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Knowledge and attitudes in regard to pandemic influenza A(H1N1) in a multiethnic community of Malaysia

Wong LP, Sam IC

Int J Behav Med, 2011 Jun;18(2):112-21.
PMID: 20835855 DOI: 10.1007/s12529-010-9114-9

BACKGROUND: Assessment of general public's knowledge and attitudes toward the development and prevention of new disease outbreaks is imperative because they have profound effects on health behaviors and may contribute to the control of the epidemic.
PURPOSE: To investigate the level of knowledge and attitudes towards the influenza A(H1N1) outbreak across various ethnic groups and socio-demographic backgrounds in Malaysia.
METHOD: A cross-sectional, population-based, computer-assisted telephone interview exploring knowledge and attitudes regarding influenza A(H1N1) was conducted in Malaysia. Between July 11 and September 12, 2009, a total of 1,050 respondents were interviewed (response rate 69.3%).
RESULTS: The mean total knowledge score for the overall sample was 7.30 (SD ± 1.961) out of a possible score of 13 (Chinese had the highest scores, followed by Indians, then Malays). Some erroneous beliefs about the modes of transmission were identified. The majority of the participants (73.8%) perceived the A(H1N1) infection as often deadly. Despite the overestimation of the severity of A(H1N1) infection, high confidence in preventing infection and low perceived susceptibility of infection were reported. Influenza A(H1N1)-related stigma was prevalent and exhibited differences across ethnic groups.
CONCLUSIONS: Findings suggest that provision of education and clear information are essential to correct the misconceptions, and increase perceived susceptibility to infection so that the general public will take precautions against A(H1N1) infection.

Matched MeSH terms: Influenza, Human/epidemiology*
Fulltext Characteristics of children hospitalized for pandemic (H1N1) 2009, Malaysia

Muhammad Ismail HI, Tan KK, Lee YL, Pau WS, Razali KA, Mohamed T, et al.

Emerg Infect Dis, 2011 Apr;17(4):708-10.
PMID: 21470467 DOI: 10.3201/eid1704.101212

To determine effects of pandemic (H1N1) 2009 on children in the tropics, we examined characteristics of children hospitalized for this disease in Malaysia. Of 1,362 children, 51 (3.7%) died, 46 of whom were in an intensive care unit. Although disease was usually mild, ≥ 1 concurrent conditions were associated with higher death rates.

Matched MeSH terms: Influenza, Human/epidemiology*
Fulltext Monitoring of the h275y mutation in pandemic influenza A(H1N1) 2009 strains isolated in Malaysia

Suppiah J, Yusof MA, Othman KA, Saraswathy TS, Thayan R, Kasim FM, et al.

Southeast Asian J. Trop. Med. Public Health, 2011 Jan;42(1):100-4.
PMID: 21323171

The 2009 pandemic influenza A(H1N1) infection in Malaysia was first reported in May 2009 and oseltamivir was advocated for confirmed cases in postexposure prophylaxis. However, there are cases of oseltamivir-resistance reported among H1N1-positive patients in other countries. Resistance is due to substitution of histidine by tyrosine at residue 275 (H275Y) of neuraminidase (NA). In this study, we have employed Sanger sequencing method to investigate the occurrence of mutations in NA segments of 67 pandemic 2009 A(H1N1) viral isolates from Malaysian patients that could lead to probable oseltamivir resistance. The sequencing analysis did not yield mutation at residue 275 for all 67 isolates indicating that our viral isolates belong to the wild type and do not confer resistance to oseltamivir.

Matched MeSH terms: Influenza, Human/epidemiology
Fulltext Investigation of a potential zoonotic transmission of orthoreovirus associated with acute influenza-like illness in an adult patient

Chua KB, Voon K, Yu M, Keniscope C, Abdul Rasid K, Wang LF

PLoS One, 2011;6(10):e25434.
PMID: 22022394 DOI: 10.1371/journal.pone.0025434

Bats are increasingly being recognized as important reservoir hosts for a large number of viruses, some of them can be highly virulent when they infect human and livestock animals. Among the new bat zoonotic viruses discovered in recent years, several reoviruses (respiratory enteric orphan viruses) were found to be able to cause acute respiratory infections in humans, which included Melaka and Kampar viruses discovered in Malaysia, all of them belong to the genus Orthoreovirus, family Reoviridae. In this report, we describe the isolation of a highly related virus from an adult patient who suffered acute respiratory illness in Malaysia. Although there was no direct evidence of bat origin, epidemiological study indicated the potential exposure of the patient to bats before the onset of disease. The current study further demonstrates that spillover events of different strains of related orthoreoviruses from bats to humans are occurring on a regular basis, which calls for more intensive and systematic surveillances to fully assess the true public health impact of these newly discovered bat-borne zoonotic reoviruses.

