Influenza Situation Update| 1 Bi-weekly Influenza Situation Update 19 December 2017 Virological Surveillance Summary The total number of specimens and number of positive specimens reported to FluNet by the Western Pacific Region countries and areas between week 1 and week 49 are presented in the table below. Influenza A(H3) is currently the predominant circulating subtype (Figure 1). Table 1: Countries and areas reporting data to FluNet, Western Pacific Region, weeks 1 to 49, 2017 Figure 1: Number of specimens positive for influenza by subtype, Western Pacific Region, week 51 2016 to week 49 2017 (Source: www.who.int/flunet) Country (most recent week of report) Total number of specimens processed Total number of influenza positive specimens Australia (week 49) 53,144 9,941 Cambodia (week 47) 1,195 214 China (week 49) 614,716 82,736 Fiji (week 42) 424 107 Japan (week 48) NA 7,861 Lao People's Democratic Republic (week 48) 4,571 752 Malaysia (week 35) 3,503 467 Mongolia (week 48) 3,316 441 New Caledonia (week 46) 1,000 172 New Zealand (week 18-39) 2,307 945 Papua New Guinea (week 39) 281 24 Philippines (week 48) 1,240 263 Republic of Korea (week 49) 10,983 849 Singapore (week 48) 1,896 961 Viet Nam (week 47) 2,097 545 Influenza Situation Update| 2 Bi-weekly Influenza Situation Update 19 December 2017 Influenza surveillance summary Influenza surveillance in the WHO Western Pacific Region is based on outpatient and inpatient sentinel indicator based surveillance (IBS) systems as well as event-based surveillance. Case definitions, populations under surveillance and data formats differ among countries. This influenza surveillance summary includes countries/areas where routine IBS is conducted and information is available. The WHO surveillance case definition for ILI is an acute respiratory infection with a measured fever of ≥38oC and cough, with symptom onset within the last 10 days. For SARI, it is an acute respiratory infection (ARI) with a history of fever or measured fever of ≥38oC and cough, with symptom onset within the last 10 days and requires hospitalization. Countries in the temperate zone of the Northern Hemisphere In most countries within the temperate zone of the Northern Hemisphere, ILI and influenza activity are consistent with seasonal trends. Outpatient ILI Surveillance China (North) During week 49, the percentage of visits for ILI at national sentinel hospitals in northern China was 4.0%, which is higher than the previous week (3.7%) as well as the same week of 2014, 2015 and 2016 (3.5%, 2.5% and 3.2%) (Figure 2). Mongolia ILI activity remained at expected levels during week 49 compared to the previous week and seasons. The most recent peak in ILI activity occurred in week 4 of 2017 (Figure 3). Mongolia publishes weekly reports, available here: http://www.flu.mn/eng/index.php?option=com_content&task= section&id=5&Itemid=51 China (North) Mongolia Figure 2: Percentage of visits for ILI at sentinel hospitals in north China, 2014-2017 (Source: China National Influenza Center) Figure 3: Proportion of outpatient ILI visits (per 10,000 people), 2014-2017 (Source: Mongolia National Influenza Center) Influenza Situation Update| 3 Bi-weekly Influenza Situation Update 19 December 2017 Republic of Korea In week 49, there were 19.0 ILI cases per 1,000 outpatient visits, which was higher than the previous week (11.5). ILI activity is increasing in line with the 2016 seasonal increase (Figure 4). Korea publishes a weekly report, available here: http://www.cdc.go.kr/CDC/info/CdcKrInfo0301.jsp?menuIds=HOME001-MNU1154-MNU0005-MNU0037- MNU1380 Republic of Korea Figure 4: Weekly ILI incidence rate per 1,000 patients, 2013-2017 (Source: Korean Centre for Disease Control and Prevention) Sentinel influenza surveillance Japan In week 48, influenza activity in Japan shows a similar seasonal pattern to previous years with few influenza cases reported weekly per reporting sentinel hospital (Figure 5). More information about historical trends are available here: https://www.niid.go.jp/niid/en/10/2096-weeklygraph/1644- 01flu.html Japan Figure 5: Number of influenza cases reported weekly per reporting sentinel hospital site, Japan 2007-2017 (Source: Japan National Institute of Infectious Diseases) Influenza Situation Update| 4 Bi-weekly Influenza Situation Update 19 December 2017 Countries/areas in the tropical zone Countries/areas in the tropical zone are observing influenza activity that is consistent with previous seasons. Surveillance Hong Kong SAR (China) – ILI and hospital Surveillance In week 49, the average consultation rate for influenza-like illness (ILI) among sentinel general outpatient clinics (GOPCs) was 3.4 ILI cases per 1,000 consultations, which was lower than that recorded in the previous week (5.9) (Figure 6). The average consultation rate for ILI among sentinel private doctors was 41.4 ILI cases per 1,000 consultations, which was higher than the rate recorded in the previous week (35.4) (Figure 7). Hong Kong SAR, China publishes a weekly report, available here: http://www.chp.gov.hk/en/guideline1_year/29/134/441/304.html Hong Kong (China) - ILI Surveillance Figure 6: ILI consultation rates at sentinel general outpatient clinics, Hong Kong 2013-2017 (Source: Hong Kong Centre for Health Protection) Figure 7: ILI consultation rates at sentinel private doctors, Hong Kong 2013-2017 (Source: Hong Kong Centre for Health Protection) China (South) - ILI Surveillance During week 49, the percentage of outpatient or emergency visits for ILI at national sentinel hospitals in southern China was 3.5%, which is higher than the last week (3.3%) as well as the same week of 2014, 2015 and 2016 (2.2%, 2.6% and 3.3%) (Figure 6). Singapore – Acute Respiratory Infection Surveillance The average daily number of patients seeking treatment in polyclinics for acute respiratory infection decreased from 2,836 per working day in week 48, to 2,711 per working day in week 49 (Figure 9). The proportion of patients with ILI among polyclinic attendances for ARI remained at 1.8%. Singapore publishes a weekly report, available here: http://www.moh.gov.sg/content/moh_web/home/statistics/infectiousDiseasesStatistics/weekly_infecti ousdiseasesbulletin.html Influenza Situation Update| 5 Bi-weekly Influenza Situation Update 19 December 2017 China (South) - ILI Surveillance Singapore – ARI Surveillance Lao PDR In week 49, influenza activity increased compared to the previous week. In week 49 the numer of cases is higher than that reported in the same week between 2012 and 2015 but lower than that reported in 2016 (see Figure 10). Figure 10: Weekly number of ILI presentations at sentinel sites, 2012 to week 49 2017, Lao PDR (Source: Lao National Center for Laboratory and Epidemiology) Figure 8: Percentage of visits due to ILI at national sentinel hospitals in South China, 2014- 2017 (Source: China National Influenza Center) Figure 9: Average daily polyclinic attendances for ARI in Singapore, 2016-2017 (Source: Singapore Ministry of Health) Influenza Situation Update| 6 Bi-weekly Influenza Situation Update 19 December 2017 Countries in the temperate zone of the southern hemisphere In the temperate zone of the southern hemisphere, influenza activity followed seasonal trends. Australia – Laboratory-confirmed influenza (no update) The number