WHO meeting of final review of the RSV surveillance pilot based on the global influenza surveillance and response system, Bangkok, Thailand, 23-25 October 2018

WHO Meeting of Final Review of the RSV Surveillance Pilot Based on the Global Influenza Surveillance and Response System Bangkok, Thailand 23 to 25 October 2018 WHO Reference number: WHO/WHE/IHM/2019.12 © World Health Organization 2019 Some rights reserved. This work is available under the Creative Commons Attribution- NonCommercial-ShareAlike 3.0 IGO licence (CC BY-NC-SA 3.0 IGO; https://creativecommons.org/licenses/by-nc-sa/3.0/igo). Under the terms of this licence, you may copy, redistribute and adapt the work for non- commercial purposes, provided the work is appropriately cited, as indicated below. In any use of this work, there should be no suggestion that WHO endorses any specific organization, products or services. The use of the WHO logo is not permitted. If you adapt the work, then you must license your work under the same or equivalent Creative Commons licence. 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This publication contains the report of the WHO Meeting of Final Review of the RSV Surveillance Pilot Based on the Global Influenza Surveillance and Response System, Bangkok, Thailand 23-25 October 2018 and does not necessarily represent the decisions or policies of WHO Printed in Switzerland Background Respiratory Syncytial Virus (RSV) is a leading viral cause of acute lower respiratory tract infections in infants and young children. The RSV vaccine development landscape is evolving rapidly with several vaccine candidates and monoclonal antibodies in various stages of clinical development. RSV surveillance has the potential to provide an evidence-base on seasonality, healthcare burden (such as hospitalisations) and risk groups to guide immunization practices once the RSV vaccine becomes available. Current evidence gaps also include RSV associated mortality both in the community and healthcare setting, long term impact of RSV infection on future wheeze and lung function, the economic burden of RSV, cost-effectiveness modelling of prevention strategies, RSV disease burden in pregnancy. The RSV surveillance may provide a platform for special studies to address some of these research questions. A three-year pilot project on RSV surveillance based on the Global Influenza Surveillance and Response System (GISRS) was initiated globally in 14 countries across all six WHO regions in 2016. The overall aim was to assess the suitability of the influenza surveillance platform for RSV surveillance and identify ways for expansion of existing surveillance criteria to meet the needs for RSV surveillance without negatively affecting influenza surveillance. At the end of the pilot project, a meeting was organised in Bangkok to bring together about 65 international experts from the influenza and RSV communities, participating countries, and other stakeholders, to review and share the final outcomes of the pilot and discuss post-pilot issues and actions including sustainability of the RSV surveillance. It was noted that when an effective RSV vaccine becomes available there will be a sudden increase in interest in RSV data among policy makers and so data-driven guidance to them will be very valuable. The pilot represents an opportunity to establish a mechanism to generate RSV data for policy purposes at the RSV surveillance pilot sites at low incremental cost. It was agreed that this was a timely opportunity to shape RSV surveillance and establish global guidelines and best practice. It was considered that virologic surveillance would be important to monitor any genetic or antigenic drift, to identify escape mutants, and to understand if genetic changes result in antigenic change and impact on virulence or monoclonal efficacy. The possible impact of any changes