Matched MeSH terms: Influenza, Human/epidemiology
Fulltext Epidemiology and clinical characteristics of hospitalized patients with pandemic influenza A (H1N1) 2009 infections: the effects of bacterial coinfection

Dhanoa A, Fang NC, Hassan SS, Kaniappan P, Rajasekaram G

Virol J, 2011;8:501.
PMID: 22050645 DOI: 10.1186/1743-422X-8-501

Numerous reports have described the epidemiological and clinical characteristics of influenza A (H1N1) 2009 infected patients. However, data on the effects of bacterial coinfection on these patients are very scarce. Therefore, this study explores the impact of bacterial coinfection on the clinical and laboratory parameters amongst H1N1 hospitalized patients.

Study site: Hospital Sultanah Aminah Johor Bahru

Matched MeSH terms: Influenza, Human/epidemiology*
An influenza B outbreak during the 2007/2008 winter among appropriately immunized elderly people living in a nursing home

Camilloni B, Neri M, Lepri E, Basileo M, Sigismondi N, Puzelli S, et al.

Vaccine, 2010 Nov 3;28(47):7536-41.
PMID: 20846530 DOI: 10.1016/j.vaccine.2010.08.064

The study evaluated the immunogenicity and efficacy of a trivalent subunit MF59-adjuvanted influenza vaccine (A/Wisconsin/67/05 (H3N2), A/Solomon Islands/3/06 (H1N1) and B/Malaysia/2506/04) in preventing serologically diagnosed infections in a group of 67 institutionalized elderly volunteers during 2007/2008 winter, characterized by co-circulation of drifted A/H3N2, A/H1N1 and B influenza viruses. Influenza vaccination induced a significant increase in the amounts of hemagglutination inhibiting antibodies, both against the vaccine and the epidemic drifted strains. However, vaccination did not prevent the circulation of the new drifted influenza B virus (B/Florida/4/06-like), belonging to the B/Yamagata/16/88-lineage, antigenically and genetically distinct from B/Victoria/2/87-lineage viruses from which the vaccine B strain was derived.

Matched MeSH terms: Influenza, Human/epidemiology*
Seasonal influenza virus strains circulating in Malaysia from 2005 to 2009

Saat Z, Abdul Rashid TR, Yusof MA, Kassim FM, Thayan R, Kuen LS, et al.

Southeast Asian J. Trop. Med. Public Health, 2010 Nov;41(6):1368-73.
PMID: 21329312

From 2005 to 2009, the Institute for Medical Research (IMR), Kuala Lumpur received a total of 7,117 respiratory specimens from patients with influenza-like illness (ILI) for influenza screening. Seasonal influenza virus was isolated from 17.3% of patients with ILI in 2005, 31.6% in 2006, 12.8% in 2007, 10.2% in 2008 and 13.5% in 2009. There were one or more influenza A and B virus strains circulating in Malaysia throughout the year, with distinctly a peak in May to August. The predominant circulating strains of seasonal influenza A were A/California/7/2004-like (H3N2) in 2005, A/New Caledonia/20/99-like (H1N1) in 2006, A/ Brisbane/10/2007-like (H3N2) in 2007 and 2008, and A/Perth/16/2009-like (H3N2) virus in 2009. The predominant circulating strains of influenza B were B/Hong Kong/330/2001-like in 2005, B/Malaysia/2506/2004-like in 2006, B/Florida/4/2006-like in 2007 and 2008, and B/Brisbane/60/2008-like in 2009.