of laboratory confirmed influenza cases has decreased from a peak reached in week 33. As of 27 October 2017 (week 42), a total of 229,579 notifications of laboratory confirmed influenza were reported to the National Notifiable Diseases Surveillance System (Figure 11). Sixty-three percent of notifications were influenza A (57% A(unsubtyped), 4% influenza A(H3N2) and 1% influenza A(H1N1pdm09)), 37% were influenza B and less than 1% were influenza A&B co-infections or untyped. Australia publishes influenza surveillance reports on a fortnightly basis during the influenza season, typically between May and October. For more information: http://www.health.gov.au/internet/main/publishing.nsf/content/cda-surveil-ozflu-flucurr.htm#current Figure 11: Australian notifications of laboratory confirmed influenza (Source: National Notifiable Diseases Surveillance System, Australian Department of Health) New Zealand – Influenza like Illness (no update) During week 39, 80 patients with influenza-like illness consulted sentinel general practices in 20 district health boards (DHBs). The weekly ILI incidence was 19.5 per 100 000 patient population. Of the 36 laboratory tested ILI cases, eight were positive for influenza viruses. This gives an ILI related influenza incidence (adjusted) of 4.3 per 100 000 patient population. New Zealand publishes a weekly report, available here: https://surv.esr.cri.nz/virology/influenza_weekly_update.php Influenza Situation Update| 7 Bi-weekly Influenza Situation Update 19 December 2017 Figure 12: Weekly resident ILI and influenza incidence since Week 1 of 2017 in New Zealand (Source: Institute of Environmental Science and Research Ltd (ESR), New Zealand) Pacific Island Countries and Areas (PICs) - ILI Surveillance In the Pacific Island Countries and Areas, in week 49, the number of ILI cases reported compared to previous weeks increased in several PICs, including Federated States of Micronesia, Fiji and Vanuatu (Figure 13). The PICs submit a report on a weekly basis, for more information: http://www.wpro.who.int/southpacific/programmes/communicable_diseases/disease_surveillance_res ponse/page/en/index2.html Influenza Situation Update| 8 Bi-weekly Influenza Situation Update 19 December 2017 Figure 13: Reported cases of influenza-like illness in Pacific Island Countries, 2017 Influenza Situation Update| 9 Bi-weekly Influenza Situation Update 19 December 2017 Global influenza situation updates Epidemiological update http://www.who.int/influenza/surveillance_monitoring/updates/latest_update_GIP_surveillance/en/ Virological update: http://www.who.int/influenza/gisrs_laboratory/updates/summaryreport/en/ Global update: http://www.who.int/influenza/surveillance_monitoring/updates/latest_update_GIP_surveillance/ Others: Recommended composition of influenza virus vaccines for use in the 2017 southern hemisphere influenza season http://www.who.int/influenza/vaccines/virus/recommendations/2017_south/en/ Recommended composition of influenza virus vaccines for use in the 2017- 2018 northern hemisphere influenza season http://www.who.int/influenza/vaccines/virus/recommendations/201703_recommendation.pdf?ua=1 Antigenic and genetic characteristics of zoonotic influenza viruses and candidate vaccine viruses developed for potential use in human vaccines http://www.who.int/influenza/vaccines/virus/characteristics_virus_vaccines/en/ 4th WHO Informal Consultation on Improving Influenza Vaccine Virus Selection http://www.who.int/influenza/vaccines/virus/4thmtg_improve_vaccine_virus_selection/en/ Video on influenza on WHO's YouTube Channel Arabic: https://www.youtube.com/watch?v=PxW6Pg1AnwI Chinese: https://www.youtube.com/watch?v=xW9gDKEPitQ English: https://www.youtube.com/watch?v=yhhJfT86Bgg French: https://www.youtube.com/watch?v=8mo8rWWJZkc Russian: https://www.youtube.com/watch?v=XQO6nbkKUWQ Spanish: https://www.youtube.com/watch?v=qXr75cKxwTY
Bi-weekly Influenza Situation Update 5 December 2017 Virological Surveillance Summary The total number of specimens and number of positive specimens reported to FluNet by the Western Pacific Region countries and areas between week 1 and week 47 are presented in the table below. Influenza A(H3) is currently the predominant circulating subtype (Figure 1). Table 1: Countries and areas reporting data to FluNet, Western Pacific Region, weeks 1 to 47, 2017 Figure 1: Number of specimens positive for influenza by subtype, Western Pacific Region, week 49 2016 to week 47 2017 (Source: www.who.int/flunet) Country (most recent week of report) Total number of specimens processed Total number of influenza positive specimens Australia (week 47) 52,575 9,910 Cambodia (week 45) 1,152 212 China (week 47) 584,172 77,534 Fiji (week 42) 424 107 Japan (week 46) NA 7,686 Lao People's Democratic Republic (week 47) 4,493 748 Malaysia (week 35) 3,503 467 Mongolia (week 46) 3,086 422 New Caledonia (week 46) 1,000 172 New Zealand (week 18-39) 2,307 945 Papua New Guinea (week 39) 281 24 Philippines (week 47) 1,211 263 Republic of Korea (week 47) 10,439 773 Singapore (week 46) 1,820 935 Viet Nam (week 37) 1,535 389 Influenza Situation Update| 2 Influenza surveillance summary Influenza surveillance in the WHO Western Pacific Region is based on outpatient and inpatient sentinel indicator based surveillance (IBS) systems as well as event-based surveillance. Case definitions, populations under surveillance and data formats differ among countries. This influenza surveillance summary includes countries/areas where routine IBS is conducted and information is available. The WHO surveillance case definition for ILI is an acute respiratory infection with a measured fever of ≥38oC and cough, with symptom onset within the last 10 days. For SARI, it is an acute respiratory infection (ARI) with a history of fever or measured fever of ≥38oC and cough, with symptom onset within the last 10 days and requires hospitalization. Countries in the temperate zone of the Northern Hemisphere In most countries within the temperate zone of the Northern Hemisphere, ILI and influenza activity are consistent with seasonal trends. Outpatient ILI Surveillance China (North) During week 47, the percentage of visits for ILI at national sentinel hospitals in northern China was 3.5%, which is higher than the previous week (2.8%) as well as the same week of 2014, 2015 and 2016 (3.2%, 2.9% and 2.5%) (Figure 2). Mongolia ILI activity remained at expected levels during week 47 compared to the previous week and seasons. The most recent peak in ILI activity occurred in week 4 of 2017 (Figure 3). Mongolia publishes weekly reports, available here: http://www.flu.mn/eng/index.php?option=com_content&task= section&id=5&Itemid=51 China (North) Mongolia Figure 2: Percentage of visits for ILI at sentinel hospitals in north China, 2014-2017 (Source: China National Influenza Center) Figure 3: Proportion of outpatient ILI visits (per 10,000 people), 2014-2017 (Source: Mongolia National Influenza Center) Influenza Situation Update| 3 Republic of Korea In week 47, there were 7.7 ILI cases per 1,000 outpatient visits, which was higher than the previous week (6.3). ILI activity remained stable, but slightly above the established baseline (6.6 per 1,000 outpatient visits) (Figure 4). Korea publishes a weekly report, available here: http://www.cdc.go.kr/CDC/info/CdcKrInfo0301.jsp?menuIds=HOME001-MNU1154-MNU0005-MNU0037- MNU1380 Republic of Korea Figure 4: Weekly ILI incidence rate per 1,000 patients, 2013-2017 (Source: Korean Centre for Disease Control and Prevention) Sentinel influenza surveillance Japan In week 46, influenza activity in Japan shows a similar seasonal pattern to previous years with few influenza cases reported weekly per reporting sentinel hospital (Figure 5). More information about historical trends are available here: https://www.niid.go.jp/niid/en/10/2096-weeklygraph/1644- 01flu.html Japan Figure 5: Number of influenza cases reported weekly per reporting sentinel hospital site, Japan 2007-2017 (Source: Japan National Institute of Infectious Diseases) Influenza Situation Update| 4 Countries/areas in the tropical zone Countries/areas in the tropical zone are observing influenza activity that is consistent with previous seasons. Surveillance Hong Kong SAR (China) – ILI and hospital Surveillance In week 47, the average consultation rate for influenza-like illness (ILI) among sentinel general outpatient clinics (GOPCs) was 3.7 ILI cases per 1,000 consultations, which was higher than that recorded in the previous week (3.5) (Figure 6). The average consultation rate for ILI among sentinel private doctors was 43.2 ILI cases per 1,000 consultations, which was higher than the rate recorded in the previous week (39.5) (Figure 7). Hong Kong SAR, China publishes a weekly report, available here: http://www.chp.gov.hk/en/guideline1_year/29/134/441/304.html Hong Kong (China) - ILI Surveillance Figure 6: ILI consultation rates at sentinel general outpatient clinics, Hong Kong 2013-2017 (Source: Hong Kong Centre for Health Protection) Figure 7: ILI consultation rates at sentinel private doctors, Hong Kong 2013-2017 (Source: Hong Kong Centre for Health Protection) China (South) - ILI Surveillance During week 47, the percentage of outpatient or emergency visits for ILI at national sentinel hospitals in southern China was 3.1%, which is higher than the last week (2.9%) as well as the same week of 2014, 2015 and 2016 (2.2%, 2.6% and 3.1%) (Figure 6). Singapore – Acute Respiratory Infection Surveillance The average daily number of patients seeking treatment in polyclinics for acute respiratory infection decreased from 2,939 per working day in week 46, to 2,910 per working day in week 47 (Figure 9). The proportion of patients with ILI among polyclinic attendances for ARI remained at 1.6%. Singapore publishes a weekly report, available here: http://www.moh.gov.sg/content/moh_web/home/statistics/infectiousDiseasesStatistics/weekly_infectio usdiseasesbulletin.html Influenza Situation Update| 5 China (South) - ILI Surveillance Singapore – ARI Surveillance Lao PDR In week 47, influenza activity decreased compared to the previous week. In week 47 the numer of cases is higher than that reported in the same week between 2012 and 2014 but lower than that reported in 2015 and 2016 (see Figure 10). Figure 10: Weekly number of ILI presentations at sentinel sites, 2012 to week 47 2017, Lao PDR (Source: Lao National Center for Laboratory and Epidemiology) Figure 8: Percentage of visits due to ILI at national sentinel hospitals in South China, 2014- 2017 (Source: China National Influenza Center) Figure 9: Average daily polyclinic attendances for ARI in Singapore, 2016-2017 (Source: Singapore Ministry of Health) Influenza Situation Update| 6 Countries in the temperate zone of the southern hemisphere In the temperate zone of the southern hemisphere, influenza activity followed seasonal trends. Australia – Laboratory-confirmed influenza (no update) The number of laboratory confirmed influenza cases has decreased from a peak reached in week 33. As of 27 October 2017 (week 42), a total of 229,579 notifications of laboratory confirmed influenza were reported to the National Notifiable Diseases Surveillance System (Figure 11). Sixty-three percent of notifications were influenza A (57% A(unsubtyped), 4% influenza A(H3N2) and 1% influenza A(H1N1pdm09)), 37% were influenza B and less than 1% were influenza A&B co-infections or untyped. Australia publishes influenza surveillance reports on a fortnightly basis during the influenza season, typically between May and October. For more information: http://www.health.gov.au/internet/main/publishing.nsf/content/cda-surveil-ozflu-flucurr.htm#current Figure 11: Australian notifications of laboratory confirmed influenza (Source: National Notifiable Diseases Surveillance System, Australian Department of Health) New Zealand – Influenza like Illness (no update) During week 39, 80 patients with influenza-like illness consulted sentinel general practices in 20 district health boards (DHBs). The weekly ILI incidence was 19.5 per 100 000 patient population. Of the 36 laboratory tested ILI cases, eight were positive for influenza viruses. This gives an ILI related influenza incidence (adjusted) of 4.3 per 100 000 patient population. New Zealand publishes a weekly report, available here: https://surv.esr.cri.nz/virology/influenza_weekly_update.php Figure 12: Weekly resident ILI and influenza incidence since Week 1 of 2017 in New Zealand (Source: Institute of Environmental Science and Research Ltd (ESR), New Zealand) Influenza Situation Update| 7 Pacific Island Countries and Areas (PICs) - ILI Surveillance In the Pacific Island Countries and Areas, in week 47, the number of ILI cases reported compared to previous weeks increased in several PICs, including French Polynesia, Niue, Samoa, Solomon Islands and Vanuatu (Figure 13). The PICs submit a report on a weekly basis, for more information: http://www.wpro.who.int/southpacific/programmes/communicable_diseases/disease_surveillance_resp onse/page/en/index2.html Figure 13: Reported cases of influenza-like illness in Pacific Island Countries, 2017 Influenza Situation Update| 8 Global influenza situation updates Epidemiological update http://www.who.int/influenza/surveillance_monitoring/updates/latest_update_GIP_surveillance/en/ Virological update: http://www.who.int/influenza/gisrs_laboratory/updates/summaryreport/en/ Global update: http://www.who.int/influenza/surveillance_monitoring/updates/latest_update_GIP_surveillance/ Others: Recommended composition of influenza virus vaccines for use in the 2017 southern hemisphere influenza season http://www.who.int/influenza/vaccines/virus/recommendations/2017_south/en/ Recommended composition of influenza virus vaccines for use in the 2017-2018 northern hemisphere influenza season http://www.who.int/influenza/vaccines/virus/recommendations/201703_recommendation.pdf?ua=1 Antigenic and genetic characteristics of zoonotic influenza viruses and candidate vaccine viruses developed for potential use in human vaccines http://www.who.int/influenza/vaccines/virus/characteristics_virus_vaccines/en/ 4th WHO Informal Consultation on Improving Influenza Vaccine Virus Selection http://www.who.int/influenza/vaccines/virus/4thmtg_improve_vaccine_virus_selection/en/ Video on influenza on WHO's YouTube Channel Arabic: https://www.youtube.com/watch?v=PxW6Pg1AnwI Chinese: https://www.youtube.com/watch?v=xW9gDKEPitQ English: https://www.youtube.com/watch?v=yhhJfT86Bgg French: https://www.youtube.com/watch?v=8mo8rWWJZkc Russian: https://www.youtube.com/watch?v=XQO6nbkKUWQ Spanish: https://www.youtube.com/watch?v=qXr75cKxwTY
