Description of influenza isolated specimens reported in TESSy (2008 to 2014)
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Weekly aggregated data on influenza isolated specimens are collected in TESSy since 2008 presented at the annual European Influenza Surveillance Network meeting, Stockholm, June 2015
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Description of influenza isolated specimens reported in TESSy (2008 to 2014)
- 1. Description of the isolation data reported in TESSy (2008 to 2014) Martina Escher, Cornelia Adlhoch, Eeva Broberg and Pasi Penttinen on behalf of the EISN European Influenza Surveillance Network Annual Meeting 2014 11 June 2015
- 2. • Weekly aggregated data on influenza isolated specimens (IS) are collected in TESSy since 2008 To monitor the influenza specimens’ availability across EU/EEA countries for antigenic characterisation influenza vaccine virus selection and production Background: Countries TESSy ? ?
- 3. Objective of the analysis • First analysis of IS data reported to TESSy to: • evaluate the usefulness of the reported data to inform the surveillance objectives • describe who report and what is reported • evaluate IS representativeness compare to other virological influenza surveillance data reported
- 4. Weekly number of isolated specimens (IS) • 6 influenza seasons: from 2008/2009 to 2013/2014 • Sentinel/non sentinel • Virus (sub-)types Weekly number of positive specimens (PS) • 6 influenza seasons: from 2008/2009 to 2013/2014 • Sentinel/non sentinel • Virus (sub-)types Weekly number of antigenic characterised strains (ACS) • 2 influenza seasons: 2012/2013 and 2013/2014 • Sentinel/non-sentinel pooled • Retrospective classification in (sub-)types Methods: influenza surveillance data used
- 5. Methods: indicators calculated 1. Description of IS reported Reporting Countries Number of isolates reported 2. IS versus PS reported Proportion of IS over PS reported and timing Comparison of proportions of Influenza (sub)types reported 3. IS versus ACS reported Reporting countries Proportion of ACS over IS reported Sentinel and non-sentinel 2008/09 – 2013/14 Sentinel and non-sentinel 2008/09 – 2013/14 Sentinel + non-sentinel 2012/13 – 2013/14
- 6. Description of IS reported Country Austria Belgium Bulgaria Czech Republic Germany Denmark Estonia Spain Finland France Greece Croatia Hungary Ireland Island Italy Lithuania Luxembourg Latvia Malta Netherlands Norway Poland Portugal Romania Sweden Slovenia Slovakia United Kingdom Sentinel (12 countries) 15 15 3 4 4 7 4 95 295 27 6 46 20 58 197 3 10 229 528 1 2 7 8 2 2 10 10 12 10 255 99 64 26 319 125 2 37 37 8 8 34 374 34 374 15 15 140 247 45 104 185 351 7 11 72 1 67 78 1 37 2 265 18 26 144 266 26 23 188 315 4 3 20 159 334 1 162 359 34 374 96 366 320 197 299 477 314 789 85 184 1176 N IIS reported2008/09 2009/10 2010/11 2011/12 2012/13 2013/14 Non-sentinel (13 countries) 15 15 3 4 4 7 4 95 295 27 6 46 20 58 197 3 10 229 528 1 2 7 8 2 2 10 10 12 10 255 99 64 26 319 125 2 37 37 8 8 34 374 34 374 15 15 140 247 45 104 185 351 7 11 72 1 67 78 1 37 2 265 18 26 144 266 26 23 188 315 4 3 20 159 334 1 162 359 34 374 96 366 320 197 299 477 314 789 85 184 1176 2378
- 7. Description of reported isolates N of reporting countries N Isolated specime ns N weeks with reported isolates Median (Range) of weekly reported isolates N of reporting countries N Isolated specime ns N weeks with reported isolates Median (Range) of weekly reported isolates 2008/09 1 34 12 0 (0-6) 1 374 15 0 (0-82) 2009/10 2 96 10 0 (0-26) 8 366 21 1 (0-53) 2010/11 7 320 26 4 (0-28) 4 197 23 4 (0-41) 2011/12 7 299 24 4 (0-38) 6 477 33 8 (1-51) 2012/13 4 314 16 0 (0-48) 5 789 28 5 (0-78) 2013/14 5 85 20 2 (0-12) 5 184 29 3 (0-30) Non sentinelSentinel Influenza season
