically (Fig. 3).

15 countries (Austria, Denmark, Finland, France, Germany, Greece, Ireland, Italy, Latvia, Norway, Portugal, the Russian Federation, Spain, Sweden, Switzerland) have characterized 475 influenza viruses genetically (Fig. 4).




# Included in the WHO-recommended composition of influenza virus vaccines for use in the 2011/2012 northern hemisphere influenza season. * Included in the WHO-recommended composition of influenza virus vaccines for use in the 2012 southern 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, WHO headquarters and European Centre for Disease Prevention and Control web sites.

(…)

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  #11  
Old March 9th, 2012, 11:16 AM
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Health EuroFlu - Weekly Electronic Bulletin - Week 9 : 27/02/2012-04/03/2012 - 09 March 2012, Issue N° 436: Very High ILI activity in Greece

[Source: EuroFlu.org, full page: (LINK). Extracts, edited.]
EuroFlu - Weekly Electronic Bulletin - Week 9 : 27/02/2012-04/03/2012 - 09 March 2012, Issue N° 436


Continued increase but large variation in influenza activity in the WHO European Region



Current situation: week 9/2012
  • This issue is based on data for week 9/2012 reported by 47 Member States in the WHO European Region.
  • Most countries reported medium-intensity, widespread activity and increasing or stable trends. Outpatient consultation rates for influenza-like illness (ILI) and acute respiratory infection (ARI) are low compared to the same period last year.
  • Overall, the number of hospitalizations due to severe acute respiratory infection (SARI) has not increased during the past 6 weeks, and the percentage of sentinel SARI specimens testing positive for influenza (about 20%) has not varied much.
  • Influenza A(H3N2) continues to be the dominant virus in circulation, with relatively few A(H1N1)pdm09 and influenza B detections reported.
  • None of the influenza A(H1N1)pdm09, A(H3N2) or B viruses screened for susceptibility to neuraminidase inhibitors was found to be resistant, although the numbers analysed were relatively low.


Outpatient surveillance for ILI and ARI

43 countries reported on trends in clinical activity: 13 stable, 19 increasing and 11 decreasing trends.

ILI and ARI consultation rates are still increasing in some countries (e.g. Croatia, Germany, Hungary and Ukraine) and have peaked and are decreasing in others (e.g. Albania, Bulgaria, Italy and Spain).

Nevertheless, consultation rates in most countries continue to be below the levels observed in the 2010/2011 season, although some are reporting increasing trends and some have exceeded the levels observed last season.

Among the 42 countries reporting on influenza intensity in week 9/2012, most (22) reported medium intensity, with 2 countries reporting high, 1 reporting very high and 17 reporting low intensity.

Of the 43 countries reporting on the geographical spread of influenza, 5 reported no activity; 13, local or sporadic activity; 7, regional activity; and 18, widespread activity.

During week 9/2012 sentinel outpatient clinics collected 1878 respiratory specimens, of which 851 (45%) tested positive for influenza viruses, similarly to the previous week.

Of the 851 positive specimens, 774 (91%) were influenza type A and 77 (9%) were influenza B (Fig. 1, Table 1).

In the 22 countries testing 20 or more sentinel specimens, influenza positivity ranged from 3% to 92%, with a median of 47% (mean: 45%).




Hospital surveillance for SARI

Similarly to the previous week, 11 countries reported data for hospital-based sentinel surveillance of SARI: Albania, Armenia, Belarus, Georgia, Kazakhstan, Kyrgyzstan, the Republic of Moldova, Romania, the Russian Federation, Serbia and Ukraine.

The number of SARI hospitalizations remained stable, but the percentage of cases testing positive for influenza was decreasing.

A total of 141 respiratory specimens was collected from SARI patients, of which 25 (18%) were positive for influenza: 23 were type A and 2 were type B.

Of the influenza A viruses, 22 were subtyped: 20 as A(H3) and 2 as A(H1)pdm09. (Fig. 2).

So far, most countries have reported influenza detections in SARI patients during the course of the current influenza season, but with considerably lower influenza-positivity rates than last season.


