scholarly journals Implementation of Real-Time Laboratory-Based Influenza Surveillance System, Thailand

2018 ◽  
Vol 10 (1) ◽  
Author(s):  
Phunlerd Piyaraj ◽  
Nira Pet-hoi ◽  
Chaiyos Kunanusont ◽  
Supanee Sangiamsak ◽  
Somsak Wankijcharoen ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Influenza Virus ◽  
Real Time ◽  
Surveillance System ◽  
Influenza A ◽  
Medical Services ◽  
Influenza Surveillance ◽  
Surveillance Systems ◽  
Private Hospitals ◽  
Influenza A H1n1

Objective: We describe the Bangkok Dusit Medical Services Surveillance System (BDMS-SS) and use of surveillance efforts for influenza as an example of surveillance capability in near real-time among a network of 20 hospitals in the Bangkok Dusit Medical Services group (BDMS).Introduction: Influenza is one of the significant causes of morbidity and mortality globally. Previous studies have demonstrated the benefit of laboratory surveillance and its capability to accurately detect influenza outbreaks earlier than syndromic surveillance.1-3 Current laboratory surveillance has an approximately 4-week lag due to laboratory test turn-around time, data collection and data analysis. As part of strengthening influenza virus surveillance in response to the 2009 influenza A (H1N1) pandemic, the real-time laboratory-based influenza surveillance system, the Bangkok Dusit Medical Services Surveillance System (BDMS-SS), was developed in 2010 by the Bangkok Health Research Center (BHRC). The primary objective of the BDMS-SS is to alert relevant stakeholders on the incidence trends of the influenza virus. Type-specific results along with patient demographic and geographic information were available to physicians and uploaded for public health awareness within 24 hours after patient nasopharyngeal swab was collected. This system advances early warning and supports better decision making during infectious disease events.2 The BDMS-SS operates all year round collecting results of all routinely tested respiratory clinical samples from participating hospitals from the largest group of private hospitals in Thailand.Methods: The BDMS has a comprehensive network of laboratory, epidemiologic, and early warning surveillance systems which represents the largest body of information from private hospitals across Thailand. Hospitals and clinical laboratories have deployed automatic reporting mechanisms since 2010 and have effectively improved timeliness of laboratory data reporting. In April 2017, the capacity of near real-time influenza surveillance in BDMS was found to have a demonstrated and sustainable capability.Results: From October 2010 to April 2017, a total of 482,789 subjects were tested and 86,110 (17.8%) cases of influenza were identified. Of those who tested positive for influenza they were aged <2 years old (4.6%), 2-4 year old (10.9%), 5-14 years old (29.8%), 15-49 years old (41.9%), 50-64 years old (8.3%) and >65 years old (3.7%). Approximately 50% of subjects were male and female. Of these, 40,552 (47.0%) were influenza type B, 31,412 (36.4%) were influenza A unspecified subtype, 6,181 (7.2%) were influenza A H1N1, 4,001 (4.6%) were influenza A H3N2, 3,835 (4.4%) were influenza A seasonal and 196 (0.4%) were respiratory syncytial virus (RSV).The number of influenza-positive specimens reported by the real-time influenza surveillance system were from week 40, 2015 to week 39, 2016. A total of 117,867 subjects were tested and 17,572 (14.91%) cases tested positive for the influenza virus (Figure 1). Based on the long-term monitoring of collected information, this system can delineate the epidemiologic pattern of circulating viruses in near real-time manner, which clearly shows annual peaks in winter dominated by influenza subtype B in 2015-1016 season. This surveillance system helps to provide near real-time reporting, enabling rapid implementation of control measures for influenza outbreaks.Conclusions: This surveillance system was the first real-time, daily reporting surveillance system to report on the largest data base of private hospitals in Thailand and provides timely reports and feedback to all stakeholders. It provides an important supplement to the routine influenza surveillance system in Thailand. This illustrates a high level of awareness and willingness among the BDMS hospital network to report emerging infectious diseases, and highlights the robust and sensitive nature of BDMS’s surveillance system. This system demonstrates the flexibility of the surveillance systems in BDMS to evaluate to emerging infectious disease and major communicable diseases. Through participation in the Thailand influenza surveillance network, BDMS can more actively collaborate with national counterparts and use its expertise to strengthen global and regional surveillance capacity in Southeast Asia, in order to secure advances for a world safe and secure from infectious disease. Furthermore, this system can be quickly adapted and used to monitor future influenzas pandemics and other major outbreaks of respiratory infectious disease, including novel pathogens.