- 8. IS versus PDS: N reported specimens and timing Sentinel IS and PS reported, 2008 to 2014 Proportion (%) of IS over PDS reported 0.3 0.6 2.3 3.1 2.3 1.2
- 9. IS versus PS: proportion of influenza (sub-)types A(NT) A(H1) A(H3) B(NL) B(Vic) B(Yam) 0 0 21 79 0 0 25 3 53 19 0 0 0 99 0 1 0 0 4 95 0 1 0 0 0 4 21 5 68 3 4 53 2 32 8 1 0 1 91 0 4 4 7 2 80 9 1 1 3 40 12 3 2 41 5 26 14 37 2 16 1 65 32 0 0 2 6 49 43 2 0 1 IS PS IS IS IS IS IS PS PS PS PS PS Influenza (sub-) type % A B Sentinel IS and PS reported, 2008 to 2014
- 10. Which conclusions can we draw? - Less than 50% of EU/EEA countries reported isolation at least in one season and in one system - Behaviour in performing isolation varied between and within countries - IS represent between 0.3% and 3.1% of the PS - Isolation was undertaken during the whole season with a pattern following the detections - Proportion of (sub-)typed IS reported not always reflected that of PS.. …representativeness of the available isolates??
- 11. IS ACS ACS/IS % IS ACS ACS/IS % Austria Belgium Bulgaria Czech Republic 255 13 Germany Denmark Estonia Greece Spain 20 Finland France Hungary Ireland Island Italy Lithuania Luxembourg Latvia 2 Malta Netherlands Norway Poland Portugal 387 Romania 149 Sweden 78 Slovenia 38 Slovakia 380 United Kingdom 1 49 2012/2013 2013/2014 IS versus ACS: Sentinel+non-sentinel IS and ACS reported, 2012 to 2014 • Reporting countries • Proportion of ACS over IS reported IS ACS ACS/IS % IS ACS ACS/IS % Austria 7 1 Belgium Bulgaria 7 Czech Republic 255 217 85% 13 19 146% Germany 289 297 Denmark 10 39 Estonia Greece 38 15 Spain 63 20 24 120% Finland 2 France Hungary Ireland 23 Island Italy 29 16 Lithuania Luxembourg 4 Latvia 2 106 5300% 124 Malta Netherlands 52 Norway 7 Poland Portugal 387 387 100% 149 Romania 22 149 56 38% Sweden 78 Slovenia 55 38 78 205% Slovakia 380 349 92% 47 United Kingdom 1 1767 176700% 49 665 1357% 2012/2013 2013/2014 IS ACS IS ACS Austria 7 1 Belgium Bulgaria 7 Czech Republic 255 217 13 19 Germany 289 297 Denmark 10 39 Estonia Greece 38 15 Spain 63 20 24 Finland 2 France Hungary Ireland 23 Island Italy 29 16 Lithuania Luxembourg 4 Latvia 2 106 124 Malta Netherlands 52 Norway 7 Poland Portugal 387 387 149 Romania 22 149 56 Sweden 78 Slovenia 55 38 78 Slovakia 380 349 47 United Kingdom 1 1767 49 665 2012/2013 2013/2014 IS ACS ACS/IS % IS ACS ACS/IS % Austria 7 1 Belgium Bulgaria 7 Czech Republic 255 217 85% 13 19 146% Germany 289 297 Denmark 10 39 Estonia Greece 38 15 Spain 63 20 24 120% Finland 2 France Hungary Ireland 23 Island Italy 29 16 Lithuania Luxembourg 4 Latvia 2 106 5300% 124 Malta Netherlands 52 Norway 7 Poland Portugal 387 387 100% 149 Romania 22 149 56 38% Sweden 78 Slovenia 55 38 78 205% Slovakia 380 349 92% 47 United Kingdom 1 1767 176700% 49 665 1357% 2012/2013 2013/2014
- 13. Conclusion • Objectives for influenza IS reporting: monitoring the influenza specimens’ availability across Europe • Do the data reported in TESSy inform this objective? • Is this surveillance objective needed at European level? ECDC surveillance strategy : “develop the quality, effectiveness and accessibility of the EU surveillance activities while ensuring that the burden on those contributing to these activities remains congruent with the benefits” • Are there alternative ways to inform the objective? • If not, should ECDC stop collecting these data?