Matched MeSH terms: Influenza, Human/epidemiology
Analysis of human infectious avian influenza virus: hemagglutinin genetic characteristics in Asia and Africa from 2004 to 2009

Zhang J, Lei F

Integr Zool, 2010 Sep;5(3):264-71.
PMID: 21392344 DOI: 10.1111/j.1749-4877.2010.00212.x

In the present study, we used nucleotide and protein sequences of avian influenza virus H5N1, which were obtained in Asia and Africa, analyzed HA proteins using ClustalX1.83 and MEGA4.0, and built a genetic evolutionary tree of HA nucleotides. The analysis revealed that the receptor specificity amino acid of A/HK/213/2003, A/Turkey/65596/2006 and etc mutated into QNG, which could bind with á-2, 3 galactose and á-2, 6 galactose. A mutation might thus take place and lead to an outbreak of human infections of avian influenza virus. The mutations of HA protein amino acids from 2004 to 2009 coincided with human infections provided by the World Health Organization, indicating a "low-high-highest-high-low" pattern. We also found out that virus strains in Asia are from different origins: strains from Southeast Asia and East Asia are of the same origin, whereas those from West Asia, South Asia and Africa descend from one ancestor. The composition of the phylogenetic tree and mutations of key site amino acids in HA proteins reflected the fact that the majority of strains are regional and long term, and virus diffusions exist between China, Laos, Malaysia, Indonesia, Azerbaijan, Turkey and Iraq. We would advise that pertinent vaccines be developed and due attention be paid to the spread of viruses between neighboring countries and the dangers of virus mutation and evolution.

Matched MeSH terms: Influenza, Human/epidemiology*
Fulltext Clinical features of Malaysian children hospitalized with community-acquired seasonal influenza

Sam IC, Abdul-Murad A, Karunakaran R, Rampal S, Chan YF, Nathan AM, et al.

Int J Infect Dis, 2010 Sep;14 Suppl 3:e36-40.
PMID: 20153233 DOI: 10.1016/j.ijid.2009.10.005

OBJECTIVES: The clinical impact of seasonal influenza is understudied in tropical countries. The aim of this study was to describe the clinical features and seasonal pattern of influenza in children hospitalized in Malaysia, and to identify predictors of severe disease.
METHODS: Children hospitalized with community-acquired, laboratory-confirmed influenza at a teaching hospital in Kuala Lumpur, Malaysia during 2002-2007 were identified retrospectively. Clinical data were collected, and predictors of severe disease were identified by multivariate logistic regression. All influenza cases from 1982 to 2007 were also analyzed for seasonal patterns.
RESULTS: A total of 132 children were included in the study, 48 (36.4%) of whom had underlying medical conditions. The mean age was 2.5 years and 116 (87.9%) were <5 years old. The most common presenting features were fever or history of fever, cough, rhinitis, vomiting, and pharyngitis. Severe influenza was seen in 16 patients (12.1%; nine previously healthy), including 12 (9.1%; eight previously healthy) requiring intensive care. There were three (2.3%) deaths. Severe disease was associated with age <12 months, female sex, and absence of rhinitis on admission. Influenza was seen year-round, with peaks in November-January and May-July.
CONCLUSIONS: Seasonal influenza has a considerable impact on children hospitalized in Malaysia, in both the healthy and those with underlying medical conditions.

Study site: University Malaya Medical Centre (UMMC)

Matched MeSH terms: Influenza, Human/epidemiology
Fulltext The association between pre-morbid conditions and respiratory tract manifestations amongst Malaysian Hajj pilgrims

Deris ZZ, Hasan H, Ab Wahab MS, Sulaiman SA, Naing NN, Othman NH

Trop Biomed, 2010 Aug;27(2):294-300.
PMID: 20962728 MyJurnal

In a very closed and overcrowding environment, influenza transmission during Hajj season is almost inevitable. The aim of this study was to determine the association between pre-morbid conditions and influenza-like illness (ILI) amongst Hajj pilgrims. A cross-sectional study was conducted amongst Malaysian Hajj pilgrims in year 2007. Survey forms were distributed at Madinatul-Hujjaj, Jeddah and Tabung Haji Clinic, Medina, Saudi Arabia where pilgrims stay on transit before returning to Malaysia. Allergic rhinitis was significantly associated with sore throat (p=0.047), longer duration of cough (p=0.017) and runny nose (p=0.016). Pilgrims who suffered from chronic obstructive pulmonary diseases (COPD) had significant association with longer duration of cough (p=0.041) and those with diabetes mellitus had significant association with longer duration of sore throat (p=0.048). Underlying asthma was significantly associated with severe influenza like illness requiring admission to hospital for further treatment of respiratory symptoms (p=0.016). Based on these findings, we suggest those with underlying asthma should be discouraged from participating in the hajj and they should seek early treatment if they develop respiratory symptoms.