on the effectiveness of interventions could then be analysed at the molecular level. At a time when the RSV research community is mainly focused on product development and research, this RSV surveillance pilot would complement by adding new public health dimensions to the global effort to enrich prevention strategies. Participants supported the approach of building RSV surveillance with available resources to be later scaled up once a vaccine becomes available. The Pilot Phase (phase 1) The pilot has made very good progress in terms of the primary objective of the pilot. It has confirmed the feasibility of adding RSV surveillance to GISRS with limited additional support. The RSV surveillance platform can produce useful RSV disease morbidity estimates such as proportion of hospitalizations associated with RSV, evaluate the performance of an RSV surveillance case definition, better understand the local RSV seasonality and global circulation of RSV. Extension of surveillance to additional (paediatric) sites has also been a benefit for influenza surveillance. No important adverse impacts, to date, were noted by countries. There was enthusiasm among participating countries for continuing RSV surveillance with similar level of financial and technical support along with careful monitoring of any potential negative impact on GISRS. Several aspects of the RSV surveillance strategy were discussed including a focus on children less than 2 years with the highest disease burden, the need to define severe clinical outcomes and a clinical severity score to allow a comparison across sites. Monitoring of the implementation of surveillance, referral patterns, contribution of nosocomial RSV infection, to improve data quality and reduce missingness so as to better interpret the findings, was emphasized. Case definition Despite initial concerns about possible adverse effects on GISRS of adoption of an extended SARI / ILI case definition, as the pilot progressed, all countries reported acceptance of these case definitions without any significant negative impact on influenza surveillance. It was clarified that the SARI case definition for influenza surveillance remained unchanged. Early challenges for physicians to use the extended SARI case definition were resolved through training. More than 21,000 patients were recruited and tested for RSV, of whom 73% were hospital admissions. Overall, 60% of patients tested were less than 5 years (20% less than 6 months, 30% between 6 months to 2 years and 10% between 2 and 5 years age). There was limited recruitment in older age groups. Use of SARI / ILI case definitions would have missed 29% of cases in infants less than 6 months (compared to when using the extended SARI definition). Seasonality RSV peaked in colder months in temperate regions (duration 5-35 weeks) and in the rainy season in tropical regions. The peaks seemed consistent from year to year in individual countries. There was no difference in season onset across age groups. It was considered essential that further details of the surveillance sites and how they implemented the surveillance (e.g. referral patterns, ICU availability, contribution of nosocomial RSV) be presented to be able to interpret data. It was noted that large sample size and data for more seasons will be required to better understand seasonality. For countries with a large latitudinal spread, sentinel sites would need to be geographically representative of the climactic zones at the sub-national level. Disease burden estimation RSV surveillance is not expected to produce detailed and robust burden of disease estimates in all or most LMIC. Nonetheless, national policy makers should find useful estimates of RSV- associated hospitalizations in the absence of sophisticated special disease burden estimation studies. A tiered approach was discussed wherein a range of options