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Ian Barr WHO Collaborating Centre for Reference & Research on Influenza, Melbourne (Now finally re-located at VIDRL) Influenza surveillance in Australia,

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Presentation on theme: "Ian Barr WHO Collaborating Centre for Reference & Research on Influenza, Melbourne (Now finally re-located at VIDRL) Influenza surveillance in Australia,"— Presentation transcript:

1 Ian Barr WHO Collaborating Centre for Reference & Research on Influenza, Melbourne (Now finally re-located at VIDRL) Influenza surveillance in Australia, NZ & other Southern Hemisphere countries www.influenzacentre.org The Melbourne WHO Collaborating Centre for Reference and Research on Influenza is supported by the Australian Government Department of Health and Ageing.

2 Useful publications on influenza Australian Influenza report NZ Influenza update www.health.gov.au www.surv.esr.cri.nz

3 Influenza like illness in 2009 in Australia Source: ASPREN Source: VIDRL Victoria Australia 2009

4 Laboratory confirmed influenza in Australia (NNDSS figures) 2009 cases by state Australian cases

5 Pandemic H1N1 is the dominant strain circulating – Sentinel surveillance in Victoria Data source VIDRL Sentinel median age 21y vs all Aus. 16y

6 Australian NNDSS lab confirmed influenza by age group; 2009 vs 2007 2009 2007

7 Australian data on Pandemic (HN1) 2009 as at 15 August 2009 29,833 Confirmed cases 29,833 Confirmed cases 3562 people hospitalized 3562 people hospitalized 451 people currently in ICU 451 people currently in ICU Total 108 deaths Total 108 deaths Hospitalised Pregnancy 3% of hospitalised 8/47 to ICU (17%)

8 Time in hospital with H1N1pdm (Queensland by age; up to 31.7.09)

9 Age of Australian fatal cases with Pandemic H1N1 2009 infections Most deaths have had underlying medical conditions; cancer, diabetes, morbid obesity

10 Australian seasonal deaths due to influenza & pneumonia appear to be normal (to July 09)

11 How are alternative influenza monitoring systems performing in the pandemic? Google Flu Trends (as at 14.8.09)

12 And in NZ….. ILI 3051 Confirmed cases H1N1pdm 3051 Confirmed cases H1N1pdm 914 people hospitalized 914 people hospitalized 225 cases pneumonic, 35 ARDS 225 cases pneumonic, 35 ARDS Total 10 deaths Total 10 deaths Data: ESR, up to 9 August

13 Pandemic H1N1 2009 is the predominant strain in NZ this year Data: ESR, up to 9 August Sentinel surveillance

14 Samples received from the region & tested at the WHO CC Melbourne in 2009

15 CDC (USA) analysis of SH H1N1 activity

16 Summary of virus analysis from samples received and tested at Melb. CC Pandemic H1N1 2009 – All very similar to the A/California/7/2009 reference strain Pandemic H1N1 2009 – All very similar to the A/California/7/2009 reference strain Seasonal H1N1 – All very similar to current vaccine strain A/Brisbane/59/2009 Seasonal H1N1 – All very similar to current vaccine strain A/Brisbane/59/2009 H3N2 viruses – Most recent viruses from Australia, Singapore, Philippines are low reactors to A/Brisbane/10/2009 & more A/Perth/16/2009-like H3N2 viruses – Most recent viruses from Australia, Singapore, Philippines are low reactors to A/Brisbane/10/2009 & more A/Perth/16/2009-like B viruses have been very few, mostly B Victoria-like B viruses have been very few, mostly B Victoria-like 2009 vaccine strains 2009 vaccine strains –H1 – A/Brisbane/59/2007-like –H3 – A/Brisbane/10/2007-like (A/Uruguay/716/2007) –B – B/Florida/4/2006-like (B/Yamagata lineage–also B/Brisbane/3/2007)