Further information on the sentinel SARI surveillance systems represented in the EuroFlu bulletin can be found in “Overview of sentinel SARI systems in EuroFlu”.



Virological overview

During week 9/2012, 43 countries reported a dominant virus type and/or subtype; 26 reported influenza A as the dominant virus and 3 reported co-dominance of influenza B with A(H3N2). 14 countries reported no dominant virus.



Influenza virus type and subtype detections

Table 1 provides an overview of the influenza virus detections by type and subtype in sentinel ILI/ARI and SARI surveillance for both the current week and the period since week 40/2011.



Table 1. Influenza virus detections in sentinel specimens

[ILI/ARI current week – SARI current week - ILI/ARI cumulative since week 40 – SARI cumulative since week 40]
  • Specimens tested – 1878 - 141 - 26791 - 2961
  • Influenza A + B - 851 (45.3%) - 25 (17.7%) - 7431 (27.7%) - 284 (9.6%)
  • Influenza A - 774 (91.0%) - 23 (92.0%) - 6905 (92.9%) - 278 (97.9%)
  • Influenza B - 77 (9.1%) - 2 (8.0%) - 526 (7.1%) - 6 (2.1%)
  • Influenza A subtyped - 632 - 22 - 6189 - 266
  • A (H1N1)pdm09 - 10 (1.6%) - 2 (9.1%) - 89 (1.4%) - 59 (22.2%)
  • A (H3N2) - 622 (98.4%) - 20 (90.9%) - 6100 (98.6%) - 207 (77.8%)
  • A (H1N1) – 0 (0.0%) - 0 (0.0%) - 0 (0.0%) - 0 (0.0%)
During week 9/2012, 2511 specimens from non-sentinel sources were reported positive for influenza: 2375 (95%) type A and 136 (5%) type B.

Of the influenza A viruses, 816 were subtyped: 794 (97%) as A(H3N2) and 22 (3%) as A(H1N1)pdm09.

Since week 40/2011, 21 448 specimens of influenza viruses from sentinel and non-sentinel sources have been typed: 20 321 (95%) were influenza A and 1127 (5%) were influenza B.

Of the influenza A viruses, 11 469 were subtyped: 11036 (96%) as A (H3N2) and 433 (4%) as A(H1N1)pdm09.

Since week 40/2010, 8 countries (Germany, Italy, the Netherlands, Norway, Portugal, Romania, Sweden and the United Kingdom) have screened 245 influenza A(H1N1)pdm09, A(H3N2) and B viruses for susceptibility to the neuraminidase inhibitors oseltamivir and zanamivir. None was resistant, although relatively few viruses have been analysed compared with the 1217 analysed by week 9 of last season.

All of the 91 A(H3N2) viruses and 7 influenza A(H1N1)pdm09 viruses that were screened for susceptibility to adamantanes were found to be resistant.



Virus strain characterizations

Influenza viruses are monitored each season for antigenic and genetic characteristics, to determine the extent to which they correspond with the viruses included in the seasonal influenza vaccine as well as the occurrence of mutations that affect pathogenicity or that are associated with susceptibility to antiviral drugs.

Since week 40/2011, 15 countries (Austria, the Czech Republic, Denmark, the United Kingdom (England), France, Germany, Greece, Latvia, Portugal, Romania, the Russian Federation, Slovakia, Slovenia, Sweden, Switzerland) have characterized 382 influenza viruses antigenically (Fig. 3).

17 countries (Austria, Belgium, Denmark, Finland, France, Germany, Greece, Ireland, Italy, Latvia, Norway, Portugal, Romania, the Russian Federation, Spain, Sweden, Switzerland) have characterized 592 influenza viruses genetically (Fig. 4).



# Included in the WHO-recommended composition of influenza virus vaccines for use in the 2011/2012 northern hemisphere influenza season.
* Included in the WHO-recommended composition of influenza virus vaccines for use in the 2012 southern 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, WHO headquarters and European Centre for Disease Prevention and Control web sites.