of morbidity or healthcare burden estimates would be available based on a review of availability of (and effort to generate) denominator-related data along with an explicit understanding of quality, limitations and potential bias of the data. The burden estimates are grouped based on increasing levels of complexity of collecting data from a sentinel surveillance platform. Tier 1 groups burden estimates related to proportions of hospitalization associated with RSV. Tier 2 groups population-based incidence estimates of hospitalization, ICU-based burden, and mortality estimates including case-fatality ratio and proportion of hospital deaths due to RSV. The third tier refers to national extrapolation of population-based hospitalization incidence rates. Countries generally agreed to collect the most basic data (tier 1) required to estimate proportions of hospitalization associated with RSV in the second phase of the surveillance. Countries with additional resources and capacities may opt to use more sophisticated approaches for estimation of RSV disease burden. It was agreed that future directions should make clearer that the RSV surveillance is not trying to encourage all countries towards sophisticated RSV disease burden estimates. Notwithstanding, it was agreed that it was important for some level of burden data feasible from surveillance platform, to be collected in the next phase. Phase 2 The main aims of RSV surveillance pilot phase 1 were focused on establishment of the essential parameters for surveillance. In Phase 2 geographical representation will be increased from the current 1-2 countries per region, focusing on GAVI-eligible countries. The general aim will be to support the future introduction of vaccine into countries. An ICD codes-based methodology for RSV surveillance developed using ICD-codes data from clinics and hospitals in Germany will be tested in other country contexts. Case definitions will be kept the same and will focus on children less than 2 years in phase-2. Case-based data would be retained in Phase 2 to gather these data over several years. The case report form (CRF) will be revised in line with the comments made at this meeting and will aim to include some readily available clinical severity- related data. The feasibility of collecting some specific economic data (direct costs of surveillance) will be explored as costs are likely to vary greatly by setting. Periodic reviews of data quality will be conducted with regular feedback to pilot sites to improve quality. RSV detection, typing and sequencing It was considered that virologic surveillance would be important to monitor genetic or antigenic drift, to identify escape mutants, and to understand if genetic changes result in antigenic change and impact on virulence or monoclonal efficacy. The possible impact of any changes on the effectiveness of interventions could then be analysed at the molecular level. The consensus was that RSV-A/RSV-B typing results and partial or complete RSV genome data would be important. RSV typing will be conducted in all sites by the National Influenza Centres (NIC)s. RSV sequencing will be supported in a few laboratories to bridge the gap of understanding and to help inform future vaccine development. Protocols for RSV sequencing will be developed in Phase 2. This will build on influenza experience with GenBank, GISAID and software tools linking sequence and clinical data. An EQA for RSV typing and for genetic sequencing and detailed guidelines on how laboratories should maintain internal quality control procedures will be developed. WHO will engage with other stakeholders to promote and support international agreement on nomenclature. It was suggested that Phase 2 should aim to show feasibility of generating quality sequence data from the GISRS RSV surveillance platform. A more formal designation as a RSV