scholarly journals Epidemiology of influenza: findings from surveillance system of 40 hospital in Thailand, 2010-2019

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
T Eamchotchawalit ◽  
P Piyaraj ◽  
P Narongdej ◽  
S Charoensakulchai ◽  
C Chanthowong
Keyword(s):  
Real Time ◽  
Surveillance System ◽  
Influenza A ◽  
Seasonal Influenza ◽  
Influenza Viruses ◽  
Cold Chain ◽  
Influenza Surveillance ◽  
Influenza B ◽  
Private Hospitals ◽  
Influenza A H1n1

Abstract Background Although recent efforts from some Asian countries to describe burden of influenza disease and seasonality, these data are missing for the vast majority, including the private section of Thailand. A near real-time laboratory-based influenza surveillance system, in a network of 40 hospitals was implemented aiming to determine influenza strains circulating in the private hospitals of Thailand and know characteristics, trend and burden of influenza viruses. Methods We obtained the data by monitoring patients with influenza-like illness (ILI) at a network of 40 private hospitals across Thailand. Throat-swab specimens in viral transport media were collected and transported within 24 h of collection using a cold-chain system. The respiratory samples were tested by rapid influenza diagnostic tests and real-time reverse transcription polymerase chain reaction. Results From January 2010 to November 2019, a total of 1,300,594 subjects were tested and 320,499 cases of influenza were identified. Of those positive cases, 116,317(36.3%) were influenza type B, 185,512(57.9%) were influenza A unspecified subtype, 8,833(2.7%) were influenza A(H1N1)pdm2009 and 6,371(1.9%) were seasonal influenza A(H3N2). Positive rate were 50.5 and 49.5 in female and male. Positivity rate was 41.4% in persons 15-49 years followed by 29.1% in 15-14 years, 17.6% in under five children and 11.7% in &gt; 49 years. In 2018-2019 season, the highest positivity rate observed in February and March (39.3%) followed by April (34.2%) and January (32.3%) while the lowest positivity rate was in May (18.1%). Conclusions In Thailand, seasonal Influenza A(H3N2), Influenza A(H1N1)pdm2009 and Influenza B viruses were circulating during 2010-2019. In last season, positivity rate and number of cases peaked in February and March. Key messages Influenza is one of public health problems in Thailand. The need to introduce influenza vaccine and antivirus is important to prevent and treat the disease in future.

scholarly journals Electronic real-time surveillance for influenza-like illness: experience from the 2009 influenza A(H1N1) pandemic in Denmark

2011 ◽  
Vol 16 (3) ◽  
Author(s):  
K M Harder ◽  
P H Andersen ◽  
I Bæhr ◽  
L P Nielsen ◽  
S Ethelberg ◽  
...  
Keyword(s):  
Real Time ◽  
Surveillance System ◽  
Influenza A ◽  
Daily Basis ◽  
Influenza Surveillance ◽  
Situational Analysis ◽  
Influenza Like Illness ◽  
Electronic Reporting ◽  
Influenza A H1n1 ◽  
Sentinel Surveillance System

To enhance surveillance for influenza-like illness (ILI) in Denmark, a year-round electronic reporting system was established in collaboration with the Danish medical on-call service (DMOS). In order to achieve real-time surveillance of ILI, a checkbox for ILI was inserted in the electronic health record and a system for daily transfer of data to the national surveillance centre was implemented. The weekly number of all consultations in DMOS was around 60,000, and activity of ILI peaked in week 46 of 2009 when 9.5% of 73,723 consultations were classified as ILI. The incidence of ILI reached a maximum on 16 November 2009 for individuals between five and 24 years of age, followed by peaks in children under five years, adults aged between 25 and 64 years and on 27 November in senior citizens (65 years old or older). In addition to the established influenza surveillance system, this novel system was useful because it was timelier than the sentinel surveillance system and allowed for a detailed situational analysis including subgroup analysis on a daily basis.

