First influenza virus detections in Europe: 2004-2005 season, European

First influenza virus detections in Europe: 2004-2005 season, European Influenza Surveillance Scheme




John Paget1 (j.paget@nivel.nl) Adam Meijer1, Olav Hungnes2




1 EISS co-ordination centre, NIVEL, Utrecht, the Netherlands
2 Norwegian Institute of Public Health, Oslo, Norway




Active surveillance of influenza in Europe by the European Influenza Surveillance Scheme (EISS, http://www.eiss.org) started in week 40 of 2004 (27 September - 3 October). EISS will present data on a weekly basis for 22 countries (19 European Union member states, plus Norway, Romania and Switzerland) during the 2004-2005 season. The current level of influenza activity is low, with only sporadic cases of laboratory confirmed influenza. One of the laboratory confirmed cases of influenza resembled viruses seen recently in the southern hemisphere.


Current situation
Based on data reported so far, the current level of influenza activity in Europe is low (at baseline levels) and there are only sporadic cases of laboratory confirmed influenza.




Among respiratory specimens reported to EISS between week 36 and week 40 of 2004 (n=590; EISS database query made on 8 October 2004 at 09:05a.m.), there were four laboratory confirmed cases of influenza A. The cases were detected in Norway (week 36; H3N2), England (week 39; untyped), Ireland (week 40; untyped) and the Czech Republic (week 40; untyped). There was also a report (in the comment section of the EISS database) of two 磇mported?cases of influenza A(H3) in France in week 39, in patients returning from China.




The Norwegian isolate has been characterised, both antigenically and genetically, and was found to be an A/Wellington/1/2004(H3N2)-like virus. This strain was recently recommended for the 2005 southern hemisphere vaccine and is antigenically distinguishable from the A/Fujian/411/2002(H3N2)-like virus [1]. There was no indication that the patient, an adult woman presenting with fever, had recently travelled abroad.




Response to the H5N1 avian influenza in South East and East Asia
In response to the outbreaks of H5N1 avian influenza in birds in South East and East Asia [2], the deaths and probable transmission among humans associated with this subtype [2,3], there has been preparation for the possible spread of influenza A(H5N1) in Europe. The first initiative was the exchange of polymerase chain reaction (PCR) protocols between the 32 laboratories participating in the Community Network of Reference Laboratories for Human Influenza in Europe [4], and making available positive controls to validate the protocols, so that all laboratories could test for this subtype. As of the end of 2003, 19 of 26 laboratories that responded to a questionnaire were able to detect the A(H5) virus, and 21 laboratories reported that they had the BSL-3 laboratory facilities [4] required by World Health Organization (WHO) guidelines to do more extensive analysis [5]. We have also modified the EISS database, so that information on this virus can be collected and communicated quickly via the EISS website and Weekly Electronic Bulletin if this subtype is detected in Europe. Finally, the EISS team are helping the European Commission抯 Directorate-General of Health and Consumer Protection (DG SANCO) to prepare different responses to the detection of influenza A(H5N1) according to the phases and levels defined in the European pandemic preparedness plan [6].




EISS will monitor the spread of influenza virus strains and their epidemiological impact in Europe during the 2004-2005 season in collaboration with the WHO Collaborating Centre in London (http://www.nimr.mrc.ac.uk/wic/). The first Weekly Electronic Bulletin of the 2004-2005 season will be published on 15 October (http://www.eiss.org/cgi-files/bulletin_v2.cgi). The bulletin will appear each week until the end of April 2005.







References:






  1. WHO Communicable Disease Surveillance & Response. Recommended composition of influenza virus vaccines for use in the 2005 influenza season. 23 September 2004. (http://www.who.int/entity/csr/disease/influenza/en/2005southinfluenza2.pdf)


  2. Goddard N. Avian influenza update: an H5N1 in South East and East Asia, and humans in Vietnam and Thailand. Eurosurveillance Weekly 2004; 8(7): 12/02/2004. (http://www.eurosurveillance.org/ew/2004/040212.asp)


  3. WHO Communicable Disease Surveillance & Response. Avian influenza ?situation in Thailand. 28 September 2004. (http://www.who.int/csr/don/2004_09_28a/en/)


  4. Meijer A, Paget J, van der Velden K. The Community Network of Reference Laboratories for Human Influenza in Europe: infrastructure, tasks and achievements [poster]. Second European Congress of Virology. 5-9 September 2004; Madrid, Spain. Abstract P8 10. (available at http://www.eiss.org/documents/eiss_poster_cnrl.pdf)


  5. WHO Communicable Disease Surveillance & Response. WHO laboratory biosafety guidelines for handling specimens suspected of containing highly pathogenic avian influenza A/H5 virus. 11 February 2004. (http://www.who.int/entity/csr/disease/avian_influenza/guidelines/handlingspecimens/en)


  6. Commission of the European Communities. Commission Working Paper on Community Influenza Pandemic Preparedness and Response Planning. Brussels: Commission of the European Communities; 26 March 2004.(http://europa.eu.int/comm/health/ph_threats/com/Influenza/com_2004_201_en.pdf)