reference laboratory together with clear terms of reference (including the level of country support envisaged) will be developed to help facilitate getting support from national authorities. It was noted that the project needed a solution for sample storage so that these can be available for future detailed genetic and antigenic characterization studies. Way forward In the second phase, geographical representation will be increased with a focus on GAVI- eligible countries. The overall aim will be to support the future introduction of vaccine into countries. The project will develop protocols for RSV typing and sequencing, shipment of virus materials, data sharing and use, and will maintain the high quality of laboratory performance through EQA monitoring. There was clear support from the Regional Offices and pilot countries for Phase 2 with similar levels of resources being made available. It was considered important to secure funding support from donor agencies to provide additional support to develop laboratory capacity and readiness. Ongoing consideration of future post-pilot sustainability was important given the context that the main financial support was external. Summary The meeting summarized the outcomes and the lessons learnt from the pilot phase. Key takeaway messages included the feasibility of leveraging the influenza surveillance platform for RSV surveillance without any significant adverse impact; the application of the extended SARI case definition for RSV surveillance; the focus on young children with the highest RSV disease burden; the need to ascertain seasonality patterns and measure simple RSV disease burden estimates such as proportions of hospitalizations due to RSV that would inform policy decisions on vaccine investment and introduction. Going forward, the meeting concluded to revise the WHO RSV Surveillance strategy for the next phase of surveillance to further focus on children less than 2 years with the highest burden; adopt a tiered approach to disease burden estimation with emphasis on basic estimates of hospital burden of RSV; ascertain RSV circulation by virus type A or B; develop laboratory protocols for RSV typing and schema for sequencing; and expand to countries that are geographically more representative as well as are eligible to receive investment from the Gavi Alliance for RSV vaccine introduction when it becomes available. Acknowledgements This meeting was supported by an award made to the World Health Organization by the Bill & Melinda Gates Foundation (grant no. OPP1127419). We thank Joshua Mott, Centers for Disease Control and Prevention, Bangkok and the WHO Country Office, Thailand for providing local support for the meeting. The WHO acknowledges the contributions by Harish Nair, Chair and all the national and international experts that participated in the meeting. We thank the RSV reference laboratories, the National Influenza Centres, and the National Epidemiology Centres for their support to the WHO RSV Surveillance. The report was prepared by Harry Campbell and reviewed internally by Siddhivinayak Hirve, Sandra Jackson, Ann Moen and Wenqing Zhang and externally by Harish Nair, Chair of the meeting. Annexes Annex 1: Agenda WHO Meeting of Final Review of the RSV Surveillance Pilot based on the Global Influenza Surveillance and Response System (GISRS) Bangkok, Thailand 23 – 25 October 2018 PROVISIONAL AGENDA Chair: H. Nair Rapporteur: H. Campbell Tuesday, 23 October 2018 08:30 – 09:00 Registration 09:00 – 09:20 Opening and welcome Kertesz D, WHO Representative, Thailand Moen A, Chief, IPR, WHO Karnkawinpong O, Dir General, Dept. of Medical Sciences, Ministry of Public Health, Thailand 09:20 – 09:30 Introduction of work Disclosure of interest Housekeeping announcement Zhang W, Head, GIP, WHO Session I: RSV - Setting the context Session co-chair: Chittaganpitch M 09:30 - 09:45 