scholarly journals Pandemic H1N1 influenza surveillance in Victoria, Australia, April – September, 2009

2009 ◽  
Vol 14 (42) ◽  
Author(s):  
J E Fielding ◽  
N Higgins ◽  
J E Gregory ◽  
K A Grant ◽  
M G Catton ◽  
...  
Keyword(s):  
General Practitioner ◽  
Surveillance System ◽  
Influenza A ◽  
Sentinel Surveillance ◽  
Influenza Surveillance ◽  
Surveillance Systems ◽  
Pandemic H1n1 ◽  
First Case ◽  
Influenza A H1n1 ◽  
Sentinel Surveillance System

Victoria was the first Australian state to report widespread transmission of pandemic H1N1 2009 influenza. Notifiable laboratory-confirmed influenza and a general practitioner sentinel surveillance system measuring influenza-like illness (ILI), including laboratory confirmation of influenza as the cause of ILI, were used to assess the pandemic. The pandemic influenza A(H1N1)v virus quickly became the dominant circulating strain and notification rates were highest in children and young adults. Despite a high number of notified cases, comparison of ILI rates suggested the season peaked in late June, was similar in magnitude to 2003 and 2007 and less severe than 1997. The majority of clinical presentations were mild, but one quarter of hospitalised cases required admission to intensive care. Given the low proportion of imported cases in the Victorian pandemic, the rapid increase in cases with no travel history and the low median age of cases notified during the phases of intense surveillance, we suggest there may have been silent importations of pandemic virus into Victoria before the first case was recognised. The usefulness of a general practitioner sentinel surveillance system to provide a comparable assessment of influenza and ILI activity over time was clearly demonstrated, and the need for similar hospital and mortality surveillance systems for influenza in Victoria was highlighted.

Dual and Triple Infections With Influenza A and B Viruses: A Case-Control Study in Southern Brazil

2019 ◽  
Vol 220 (6) ◽  
pp. 961-968 ◽  
Author(s):  
Tatiana Schäffer Gregianini ◽  
Ivana R Santos Varella ◽  
Patricia Fisch ◽  
Letícia Garay Martins ◽  
Ana B G Veiga
Keyword(s):  
Influenza Virus ◽  
Influenza A ◽  
Clinical Symptoms ◽  
Antiviral Treatment ◽  
Influenza Virus Infection ◽  
H3n2 Virus ◽  
Influenza Surveillance ◽  
Influenza B Virus ◽  
Influenza B ◽  
Influenza A H1n1

Abstract Influenza surveillance is important for disease control and should consider possible coinfection with different viruses, which can be associated with disease severity. This study analyzed 34 459 patients with respiratory infection from 2009 to 2018, of whom 8011 were positive for influenza A virus (IAV) or influenza B virus (IBV). We found 18 cases of dual influenza virus infection, including coinfection with 2009 pandemic influenza A(H1N1) virus (A[H1N1]pdm09) and influenza A(H3N2) virus (1 case), A(H1N1)pdm09 and IBV (6 cases), A(H3N2) and IBV (8 cases), and nonsubtyped IAV and IBV (3 cases); and 1 case of triple infection with A(H3N2), A(H1N1)pdm09, and IBV. Compared with 76 monoinfected patients, coinfection was significantly associated with cardiopathy and death. Besides demographic characteristics and clinical symptoms, we assessed vaccination status, antiviral treatment, timeliness of antiviral use, hospitalization, and intensive care unit admission, but no significant differences were found between coinfected and monoinfected cases. Our findings indicate that influenza virus coinfection occurs more often than previously reported and that it can lead to a worse disease outcome.