(…)
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  #12  
Old March 16th, 2012, 11:43 AM
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Health EuroFlu - Weekly Electronic Bulletin - Week 10 : 05/03/2012-11/03/2012 - 16 March 2012, Issue N° 437

[Source: EuroFlu.org, full page: (LINK). Extracts, edited.]
EuroFlu - Weekly Electronic Bulletin - Week 10 : 05/03/2012-11/03/2012 - 16 March 2012, Issue N° 437


Stable or decreasing Influenza activity in most countries in the WHO European Region



Current situation: week 10/2012
  • This issue is based on data for week 10/2012 reported by 46 Member States in the WHO European Region.
  • In contrast to previous seasons, the 2011/2012 season has shown no particular pattern of spread of influenza across the Region. Instead, influenza activity has peaked simultaneously in countries in different parts of the Region.
  • Outpatient consultation rates for influenza-like illness (ILI) and acute respiratory infection (ARI) are low compared to the same period last year.
  • Overall, the number of hospitalizations due to severe acute respiratory infection (SARI) has not increased in the past 5 weeks, and the percentage of sentinel SARI specimens testing positive for influenza (about 20%) has been stable.
  • Influenza A(H3N2) continues to be the dominant virus in circulation, with an increasing number of influenza B detections, and relatively few A(H1N1)pdm09, reported.
  • None of the influenza A(H1N1)pdm09, A(H3N2) or B viruses screened for susceptibility to neuraminidase inhibitors was found to be resistant, although the numbers analysed were relatively low.
Outpatient surveillance for ILI and ARI

41 countries reported on trends in clinical activity: 14 stable, 7 increasing and 20 decreasing trends.

ILI and ARI consultation rates are increasing in some Baltic and south-eastern European countries and have peaked in 5 countries.

Consultation rates in most countries continue to be below the levels observed in the 2010/2011 season.

Among the 40 countries reporting on influenza intensity in week 10/2012, most (21) reported medium intensity, with 2 countries reporting high, 1 reporting very high and 16 reporting low intensity.

Of the 41 countries reporting on the geographical spread of influenza, 4 reported no activity; 13, local or sporadic activity; 7, regional activity; and 17, widespread activity.

During week 10/2012 sentinel outpatient clinics collected 1708 respiratory specimens, of which 723 (42%) tested positive for influenza viruses, a slight decrease from the previous week.

Of the 723 positive specimens, 605 (84%) were influenza type A and 118 (16%) were influenza B (Fig. 1, Table 1).

In the 23 countries testing 20 or more sentinel specimens, influenza positivity ranged from 20% to 78%, with a median of 45% (mean: 45%).



Hospital surveillance for SARI

10 countries reported data for hospital-based sentinel surveillance of SARI: Armenia, Belarus, Georgia, Kazakhstan, Kyrgyzstan, the Republic of Moldova, Romania, the Russian Federation, Serbia and Ukraine.

The number of SARI hospitalizations remained stable, but with a higher percentage of influenza-positive cases in some countries.

A total of 121 respiratory specimens was collected from SARI patients, of which 27 (22%) were positive for influenza: 25 were type A and 2 were type B.

Of the influenza A viruses, 25 were subtyped: 22 as A(H3) and 3 as A(H1)pdm09. (Fig. 2).

So far, most countries have reported influenza detections in SARI patients during the course of the current influenza season, but with considerably lower influenza-positivity rates than last season.



Further information on the sentinel SARI surveillance systems represented in the EuroFlu bulletin can be found in “Overview of sentinel SARI systems in EuroFlu”.



Virological overview

During week 10/2012, 40 countries reported a dominant virus based on both sentinel and non-sentinel detections. 26 countries reported influenza A and/or A(H3N2) as the dominant virus and 4 reported co-dominance of influenza B with A(H3N2). 10 countries reported that no virus was dominant.



Influenza virus type and subtype detections

Table 1 provides an overview of the influenza virus detections by type and subtype in sentinel ILI/ARI and SARI surveillance for both the current week and the period since week 40/2011.