17 Phylogenetic analysis of H1N1 2009 viruses Common swine ancestor Common swine ancestor Homogeneous so far, few differences (nt or aa) in H1N1 2009 viruses Homogeneous so far, few differences (nt or aa) in H1N1 2009 viruses Distinct from previous swine & human swine viruses Distinct from previous swine & human swine viruses Distinct from seasonal H1N1 viruses Distinct from seasonal H1N1 viruses Reference and vaccine virus is A/California/7/2009 Reference and vaccine virus is A/California/7/2009 Victoria/2025/09 PortMoresby/2001/09 Darwin/2001/09 Victoria/2001/09 Darwin/2004/09 Darwin/2001/09 StAustralia/2001/09 Darwin/2008/09 Brisbane/17/09 Victoria/2029/09 Brisbane/2011/09 Victoria/2024/09 SthAustralia/2002/09dec Canberra/2006/09 Brisbane/2008/09 Shanghai/1/09 Ohio/7/09 NewYork/18/09e Canada-AB/RV1532/09 Victoria/2004/09 Philippines/2003/09 Philippines/2009/09 Victoria/2004/09c Auckland/1/09 Mexico/4482/09e Auckland/4/09 Auckland/3/09 Auckland/2/09 Perth/29/09c Korea/01/09 Philippines/2001/09c England/195/09 Palau/1/09 Mexixo/4176/09 Osaka/1/09 Texas/05/09 NewJersey/02/09 Christchurch/2/09 Philippines/2006/09 California/07/09 California/04/09 Wisconsin/10/98 sw/Ohio/891/01 H1N2 sw/Indiana/9K035/99 H1N2 Philippines/344/04 H1N2 sw/Iowa/31483/88 NewJersey/8/76 Thailand/271/05 Brisbane/1/09 Townsville/1/09 Brisbane/13/09 Brisbane/59/07 Perth/1/09 Darwin/8/08 Brisbane/12/09 Sydney/601/09 SthAustralia/28/08 Guam/1/07 Malaysia/213/08 SolomonIslands/3/06 NewCaledonia/20/99 0.01 Swine H1N1 2009 Swine H1N1/H1N2 1976-2005 Seasonal H1N1 1999-2009 Vaccine H1 Haemagglutinin gene

18 Few antigenic differences in H1N1 2009 (by HI or virus neutralization assays) All H1N1 2009 viruses similar to the vaccine strain A/California/7/2009 Virus Ferret sera Brisb Cal 7 Auck A/Brisb/59/2007 H1 seasonal 640<80<20 A/Cal/7/2009 H1N1 pandemic <20640320 A/Auck/1/2009 H1N1 pandemic <201280320 A/Perth/36/2009<202560640 A/Brisbane/51/2009<202560640 A/Canberra/2023/2009<201280320 A/Darwin/2003/2009<20640320 A/Tasmania/2002/2009<201280640 A/Victoria/2022/2009<20640320

