Mapping influenza activity in Europe

The Influenza Web-GIS is now available online and can be viewed by clicking here. (JP)

Publication of the 2008 Inter-season Electronic Bulletin has started

The first Inter-season Electronic Bulletin has been published for 2008 (click here).

The Inter-season Electronic Bulletin presents and comments influenza activity based on virological data reported to EISS. The Inter-season Electronic Bulletin will be published between week 21/2008 and week 39/2008. (JP)

Last Weekly Electronic Bulletin of the 2007-2008 season

On 25 April 2008 the last Weekly Electronic Bulletin of the 2007-2008 influenza season was published on the EISS website (click here). As of week 21/2008, the Inter-season Electronic Bulletin will present and comment influenza activity based on virological data reported to EISS. This Inter-season Electronic Bulletin will be published between week 21/2008 and week 39/2009. [AA]

A(H1N1) viruses resistant to oseltamivir

To view the latest data for Europe (including historical data), please click here. (AM)

Emergence of resistance to oseltamivir among influenza A(H1N1) viruses in Europe

Eurosurveillance publication on 31 January 2008: click here
ECDC Editorial in Eurosurveillance on 31 January 2008: click here

Initial VIRGIL/EISS announcement on 25 January 2008: click here

PRESS INFORMATION: Europe’s winter flu season starts

EISS-ECDC Press Release: Utrecht, the Netherlands and Stockholm, Sweden, January 24, 2008: The ‘flu’ has arrived in Europe, according to the European Influenza Surveillance Scheme (EISS) and the European Centre for Disease Prevention and Control (ECDC). The two organisations confirm an upsurge in the number of laboratory confirmed cases of influenza in several European countries.

Click here for the Press Release. (JP)

Europe will probably experience continued low levels of influenza activity over Christmas and New Year

Weekly Electronic Bulletin summary [week 50/2007]:

Levels of influenza activity remained low in Europe, at levels normally
seen outside the seasonal influenza peak period in most countries. A total of 28 countries reported no or only sporadic influenza activity in week 50/2007. The percentage of respiratory specimens testing positive for influenza virus in Europe remains low at about 5%, despite the increase in laboratory confirmed cases for Europe as a whole. Of the total virus detections since week 40, 78% were influenza A of which about 90% were of the H1 subtype.

Click here for the full report. (JP & AA)

Influenza activity in Europe during eight seasons: 1999-2007

The EISS dataset was used to characterise important epidemiological features of influenza activity in Europe during eight winters (1999-2007).

The analysis found that: 1) the clinical data reported by sentinel physicians is a valid indicator of influenza activity; 2) the length of influenza activity across the whole of Europe was surprisingly long, ranging from 12-19 weeks; 3) in 4 out of the 8 seasons, there was a west-east spread of influenza, in 3 seasons a south-north spread; not associated with type of dominant virus in those seasons.

To view the full text, please click here. (JP)

Epidemiological and virological assessment of influenza acitivity in Europe during the winter of 2006-2007

Poster presented at the 2007 European Scientific Conference on Applied Infectious Disease Epidemiology (ESCAIDE), Stockholm, 18-20 October 2007 (click here). (JP and AA)

Influenza activity in Europe during the winter 2005-2006

An epidemiological and virological assessment of the influenza acitivity in Europe during the winter 2005-2006 has been published in Eurosurveillance Monthly.

Influenza activity in Europe during the winter 2005-2006 started late January - early February 2006 and first occurred in the Netherlands, France, Greece and England. Subsequently, countries were affected in a random pattern across Europe and the period of influenza activity lasted till the end of April. In contrast to the winter seasons in the period 2001-2005, no west-east pattern was detected. In 12 out of 23 countries, the consultation rates for influenza-like illness or acute respiratory infection in the winter 2005-2006 were similar or higher than in the winter 2004-2005, despite a dominance of influenza B viruses that normally cause milder disease than influenza A viruses. In the remaining 11 countries the consultation rates were lower to much lower than in the winter 2004-2005. The highest consultation rates were usually observed among children aged 0-14. The circulating influenza virus types and subtypes were distributed heterogeneously across Europe. Although the figures for total virus detections in Europe indicated a predominance of influenza B virus (58% of all virus detections), in many countries influenza B virus was predominant only early in the winter, whilst later there was a marked increase in influenza A virus detections. Among the countries where influenza A viruses were co-dominant with B viruses (9/29) or were predominant (4/29), the dominant influenza A subtype was H3 in seven countries and H1 in four countries. The vast majority of characterised influenza B viruses (90%) were similar to the B/Victoria/2/87 lineage of influenza B viruses that re-emerged in Europe in the winter 2004-2005 but were not included in the vaccine for the influenza season 2005-2006. This might help to explain the dominance of influenza B viruses in many countries in Europe during the winter 2005-2006. The influenza A(H3) and A(H1) viruses were similar to the reference strains included in the 2005-2006 vaccine, A/California/7/2004 (H3N2) and A/New Caledonia/20/99 (H1N1), respectively. In conclusion, the 2005-2006 influenza epidemic in Europe was characterised by moderate clinical activity, a heterogeneous spread pattern across Europe, and a variable virus dominance by country, although an overall dominance of influenza B viruses that did not match the virus strain included in the vaccine was observed.