scholarly journals Detecting influenza and emerging avian influenza virus by influenza and pneumonia surveillance systems in a large city in China, 2005 to 2016

2019 ◽  
Author(s):  
Xiaorong Guo ◽  
Dong Yang ◽  
Ruchun Liu ◽  
Yaman Li ◽  
Qingqing Hu ◽  
...  
Keyword(s):  
Influenza Virus ◽  
Avian Influenza ◽  
Avian Influenza Virus ◽  
Influenza A ◽  
Influenza Viruses ◽  
Surveillance Systems ◽  
Avian Influenza Viruses ◽  
Influenza A H1n1 ◽  
Death Cases ◽  
Positive Results

Abstract Background: Detecting avian influenza virus has become an important public health strategy for controlling the emerging infectious disease. This study aimed to analyze the efficiency of two surveillance systems in detecting the emerging avian influenza viruses. Methods: A modified influenza surveillance system (ISS) and a new built pneumonia surveillance system (PSS) have been used to monitor the viruses in Changsha City, China. The ISS is based on monitoring outpatients in two sentinel hospitals to detect mild influenza and avian influenza cases, and PSS is based on monitoring inpatients in all 49 hospitals to detect severe and death influenza cases. Results: During the study period, 3551917 outpatients were monitored by the ISS system, among which 126076 were influenza-like illness (ILI) cases, with the ILI% of 3.55%. Totally, 14913 throat swabs were collected by the ISS system, among which 2016 were tested positive of influenza or avian influenza virus. Among the positive results, 621 were H3N2, 135 were seasonal H1N1, 610 were influenza A/H1N1 (pandemic in 2009), 106 were untyped influenza A, 540 were B, 1 was H5N6, 1 was H7N9, and 2 were H9N2 virus. 5491560 inpatient people were monitored by the PSS system, among which 6.61% (362743/5491560) were pneumonia cases. 10.55% (38260/362743) of reported pneumonia was severe or death cases. 3401 throat swab or lower respiratory tract samples were collected, among which 2094 were tested positive of influenza or avian influenza virus. Among the positive results, 78 were H3N2, 17 were seasonal H1N1, 1871 were influenza A/H1N1, 103 were untyped influenza A, 16 were B, 1 was H5N6, and 8 were H7N9 virus. Of 15 avian influenza cases reported from January, 2005 to September, 2016, 26.7% (4/15) were mild cases detected by the ISS system, while 60.0% (9/15) were severe or death cases detected by the PSS system. Two H5N1 severe cases were missed by the ISS system in January, 2009 when the PSS system was not available. Conclusion: The two systems seem to be of high efficiency in detecting the emerging avian influenza viruses but need to be verified in other cities or countries.

Implementation of Real-Time Laboratory-Based Influenza Surveillance System, a Network of 20 Hospitals in Bangkok Dusit Medical Services Public Company Limited, Thailand

2017 ◽  
Vol 13 (02) ◽  
pp. 1-4
Author(s):  
Phunlerd Piyaraj ◽  
Nira Pet-hoi ◽  
Chaiyos Kunanusont ◽  
Supanee Sangiamsak ◽  
Somsak Wankijcharoen ◽  
...  
Keyword(s):  
Real Time ◽  
Surveillance System ◽  
Medical Services ◽  
Influenza Surveillance ◽  
System A ◽  
Company Limited ◽  
Public Company

scholarly journals Detecting influenza and emerging avian influenza virus by influenza and pneumonia surveillance systems in a large city in China, 2005 to 2016

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Xiaorong Guo ◽  
Dong Yang ◽  
Ruchun Liu ◽  
Yaman Li ◽  
Qingqing Hu ◽  
...  
Keyword(s):  
Influenza Virus ◽  
Avian Influenza ◽  
Avian Influenza Virus ◽  
Surveillance System ◽  
Large City ◽  
Influenza Viruses ◽  
Influenza Surveillance ◽  
Surveillance Systems ◽  
Incident Cases ◽  
Death Cases