RSV vaccine development - strategic priorities Higgins D 09:45 - 10:00 RSV epidemiology - knowledge gaps Nair H 10:00 - 10:15 WHO RSV surveillance strategy – recap Broor S 10:15 - 10:30 RSV surveillance - progress so far Hirve S 10:30 - 11:00 Coffee Break 11:00 - 11:30 Focused plenary discussion Moderator: Gerber S 11:30 - 11:45 Variability in RSV F protein - implications for global surveillance Williams T (Webex) Session II: RSV surveillance - Pilot Outcomes Session co-chair: Mott J 11:45 - 11:55 Outcome # 1: WHO RSV surveillance strategy Campbell H 11:55 - 12:15 Plenary feedback Moderator - Ziegler T 12:15 - 13:15 Lunch break 13:15 - 13:25 Outcome # 2: External Quality Assurance Baumeister E 13:25 - 13:45 Plenary feedback Moderator - Ziegler T 13:45 - 14:00 Outcome # 3: Case definition Crawford N 14:00 - 14:15 Outcome # 4: RSV seasonality Chadha M 14:15 - 14:30 Outcome # 5: RSV disease burden Moyes J 14:30 - 15:00 Coffee break 15:00 - 17:30 WG - case definition WG - seasonality WG – burden Moderator: Broberg E Moderator: Ziegler T Moderator: Pebody R 19.00 – 21.00 Cocktail Reception Wednesday, 24 October 2018 09:00 – 09:10 Recap of Day 1 Nair H / Campbell H 09:10 - 10:00 Feed-forward - WG (case definition) WG (seasonality) WG (burden) Broberg E Ziegler T Pebody R 10:00 - 10:15 Outcome # 6: Using ICD-10 based data for RSV surveillance Cai W 10:15 - 10:30 Outcome # 7: Risk factors for severe RSV disease based on ICD codes Cai W 10:30 - 11:00 Coffee break 11:00 - 11:15 Plenary discussion: Limitations and challenges in use of ICD codes for RSV surveillance Moderator – Buda S 11:15 - 11:45 Panel discussion: RSV surveillance outcomes - caveats and their implications on the outcomes Moderator: Gerber S Panelist: Baumeister E; Bont L; Pebody R; Nair H 11:45 - 12:15 Plenary discussion - what could have been done differently? Moderator – Fasce R 12:15 - 12:30 Strategic priorities and expectations - a BMGF perspective Srikantiah P 12:30 - 13:30 Lunch break Session III: RSV surveillance - next phase Session co-chair: Moen A 13:30 - 13:40 RSV surveillance: What next? Zhang W 13:40 - 14:10 Plenary discussion Moderator - Nair H Parallel session IIIA: Lab-related Moderator: Venter M; Rapporteur: Teurnicht F Parallel session IIIB: Epi-related Moderator: Bont L; Rapporteur: Campbell H 14:10 – 14:25 RT-PCR assay protocols for RSV subtyping Lindstrom S RSV surveillance: Sampling strategy Campbell H 14:25 - 15:00 Group Discussion Group Discussion 15:00 - 15:30 Tea / coffee break 15:30 - 15:45 Schema for RSV sequencing Zambon M Estimating RSV disease burden Moyes J 15:45 - 16:30 Group Discussion Group Discussion 16:30 - 16:45 EQAP for next phase Barr I Minimum data - clinical, laboratory Crawford N 16:45 - 17:30 Group Discussion Group Discussion 17:30 – 17:45 Group Discussion – any other issue Group Discussion – any other issue 17:45 Close of Day Thursday, 25 October 2018 09:00 – 9:10 Recap of Day 2 Nair H / Campbell H 09:10 - 09:50 Feed-forward - Epi Group Campbell H 09:50 - 10:30 Feed-forward - Lab Group Treurnicht F 10:30 - 11:00 Coffee break Session IV: Way forward Session co-chair: Gerber S 11:00 - 11:40 RSV reference laboratories - roles and expectations Lindstrom S (CDC) Todd A (VIDRL) Zambon M (PHE) Treurnicht F (NICD) 11:40 - 12:15 Plenary discussion Moderator: Broor S 12:15 - 13:15 Lunch break 13:15 - 13:25 Sustainability - incremental costs Jackson S 13:25 - 13:45 Plenary discussion Moderator: Moen A 13:45 - 14:00 RSV surveillance: Work Plan for the next phase Hirve S 14:00 - 14:45 Plenary discussion Moderator: Zhang W 14:45 - 15:15 Coffee break 15:15 - 15:45 Panel discussion: Implications of RSV surveillance for GISRS - a perspective from the WHO regions Moderator: Teurnicht F Panelist: Palekar R (AMRO)- webex Rajatonirina S (AFRO) Malik S (EMRO) Gould P (SEARO) Kato M (WPRO) webex 15:45 – 16:15 Plenary discussion: Implications