19 February 2009 March 2009 April 2009 May 2009 June 2009 vaccine strain e: egg isolate HI reference antigen Victoria/505/09 5/09 Sydney/31/08 6/09 Sydney/25/09 6/09 Sydney/45/09 6/09 Guam/2/09 5/09 Guam/1/09 5/09 Chuuk/3/09 6/09 Johannesburg/883/09 6/09 CapeTown/783/09 5/09 Perth/26/09 5/09 PortMoresby/9/09 6/09 PtMoresby/2/09 6/09 Malaysia/542/09 3/09 Philippines/40/09 4/09 Malaysia/788/09 5/09 PHILIPPINES/16/09 3/09 Philippines/5/09 3/09 Malaysia/614/09 4/09 Perth/15/09 4/09 PERTH/16/09e 4/09 Perth/14/09 4/09 Brisbane/52/09 5/09 Singapore/34/09 6/09 Singapore/39/09 3/09 Victoria/209/09e 6/09 Darwin/7/09 6/09 Singapore/22/09 3/09 Johannesburg/1006/09 6/09 WesternSepik/109/09 6/09 Victoria/206/09 6/09 Malaysia/720/09 5/09 Brisbane/14/09 2/09 Victoria/231/08 10/08 SthAustralia/59/08 10/08 Victoria/542/08 12/08 Singapore/619/08 11/08 Sydney/301/09 2/09 Philippines/3688/08 11/08 Taiwan/724/09 4/09 Perth/13/09 Singapore/32/09 3/09 Durban/863/09 6/09 Johannesburg/753/09 6/09 Perth/109/08res 9/08 Sydney/29/08 8/08 Singapore/631/08 12/08 SriLanka/21/08 5/08 Darwin/1/08res 8/08 Auckland/121/08 8/08 Sydney/31/08 7/08 Waikato/6/08 5/08res Tasmania/4/08res 6/08 Victoria/530/08 10/08 NewYork/09/08cdc 4/08 Philippines/3803/08 11/08 Victoria/500/08 Sydney/602/09 Sydney/603/09 2/09 Montana/02/08cdc 12/08 Townsville/2/09 2/09 Darwin/7/08 10/08 Victoria/502/09res 1/09 SURATTHANI/72/09 2/09 Macau/1343/08 7/04 Tasmania/201/08 9/08 Virginia/4/07e 1/08 BRISBANE/24/08e 6/08 Thailand/519/08 5/08 Perth/201/08e 7/08 Thailand/508/08 5/08 Cambodia/3/08res Thailand/561/08 6/08 Singapore/215/08 Singapore/21/08 Philippines/1713/08 4/08 Taiwan/471/08niid 4/08 Victoria/500/09 1/09 Wisconsin/3/07e cdc 1/07 URUGUAY/716/07e cdc Malaysia/0032/0res9 1/09 Thailand/563/08res 6/08 Singapore/241/08 6/08 Malaysia/306/08 BRISBANE/10/07e 2/07 PERTH/27/07 7/07 BRISBANE/9/06e 6/06sen Nepal/921/06e 7/06 sen Thailand/31/07 1/07 sen Brisbane/4/07e 1/07res WISCONSIN/67/05e res California/7/04 9/04 sen NEWYORK/55/04 11/04 0.01 S193F D225N G50E K140I K173Q N144K T212A I260M R261Q E62K K158N N189K I214S V213A A/Brisbane/10/2007 A/Uruguay/617/2007 A/Perth/16/2009-like H3 HA genes

20 Summary Australia, NZ and other Sth Hemisphere countries dominated by Pandemic H1N1 Australia, NZ and other Sth Hemisphere countries dominated by Pandemic H1N1 Outbreaks have been short/sharp but cases still persist in most countries Outbreaks have been short/sharp but cases still persist in most countries Children & young adults most infected Children & young adults most infected Disease has been relatively mild but has affected some groups disproportionally eg. Pregnant women, aboriginals, obese patients Disease has been relatively mild but has affected some groups disproportionally eg. Pregnant women, aboriginals, obese patients Pandemic H1N1 viruses very similar to A/California/7/2009 reference/vaccine virus Pandemic H1N1 viruses very similar to A/California/7/2009 reference/vaccine virus Emergence of a H3N2 variant – A/Perth/16/2009-like Emergence of a H3N2 variant – A/Perth/16/2009-like WHO Sth Hem. Formulation meeting in Melbourne 18-23 Sept. 2009, followed by 5 th AIS 24-25 Sept. WHO Sth Hem. Formulation meeting in Melbourne 18-23 Sept. 2009, followed by 5 th AIS 24-25 Sept.

21 Melbourne WHO Influenza Centre Staff and collaborators Other collaborators Heath Kelly Paul Selleck Deb Middleton Sue Lowther Lori Brown Steve Rockman Peter Schoofs Phil Franchina Malik Peiris Wilina Lim Other CC’s Other Labs WPROVIDRLAAHLAAHLAAHLUMCSLCSLCSLHKU HK PKL NIC’sNHMRCDoHA

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