Matched MeSH terms: Influenza, Human/epidemiology
Influenza B outbreak among influenza-vaccinated welfare home residents in Singapore

Win MK, Chow A, Chen M, Lau YF, Ooi EE, Leo YS

Ann Acad Med Singap, 2010 Jun;39(6):448-52.
PMID: 20625620

INTRODUCTION: Outbreaks of acute respiratory illness occur commonly in long-term care facilities (LTCF), due to the close proximity of residents. Most influenza outbreak reports have been from temperate countries. This study reports an outbreak of influenza B among a highly immunised resident population in a welfare home in tropical Singapore, and discusses vaccine efficacy and the role of acute respiratory illness surveillance for outbreak prevention and control.
MATERIALS AND METHODS: During the period from 16 to 21 March 2007, outbreak investigations and active case finding were carried out among residents and nursing staff at the welfare home. Interviews and medical notes review were conducted to obtain epidemiological and clinical data. Hospitalised patients were tested for respiratory pathogens. Further genetic studies were also carried out on positive respiratory samples.
RESULTS: The overall clinical attack rate was 9.4% (17/180) in residents and 6.7% (2/30) in staff. All infected residents and staff had received influenza immunisation. Fifteen residents were hospitalised, with 2 developing severe complications. Genetic sequencing revealed that the outbreak strain had an 8.2% amino acid difference from B/Malaysia/2506/2004, the 2006 southern hemisphere influenza vaccine strain, which the residents and staff had earlier received.
CONCLUSIONS: A mismatch between the vaccine and circulating influenza virus strains can result in an outbreak in a highly immunised LTCF resident population. Active surveillance for acute respiratory illness in LTCFs could be implemented for rapid detection of antigenic drift. Enhanced infection control and other preventive measures can then be deployed in a timely manner to mitigate the effect of any outbreaks.

Matched MeSH terms: Influenza, Human/epidemiology*
Fulltext Influenza outbreaks during World Youth Day 2008 mass gathering

Blyth CC, Foo H, van Hal SJ, Hurt AC, Barr IG, McPhie K, et al.

Emerg Infect Dis, 2010 May;16(5):809-15.
PMID: 20409371 DOI: 10.3201/eid1605.091136

Influenza outbreaks during mass gatherings have been rarely described, and detailed virologic assessment is lacking. An influenza outbreak occurred during World Youth Day in Sydney, Australia, July 2008 (WYD2008). We assessed epidemiologic data and respiratory samples collected from attendees who sought treatment for influenza-like illness at emergency clinics in Sydney during this outbreak. Isolated influenza viruses were compared with seasonal influenza viruses from the 2008 influenza season. From 100 infected attendees, numerous strains were identified: oseltamivir-resistant influenza A (H1N1) viruses, oseltamivir-sensitive influenza A (H1N1) viruses, influenza A (H3N2) viruses, and strains from both influenza B lineages (B/Florida/4/2006-like and B/Malaysia/2506/2004-like). Novel viruses were introduced, and pre-WYD2008 seasonal viruses were amplified. Viruses isolated at mass gatherings can have substantial, complex, and unpredictable effects on community influenza activity. Greater flexibility by public health authorities and hospitals is required to appropriately manage and contain these outbreaks.

Matched MeSH terms: Influenza, Human/epidemiology*
Fulltext Influenza A (H1N1) 2009 pandemic virus: learning from the first wave, preparing for the second