Abstract Background Detecting avian influenza virus has become an important public health strategy for controlling the emerging infectious disease. Methods The HIS (hospital information system) modified influenza surveillance system (ISS) and a newly built pneumonia surveillance system (PSS) were used to monitor the influenza viruses in Changsha City, China. The ISS was used to monitor outpatients in two sentinel hospitals and to detect mild influenza and avian influenza cases, and PSS was used to monitor inpatients in 49 hospitals and to detect severe and death influenza cases. Results From 2005 to 2016, there were 3,551,917 outpatients monitored by the ISS system, among whom 126,076 were influenza-like illness (ILI) cases, with the ILI proportion (ILI%) of 3.55%. After the HIS was used, the reported incident cases of ILI and ILI% were increased significantly. From March, 2009 to September, 2016, there were 5,491,560 inpatient cases monitored by the PSS system, among which 362,743 were pneumonia cases, with a proportion of 6.61%. Among pneumonia cases, about 10.55% (38,260/362,743) of cases were severe or death cases. The pneumonia incidence increased each year in the city. Among 15 avian influenza cases reported from January, 2005 to September, 2016, there were 26.7% (4/15) mild cases detected by the HIS-modified ISS system, while 60.0% (9/15) were severe or death cases detected by the PSS system. Two H5N1 severe cases were missed by the ISS system in January, 2009 when the PSS system was not available. Conclusions The HIS was able to improve the efficiency of the ISS for monitoring ILI and emerging avian influenza virus. However, the efficiency of the system needs to be verified in a wider area for a longer time span in China.

Absenteeism in schools during the 2009 influenza A(H1N1) pandemic: a useful tool for early detection of influenza activity in the community?

2011 ◽  
Vol 140 (7) ◽  
pp. 1328-1336 ◽  
Author(s):  
E. O. KARA ◽  
A. J. ELLIOT ◽  
H. BAGNALL ◽  
D. G. F. FOORD ◽  
R. PNAISER ◽  
...  
Keyword(s):  
Syndromic Surveillance ◽  
Influenza A ◽  
Laboratory Data ◽  
Influenza Surveillance ◽  
Surveillance Systems ◽  
H1n1 Pandemic ◽  
School Absenteeism ◽  
Sentinel Network ◽  
Influenza A H1n1 ◽  
Influenza Activity

SUMMARYCertain influenza outbreaks, including the 2009 influenza A(H1N1) pandemic, can predominantly affect school-age children. Therefore the use of school absenteeism data has been considered as a potential tool for providing early warning of increasing influenza activity in the community. This study retrospectively evaluates the usefulness of these data by comparing them with existing syndromic surveillance systems and laboratory data. Weekly mean percentages of absenteeism in 373 state schools (children aged 4–18 years) in Birmingham, UK, from September 2006 to September 2009, were compared with established syndromic surveillance systems including a telephone health helpline, a general practitioner sentinel network and laboratory data for influenza. Correlation coefficients were used to examine the relationship between each syndromic system. In June 2009, school absenteeism generally peaked concomitantly with the existing influenza surveillance systems in England. Weekly school absenteeism surveillance would not have detected pandemic influenza A(H1N1) earlier but daily absenteeism data and the development of baselines could improve the timeliness of the system.

scholarly journals Enhancement of the Influenza Surveillance System in the Russian Federation: the Main Results of the Sentinel Surveillance for Influenza and other Acute Respiratory Viral Infections

2017 ◽  
Vol 16 (1) ◽  
pp. 7-15 ◽  
Author(s):  
A. A. Sominina ◽  
E. A. Smorodintseva ◽  
K. A. Stolyarov ◽  
A. A. Mel'nikova
Keyword(s):  
Respiratory Infection ◽  
Surveillance System ◽  
Acute Respiratory Infection ◽  
Influenza A ◽  
Hospitalized Patients ◽  
Sentinel Surveillance ◽  
Influenza Surveillance ◽  
Influenza B Virus ◽  
Influenza B ◽  
Influenza A H1n1