Click here for the full Eurosurveillance Monthly text.
The supplement can be found here. (AM)

Publication of the EISS Annual Report - 2005-2006 influenza season

The Annual Report is now available on the EISS website (click here). Previous reports can be viewed here. (JP)

Influenza antiviral susceptibility monitoring activities in relation to national antiviral stockpiles in Europe during the winter 2006/2007 season

Due to the influenza pandemic threat, many countries are stockpiling antivirals in the hope of limiting the impact of a future pandemic virus. Since resistance to antiviral drugs would probably significantly alter the effectiveness of antivirals, surveillance programmes to monitor the emergence of resistance are of considerable importance.

During the 2006/2007 influenza season, an inventory was conducted by the European Surveillance Network for Vigilance against Viral Resistance (VIRGIL) in collaboration with the European Influenza Surveillance Scheme (EISS) to evaluate antiviral susceptibility testing by the National Influenza Reference Laboratories (NIRL) in relation to the national antiviral stockpile in 30 European countries that are members of EISS.

All countries except Ukraine had a stockpile of the neuraminidase inhibitor (NAI) oseltamivir. Additionally, four countries had a stockpile of the NAI zanamivir and three of the M2 ion channel inhibitor rimantadine. Of 29 countries with a NAI stockpile, six countries’ NIRLs could determine virus susceptibility by 50% inhibitory concentration (IC50) and in 13 countries it could be done by sequencing. Only in one of the three countries with a rimantadine stockpile could the NIRL determine virus susceptibility, by sequencing only. However, including the 18 countries that had plans to introduce or extend antiviral susceptibility testing, the NIRLs of 21 of the 29 countries with a stockpile would be capable of susceptibility testing appropriate to the stockpiled drug by the end of the 2007/2008 influenza season.

Although most European countries in this study have stockpiles of influenza antivirals, susceptibility surveillance capability by the NIRLs appropriate to the stockpiled antivirals is limited.

Click here for the full Eurosurveillance Monthly text. (AM)

The 2006-2007 influenza season is ending in Europe

Weekly Electronic Bulletin summary [week 12/2007]:

Seasonal influenza activity is declining in all European countries and is now back or almost back to levels seen outside the winter period in most countries. In Denmark consultation rates for influenza-like illness remain at increased levels after peaking in week 10. Influenza A(H3N2) remains the dominant virus in Europe.

Click here to view the full bulletin. (AM)

Declining influenza activity in the West of Europe but increasing in the North-East

This winter, the consultation rates for influenza like illness (ILI) and/or acute respiratory infection (ARI) started to increase around New Year in Scotland, Greece and Spain, where it has already returned to levels seen outside the winter period. For most other countries in the South-West of Europe consultation rates started to increase around mid January 2007 and have passed the peak. In large parts of Central and North-East Europe, activity started to increase in February and is still continuing. All 30 countries participating in EISS have now reported increased levels of influenza activity this winter. Influenza A(H3N2) remains the dominant virus circulating in Europe.

Click here to view the full report published in Eurosurveillance Weekly on 8 March 2007. (AM)

Seasonal influenza beginning in Europe

Increased influenza activity was reported in six countries in the second week of 2007: Greece, the Netherlands, United Kingdom (Northern Ireland), Scotland, Spain and Switzerland. Based on trends of previous years, influenza activity is expected to increase in many more European countries in the weeks ahead. The influenza activity reported so far has mainly been associated with influenza A viruses. (click here to view the full report published in Eurosurveillance Weekly on 25 January 2007 ). (JP)