Bi-weekly Influenza Situation Update 21 November 2017 Virological Surveillance Summary The total number of specimens and number of positive specimens reported to FluNet by the Western Pacific Region countries and areas between week 1 and week 45 are presented in the table below. Influenza A(H3) is currently the predominant circulating subtype (Figure 1). Table 1: Countries and areas reporting data to FluNet, Western Pacific Region, weeks 1 to 45, 2017 Figure 1: Number of specimens positive for influenza by subtype, Western Pacific Region, week 47 2016 to week 45 2017 (Source: www.who.int/flunet) Country (most recent week of report) Total number of specimens processed Total number of influenza positive specimens Australia (week 45) 48,371 9,769 Cambodia (week 43) 1,122 207 China (week 45) 555,427 74,904 Fiji (week 42) 424 107 Japan (week 44) NA 7,564 Lao People's Democratic Republic (week 45) 4,363 735 Malaysia (week 35) 3,503 467 Mongolia (week 42) 2,512 414 New Caledonia (week 42) 848 155 New Zealand (week 18-39) 2,307 945 Papua New Guinea (week 39) 281 24 Philippines (week 37) 942 191 Republic of Korea (week 42) 9,212 755 Singapore (week 44) 1,756 910 Viet Nam (week 37) 1,535 389 Influenza Situation Update| 2 Influenza surveillance summary Influenza surveillance in the WHO Western Pacific Region is based on outpatient and inpatient sentinel indicator based surveillance (IBS) systems as well as event-based surveillance. Case definitions, populations under surveillance and data formats differ among countries. This influenza surveillance summary includes countries/areas where routine IBS is conducted and information is available. The WHO surveillance case definition for ILI is an acute respiratory infection with a measured fever of ≥38oC and cough, with symptom onset within the last 10 days. For SARI, it is an acute respiratory infection (ARI) with a history of fever or measured fever of ≥38oC and cough, with symptom onset within the last 10 days and requires hospitalization. Countries in the temperate zone of the Northern Hemisphere In most countries within the temperate zone of the Northern Hemisphere, ILI and influenza activity are consistent with seasonal trends. Outpatient ILI Surveillance China (North) During week 45, the percentage of visits for ILI at national sentinel hospitals in northern China was 2.8%, which is higher than the previous week (2.7%) as well as the same week of 2014, 2015 and 2016 (2.6%, 2.5% and 2.7%) (Figure 2). Mongolia ILI activity remained at expected levels during week 45 compared to the previous week and seasons. The most recent peak in ILI activity occurred in week 4 of 2017 (Figure 3). Mongolia publishes weekly reports, available here: http://www.flu.mn/eng/index.php?option=com_content&task=s ection&id=5&Itemid=51 China (North) Mongolia Figure 2: Percentage of visits for ILI at sentinel hospitals in north China, 2014-2017 (Source: China National Influenza Center) Figure 3: Proportion of outpatient ILI visits (per 10,000 people), 2014-2017 (Source: Mongolia National Influenza Center) Republic of Korea In week 45, there were 5.3 ILI cases per 1,000 outpatient visits, which was higher than the previous week (5.2). ILI activity remained stable and below the established baseline (6.6 per 1,000 outpatient visits) (Figure 4). Korea publishes a weekly report, available here: http://www.cdc.go.kr/CDC/info/CdcKrInfo0301.jsp?menuIds=HOME001-MNU1154-MNU0005-MNU0037- MNU1380 Influenza Situation Update| 3 Republic of Korea Figure 4: Weekly ILI incidence rate per 1,000 patients, 2013-2017 (Source: Korean Centre for Disease Control and Prevention) Sentinel influenza surveillance Japan In week 44, influenza activity in Japan shows a similar seasonal pattern to previous years with few influenza cases reported weekly per reporting sentinel hospital (Figure 5). More information about historical trends are available here: https://www.niid.go.jp/niid/en/10/2096-weeklygraph/1644- 01flu.html Japan Figure 5: Number of influenza cases reported weekly per reporting sentinel hospital site, Japan 2007-2017 (Source: Japan National Institute of Infectious Diseases) Countries/areas in the tropical zone Countries/areas in the tropical zone are observing influenza activity that is consistent with previous seasons. Surveillance Hong Kong SAR (China) – ILI and hospital Surveillance In week 45, the average consultation rate for influenza-like illness (ILI) among sentinel general outpatient clinics (GOPCs) was 4.7 ILI cases per 1,000 consultations, which was higher than that recorded in the previous week (2.9) (Figure 6). The average consultation rate for ILI among sentinel private doctors was 43.8 ILI cases per 1,000 consultations, which was higher than the rate recorded in the previous week (37.8) (Figure 7). Hong Kong SAR, China publishes a weekly report, available here: http://www.chp.gov.hk/en/guideline1_year/29/134/441/304.html Influenza Situation Update| 4 Hong Kong (China) - ILI Surveillance Figure 6: ILI consultation rates at sentinel general outpatient clinics, Hong Kong 2013-2017 (Source: Hong Kong Centre for Health Protection) Figure 7: ILI consultation rates at sentinel private doctors, Hong Kong 2013-2017 (Source: Hong Kong Centre for Health Protection) China (South) - ILI Surveillance During week 45, the percentage of outpatient or emergency visits for ILI at national sentinel hospitals in southern China was 2.9%, lower than the last week (3.0%), higher than the same week of 2014 and 2015 (2.2% and 2.5%, respectively) and equal to the same week of 2016 (2.9%) (Figure 6). Singapore – Acute Respiratory Infection Surveillance The average daily number of patients seeking treatment in polyclinics for acute respiratory infection decreased from 2,882 per working day in week 44, to 2,862 per working day in week 45 (Figure 9). The proportion of patients with ILI among polyclinic attendances for ARI remained at 1.6%. Singapore publishes a weekly report, available here: http://www.moh.gov.sg/content/moh_web/home/statistics/infectiousDiseasesStatistics/weekly_infectio usdiseasesbulletin.html China (South) - ILI Surveillance Singapore – ARI Surveillance Figure 8: Percentage of visits due to ILI at national sentinel hospitals in South China, 2014-2017 (Source: China National Influenza Center) Figure 9: Average daily polyclinic attendances for ARI in Singapore, 2016-2017 (Source: Singapore Ministry of Health) Influenza Situation Update| 5 Lao PDR In week 45 (seven sentinel sites reporting), influenza activity decreased compared to the previous week (six sentinel sites reporting). In week 45 the numer of cases is higher than that reported in the same week between 2012 and 2015 but lower than that reported in 2016 (see Figure 10). Figure 10: Weekly number of ILI presentations at sentinel sites, 2012 to week 45 2017, Lao PDR (Source: Lao National Center for Laboratory and Epidemiology) Countries in the temperate zone of the southern hemisphere In the temperate zone of the southern hemisphere, influenza activity followed seasonal trends. Australia – Laboratory-confirmed influenza The number of laboratory confirmed influenza cases has decreased from a peak reached in week 33. As of 27 October 2017 (week 42), a total of 229,579 notifications of laboratory