Lee CK

Med J Malaysia, 2010 Mar;65(1):1-2.
PMID: 21265237

In a short period of two months, the novel influenza A/H1N1 virus has circumnavigated the entire planet leaving behind in its wake approximately 3000 reported deaths worldwide. Fortunately, in many areas around the world, September 2009 brought a lull in the number of new H1N1 infections. This brought welcomed relief in many countries that had earlier experienced high respiratory disease activity in their communities. However, based on previous influenza pandemics, this reprieve may well be short-lived. As the Northern hemisphere approaches its winter months, many experts are now predicting a second wave of influenza A/H1N1 infections. This prediction maybe well placed as all 3 influenza pandemics in the last century reported second or even subsequent waves of new infections, all of which appeared to be more severe than the primary event (ref). The timing of these second waves have varied from 6 months to 3 years and invariably seemed to be linked to the winter months. It is unclear precisely what changes caused the increased severity seen during the second waves; one possibility is the progressive adaptation of the novel influenza virus to its new human host . Molecular analysis, for example, suggests that the 1918 Spanish influenza virus that emerged during the second wave had undergone changes in the hemagglutinin binding site that increased the binding specificity for human receptors. This is thought to have increased the replicative capacity and hence, the pathogenicity of the virus. It is also evident that as the H1N1 2009 pandemic virus continues to spread, opportunities for adaptation that increases virulence will also increase. Nonetheless, the changes needed for such adaptation and for increased virulence are unpredictable and by no means inevitable

Matched MeSH terms: Influenza, Human/epidemiology*
Fulltext The prevalence of acute respiratory symptoms and role of protective measures among Malaysian hajj pilgrims

Deris ZZ, Hasan H, Sulaiman SA, Wahab MS, Naing NN, Othman NH

J Travel Med, 2010 Mar-Apr;17(2):82-8.
PMID: 20412173 DOI: 10.1111/j.1708-8305.2009.00384.x

BACKGROUND: Respiratory symptoms including cough, runny nose, sore throat, and fever are the most common clinical manifestations faced by hajj pilgrims in Mecca. The aim of the study was to determine the prevalence of respiratory symptoms among Malaysian hajj pilgrims and the effect of a few protective measures taken by hajj pilgrims to reduce respiratory symptoms.
METHODS: A cross-sectional study was conducted by distributing survey forms to Malaysian hajj pilgrims at transit center before flying back to Malaysia. The recruitment of respondents to the survey was on a voluntary basis.
RESULTS: A total of 387 survey forms were available for analysis. The mean age was 50.4 +/- 11.0 years. The common respiratory symptoms among Malaysian hajj pilgrims were: cough 91.5%, runny nose 79.3%, fever 59.2%, and sore throat 57.1%. The prevalence of hajj pilgrims with triad of cough, subjective fever, and sore throat were 40.1%. The symptoms lasted less than 2 weeks in the majority of cases. Only 3.6% did not suffer from any of these symptoms. Seventy-two percent of hajj pilgrims received influenza vaccination before departure and 72.9% wore facemasks. Influenza vaccination was not associated with any of respiratory symptoms but it was significantly associated with longer duration of sore throat. Wearing masks was significantly associated with sore throat and longer duration of sore throat and fever.
CONCLUSIONS: The prevalence of respiratory symptoms was high among Malaysian hajj pilgrims and the current protective measures seemed inadequate to reduce it. Beside standardization of the term used in hajj studies, more collaborative effort should be taken to reduce respiratory symptoms. The hajj authority should prepare for the challenge of pandemic influenza by providing more healthcare facilities and implementation of more strict measures to reduce the transmission of pandemic influenza strain among hajj pilgrims.

Matched MeSH terms: Influenza, Human/epidemiology
Fulltext Initial psychological responses to Influenza A, H1N1 ("Swine flu")

