Influenza surveillance = Surveillace de la grippe

Wldy Epldnn. Ra:.: No. 4 - 27 Jamwy 1984 whooping cough since the end of March 1983. Twenty-three per cent of cases were below 2 years of age and 5ft below 5 years of age (Table 1). A more detailed investigation was carried out in June 1983 in 3 wards. This included the detailed disease histories since January 1983 and immunization status of children. The investigation included children under l O years of age living in the neighbourhood of the index case. After identification of the index case, every household adjacent to the index case was visited and the mothers were interviewed according to a special question- naire. Interviews were obtained from mothers of9 l children below 10 years of age. Sixty-two of these children (68%) had a history of whooping cough (Table 1): The attack rates were highest in age groups 1-2 and 3-4 years. The analysis of immunization history showed that 61 out of 62 cases (98%) had not been immunized or had received only 1 dose of OPT vaccine. Only 1 child had received 2 doses of OPT vaccine, a full course according to the presently recommended immunization schedule in Indonesia.* Among children without a history of whooping cough, 69% were not immunized or had received only 1 dose, and 31% were immunized with 2 doses of DPT vaccine (Table 3). · , - 27 - kw,I lpulln,. ht!bd.:N•4-27,flmer t9k Vingt-trois pour cent des cas etaient Ages de moins de 2 ans et 5ft de moins de 5 ans (Tableau 1). ·· · · ·. · Une enqucte plus poussee a ete .effectuee enjuin 1983 dam 3 quartiers. Elle a consiste a enregi.strer les antecedents pathologiques detaillesdepuis janvier 1983 ainsi que la situation vaccinale des enfants. L'enqucte a porte sur les enfants de moins de 1 O ansqui vivaient dam le voisinage du cas initial. Apres identification du cas initial. on s'est rendu damchacun des foyers situesaux alentours et l'on a intem>ge Jes meres au moyen d'un questionnaire special. Ont et6 ainsi interrogees Jes meres de 91 enfants de moins de 10 ans. Soixante-deux de ces enfants (68%) avaient eu la coqueluche (Tableau 1). C'est dams Jes groupes d'Age des 1-2 ans et des 3-4 ans que les taux d'atteinte etaient les plus eleves. L'etude de la situation vaccinale de ces enfants a montre que 61 des 62 cas (98,i.) n'avaient pas ete vaccines ou n'avaient ~ qu'une dose de vaccin OTC. Un seul enfant avait ~ 2 doses de OTC, c'est-a-dire la serie complete selon le schema de vaccination actuellement recommande en lndonesie. * Pimni lea enfants qui n'avaient pas eu la coqueluche, 69% n'etaientpasvaccinesoun'avaientn:9Uqu'unedoseet31,i.avaientn:9U2 doses de vaccin OTC (Tableau 3). Table 2. Attack Rates from Whooplna Coua)a by Ate, Nordl Salawesl, Indonesia, January-J'uae 1983 Tableau 2. Taux d'atteinte de la coquelache par Age, Sala~Nord, lndonlsle, janvier-jtdn 1983 Attact Rate Aaefm Years) No.ofChildren No.ofCua (in1-) Aae (annees) Nombre d'entimu Nombredecu Tawr. d'aUlllntc. (en1-) <I 14 7 50 1-2 17 13 76 3-4 21 17 81 5-6 16 10 63 7-10 23 IS 6S Telal 91 62 '8 Table 3. Immunhation Status of Children With and Without History of Whooplq C...., North Salawesl, Indonesia, Juuary:-JUle 1983 Tableau 3. Situation vacdnale des enfants avec 011 sans an1'cedents de (OQlleI,die, Salawesi-Nord, Indon&le., jantk!r-Jllin 1983 I Jmmlllliaed willl DPT Vaa:me His10ry of Whooping Couab Not Immunized Vllil:da6I &11 DTC Tomi Antkedenu decoquelucbe Non vaccinell Positive - Oui • • • • ♦ • • • • •• 49 Negative - Non . . ... ~ . . . . 19 Total ..••....•••..•.•. 68 Vaccine efflcacy - Efticacite du vaccin; 611\11isl/l0 - 87'1ft Two doses of OPT vaccine seem to have had a significant pro- tective effect against whooping cough in tltis · outbreak. The vaccine efficacy calculated for 2 versus none and 1 dose of DPT vaccine was 87% in this very small sample. I Dole 2Dolel 12 1 6:Z 1 9 29 13 10 91 Deux doses de vaccin DTC semblent avoir ~. au COW'S.de cette flambee, une protection notable contre la coqueluche. · Vefficacite du vaccin, calculee en comparant les enfants ayaat ~ 2 doses de OTC a ceux qui n'en avaient ~ qu'une ou pas du tout, est de 87% dans ce tres petit echantillon. (Based on/D'apres: Assignment Report of a Short-term Consultant, Indonesia, June 1983/Rapport de mission d'un consultant a court terme en Indonesie, juin 1983.) EDITORIAL NOTE: Whooping cough is a relatively difficult dis- ease to diagnose and report through the routine surveillance system. Therefore, any opportunity should be used to collect infor• mation on the disease. . . The investigation oftltis outbreak in North Sulawesi illustrates how valuable information on the epidemiology of the disease and the efficacy of the vaccine can be collected. • lt is~y recommended that 3 doses ofDPT'YllCcine should be given uearly u possible m the lint year of life in order to ensure IW1 pn>tection aplnst whooping cough. INFLUENZA.SURVEILLANCE C'.zECHOSWVAKIA (10 January 1984). - Influenza A(HlNl) virus has been isolated from 1 case during a localized outbreak in Bohemia (western part of the country), which began at 1he end of December. About 10% of young adults in the area of the outbreak were affected. Some further strains of the same virus were also isolated in Slovakia during the outbreak reported previously 1, as well as from sporadic cases in young persons in Bratislava. . • See No. 1, 19&4, p. 4. NOTB DB LA RBDAcnON: La coqueluche est une maladie relativement difficile a diagnostiquer et a notifier dans le cadre du sys~e de surveil- lance systematique. Deslors, il faut saisir toutes les occasions qui s'oftrent de recueillir des informations de base sur cette affection:. Cette enqucte sur une poussee epidemique dans la province de Sula- wesi-Nord montre comment on peut recueillir d'utiles informations sur J'epidemiologie de la maladie et l'efficacite du vaccin. • On ffllOlllmllldea,Wralemcml'adminllttation de 3 cbn de ~DTCleptn tatpomble au eoun de la p!ellli6re llmfJe afln d'mum une proteCtion totale comn, la coquduche. SURVEILLANCE DE LA GRIPPE TCHECOSWVAQUD! (l0janvier 1984)- Au coursd'une flambee loca- lisee survenue en Bohame (ouest du pays) a la fin decemtn, on a pu isoler · le virus grippal A(HlNl). Environ 10% des jeunes adultes vivant clans la region touchee etaient atteints. D'autres souches du mcme virus ont eplement ete isolees en Slovaquie au cours de la flambee precedemment notifiee1 et l'on a note des cas sporadiques chez des jeunes a Bratis- lava. I Voir N" I, 19114, p. 4.