confirmed influenza were reported to the National Notifiable Diseases Surveillance System (Figure 11). Sixty-three percent of notifications were influenza A (57% A(unsubtyped), 4% influenza A(H3N2) and 1% influenza A(H1N1pdm09)), 37% were influenza B and less than 1% were influenza A&B co-infections or untyped. Australia publishes influenza surveillance reports on a fortnightly basis during the influenza season, typically between May and October. For more information: http://www.health.gov.au/internet/main/publishing.nsf/content/cda-surveil-ozflu-flucurr.htm#current Figure 11: Australian notifications of laboratory confirmed influenza (Source: National Notifiable Diseases Surveillance System, Australian Department of Health) Influenza Situation Update| 6 New Zealand – Influenza like Illness (no update) During week 39, 80 patients with influenza-like illness consulted sentinel general practices in 20 district health boards (DHBs). The weekly ILI incidence was 19.5 per 100 000 patient population. Of the 36 laboratory tested ILI cases, eight were positive for influenza viruses. This gives an ILI related influenza incidence (adjusted) of 4.3 per 100 000 patient population. New Zealand publishes a weekly report, available here: https://surv.esr.cri.nz/virology/influenza_weekly_update.php Figure 12: Weekly resident ILI and influenza incidence since Week 1 of 2017 in New Zealand (Source: Institute of Environmental Science and Research Ltd (ESR), New Zealand) Pacific Island Countries and Areas (PICs) - ILI Surveillance In the Pacific Island Countries and Areas, in week 44, the number of ILI cases reported compared to previous weeks increased in several PICs, including Kiribati, Niue, Samoa and Vanuatu (Figure 13). The PICs submit a report on a weekly basis, for more information: http://www.wpro.who.int/southpacific/programmes/communicable_diseases/disease_surveillance_resp onse/page/en/index2.html Influenza Situation Update| 7 Figure 13: Reported cases of influenza-like illness in Pacific Island Countries, 2017 Global influenza situation updates Epidemiological update http://www.who.int/influenza/surveillance_monitoring/updates/latest_update_GIP_surveillance/en/ Virological update: http://www.who.int/influenza/gisrs_laboratory/updates/summaryreport/en/ Global update: http://www.who.int/influenza/surveillance_monitoring/updates/latest_update_GIP_surveillance/ Others: Recommended composition of influenza virus vaccines for use in the 2017 southern hemisphere influenza season http://www.who.int/influenza/vaccines/virus/recommendations/2017_south/en/ Recommended composition of influenza virus vaccines for use in the 2017-2018 northern hemisphere influenza season http://www.who.int/influenza/vaccines/virus/recommendations/201703_recommendation.pdf?ua=1 Antigenic and genetic characteristics of zoonotic influenza viruses and candidate vaccine viruses developed for potential use in human vaccines http://www.who.int/influenza/vaccines/virus/characteristics_virus_vaccines/en/ 4th WHO Informal Consultation on Improving Influenza Vaccine Virus Selection http://www.who.int/influenza/vaccines/virus/4thmtg_improve_vaccine_virus_selection/en/ Video on influenza on WHO's YouTube Channel Arabic: https://www.youtube.com/watch?v=PxW6Pg1AnwI Chinese: https://www.youtube.com/watch?v=xW9gDKEPitQ English: https://www.youtube.com/watch?v=yhhJfT86Bgg French: https://www.youtube.com/watch?v=8mo8rWWJZkc Russian: https://www.youtube.com/watch?v=XQO6nbkKUWQ Spanish: https://www.youtube.com/watch?v=qXr75cKxwTY
Bi-weekly Influenza Situation Update 7 November 2017 Virological Surveillance Summary The total number of specimens and number of positive specimens reported to FluNet by the Western Pacific Region countries and areas between week 1 and week 43 are presented in the table below. Influenza A(H3) is currently the predominant circulating subtype (Figure 1). Table 1: Countries and areas reporting data to FluNet, Western Pacific Region, weeks 1 to 43, 2017 Figure 1: Number of specimens positive for influenza by subtype, Western Pacific Region, week 45 2016 to week 43 2017 (Source: www.who.int/flunet) Country (most recent week of report) Total number of specimens processed Total number of influenza positive specimens Australia (week 43) 47,578 9,705 Cambodia (week 42) 1,092 196 China (week 43) 526,776 73,030 Fiji (week 42) 424 107 Japan (week 42) NA 7,484 Lao People's Democratic Republic (week 43) 4,191 711 Malaysia (week 35) 3,503 467 Mongolia (week 41) 2,512 414 New Caledonia (week 42) 848 155 New Zealand (week 18-39) 2,307 945 Papua New Guinea (week 39) 281 24 Philippines (week 37) 942 191 Republic of Korea (week 42) 9,212 755 Singapore (week 42) 1,717 893 Viet Nam (week 37) 1,535 389 Influenza Situation Update | 2 Influenza surveillance summary Influenza surveillance in the WHO Western Pacific Region is based on outpatient and inpatient sentinel indicator based surveillance (IBS) systems as well as event-based surveillance. Case definitions, populations under surveillance and data formats differ among countries. This influenza surveillance summary includes countries/areas where routine IBS is conducted and information is available. The WHO surveillance case definition for ILI is an acute respiratory infection with a measured fever of ≥38oC and cough, with symptom onset within the last 10 days. For SARI, it is an acute respiratory infection (ARI) with a history of fever or measured fever of ≥38oC and cough, with symptom onset within the last 10 days and requires hospitalization. Countries in the temperate zone of the Northern Hemisphere In most countries within the temperate zone of the Northern Hemisphere, ILI and influenza activity are consistent with seasonal trends. Outpatient ILI Surveillance China (North) During week 43, the percentage of visits for ILI at national sentinel hospitals in northern China was 2.6%, which is unchanged since the previous week (2.6%) and consistent with the same week of 2014, 2015 and 2016 (2.4%, 2.5% and 2.4%) (Figure 2). Mongolia ILI activity remained at expected levels during week 43 of 2017 compared to the previous week and seasons. The most recent peak in ILI activity occurred in week 4 of 2017 (Figure 3). Mongolia publishes weekly reports, available here: http://www.flu.mn/eng/index.php?option=com_content&task=s ection&id=5&Itemid=51 China (North) Mongolia Figure 2: Percentage of visits for ILI at sentinel hospitals in north China, 2014-2017 (Source: China National Influenza Center) Figure 3: Proportion of outpatient ILI visits (per 10,000 people), 2014-2017 (Source: Mongolia National Influenza Center) Influenza Situation Update | 3 Republic of Korea In week 43, 2017, there were 4.1 ILI cases per 1,000 outpatient visits, which was lower than the previous week (4.2). ILI activity remained stable and below the established baseline (6.6 per 1,000 outpatient visits) (Figure 4). Korea publishes a weekly report, available here: http://www.cdc.go.kr/CDC/info/CdcKrInfo0301.jsp?menuIds=HOME001-MNU1154-MNU0005-MNU0037- MNU1380 Republic of Korea Figure 4: Weekly ILI incidence rate per 1,000 patients, 2013-2017 (Source: Korean Centre for Disease Control and Prevention) Sentinel influenza surveillance Japan As of week 41 2017, influenza activity in Japan shows a similar seasonal pattern to previous years with