Epidemiologic and virologic assessment of the 2009 influenza A (H1N1) pandemic on selected temperate countries in the Southern Hemisphere: Argentina, Australia, Chile, New Zealand and South Africa.

UNLABELLED: INTRODUCTION AND SETTING: Our analysis compares the most comprehensive epidemiologic and virologic surveillance data compiled to date for laboratory-confirmed H1N1pdm patients between 1 April 2009 - 31 January 2010 from five temperate countries in the Southern Hemisphere-Argentina, Australia, Chile, New Zealand, and South Africa. OBJECTIVE: We evaluate transmission dynamics, indicators of severity, and describe the co-circulation of H1N1pdm with seasonal influenza viruses. RESULTS: In the five countries, H1N1pdm became the predominant influenza strain within weeks of initial detection. South Africa was unique, first experiencing a seasonal H3N2 wave, followed by a distinct H1N1pdm wave. Compared with the 2007 and 2008 influenza seasons, the peak of influenza-like illness (ILI) activity in four of the five countries was 3-6 times higher with peak ILI consultation rates ranging from 35/1,000 consultations/week in Australia to 275/100,000 population/week in New Zealand. Transmission was similar in all countries with the reproductive rate ranging from 1.2-1.6. The median age of patients in all countries increased with increasing severity of disease, 4-14% of all hospitalized cases required critical care, and 26-68% of fatal patients were reported to have ≥1 chronic medical condition. Compared with seasonal influenza, there was a notable downward shift in age among severe cases with the highest population-based hospitalization rates among children <5 years old. National population-based mortality rates ranged from 0.8-1.5/100,000. CONCLUSIONS: The difficulty experienced in tracking the progress of the pandemic globally, estimating its severity early on, and comparing information across countries argues for improved routine surveillance and standardization of investigative approaches and data reporting methods.

Influenza surveillance and immunisation in New Zealand, 1997-2006.

BACKGROUND: The national influenza surveillance in New Zealand is an essential public health component for assessing and implementing strategies to control influenza. OBJECTIVE: The aim of this study is to report the national influenza surveillance data collected during 1997-2006 in terms of the community disease burden, circulating viral strains, hospitalisations, mortality, and immunisation coverage. METHODS: The national influenza surveillance system includes sentinel general practice surveillance, laboratory-based surveillance, and hospital admission and mortality surveillance and immunisation coverage. The results obtained during 1997-2006 were analysed. RESULTS: When the last 10 years were compared to the previous years, sentinel general practice surveillance recorded a decreasing trend of influenza-like illness rates in the community. Sentinel surveillance also showed that children aged 0-4 years were the most affected. Influenza-related hospitalisation surveillance reported an increasing trend of hospital admissions particularly in children aged 0-19 years. Introduction of routine influenza vaccination among the New Zealand elderly was associated with a significant decrease of influenza-related mortality. CONCLUSIONS: This report demonstrates that an integrated virological and epidemiological surveillance system for influenza is essential for monitoring the disease burden, identifying circulating strains, guiding effective vaccination and planning for a potential pandemic.