ABSTRACT
During the 2009 influenza A(H1N1) pandemic, a new laboratory-based virological sentinel surveillance system, the Respiratory DataMart System (RDMS), was established in a network of 14 Health Protection Agency (now Public Health England (PHE)) and National Health Service (NHS) laboratories in England. Laboratory results (both positive and negative) were systematically collected from all routinely tested clinical respiratory samples for a range of respiratory viruses including influenza, respiratory syncytial virus (RSV), rhinovirus, parainfluenza virus, adenovirus and human metapneumovirus (hMPV). The RDMS also monitored the occurrence of antiviral resistance of influenza viruses. Data from the RDMS for the 20092012 period showed that the 2009 pandemic influenza virus caused three waves of activity with different intensities during the pandemic and post pandemic periods. Peaks in influenza A(H1N1)pdm09 positivity (defined as number of positive samples per total number of samples tested) were seen in summer and autumn in 2009, with slightly higher peak positivity observed in the first post-pandemic season in 2010/2011. The influenza A(H1N1)pdm09 virus strain almost completely disappeared in the second postpandemic season in 2011/2012. The RDMS findings are consistent with other existing community-based virological and clinical surveillance systems. With a large sample size, this new system provides a robust supplementary mechanism, through the collection of routinely available laboratory data at minimum extra cost, to monitor influenza as well as other respiratory virus activity. A near real-time, daily reporting mechanism in the RDMS was established during the London 2012 Olympic and Paralympic Games. Furthermore, this system can be quickly adapted and used to monitor future influenza pandemics and other major outbreaks of respiratory infectious disease, including novel pathogens.
Subject(s)
Influenza A Virus, H1N1 Subtype/isolation & purification , Influenza, Human/diagnosis , Laboratories/statistics & numerical data , Respiratory Syncytial Virus Infections/diagnosis , Respiratory Syncytial Virus, Human/isolation & purification , Sentinel Surveillance , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , England/epidemiology , Female , Humans , Infant , Influenza, Human/epidemiology , Influenza, Human/virology , Male , Mandatory Reporting , Middle Aged , Pandemics , Polymerase Chain Reaction , Respiratory Syncytial Virus Infections/epidemiology , Respiratory Syncytial Virus Infections/virology , Seasons , Young AdultABSTRACT
The early experience of the United Kingdom (UK) is that influenza B has dominated the influenza 2012/13 season. Overall trivalent influenza vaccine (TIV) adjusted vaccine effectiveness (VE) against all laboratory-confirmed influenza in primary care was 51% (95% confidence interval (CI): 27% to 68%); TIV adjusted VE against influenza A alone or influenza B alone was 49% (95% CI: -2% to 75%) and 52% (95% CI: 23% to 70%) respectively. Vaccination remains the best protection against influenza.
Subject(s)
Influenza A virus/isolation & purification , Influenza B virus/isolation & purification , Influenza Vaccines/administration & dosage , Influenza, Human/prevention & control , Seasons , Adolescent , Adult , Age Distribution , Aged , Aged, 80 and over , Case-Control Studies , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Influenza A virus/genetics , Influenza A virus/immunology , Influenza B virus/genetics , Influenza B virus/immunology , Influenza Vaccines/immunology , Influenza, Human/diagnosis , Influenza, Human/epidemiology , Influenza, Human/virology , Logistic Models , Male , Middle Aged , Odds Ratio , Primary Health Care , Real-Time Polymerase Chain Reaction , Sentinel Surveillance , Surveys and Questionnaires , Treatment Outcome , United Kingdom/epidemiology , Vaccination/statistics & numerical data , Young AdultABSTRACT
This study provides mid-season estimates of the effectiveness of 2010/11 trivalent influenza vaccine and previous vaccination with monovalent influenza A(H1N1)2009 vaccine in preventing confirmed influenza A(H1N1)2009 infection in the United Kingdom in the 2010/11 season. The adjusted vaccine effectiveness was 34% (95% CI: -10 - 60%) if vaccinated only with monovalent vaccine in the 2009/10 season; 46% (95% CI: 7 - 69%) if vaccinated only with trivalent influenza vaccine in the 2010/11 season and 63% (95% CI: 37 - 78%) if vaccinated in both seasons.
Subject(s)
Influenza A Virus, H1N1 Subtype/immunology , Influenza Vaccines/administration & dosage , Influenza, Human/prevention & control , Pandemics , Adolescent , Adult , Aged , Aged, 80 and over , Case-Control Studies , Child , Child, Preschool , Female , Humans , Influenza Vaccines/immunology , Influenza, Human/diagnosis , Influenza, Human/epidemiology , Male , Middle Aged , Seasons , Sentinel Surveillance , Treatment Outcome , United Kingdom/epidemiology , Vaccination/statistics & numerical data , Young AdultABSTRACT
This paper describes the epidemiology of fatal pandemic influenza A(H1N1) cases in the United Kingdom (UK) since April 2009 and in particular risk factors associated with death. A fatal case was defined as a UK resident who died between 27 April 2009 and 12 March 2010, in whom pandemic influenza A(H1N1) infection was confirmed by laboratory or recorded on death certificate. Case fatality ratios (CFR) were calculated using the estimated cumulative number of clinical cases as the denominator. The relative risk of death was estimated by comparing the population mortality rate in each risk group, with those not in a risk group. Across the UK, 440 fatal cases were identified. In England, fatal cases were mainly seen in young adults (median age 43 years, 85% under 65 years), unlike for seasonal influenza. The majority (77%) of cases for whom data were available (n=308) had underlying risk factors for severe disease. The CFR in those aged 65 years or over was nine per 1,000 (range 3 - 26) compared to 0.4 (range 0.2 to 0.9) for those aged six months to 64 years. In the age group between six month and 64 years, the relative risk for fatal illness for those in a risk group was 18. The population attributable fractions in this age group were highest for chronic neurological disease (24%), immunosuppression (16%) and respiratory disease (15%). The results highlight the importance of early targeted effective intervention programmes.
Subject(s)
Influenza A Virus, H1N1 Subtype , Influenza, Human/mortality , Mortality/trends , Adolescent , Adult , Aged , Disease Outbreaks , Epidemiologic Studies , Female , Humans , Male , Middle Aged , Risk Factors , United Kingdom/epidemiology , Young AdultABSTRACT
In 1996 a consensus statement on the surveillance of tuberculosis in Europe, recommended the collection of data on all cases of tuberculosis at the local level. The statement, backed by the International Union Against Tuberculosis and Lung Disease, the Wo
ABSTRACT
This paper summarises recommendations for uniform reporting on tuberculosis cases made by a working group set up in 1994 following a meeting on tuberculosis control in low prevalence countries. The meeting had been organised jointly by the World Health Or