Table 1. Influenza virus detections in sentinel specimens

[Specimens tested and viruses - Current week (number and %): ILI/ARI – SARI - Cumulative since week 40 (number and %): ILI/ARI – SARI]
  • Specimens tested – 1708 - 121 - 28839 - 3115
  • Influenza A + B – 723 (42.3%) - 27 (22.3%) - 8383 (29.1%) - 327 (10.5%)
  • Influenza A - 605 (83.7%) - 25 (92.6%) - 7719 (92.1%) - 317 (96.9%)
  • Influenza B - 118 (16.3%) - 2 (7.4%) - 664 (7.9%) - 10 (3.1%)
  • Influenza A subtyped - 486 - 25 - 6960 - 297
  • A (H1N1)pdm09 - 9 (1.9%) - 3 (12.0%) - 105 (1.5%) - 59 (19.9%)
  • A (H3N2) - 477 (98.2%) - 22 (88.0%) - 6855 (98.5%) - 238 (80.1%)
  • A (H1N1) - 0 (0.0%) - 0 (0.0%) - 0 (0.0%) - 0 (0.0%)
During week 10/2012, 2856 specimens from non-sentinel sources were reported positive for influenza: 2694 (94%) type A and 162 (6%) type B.

Of the influenza A viruses, 920 were subtyped: 887 (96%) as A(H3N2) and 33 (4%) as A(H1N1)pdm09.

Since week 40/2011, 25 167 specimens of influenza viruses from sentinel and non-sentinel sources have been typed: 23 613 (94%) were influenza A and 1554 (6%) were influenza B.

Of the influenza A viruses, 11 943 were subtyped: 11 374 (95%) as A (H3N2) and 569 (5%) as A(H1N1)pdm09.

Since week 40/2010, 8 countries (Germany, Italy, the Netherlands, Norway, Portugal, Romania, Sweden and the United Kingdom) have screened 297 influenza A(H3N2), A(H1N1)pdm09 and B viruses for susceptibility to the neuraminidase inhibitors oseltamivir and zanamivir.

None was resistant, although relatively few viruses have been analysed compared with the 1227 analysed by week 10/2011.

All of the 98 A(H3N2) viruses and 7 influenza A(H1N1)pdm09 viruses that were screened for susceptibility to adamantanes were found to be resistant.



Virus strain characterizations

Influenza viruses are monitored each season for antigenic and genetic characteristics, to determine the extent to which they correspond with the viruses included in the seasonal influenza vaccine as well as the occurrence of mutations that affect pathogenicity or that are associated with susceptibility to antiviral drugs.

Since week 40/2011, 15 countries (Austria, the Czech Republic, Denmark, the United Kingdom (England), France, Germany, Greece, Latvia, Portugal, Romania, the Russian Federation, Slovakia, Slovenia, Sweden, Switzerland) have characterized 567 influenza viruses antigenically (Fig. 3).

17 countries (Austria, Belgium, Denmark, Finland, France, Germany, Greece, Ireland, Italy, Latvia, Norway, Portugal, Romania, the Russian Federation, Spain, Sweden, Switzerland) have characterized 670 influenza viruses genetically (Fig. 4).



# Included in the WHO-recommended composition of influenza virus vaccines for use in the 2011/2012 northern hemisphere influenza season. * Included in the WHO-recommended composition of influenza virus vaccines for use in the 2012 southern 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, WHO headquarters and European Centre for Disease Prevention and Control web sites.


(…)
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  #13  
Old March 23rd, 2012, 12:24 PM
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Health EuroFlu - Weekly Electronic Bulletin - Week 11 : 12/03/2012-18/03/2012 - 23 March 2012, Issue N° 438 (edited)

[Source: EuroFlu, full page: (LINK). Extracts, edited.]
EuroFlu - Weekly Electronic Bulletin - Week 11 : 12/03/2012-18/03/2012 - 23 March 2012, Issue N° 438


Influenza activity continues to decrease in many countries of the WHO European Region



Current situation: week 11/2012
  • This issue is based on data for week 11/2012 reported by 47 Member States in the WHO European Region.
  • Influenza activity is generally decreasing, but consultation rates are still above the thresholds in 50% of the countries reporting.
  • The number of hospitalizations due to severe acute respiratory infection (SARI) is also decreasing, but there has been an increase in the percentage of influenza-positive cases.
  • Influenza A(H3N2) viruses continue to dominate, with some influenza B and a few A(H1N1)pdm09 detections being reported.
Outpatient surveillance for ILI and ARI

40 countries reported on trends in clinical activity: 7 stable, 13 increasing and 20 decreasing trends.