few influenza cases reported weekly per reporting sentinel hospital (Figure 5). More information about historical trends are available here: https://www.niid.go.jp/niid/en/10/2096-weeklygraph/1644- 01flu.html Japan Figure 5: Number of influenza cases reported weekly per reporting sentinel hospital site, Japan 2007-2017 (Source: Japan National Institute of Infectious Diseases) Influenza Situation Update | 4 Countries/areas in the tropical zone Countries/areas in the tropical zone are observing influenza activity that is consistent with previous seasons. Surveillance Hong Kong SAR (China) – ILI and hospital Surveillance In week 43, the average consultation rate for influenza-like illness (ILI) among sentinel general outpatient clinics (GOPCs) was 3.3 ILI cases per 1,000 consultations, which was the higher than that recorded in the previous week (3.0) (Figure 6). The average consultation rate for ILI among sentinel private doctors was 40.1 ILI cases per 1,000 consultations, which was lower than rates recorded in the previous week (43.7) (Figure 7). Hong Kong SAR, China publishes a weekly report, available here: http://www.chp.gov.hk/en/guideline1_year/29/134/441/304.html Hong Kong (China) - ILI Surveillance Figure 6: ILI consultation rates at sentinel general outpatient clinics, Hong Kong 2013-2017 (Source: Hong Kong Centre for Health Protection) Figure 7: ILI consultation rates at sentinel private doctors, Hong Kong 2013-2017 (Source: Hong Kong Centre for Health Protection) China (South) - ILI Surveillance During week 43, the percentage of outpatient or emergency visits for ILI at national sentinel hospitals in southern China was 2.9%, higherer than the last week (2.8%) and the same week of 2014, 2015 and 2016 (2.3%, 2.5% and 2.8%) (Figure 6). Singapore – Acute Respiratory Infection Surveillance The average daily number of patients seeking treatment in polyclinics for acute respiratory infection decreased from 3,125 per working day in week 42, to 2,869 per working day in week 43 (Figure 9). The proportion of patients with ILI among polyclinic attendances for ARI remained at 1.7%. Singapore publishes a weekly report, available here: http://www.moh.gov.sg/content/moh_web/home/statistics/infectiousDiseasesStatistics/weekly_infectio usdiseasesbulletin.html Influenza Situation Update | 5 China (South) - ILI Surveillance Singapore – ARI Surveillance Lao PDR In week 43 (seven sentinel sites reporting), influenza activity has decreased compared to last week (six sentinel sites reporting), and the numer of cases is higher than that reported in the previous 5 years (see Figure 10). The number of severe acute respiratory infections continued to increase and was higher than numbers reported during week 43 in the past 5 years. Figure 10: Weekly number of ILI presentations at sentinel sites, 2012 to week 43, 2017, Lao PDR (Source: Lao National Center for Laboratory and Epidemiology) Figure 8: Percentage of visits due to ILI at national sentinel hospitals in South China, 2014- 2017 (Source: China National Influenza Center) Figure 9: Average daily polyclinic attendances for ARI in Singapore, 2016-2017 (Source: Singapore Ministry of Health) Influenza Situation Update | 6 Countries in the temperate zone of the southern hemisphere In the temperate zone of the southern hemisphere, influenza activity followed seasonal trends. Australia – Laboratory-confirmed influenza The number of laboratory confirmed influenza cases has decreased from a peak reached in week 33. As of 13 October 2017 (week 39), a total of 215,280 notifications of laboratory confirmed influenza were reported to the National Notifiable Diseases Surveillance System (Figure 11). Sixty-three percent of notifications were influenza A (57% A(unsubtyped), 5% influenza A(H3N2) and 1% influenza A(H1N1pdm09)), 36% were influenza B and less than 1% were influenza A&B co-infections or untyped. Australia publishes influenza surveillance reports on a fortnightly basis during the influenza season, typically between May and October. For more information: http://www.health.gov.au/internet/main/publishing.nsf/content/cda-surveil-ozflu-flucurr.htm#current Figure 11: Australian notifications of laboratory confirmed influenza (Source: National Notifiable Diseases Surveillance System, Australian Department of Health) New Zealand – Influenza like Illness (no update) During week 39, 80 patients with influenza-like illness consulted sentinel general practices in 20 district health boards (DHBs). The weekly ILI incidence was 19.5 per 100 000 patient population. Of the 36 laboratory tested ILI cases, 8 were positive for influenza viruses. This gives an ILI related influenza incidence (adjusted) of 4.3 per 100 000 patient population. New Zealand publishes a weekly report, available here: https://surv.esr.cri.nz/virology/influenza_weekly_update.php Influenza Situation Update | 7 Figure 12: Weekly resident ILI and influenza incidence since Week 1 of 2017 in New Zealand (Source: Institute of Environmental Science and Research Ltd (ESR), New Zealand) Pacific Island Countries and Areas (PICs) - ILI Surveillance In the Pacific Island Countries and Areas, in week 43, the number of ILI cases reported compared to previous weeks increased in several PICs, including French Polynesia, Niue, Samoa, Solomon islands and Tonga (Figure 13). The PICs submit a report on a weekly basis, for more information: http://www.wpro.who.int/southpacific/programmes/communicable_diseases/disease_surveillance_resp onse/page/en/index2.html Influenza Situation Update | 8 Figure 13: Reported cases of influenza-like illness in Pacific Island Countries, 2017 Global influenza situation updates Epidemiological update http://www.who.int/influenza/surveillance_monitoring/updates/latest_update_GIP_surveillance/en/ Virological update: http://www.who.int/influenza/gisrs_laboratory/updates/summaryreport/en/ Global update: http://www.who.int/influenza/surveillance_monitoring/updates/latest_update_GIP_surveillance/ Others: Recommended composition of influenza virus vaccines for use in the 2017 southern hemisphere influenza season http://www.who.int/influenza/vaccines/virus/recommendations/2017_south/en/ Recommended composition of influenza virus vaccines for use in the 2017-2018 northern hemisphere influenza season http://www.who.int/influenza/vaccines/virus/recommendations/201703_recommendation.pdf?ua=1 Antigenic and genetic characteristics of zoonotic influenza viruses and candidate vaccine viruses developed for potential use in human vaccines http://www.who.int/influenza/vaccines/virus/characteristics_virus_vaccines/en/ 4th WHO Informal Consultation on Improving Influenza Vaccine Virus Selection http://www.who.int/influenza/vaccines/virus/4thmtg_improve_vaccine_virus_selection/en/ Video on influenza on WHO's YouTube Channel Arabic: https://www.youtube.com/watch?v=PxW6Pg1AnwI Chinese: https://www.youtube.com/watch?v=xW9gDKEPitQ English: https://www.youtube.com/watch?v=yhhJfT86Bgg French: https://www.youtube.com/watch?v=8mo8rWWJZkc Russian: https://www.youtube.com/watch?v=XQO6nbkKUWQ Spanish: https://www.youtube.com/watch?v=qXr75cKxwTY