Goodwin R, Haque S, Neto F, Myers LB

BMC Infect Dis, 2009 Oct 06;9:166.
PMID: 19807908 DOI: 10.1186/1471-2334-9-166

BACKGROUND: The outbreak of the pandemic flu, Influenza A H1N1 (Swine Flu) in early 2009, provided a major challenge to health services around the world. Previous pandemics have led to stockpiling of goods, the victimisation of particular population groups, and the cancellation of travel and the boycotting of particular foods (e.g. pork). We examined initial behavioural and attitudinal responses towards Influenza A, H1N1 ("Swine flu") in the six days following the WHO pandemic alert level 5, and regional differences in these responses.
METHODS: 328 respondents completed a cross-sectional Internet or paper-based questionnaire study in Malaysia (N = 180) or Europe (N = 148). Measures assessed changes in transport usage, purchase of preparatory goods for a pandemic, perceived risk groups, indicators of anxiety, assessed estimated mortality rates for seasonal flu, effectiveness of seasonal flu vaccination, and changes in pork consumption
RESULTS: 26% of the respondents were 'very concerned' about being a flu victim (42% Malaysians, 5% Europeans, p < .001). 36% reported reduced public transport use (48% Malaysia, 22% Europe, p < .001), 39% flight cancellations (56% Malaysia, 17% Europe, p < .001). 8% had purchased preparatory materials (e.g. face masks: 8% Malaysia, 7% Europe), 41% Malaysia (15% Europe) intended to do so (p < .001). 63% of Europeans, 19% of Malaysians had discussed the pandemic with friends (p < .001). Groups seen as at 'high risk' of infection included the immune compromised (mentioned by 87% respondents), pig farmers (70%), elderly (57%), prostitutes/highly sexually active (53%), and the homeless (53%). In data collected only in Europe, 64% greatly underestimated the mortality rates of seasonal flu, 26% believed seasonal flu vaccination gave protection against swine flu. 7% had reduced/stopped eating pork. 3% had purchased anti-viral drugs for use at home, while 32% intended to do so if the pandemic worsened.
CONCLUSION: Initial responses to Influenza A show large regional differences in anxiety, with Malaysians more anxious and more likely to reduce travel and to buy masks and food. Discussions with family and friends may reinforce existing anxiety levels. Particular groups (homosexuals, prostitutes, the homeless) are perceived as at greater risk, potentially leading to increased prejudice during a pandemic. Europeans underestimated mortality of seasonal flu, and require more information about the protection given by seasonal flu inoculation.

Matched MeSH terms: Influenza, Human/epidemiology
Fulltext Pandemic influenza A (H1N1) 2009 in Malaysia--the next phase

Sam IC, Abu Bakar S

Med J Malaysia, 2009 Jun;64(2):105-7.
PMID: 20058566

In recent years, zoonotic RNA viruses such as Nipah, SARS coronavirus, avian influenza (H5N1) and Chikungunya have emerged with global impact. The latest has now been designated by World Health Organization (WHO) as pandemic (H1N1) 2009 virus. It was first reported as an outbreak in Mexico in April, and has now caused the first influenza pandemic since 1968. By July 11, 2009, there were 105,304 confirmed cases and 463 deaths in 143 countries, including 627 cases in Malaysia1 . The rapid spread of the disease has been matched by the speed of dissemination of information and protocols, co-ordinated by WHO. The experiences of SARS and H5N1 have been enormously beneficial in preparing the world for a pandemic.

Matched MeSH terms: Influenza, Human/epidemiology*
Fulltext Component-specific effectiveness of trivalent influenza vaccine as monitored through a sentinel surveillance network in Canada, 2006-2007

Skowronski DM, De Serres G, Dickinson J, Petric M, Mak A, Fonseca K, et al.

J Infect Dis, 2009 Jan 15;199(2):168-79.
PMID: 19086914 DOI: 10.1086/595862

Trivalent inactivated influenza vaccine (TIV) is reformulated annually to contain representative strains of 2 influenza A subtypes (H1N1 and H3N2) and 1 B lineage (Yamagata or Victoria). We describe a sentinel surveillance approach to link influenza variant detection with component-specific vaccine effectiveness (VE) estimation.

Matched MeSH terms: Influenza, Human/epidemiology*
Molecular characterization of influenza viruses circulating in Northern Italy during two seasons (2005/2006 and 2006/2007) of low influenza activity

Pariani E, Amendola A, Zappa A, Bianchi S, Colzani D, Anselmi G, et al.

J Med Virol, 2008 Nov;80(11):1984-91.
PMID: 18814246 DOI: 10.1002/jmv.21323

The influenza activity and circulation of influenza viruses in Lombardy (the most populous Italian region) were observed during two consecutive seasons (2005/2006 and 2006/2007) characterized by low influenza activity by the Italian Influenza Surveillance Network. The molecular characteristics of circulating viruses were analyzed to evaluate the introduction of new variants and emergence of vaccine-escape viruses. In both seasons, the epidemic in Lombardy was sustained almost exclusively by influenza A viruses, accounting for 80.5% and 93.6% of total detections, respectively, and the co-circulation of A/H3 viruses belonging to distinct phylogenetic groups was observed. The A/H1N1 viruses isolated during the 2005/2006 season were closely related to A/New Caledonia/20/99, while the hemagglutinin (HA) sequences of the A/H1N1 viruses from the 2006/2007 season exhibited a greater diversity. These viruses were A/Solomon Islands/3/2006-like and showed several variants. All B isolates were similar to B/Malaysia/2506/2004 belonging to the B/Victoria/2/87-lineage. Influenza B virus was the dominant virus in Europe in the 2005/2006 season and accounted for the 20% of total detections in Lombardy. Overall, the viruses studied presented heterogeneity in their HA sequences suggesting the circulation of a miscellaneous set of variants during the two seasons notwithstanding the medium-low activity of influenza. The importance of virological surveillance of influenza viruses is recognized widely and the molecular characterization of the viruses, especially in vaccinated subjects, is of particular importance to evaluate the introduction and circulation of new variants.

