A Surveillance System for the Real-Time Reporting of Influenza Activity
Tóm tắt
Background: Effective influenza surveillance and communication of influenza activity are crucial for the management of influenza outbreaks. The accuracy of clinical diagnoses can be enhanced if the influenza virus is known to be circulating in the community.
Objective: To report on the development of a new influenza surveillance system in Germany (2001–2002) based on consultation rates and near patient test results using the Influenza A/B Rapid Test (IRT) and RealFlu™ Surveillance methodology.
Methods: This is the first internationally standardized, rapid influenza surveillance system providing harmonized influenza-specific information. RealFlu™ Surveillance is unique in its approach by generating two baselines: one with morbidity rates and one with specific influenza activity based on near patient test results. The baselines are set independently for each participating country and its constituent regions, thereby allowing monitoring of national as well as regional influenza activity. The system is highly specific and sensitive to influenza and differentiates between three levels of the RealFlu™ Surveillance influenza activity: (i) no/sporadic activity; (ii) moderate activity; and (iii) high activity. Weekly activity is presented in graphs, maps, and data tables with daily updates and comments. In this report, data collected during the influenza season 2001–2002 in Germany are presented.
Results: The RealFlu™ Surveillance system has been running for four consecutive influenza seasons since 1999. The first increase in influenza circulation was seen from week 2 (from year start) to week 4. In week 5, a steep increase in influenza positives was observed. A significant amount of excess morbidity was seen from week 7, peaking in week 11. The season started in western regions of Germany and ended in eastern regions of Germany. Regional outbreaks were detected also when the aggregated country data did not indicate any significant increase in influenza activity.
Conclusion: By providing specific, real-time monitoring of regional and national influenza outbreaks, the RealFlu™ Surveillance system complements existing schemes and presents a practical surveillance methodology for countries where influenza surveillance does not exist.
Tài liệu tham khảo
Barker WH, Mulloly JP. Impact of epidemic type A influenza in a defined adult population. Am J Epidemiol. 1980; 112: 798–813
Centers for Disease Control and Prevention. Prevention and control of influenza: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Morb Mortal Wkly Rep 2000; 49(RR-04): 1–38
Simonsen L, Fukuda K, Schoenberger LB, et al. Impact of influenza epidemics on hospitalizations. J Infect Dis 2000; 181: 831–7
Gubareva LV, Kaiser L, Hayden FG. Influenza virus neuraminidase inhibitors. Lancet 2000; 355: 827–35
Nicholson KG, Aoki FY, Osterhaus ADME, et al. Treatment of acute influenza: efficacy and safety of the oral neuraminidase inhibitor oseltamivir. Lancet 2000; 355: 1845–50
Aoki F, MacLeod M, Paggiaro P, et al. Maximising benefits of influenza treatment with oral oseltamivir: results of the IMPACT study. J Antimicrob Chemother 2003; 51: 123–9
Lange W, Uphoff H, Behrens M. Practicability and costs of on-site testing during an influenza epidemic [abstract W8-6]. European Scientific Working Group on Influenza. First European Influenza Conference, ESWI; 2002 Oct 20–23; Malta
Fleming D, Wood M. The clinical diagnosis of influenza. Curr Med Res Opin 2002; 18: 338–41
Treanor JJ, Hayden FG, Vrooman PS, et al. Efficacy and safety of the oral neuraminidase inhibitor oseltamivir in treating acute influenza. JAMA 2000; 283: 1016–24
Whitley RJ, Hayden FG, Reisinger KS, et al. Oral oseltamivir treatment of influenza in children. Pediatr Infect Dis J 2001; 20: 127–33
Hayden FG, Osterhaus ADME, Treanor JJ, et al. Efficacy and safety of the neuraminidase inhibitor zanamivir in the treatment of influenza virus infections. N Engl J Med 1997; 337: 874–80
Monto AS, Fleming DM, Henry D, et al. Efficacy and safety of the neuraminidase inhibitor zanamivir in the treatment of influenza A and B virus infections. J Infect Dis 1999; 180: 254–61
Mäkelä MJ, Pauksens K, Rostila T, et al. Clinical efficacy and safety of the orally inhaled neuraminidase inhibitor zanamivir in the treatment of influenza: a randomized, double-blind, placebo-controlled European study. J Infect 2000; 40: 42–8
Zambon M, Hays J, Webster A, et al. Diagnosis of influenza in the community. Arch Intern Med 2001; 161: 2116–22
Data on file, Roche, 2004
Influenza A/B Rapid Test package insert. Mannheim: Roche Diagnostics GmbH, 2002
ArbeitsGemeinschaft Influenza. Abschlussbericht der Influenzasaison 2001/02, Berlin 2002 [online]. Available from URL: http://www.dgk.de/agi/ [Accessed 2004 Mar 30]
Snacken R. Managing influenza in primary care: a practical guide to clinical diagnosis. Dis Manage Health Outcomes 2000; 8: 79–85
Thomas Y, Kaiser L, Mueller D, et al. Surveillance of influenza epidemics between 1999 and 2002 using a rapid antigen detection test. First European Influenza Conference, ESWI; 2002 Oct 20–23; Malta
Carman WF, Wallace LA, Walker J, et al. Rapid virological surveillance of community influenza infection in general influenza. BMJ 2000; 321: 736–7
Aoki FY, Macleod MD, Paggiaro P, et al. Early administration of oral oseltamivir increases the benefits of influenza treatment. J Antimicrob Chemother 2003; 51: 123–9
Kaiser L, Wat C, Mills T, et al. Impact of oseltamivir treatment on influenzarelated lower respiratory tract complications and hospitalizations. Arch Intern Med 2003; 163: 1667–72