Bi-weekly Influenza Situation Update 24 October 2017 Virological Surveillance Summary The total number of specimens and number of positive specimens reported to FluNet by the Western Pacific Region countries and areas between week 1 and week 41 are presented in the table below. Influenza A(H3) is currently the predominant circulating subtype (Figure 1). Table 1: Countries and areas reporting data to FluNet, Western Pacific Region, weeks 1 to 41, 2017 Figure 1: Number of specimens positive for influenza by subtype, Western Pacific Region, week 43 2016 to week 41 2017 (Source: www.who.int/flunet) Country (most recent week of report) Total number of specimens processed Total number of influenza positive specimens Australia (week 41) 46,579 9,443 Cambodia (week40) 10,40 172 China (week 41) 498,565 71,239 Fiji (week 35) 331 95 Japan (week 40) NA 74,23 Lao People's Democratic Republic (week 41) 3,948 652 Malaysia (week 35) 3,503 467 Mongolia (week ) 2,342 414 New Caledonia (week 40) 744 130 New Zealand (week 18-39) 2,307 945 Papua New Guinea (week 39) 281 24 Philippines (week 37) 942 191 Republic of Korea (week 41) 8,995 753 Singapore (week 40) 1,672 877 Viet Nam (week 37) 1,535 389 Influenza Situation Update| 2 Influenza surveillance summary Influenza surveillance in the WHO Western Pacific Region is based on outpatient and inpatient sentinel indicator based surveillance (IBS) systems as well as event-based surveillance. Case definitions, populations under surveillance and data formats differ among countries. This influenza surveillance summary includes countries/areas where routine IBS is conducted and information is available. The WHO surveillance case definition for ILI is an acute respiratory infection with a measured fever of ≥38oC and cough, with symptom onset within the last 10 days. For SARI, it is an acute respiratory infection (ARI) with a history of fever or measured fever of ≥38oC and cough, with symptom onset within the last 10 days and requires hospitalization. Countries in the temperate zone of the Northern Hemisphere In most countries within the temperate zone of the Northern Hemisphere, ILI and influenza activity are consistent with seasonal trends. Outpatient ILI Surveillance China (North) During week 40, the percentage of visits for ILI at national sentinel hospitals in northern China was 3.2%, higher than the last week (2.5%) and the same week of 2014, 2015 and 2016 (2.8%, 2.5% and 2.6%) (Figure 2). Mongolia ILI activity remained at expected levels during week 41 of 2017 compared to the previous week and seasons. The most recent peak in ILI activity occurred in week 4 of 2017 (Figure 3). Mongolia publishes weekly reports, available here: http://www.flu.mn/eng/index.php?option=com_content&task=s ection&id=5&Itemid=51 China (North) Mongolia Figure 2: Percentage of visits for ILI at sentinel hospitals in north China, 2014-2017 (Source: China National Influenza Center) Figure 3: Proportion of outpatient ILI visits (per 10,000 people), 2014-2017 (Source: Mongolia National Influenza Center) Republic of Korea In week 41, 2017, there were 3.8 ILI cases per 1,000 outpatient visits, which was higher than the previous week (3.1%). ILI activity remained stable and below the established baseline (6.6 per 1,000 outpatient visits) (Figure 4). Korea publishes a weekly report, available here: http://www.cdc.go.kr/CDC/info/CdcKrInfo0301.jsp?menuIds=HOME001-MNU1154-MNU0005-MNU0037- MNU1380 Influenza Situation Update| 3 Republic of Korea Figure 4: Weekly ILI incidence rate per 1000 patients, 2013-2017 (Source: Korean Centre for Disease Control and Prevention) Sentinel influenza surveillance Japan As of week 40 2017, influenza activity in Japan shows a similar seasonal pattern to previous years with few influenza cases reported weekly per reporting sentinel hospital (Figure 5). More information about historical trends are available here: https://www.niid.go.jp/niid/en/10/2096-weeklygraph/1644- 01flu.html Japan Figure 5: Number of influenza cases reported weekly per reporting sentinel hospital site, Japan 2007-2017 (Source: Japan National Institute of Infectious Diseases) Countries/areas in the tropical zone Countries/areas in the tropical zone are observing influenza activity that is consistent with previous seasons. Surveillance Hong Kong SAR (China) – ILI and hospital surveillance In week 41, the average consultation rate for influenza-like illness (ILI) among sentinel general outpatient clinics (GOPCs) was 4.6 ILI cases per 1,000 consultations, which was lower than 5.6 recorded in the previous week (Figure 6). The average consultation rate for ILI among sentinel private doctors was 34.0 ILI cases per 1,000 consultations, which was lower than rates recorded in the previous week (39.4 Influenza Situation Update| 4 ILI cases per 1,000 consultations) (Figure 7). Hong Kong SAR, China publishes a weekly report, available here: http://www.chp.gov.hk/en/guideline1_year/29/134/441/304.html Hong Kong (China) - ILI Surveillance Figure 6: ILI consultation rates at sentinel general outpatient clinics, Hong Kong 2013-2017 (Source: Hong Kong Centre for Health Protection) Figure 7: ILI consultation rates at sentinel private doctors, Hong Kong 2013-2017 (Source: Hong Kong Centre for Health Protection) China (South) - ILI Surveillance During week 40, the percentage of outpatient or emergency visits for ILI at national sentinel hospitals in southern China was 3.7%, higher than the last week (3.2%) and the same week of 2014, 2015 and 2016 (2.8%, 2.7% and 2.9%) (Figure 6). Singapore – Acute Respiratory Infection Surveillance The average daily number of patients seeking treatment in polyclinics for acute respiratory infection increased from 2,881 per working day in week 40, to 3,016 per working day in week 41 (Figure 9). The proportion of patients with ILI among polyclinic attendances for ARI remained low at 1.9%. Singapore publishes a weekly report, available here: http://www.moh.gov.sg/content/moh_web/home/statistics/infectiousDiseasesStatistics/weekly_infecti ousdiseasesbulletin.html China (South) - ILI Surveillance Singapore – ARI Surveillance Figure 8: Percentage of visits due to ILI at national sentinel hospitals in South China, 2014- 2017 (Source: China National Influenza Center) Figure 9: Average daily polyclinic attendances for ARI in Singapore, 2016-2017 (Source: Singapore Ministry of Health) Influenza Situation Update| 5 Lao PDR In week 41, influenza activity has decreased compared to last week and the numer of cases is lower than numbers reported in the previous year (see Figure 10). The number of severe acute respiratory infections continued to increase and was higher than numbers reported last week and in the past 5 years. Figure 10: Weekly number of ILI presentations at sentinel sites, 2012 to week 41, 2017, Lao PDR (Source: Lao National Center for Laboratory and Epidemiology) Countries in the temperate zone of the southern hemisphere In the temperate zone of the southern hemisphere, influenza activity followed seasonal trends. Australia – Laboratory-confirmed influenza The number of laboratory confirmed influenza cases has decreased from a peak reached in week 33. As of 13 October 2017 (week 41), a total of 215,280 notifications of laboratory confirmed influenza were reported to the National Notifiable Diseases Surveillance System (Figure 11). Sixty-three percent of notifications were influenza A (57% A(unsubtyped), 5% influenza A(H3N2) and 1% influenza A(H1N1pdm09)), 36% were influenza B and