Matched MeSH terms: Influenza, Human/epidemiology
Epidemiological and virological assessment of influenza activity in Europe, during the 2006-2007 winter

Arkema JM, Meijer A, Meerhoff TJ, Van Der Velden J, Paget WJ, European Influenza Surveillance Scheme (EISS)

Euro Surveill, 2008 Aug 21;13(34).
PMID: 18761888

Influenza surveillance in Europe is based on influenza surveillance networks that cooperate and share information through the European Influenza Surveillance Scheme (EISS). EISS collected clinical and virological data on influenza in 33 countries during the 2006-2007 winter. Influenza activity started around 1 January and first occurred in Greece, Scotland and Spain. It then moved gradually across Europe from south to north and lasted until the end of March. In 29 out of 33 countries, the consultation rates for influenza-like-illness or acute respiratory infections in the winter of 2006-2007 were similar or somewhat higher than in the 2005-2006 winter. The highest consultation rates for influenzal ike-illness were generally observed among children aged 0-4 years and 5-14 years. The predominant virus strain was influenza A (97% of total detections) of the H3 subtype (93% of H-subtyped A viruses; 7% were A(H1)). The influenza A(H3) and A(H1) viruses were similar to the vaccine reference strains for the 2006-2007 season, A/Wisconsin/67/2005 (H3N2) and A/New Caledonia/20/99 (H1N1) respectively. The majority of the influenza B viruses were similar to the reference strain B/Malaysia/2506/2004, included in the 2006-2007 vaccine. In conclusion, the 2006-2007 influenza season in Europe was characterised by moderate clinical activity, a south to north spread pattern across Europe, and a dominance of influenza A(H3). Overall there was a good match between the vaccine virus strains and the reported virus strains.

Matched MeSH terms: Influenza, Human/epidemiology*
Influenza viruses circulating in Thailand in 2004 and 2005

Waicharoen S, Thawatsupha P, Chittaganpitch M, Maneewong P, Thanadachakul T, Sawanpanyalert P

Jpn J Infect Dis, 2008 Jul;61(4):321-3.
PMID: 18653981

Determining the local circulating strain of influenza is essential to prevent and control epidemics. In the years 2004 and 2005, the National Influenza Center of Thailand received 3,854 and 3,834 specimens, respectively, from patients throughout the country, including submissions from 4 established influenza surveillance sentinel sites. In 2004, of 539 influenza-positive specimens, 461 were positive for influenza A and 78 were positive for influenza B by isolation. Influenza A subtyping revealed that 249, 197, and 15 isolates were H1N1, H3N2, and H5N1, respectively. In 2005, of 748 influenza-positive specimens, 492 were influenza A and the remaining 256 were influenza B. The results of influenza A subtyping indicated that 55, 437, and 5 isolates were H1N1, H3N2, and H5N1. All isolated strains of subtype H1N1 were A/New Caledonia/20/99-like. The isolated strains of H3N2 were A/Fujian/411/2002-like in the first half of the year 2004, while those in the latter half of 2004 gradually drifted to a mixture of A/Wellington/1/2004-like, A/California/7/2004-like, and A/Wisconsin/67/2005-like, and this mixture continued through the end of 2005. The influenza B strains were B/Sichuan/379/99-like, B/Hong Kong/330/2001-like, B/Shanghai/361/2002-like and B/Malaysia/2506/2004-like. The strains circulating in the years 2004 and 2005 were antigenically similar to the vaccine formulas recommended in the same period by WHO. Our results underscore that local influenza surveillance plays an important role in responding to epidemics and potential pandemics.

Matched MeSH terms: Influenza, Human/epidemiology*

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