Existing influenza surveillance system is constantly improved to obtain comprehensive information for understanding of continuously changing situation with the influenza, which is a consequence of the highest variability of the pathogen, its ability to reassortment and the imminence of emergence a new shift-variants of the virus that could cause the next pandemic events. For this purpose, since the 2010 - 2011 epidemic season, in addition to the traditional surveillance system (TS) a new well standardized sentinel surveillance system (SS) for rapid clinical and epidemiological data obtaining was introduced in Russia. A total 7812 hospitalized patients with severe acute respiratory infection (SARI) and 9854 outpatients with influenza-like illness and acute respiratory infection (ILI/ARI) were investigated during the 6-year period in SS. Percent of SARI among all hospitalized patients ranged from 1.7 to 3.1%; about 5.3 - 7.5% SARI patients were placed in the Intensive Care Unit. Etiological monitoring using PCR showed influenza spread trends in SS similar to those registered in the TS: a clear predominance of influenza A (H1N1) pdm09 among SARI and ILI/ARI in 2010 - 2011 and 2015 - 2016 epidemic seasons, influenza A (H3N2) in the epidemic seasons 2011 - 2012 and 2014 - 2015, the co-circulation of these pathogens in 2012 - 2013, 2013 - 2014 seasons in Russia. SARI caused by influenza B virus were detected less frequently than influenza A but increased influenza B activity was registered in the epidemic of 2014 -2015, when Yamagata lineage changed suddenly for the Victorian one. The average frequency of influenza diagnosis among SARI between the seasons varied in the range 12.5 - 27.1%, at the peak of the epidemic it reached 44.8 - 73.5% and was the highest during the season with active circulation of influenza A (H1N1) pdm09 virus. The rate of influenza diagnosis among ILI/ARI has always been lower than that among SARI. Studies have also shown the importance of rhinovirus, RS-virus and parainfluenza infections in SARI development. The frequency of registration of coronaviruses, metapneumovirus and bocavirus infection was very low in SARI and ILI/ARI. It was found that in all studied seasons most of SARI patients with influenza have not been vaccinated. Among ILI/ARI outpatients with influenza, the frequency of vaccinated individuals for the entire period of the study was estimated as 10.1%, which was 4.2 times higher than that in SARI, where only 2.4% of patients were vaccinated. In addition, it was found that for all six seasons the SARI patients with influenza were treated with antivirals drugs 2 times less often compared to outpatients. Analysis of data on concomitant diseases and conditions in SARI patients with influenza confirmed the leading role of pregnancy as a risk factor for hospitalization in all influenza epidemics, irrespective of their etiology. In addition, diabetes and cardiovascular disease were recognized as risk factors for influenza associated SARI development.

scholarly journals Future Pandemic Influenza Virus Detection Relies on the Existing Influenza Surveillance Systems: A Perspective from Australia and New Zealand

2019 ◽  
Vol 4 (4) ◽  
pp. 121
Author(s):  
Lance C. Jennings ◽  
Ian G. Barr
Keyword(s):  
New Zealand ◽  
Influenza A ◽  
Seasonal Influenza ◽  
Control Strategies ◽  
Influenza Pandemic ◽  
Virus Detection ◽  
World Health ◽  
Influenza Surveillance ◽  
Surveillance Systems ◽  
Influenza A H1n1

The anniversary of the 1918–1919 influenza pandemic has allowed a refocusing on the global burden of influenza and the importance of co-ordinated international surveillance for both seasonal influenza and the identification of control strategies for future pandemics. Since the introduction of the International Health Regulations (IHR), progress had been slow, until the emergence of the novel influenza A(H1N1)2009 virus and its global spread, which has led to the World Health Organization (WHO) developing a series of guidance documents on global influenza surveillance procedures, severity and risk assessments, and essential measurements for the determination of national pandemic responses. However, the greatest burden of disease from influenza occurs between pandemics during seasonal influenza outbreaks and epidemics. Both Australia and New Zealand utilise seasonal influenza surveillance to support national influenza awareness programs focused on seasonal influenza vaccination education and promotion. These programs also serve to promote the importance of pandemic preparedness.

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