Editor's Notes
- - number of specimens processed per week; - number of isolates obtained by subtype (i.e. A(H1), A(H3), A(H5), pandemic (H1N1) 2009, A(not subtyped) and B); What data are reported??? Which PH information these data provide?
- establishment of the WHO Global Influenza Surveillance Network (GISN). Virological weekly data (INFLVIRWAGGR) The objectives for virological surveillance are: To collect and provide timely information on the distribution of types, subtypes, lineages and clades among circulating influenza viruses over the influenza season. Early warning upon emergence of new subtypes. To assess the start of the influenza season. To monitor the intensity and geographic progression of influenza throughout the season Inform public health preparedness in Europe, especially in countries not yet affected by widespread influenza epidemics, and trigger operational plans (e.g. use of antivirals and personal protective measures). To inform WHO vaccine composition meeting. Aggregated virological data should be reported weekly during the influenza season (week 40 to week 20 of the following year). The metadata includes information on virus detection by (sub-)type from sentinel and non-sentinel sources, number virus (sub-)types isolated by sentinel and non-sentinel sources and characterisation of viruses by genetic and antigenetic methods. In addition to influenza, respiratory syncytial virus (RSV) detections can also be reported from sentinel and non-sentinel sources (see TESSy metadata). The characterisation data of viruses should preferably be reported via the strain-based reporting in the INFLANTIVIR record type (see Influenza antiviral susceptibility strain-based (INFLANTIVIR)). The aggregate reporting for characterisation data should only be used if the country does not have resources for strain-based reporting. The virological data are entered in the week that the swab was taken (by week of sampling). One virus detection corresponds to the detection of influenza in one patient, regardless of the number of specimens taken from that patient, or which technique(s) were used to detect the virus. Case definition Influenza and RSV case definitions are specified in the EU Commission Decision 2012/506/EU of 8 August 2012. Population under surveillance Virological surveillance can be either sentinel or non-sentinel. Surveillance is considered sentinel when virological testing is performed in the same population in which clinical cases are recorded and reported taking a country-wide representative collection scheme into account. The virological surveillance of laboratory-confirmed influenza and RSV in Europe uses the same primary healthcare sentinel network model as the syndromic surveillance of ILI/ARI. The catchment population of the sentinel physicians forms the main population under surveillance. Patients with ILI/ARI (or a subset of these patients) seen by a sentinel physician are swabbed according to a defined sampling protocol. The virological surveillance system also captures non-sentinel detections of influenza virus, but the non-sentinel population under surveillance is not defined in all Member States. Virological data from non-sentinel sources can be from patients presenting at outpatient or inpatient health care facilities, outbreak investigations and as part of enhanced surveillance, for example as performed by countries during the early stages of the pandemic.
- Overall, 16 different countries reported isolation data for at least one season during the study period , 13 (1-7) in the sentinel and 14 (1-8) in the non-sentinel system. However a grate variation of reporting behaviour between countries was observed. Countries reported between 1– 334 considering the two systems
- 0.1% and 100% depending on the country and on the season