of RSV surveillance for GISRS - a country perspective Moderator: Venter M 16:15 - 16:25 Wrap up Nair H 16:25 - 16:35 What next? Zhang W 16:35 - 16:40 Closure of the meeting Moen A Annex 2: Provisional list of participants Dr Burmaa Alyeksandr National Influenza Surveillance Division, NIC National Centre of Communicable Diseases Ministry of Health Ulaanbataar Mongolia Tel: + 976 99085415 email: aburma69@gmail.com Dr Darmaa Badarch Virology Laboratory, NIC National Centre of Communicable Diseases Ministry of Health Ulaanbataar Mongolia Tel: + 976-11-455847 Mobile: + 976-99754824 email: darmaanicmn@gmail.com Dr Cristina Bancej Vaccine Safety Surveillance and Epidemiology Division Public Health Agency Ottawa, Ontario K1A 0K9 Canada Tel: + email: christina.bancej@phac- aspc.gc.ca Dr Ian Barr WHO Collaborating Centre for Reference and Research on Influenza (VIDRL) Peter Doherty Institute for Infection & Immunity Melbourne. VIC 3000 Australia Tel: + 613 93429311 email: Ian.Barr@influenzacentre.org Dr Elsa Baumeister Servicio Virosis Respiratorias Departamento Virología-Centro Nacional de Influenza de OPS/OMS INEI-ANLIS “Carlos G. Malbrán” Buenos Aires Argentina Tel: + 54 11 4301 1035 email: elsabaumeister@gmail.com; ebaumeister@anlis.gov.ar Professor Louis Bont University Medical Center Utrecht Heidelberglaan 100 3584 CX Utrecht Netherlands Tel: + email: L.Bont@umcutrecht.nl Dr Eeva Broberg Disease Programme Influenza and other Respiratory Viruses (IRV) European Centre for Disease Prevention and Control 171 83 Stockholm Sweden Tel: + 46707763835 email: eeva.broberg@ecdc.europa.eu Dr Shobha Broor SGT University Chandu-Budhera Gurgaon (Haryana) India Tel: + 919958968787 email: shobha.broor@gmail.com Dr Silke Buda Robert Koch Institue D-13302 Berlin Germany Tel: + email: BudaS@rki.de Dr Wei Cai Unit 36 Respiratory Infections Department for Infectious Disease Epidemiology Robert Koch Institute 13353 Berlin Germany Tel: + 49 30 18754 3889 email: CaiW@rki.de Dr Harry Campbell Centre for Population Health Sciences The University of Edinburgh Medical School, Teviata Place Edinburgh EH8 9AG UK Tel: + 441316503214 email: harry.campbell@ed.ac.uk Dr Mandeep Chadha Influenza Group National Institute of Virology Pune 411001 India Tel: + 91 9860038654 email: mscniv@gmail.com Ms Amonlaya Chaiyakum U.S. CDC Collaboration Ministry of Public Health Nonthaburi 11000 Thailand Tel: + email: wzi2@cdc.gov Ms Malinee Chittaganpitch National Institute of Health Department of Medical Sciences Ministry of Public Health Nonthaburi 11000 Thailand Tel: + 668 18752792 email: malinee.c@dmsc.mail.go.th Dr Supamit Chunsuttiwat Department of Disease Control Ministry of Public Health Thailan Dr Daouda Coulibaly Institut National de l'Hygiène Publique Treichville Km 4 Ivory Coast Tel: + email: daocoul@yahoo.fr Dr Nigel Crawford SAEFVIC Murdoch Childrens Research Institute Tel: + email: nigel.crawford@mcri.edu.au Parkville Victoria 3052 Australia Dr Terezinha Maria de Paiva Instituto Adolfo Lutz CEP 01246-902 - Sao Paolo Brazil Tel: + 19 97130 9595 email: tterezinha@uol.com.br Dr Dominic Dwyer NSWHP Public Health Pathology Institute of Clinical Pathology and Medical Research Westmead Hospital New South Wales Australia Tel: + 61298456635 email: dominic_dwyer@wmi.usyd.edu.au Dr Joanna Ellis National Influenza Centre Public Health England London, NW9 5HT UK Tel: + 44 20 8327 7633 email: joanna.ellis@phe.gov.uk Dr Rodrigo Fasce Departamento de Laboratorio Biomédico Instituto de Salud Pública de Chile Santiago Chile Tel: + 56 2 5755447 email: rfasce@ispch.cl Dr Susan I. Gerber Respiratory Viruses Branch (RVB) National Center for Immunization and Respiratory Diseases Centers for Disease Control and Prevention Atlanta, GA 30333 USA Tel: + email: bhx1@cdc.gov Dr Erica Guthrie National Center for Immunization and Respiratory Diseases Centers for Disease Control and