Of the 40 countries reporting on the geographical spread of influenza, 4 reported no activity; 7, sporadic activity; 3, local activity; 9, regional activity; and 17, widespread activity.

Low intensity was reported by 15 countries, medium by 23 and high by 1 country (Sweden).

Of the 18 countries reporting a threshold for the 2011/2012 season, the consultation rates are still above the threshold in 9 countries (Belgium, Estonia, Kyrgyzstan, Romania, the Russian Federation, Serbia, Sweden, Switzerland and Ukraine).

During week 11/2012 sentinel outpatient clinics collected 1482 respiratory specimens, of which 588 (40%) tested positive for influenza viruses, a slight decrease in comparison with the previous week.

Of these positive specimens, 483 (82%) were influenza type A and 105 (18%) were influenza B (Table 1, Fig. 1).

In the 24 countries testing 20 or more sentinel specimens, influenza positivity ranged from 8% to 83%, with a median of 41% (mean: 42%).


Hospital surveillance for SARI

11 countries reported data for hospital-based sentinel surveillance of SARI: Albania, Armenia, Belarus, Georgia, Kazakhstan, Kyrgyzstan, the Republic of Moldova, Romania, the Russian Federation, Serbia and Ukraine.

Of these 11countries only the Republic of Moldova has reported no detection of influenza among SARI cases so far this season.

The number of SARI hospitalizations was lower compared to the previous week, but there was a slight increase in the percentage of influenza-positive cases in some countries.

A total of 142 respiratory specimens was collected from SARI patients, of which 45 (32%) were positive for influenza: 42 were type A and 3 were type B.

All influenza A viruses were subtyped: 40 as A(H3) and 2 as A(H1)pdm09.(Fig. 2).



Further information on the sentinel SARI surveillance systems represented in the EuroFlu bulletin can be found in “Overview of sentinel SARI systems in EuroFlu”.



Virological overview

During week 11/2012, 42 countries reported a dominant virus based on both sentinel and non-sentinel detections.
29 countries reported influenza A and/or A(H3N2) as the dominant virus and 2 reported co-dominance of influenza B with A(H3N2). 11 countries reported that no virus was dominant.



Influenza virus type and subtype detections

Table 1 provides an overview of the influenza virus detections by type and subtype in sentinel ILI/ARI and SARI surveillance for both the current week and the period since week 40/2011.



Table 1. Influenza virus detections in sentinel specimens

[Specimens tested and viruses - Current week: (number and %) ILI/ARI – SARI - Cumulative since week 40: (number and %) ILI/ARI – SARI]
  • Specimens tested – 1482 - 142 - 30432 - 3350
  • Influenza A + B - 588 (39.7%) - 45 (31.7%) - 9096 (29.9%) - 423 (12.6%)
  • Influenza A – 483 (82.1%) - 42 (93.3%) - 8310 (91.4%) - 409 (96.7%)
  • Influenza B - 105 (17.9%) - 3 (6.7%) - 786 (8.6%) - 14 (3.3%)
  • Influenza A subtyped - 371 - 42 - 7525 - 392
  • A (H1N1)pdm09 - 8 (2.2%) - 1 (2.4%) - 125 (1.7%) - 60 (15.3%)
  • A (H3N2) - 363 (97.8%) - 40 (95.2%) - 7400 (98.3%) - 331 (84.4%)
  • A (H1N1) - 0 (0.0%) - 1 (2.4%) - 0 (0.0%) - 1 (0.3%)
During week 11/2012, 2624 specimens from non-sentinel sources were reported positive for influenza: 2439 (93%) type A and 185 (7%) type B.

