1. 1 Division of Health Security and Emergencies (DSE) WHO Western Pacific Regional Office (WPRO) Fifth Meeting of National Influenza Centres in the Western Pacific and South East Asia Regions 7 June 2011 Vientiane, Lao PDR Summary of Influenza Activity June 2010 - May 2011 Dr Jeffrey Partridge (PhD) WHO/WPRO/ESR

2. 2 Division of Health Security and Emergencies (DSE) WHO Western Pacific Regional Office (WPRO) Influenza Updates Bi-weekly Influenza Updates for the Western Pacific Region http://www.wpro.who.int/health_topics/influenza/

3. 3 Division of Health Security and Emergencies (DSE) WHO Western Pacific Regional Office (WPRO) 37 – Countries & Areas 3 – WHO Collaborating Centers 21 – National Influenza Centers in 15 countries WHO CCs and NICs - WPR

4. 4 Division of Health Security and Emergencies (DSE) WHO Western Pacific Regional Office (WPRO) Number of specimens processed by week by GISN (From 30 May 2010 to 8 May 2011) 379,514 215,354 76,622 12,955 September Wk 35 12,313 September Wk 35 6073 January Wk 1 Data source: FluNet, Global Influenza Surveillance Network (GISN) 10 countries 12 countries

5. 5 Division of Health Security and Emergencies (DSE) WHO Western Pacific Regional Office (WPRO) Percentage of influenza viruses by subtypes (From 30 May 2010 to 8 May 2011)

6. 6 Division of Health Security and Emergencies (DSE) WHO Western Pacific Regional Office (WPRO) Number of specimens positive for influenza by subtypes (From 30 May 2010 to 8 May 2011) Data source: FluNet, Global Influenza Surveillance Network (GISN)

7. 7 Division of Health Security and Emergencies (DSE) WHO Western Pacific Regional Office (WPRO) Avian Influenza H5N1 As of 3 June 2011, only Cambodia has reported cases in 2011—there have been 5 cases, all of which were fatal

8. 8 Division of Health Security and Emergencies (DSE) WHO Western Pacific Regional Office (WPRO) Current situation (mid-April to mid-May 2011) ILI activity low in Northern Hemisphere, Tropics, and Southern Hemisphere Mix of influenza viruses reported from nine countries, but predominantly B viruses (>70% of positives) followed by A/H3 then A/H1N1

9. 9 Division of Health Security and Emergencies (DSE) WHO Western Pacific Regional Office (WPRO) Epidemiological and Virological characteristics of influenza in the Western Pacific Region, 2008 - 2010

10. 10 Division of Health Security and Emergencies (DSE) WHO Western Pacific Regional Office (WPRO) Aims To summarize the available epidemiological and virological data on influenza from the Western Pacific Region from 2008-2010 Contribute to an improved understanding of disease burden in the Western Pacific Region Identify areas for improvement for surveillance and reporting

11. 11 Division of Health Security and Emergencies (DSE) WHO Western Pacific Regional Office (WPRO) Methods Influenza disease data was collected via survey conducted by 16 countries or areas Requested each country's or area's weekly or monthly data by age group: –influenza-like illness (ILI) –acute respiratory infection (ARI) –severe acute respiratory infection (SARI) –all-cause outpatient visits or hospital admissions data Virological data extracted from the Global Influenza Surveillance Network (GISN) database, FluNet and validated and updated as required

12. 12 Division of Health Security and Emergencies (DSE) WHO Western Pacific Regional Office (WPRO) Results All 16 countries or areas responded to the survey Surveillance systems and data collection methods, cases definitions, and age categorizations varied across the region ILI, SARI and ARI were reported from 14, 5, and 4 countries or areas, respectively

13. 13 Division of Health Security and Emergencies (DSE) WHO Western Pacific Regional Office (WPRO) Challenges Many! Data Collection –Not easy to access for all countries or areas –Time-consuming Variations in collection methods –Different case definitions –Different methodology in collection/sampling –Age groups different

14. 14 Division of Health Security and Emergencies (DSE) WHO Western Pacific Regional Office (WPRO) More Challenges Missing data –Denominator data –Some data not available e.g. missing years Interpretation issues –Changes to case definitions (within countries or areas) –Plausibility issues – some data doesn't make sense e.g. ILI case number is higher than denominator data –Three years is a small time period to determine patterns, particularly as this period included the 2009 pandemic –Not enough data on ARI, SARI and age data to make any solid conclusions

15. 15 Division of Health Security and Emergencies (DSE) WHO Western Pacific Regional Office (WPRO) Next steps Looking for guidance and advice from you tomorrow during Group Work 2 Identify areas for improvement for surveillance and reporting Try this exercise again in 5 years??

16. 16 Division of Health Security and Emergencies (DSE) WHO Western Pacific Regional Office (WPRO) Thank You National Center for Laboratory and Epidemiology, Laos PDR, Became the newest NIC in the WPR on 16 August 2010. On October 28, 2010 Chinese National Influenza Center, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention was officially designated a WHO Collaborating Center for Reference and Research on Influenza.