Prevention Atlanta, GA 30333 USA Tel: + 1 404-639-3795 email: ilj2@cdc.gov Dr Deborah Higgins RSV Vaccine Project PATH - Vaccine Development Global Program Seattle, WA 98121 USA Tel: + 1 2066198903 email: dhiggins@path.org Dr Sopon Iamsirithaworn Department of Disease Control Ministry of Public Health Thailand Dr Herve Kadjo Institut Pasteur de Côte d'Ivoire Tel: + 225 07 78 61 95 Department of Epidemic Viruses Respiratory Viruses Unit 01 BP 490 Abidjan 01 Ivory Coast email: rvkdjo@yahoo.fr; hervekadjo@pasteur.ci Dr Opart Karnkawinpong Department of Medical Sciences Ministry of Public Health Nonthaburi 11000 Thailand Tel: + email: Dr Stephen Lindstrom Virus Surveillance and Diagnosis Branch Influenza Division, NCIRD Centers for Disease Control and Prevention Atlanta, GA 30333 USA Tel: + 1 404 639 1587 email: sql5@cdc.gov Dr Alissa McMinn SAEFVIC Murdoch Children's Research Institute The Royal Children's Hospital Victoria 3052 Australia Tel: + 61438615108 email: alissa.mcminn@mcri.edu.au Dr Manal Morcos Fahim Acute Respiratory Illness and Influenza Ministry of Health and Population Cairo Egypt Tel: + 20122598200 email: fahimmanal@yahoo.com Dr Joshua Mott U.S. CDC Collaboration Ministry of Public Health Nonthaburi 11000 Thailand Tel: + email: zud9@cdc.gov Dr Jocelyn Moyes National Institute for Communicable Diseases Centre for Respiratory Diseases and Meningitis (Virology) NICD Sandringham, Johannesburg South Africa Tel: + 27828832044 email: jocelynm@nicd.ac.za; jossmoyes@gmail.com Professor Harish Nair Centre for Global Health Research The University of Edinburgh Edinburgh EH8 9AG UK Tel: + 44 131 6506963 email: Harish.Nair@ed.ac.uk Dr Richard Pebody Flu Surveillance Public Health England London UK Tel: + 44 7740896768 email: Richard.Pebody@phe.gov.uk Dr Maria Pisareva Research Institute of Influenza Russian Academy of Medical Sciences National Influenza Center 197376 St Petersburg Russian Federation Tel: + email: pisareva@influenza.spb.ru; pisarevam@gmail.com Dr Patrick Reading Peter Doherty Institute for Infection and Immunity Melbourne Australia Tel: + +61 3 9342 9300 email: Patrick.Reading@influenzacentre.org Dr Paola Resende Silva Laboratorio de Virus Respiratorios Instituto Oswaldo Cruz (IOC) Fundação Oswaldo Cruz (FIOCRUZ) 21045-900 - Rio de Janeiro Brazil Tel: + 55 21984030221 email: paola@ioc.fiocruz.br Dr Simran Sandhu Public Health Agency Ottawa, Ontario K1A 0K9 Canada Tel: + email: simran.sandhu2@canada.ca Professor Eric Simoes Colorado School of Public Health Children's Hospital Colorado Aurora, CO 80045 USA Tel: + email: Eric.Simoes@ucdenver.edu Professor Peter George Smith MRC Tropical Epidemiology Group London School of Hygiene & Tropical Medicine London WC1E 7HT UK Tel: + email: Peter.Smith@lshtm.ac.uk Dr Elizaveta Smorodintseva Research Institute of Influenza Ministry of Health of the Russian Federation 197376 Saint Petersburg Russian Federation Tel: + 78 124991509 email: smorodintseva@influenza.spb.ru Dr Viviana Sotomayor Ministerio de Salud Chile Division de Planificacion Sanitaria Santiago Chile Tel: + 56977596014 email: vsotomay@minsal.cl Dr Padmini Srikantiah Infectious Diseases Global Health Program Bill & Melinda Gates Foundation Seattle, WA 98109 USA Tel: + email: padmini.srikantiah@gatesfoundation.org Ms Suthanun Suthachana Bureau of Epidemiology Department of Diseases Control Chang Wat Nonthaburi 11000 Thailand Tel: + 66816213654 email: suthachana@gmail.com Miss Rutairut Tago National Institute of Health Department of Medical Sciences Thailand Tel: + 66928840928 email: pap_11@hotmail.com Dr Thanawadee Department of Disease Control Ministry of Public Health Thailand Dr Sombat Thanphasertsuk Department of Disease Control Ministry of Public Health Thailand Dr Almiro Tivane Laboratório de Isolamento Viral Departmento de Plataformas Tecnológicas Instituto Nacional de Saúde/MISAU Maputo Mozambique Tel: + 258)21 30 93 17 Cell: +258 82 68 25 330 email: artivane@gmail.com Dr Angela Todd Genetic Analysis Unit The Peter Doherty Institute for Infection and Immunity Melbourne Victoria, 3000 Australia Tel: + 61 3 9342 9319 email: angela.todd@influenzacentre.org Dr Florette Treurnicht Centre for Respiratory Diseases and Meningitis (CRDM) National Institute for Communicable Diseases National Health Laboratory Service Sandringham, 2131 South Africa Tel: + 27-11-386 6390, 27-73287 5708 email: florettet@nicd.ac.za Dr Miquelina Vaz Nacional de Saúde Pública Departamento de Epidemiologia Maputo Mozambique Tel: + email: Professor Marietjie Venter Zoonotic arbo- and Respiratory virus Research program Center for Viral Zoonosis Department Medical Virology University of Pretoria Arcadia, 0007 Tel: + 27832930884 email: marietjie.venter@up.ac.za South Africa Professor Maria Zambon Virus Reference Department Respiratory Virus Unit Public Health England NW9 5HT - London UK Tel: + 44 208 327 6207, +44 20 8327 6810 (PA) email: maria.zambon@phe.gov.uk Dr Niteen Wairagkar Seattle, WA 98109 USA Tel: + email: Dr Thomas William Institute of Genetics and Molecular Medicine University of Edinburgh Crewe Road EH4 2XU UK Tel: + email: Dr Theodor Ziegler Kaivokatu 8 A 19 FI-20500 Turku Finland Tel: + 358 40 532 4790 email: thedi.ziegler@utu.fi WHO Secretariat Claire Blackmore SE/ACO/THA Tel: blackmorec@who.int Phiangjai Boonsuk SE/ACO/THA Tel: boonsukp@who.int Sylvie Briand HQ/WHE/IHM Tel: 41 22 791 2372 briands@who.int Richard Brown SE/ACO/THA Tel: 66 25 470103 brownr@who.int Hien Doan HQ/WHE/IHM/IPR Tel: 41 22 791 2226 doanh@who.int Daniel Feikin HQ/FWC/IVB Tel: feikind@who.int Martin Friede HQ/FWC/IVB/IVR Tel: 41 22 791 4398 friedem@who.int Christian Fuster HQ/WHE/IHM/IPR Tel: 41 22 791 2869 fusterc@who.int Philip Gould SE/RGO/WHE/IHM Tel: 911123370804 gouldp@who.int Siddhivinayak Hirve HQ/WHE/IHM/IPR Tel: 41 22 791 3413 hirves@who.int Sandra Jackson HQ/WHE/IHM/IPR Tel: jacksons@who.int Masaya Kato WP/RGO/WHE/CPI Tel: 63 2 5289828 katom@who.int Daniel Kertesz SE/ACO/THA Tel: 258 21 491991 kerteszd@who.int Mamunur Malik EM/RGO/WHE/IHM Tel: 20-2-22765583 malikm@who.int Ann Moen HQ/WHE/IHM/IPR Tel: 41 22 791 4309 moena@who.int Piers A. N. Mook EU/RGO/WHE/IHM Tel: 45 45 337 078 mookp@who.int Sonja Olsen EU/RGO/WHE/IHM Tel: olsens@who.int Catherine Oswald HQ/WHE/IHM Tel: 41 22 791 2274 oswaldc@who.int Rakhee Palekar AM/PAHO Tel: palekarr@paho.org Soatiana Rajatonirina AF/RGO/WHE/IHM Tel: rajatonirinas@who.int Raphael Slattery HQ/WHE/IHM Tel: 41 22 791 3692 slatteryr@who.int Wenqing Zhang HQ/WHE/IHM/IPR Tel: 41 22 791 4282 zhangw@who.int Annex 3: Disclosure of interest by experts Disclosure of Interest Eeva Broberg None Shobha Broor None Silke Buda None Rodrigo Fasce None Sue Gerber None Malinee Chittaganpitch None Richard Pebody None Maritjie Venter None Thedi Ziegler None Josh Mott Not shared Louis Bont Not recd. Personal fees. UMC, Utrect recd >100,000 EUR per industrial partner for investigator initiated studies from AbbVie, Jansen, MedImmune. UMC, Utrect recd minor funding for consultation and invited lectures by industry (total annual estimate <Eur 20,000) Harry Campbell Consultancy contract with U of Edinburg (benefits to University and personal): BMGF, US fund for UNICEF, Sanofi (for Clostridium, meningitis, Strep pneumonia) Research grants: BMGF, WHO, Sanofi, EU IMI / EFPIA, UK NIHR, RESPIRE Non-monetary support for travel / conference attendance: WHO, World Society for Ped Infectious Diseases, Salk Institute, Merieux Foundation Harish Nair Advisory Board MEDI8897, WHO RSV surveillance Research Grants for RSV, influenza, child pneumonia: Sanofi (GBP 1.1 million), BMGF GBP 5 million), IMI (GBP 4 million), NIHR (GBP 7 million), WHO (GBP 650,000) Honoraria for speakership: Abbvie (GBP 1200) Florette Teurnicht Research grant: CDC (USD 2.1 million)