Of the influenza A viruses, 870 were subtyped: 847 (97%) as A(H3N2) and 23 (3%) as A(H1N1)pdm09.

Since week 40/2011, 28 788 influenza viruses from sentinel and non-sentinel sources have been typed: 26 919 (94%) were influenza A and 1869 (6%) were influenza B.

Of the influenza A viruses, 13 531 were subtyped: 12 903 (95%) as A(H3N2) and 628 (5%) as A(H1N1)pdm09.



Virus strain characterizations

Influenza viruses are monitored each season for antigenic and genetic characteristics, to determine the extent to which they correspond with the viruses included in the seasonal influenza vaccine as well as the occurrence of mutations that affect pathogenicity or that are associated with susceptibility to antiviral drugs.

Since week 40/2011, 16 countries (Austria, the Czech Republic, Denmark, the United Kingdom (England), France, Germany, Greece, Hungary, Latvia, Portugal, Romania, the Russian Federation, Slovakia, Slovenia, Sweden, Switzerland) have characterized 668 influenza viruses antigenically (Fig. 3).

17 countries (Austria, Belgium, Denmark, Finland, France, Germany, Greece, Ireland, Italy, Latvia, Norway, Portugal, Romania, the Russian Federation, Spain, Sweden, Switzerland) have characterized 732 influenza viruses genetically (Fig. 4).




# Included in the WHO-recommended composition of influenza virus vaccines for use in the 2011/2012 northern hemisphere influenza season. * Included in the WHO-recommended composition of influenza virus vaccines for use in the 2012 southern 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, WHO headquarters and European Centre for Disease Prevention and Control web sites.

(…)
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  #14  
Old March 30th, 2012, 11:10 AM
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Health EuroFlu - Weekly Electronic Bulletin - Week 12 : 19/03/2012-25/03/2012 - 30 March 2012, Issue N° 439 (edited)

[Source: EuroFlu, full page: (LINK). Extracts, edited.]
EuroFlu - Weekly Electronic Bulletin - Week 12 : 19/03/2012-25/03/2012 - 30 March 2012, Issue N° 439


Decreasing clinical activity in most countries of the WHO European Region



Current situation: week 12/2012
  • This issue is based on data for week 12/2012 reported by 45 Member States in the WHO European Region.
  • Consultation rates continue to decrease with only 7 countries reporting consultation rates above their thresholds, and percentages of influenza-positive cases remain similar to the previous week.
  • The number of hospitalizations due to severe acute respiratory infection (SARI) and the SARI influenza-positivity rate is generally stable.
  • Influenza A(H3N2) viruses continue to dominate, despite a slight increase in influenza B detections and a few A(H1N1)pdm09 detections
Outpatient surveillance for ILI and ARI

42 countries reported on trends in clinical activity: 7 stable, 5 increasing and 30 decreasing trends.

Of the 42 countries reporting on the geographical spread of influenza: 5 reported no activity; 8, sporadic activity; 10, local activity; 7, regional activity; and 12, widespread activity.

No country reported high or very high intensity while 23 reported low intensity and 19, medium intensity.

Of the 19 countries that reported a threshold for the 2011/2012 season, the consultation rates are still above the threshold in 7 countries (Estonia, Latvia, the Russian Federation, Serbia, Sweden, Switzerland and Ukraine).

During week 12/2012 sentinel outpatient clinics collected 1252 respiratory specimens, of which 511 (41%) tested positive for influenza viruses, a percentage similar to the previous week.

Of these positive specimens, 368 (72%) were influenza type A and 143 (28%) were influenza B Table 1, Fig. 1).

In the 20 countries testing 20 or more sentinel specimens, influenza positivity ranged from 11% to 85%, with a median of 47% (mean: 44%).




Hospital surveillance for SARI

8 countries reported data for hospital-based sentinel surveillance of SARI: Armenia, Belarus, Georgia, Kazakhstan, Kyrgyzstan, the Russian Federation, Serbia and Ukraine.

A total of 122 respiratory specimens was collected from SARI patients, of which 38 (31%) were positive for influenza: 34 were type A and 4 were type B.

All influenza A viruses were subtyped: 30 as A(H3) and 4 as A(H1)pdm09. (Fig. 2).





Further information on the sentinel SARI surveillance systems represented in the EuroFlu bulletin can be found in “Overview of sentinel SARI systems in EuroFlu”.



Virological overview

During week 12/2012, 39 countries reported a dominant virus based on both sentinel and non-sentinel detections.

25 countries reported influenza A and/or A(H3N2) as the dominant virus and 1 reported co-dominance of influenza B with A(H3N2).

13 countries reported that no virus was dominant.



Influenza virus type and subtype detections

Table 1 provides an overview of the influenza virus detections by type and subtype in sentinel ILI/ARI and SARI surveillance for both the current week and the period since week 40/2011.



Table 1. Influenza virus detections in sentinel specimens

[Specimens tested and viruses - Current week (number and %): ILI/ARI – SARI - Cumulative since week 40 (number and %): ILI/ARI – SARI]
  • Specimens tested – 1252 - 122 - 31917 - 3499
  • Influenza A + B - 511 (40.8%) - 38 (31.2%) - 9763 (30.6%) - 485 (13.9%)
  • Influenza A - 368 (72.0%) - 34 (89.5%) - 8787 (90.0%) - 466 (96.1%)
  • Influenza B - 143 (28.0%) - 4 (10.5%) - 976 (10.0%) - 19 (3.9%)
  • Influenza A subtyped - 293 - 34 - 7951 – 441
  • A (H1N1)pdm09 - 11 (3.8%) - 4 (11.8%) - 138 (1.7%) - 60 (13.6%)
  • A (H3N2) - 282 (96.3%) - 30 (88.2%) - 7813 (98.3%) - 380 (86.2%)
  • A (H1N1) - 0 (0.0%) - 0 (0.0%) - 0 (0.0%) - 1 (0.2%)
During week 12/2012, 2272 specimens from non-sentinel sources were reported positive for influenza: 2008 (88%) type A and 264 (12%) type B.

Of the influenza A viruses, 771 were subtyped: 735 (95%) as A(H3N2) and 36 (5%) as A(H1N1)pdm09.

Since week 40/2011, 31 964 influenza viruses from sentinel and non-sentinel sources have been typed: 29 620 (93%) were influenza A and 2344 (7%) were influenza B.

Of the influenza A viruses, 14 857 were subtyped: 14 160 (95%) as A(H3N2) and 697 (5%) as A(H1N1)pdm09.



Virus strain characterizations

Influenza viruses are monitored each season for antigenic and genetic characteristics, to determine the extent to which they correspond with the viruses included in the seasonal influenza vaccine as well as the occurrence of mutations that affect pathogenicity or that are associated with susceptibility to antiviral drugs.

Since week 40/2011, 17 countries (Austria, the Czech Republic, Denmark, the United Kingdom (England), France, Germany, Greece, Hungary, Italy, Latvia, Portugal, Romania, the Russian Federation, Slovakia, Slovenia, Sweden, Switzerland) have characterized 1021 influenza viruses antigenically (Fig. 3).

17 countries (Austria, Belgium, Denmark, Finland, France, Germany, Greece, Ireland, Italy, Latvia, Norway, Portugal, Romania, the Russian Federation, Spain, Sweden, Switzerland) have characterized 922 influenza viruses genetically (Fig. 4).






# Included in the WHO-recommended composition of influenza virus vaccines for use in the 2011/2012 northern hemisphere influenza season.
* Included in the WHO-recommended composition of influenza virus vaccines for use in the 2012 southern 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, WHO headquarters and European Centre for Disease Prevention and Control web sites.

(…)
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Old April 6th, 2012, 11:59 AM
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Books EuroFlu - Weekly Electronic Bulletin, Archive for the 2011/2012 Influenza Season

This archive contains a series of edited weekly bulletins dispatched by the EuroFlu WHO/ECDC program for seasonal influenza surveillance in the European Region, 2011/2012 Season.
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