less than 1% were influenza A&B co-infections or untyped. Australia publishes influenza surveillance reports on a fortnightly basis during the influenza season, typically between May and October. For more information: http://www.health.gov.au/internet/main/publishing.nsf/content/cda-surveil-ozflu-flucurr.htm#current Figure 11: Australian notifications of laboratory confirmed influenza (Source: National Notifiable Diseases Surveillance System, Australian Department of Health) Influenza Situation Update| 6 New Zealand – Influenza like Illness (no update) During week 39, 80 patients with influenza-like illness consulted sentinel general practices in 20 district health boards (DHBs). The weekly ILI incidence was 19.5 per 100 000 patient population. Of the 36 laboratory tested ILI cases, eight were positive for influenza viruses. This gives an ILI related influenza incidence (adjusted) of 4.3 per 100 000 patient population. New Zealand publishes a weekly report, available here: https://surv.esr.cri.nz/virology/influenza_weekly_update.php Figure 12: Weekly resident ILI and influenza incidence since Week 1 of 2017 in New Zealand (Source: Institute of Environmental Science and Research Ltd (ESR), New Zealand) Pacific Island Countries and Areas (PICs) - ILI Surveillance In the Pacific Island Countries and Areas, in week 40, the number of ILI cases reported compared to previous weeks increased in several PICs, including Federated States of Micronesia, Fiji, Guam, Niue and Samoa (Figure 13). The PICs submit a report on a weekly basis, for more information: http://www.wpro.who.int/southpacific/programmes/communicable_diseases/disease_surveillance_res ponse/page/en/index2.html Influenza Situation Update| 7 Figure 13: Reported cases of influenza-like illness in Pacific Island Countries, 2017 Global influenza situation updates Epidemiological update http://www.who.int/influenza/surveillance_monitoring/updates/latest_update_GIP_surveillance/en/ Virological update: http://www.who.int/influenza/gisrs_laboratory/updates/summaryreport/en/ Global update: http://www.who.int/influenza/surveillance_monitoring/updates/latest_update_GIP_surveillance/ Others: Recommended composition of influenza virus vaccines for use in the 2017 southern hemisphere influenza season http://www.who.int/influenza/vaccines/virus/recommendations/2017_south/en/ Antigenic and genetic characteristics of zoonotic influenza viruses and candidate vaccine viruses developed for potential use in human vaccines http://www.who.int/influenza/vaccines/virus/characteristics_virus_vaccines/en/ 4th WHO Informal Consultation on Improving Influenza Vaccine Virus Selection http://www.who.int/influenza/vaccines/virus/4thmtg_improve_vaccine_virus_selection/en/ Video on influenza on WHO's YouTube Channel Arabic: https://www.youtube.com/watch?v=PxW6Pg1AnwI Chinese: https://www.youtube.com/watch?v=xW9gDKEPitQ English: https://www.youtube.com/watch?v=yhhJfT86Bgg French: https://www.youtube.com/watch?v=8mo8rWWJZkc Russian: https://www.youtube.com/watch?v=XQO6nbkKUWQ Spanish: https://www.youtube.com/watch?v=qXr75cKxwTY Recommended composition of influenza virus vaccines for use in the 2017-2018 northern hemisphere influenza season http://www.who.int/influenza/vaccines/virus/recommendations/201703_recommendation.pdf?ua=1
Bi-weekly Influenza Situation Update 10 October 2017 Virological Surveillance Summary The total number of specimens and number of positive specimens reported to FluNet by the Western Pacific Region countries and areas between week 1 and week 39 are presented in the table below. Influenza A(H3) is currently the predominant circulating subtype (Figure 1). Table 1: Countries and areas reporting data to FluNet, Western Pacific Region, weeks 1 to 39, 2017 Figure 1: Number of specimens positive for influenza by subtype, Western Pacific Region, week 41 2016 to week 39 2017 (Source: www.who.int/flunet) Country (most recent week of report) Total number of specimens processed Total number of influenza positive specimens Australia (week 39) 43,153 8,936 Cambodia (week 38) 973 137 China (week 38) 467,904 68,889 Fiji (week 35) 331 95 Japan (week 38) NA 7,389 Lao People's Democratic Republic (week 38) 3,631 558 Malaysia (week 22) 2,277 298 Mongolia (week 39) 2,342 414 New Caledonia (week 38) 609 78 New Zealand (week 18-39) 2,307 945 Papua New Guinea (week 33) 228 24 Philippines (week 37) 942 191 Republic of Korea (week 38) 8,639 750 Singapore (week 38) 1,619 855 Viet Nam (week 37) 1,535 389 Influenza Situation Update | 2 Influenza surveillance summary Influenza surveillance in the WHO Western Pacific Region is based on outpatient and inpatient sentinel indicator based surveillance (IBS) systems as well as event-based surveillance. Case definitions, populations under surveillance and data formats differ among countries. This influenza surveillance summary includes countries/areas where routine IBS is conducted and information is available. The WHO surveillance case definition for ILI is an acute respiratory infection with a measured fever of ≥38oC and cough, with symptom onset within the last 10 days. For SARI, it is an acute respiratory infection (ARI) with a history of fever or measured fever of ≥38oC and cough, with symptom onset within the last 10 days and requires hospitalization. Countries in the temperate zone of the Northern Hemisphere In most countries within the temperate zone of the Northern Hemisphere, ILI and influenza activity are consistent with seasonal trends. Outpatient ILI Surveillance China (North) During week 38, the percentage of visits for ILI at national sentinel hospitals in northern China was 2.5%, higher than the last week and the same week of 2014 and 2016 (2.4%, 2.3% and 2.2%) (Figure 2). Mongolia (no updates) ILI activity remained at expected levels during week 37 of 2017 compared to the previous week and seasons. The most recent peak in ILI activity occurred in week 4 of 2017 (Figure 3). Mongolia publishes weekly reports, available here: http://www.flu.mn/eng/index.php?option=com_content&task=section&id=5&Itemid=51 China (North) Mongolia Figure 2: Percentage of visits for ILI at sentinel hospitals in north China, 2014-2017 (Source: China National Influenza Center) Figure 3: Proportion of outpatient ILI visits (per 10,000 people), 2014-2017 (Source: Mongolia National Influenza Center) Influenza Situation Update | 3 Republic of Korea In week 38, 2017, there were 5.1 ILI cases per 1,000 outpatient visits, which was the same as the previous week. ILI activity remained stable and below the established baseline (6.6 per 1,000 outpatient visits) (Figure 4). Korea publishes a weekly report, available here: http://www.cdc.go.kr/CDC/info/CdcKrInfo0301.jsp?menuIds=HOME001-MNU1154-MNU0005-MNU0037- MNU1380 Republic of Korea Figure 4: Weekly ILI incidence rate per 1000 patients, 2013-2017 (Source: Korean Centre for Disease Control and Prevention) Sentinel influenza surveillance Japan As of week 38 2017, influenza activity in Japan shows a similar seasonal pattern to previous years with few influenza cases reported weekly per reporting sentinel hospital (Figure 5). More information about historical trends are available here: https://www.niid.go.jp/niid/en/10/2096-weeklygraph/1644- 01flu.html Japan Figure 5: Number of influenza cases reported weekly per reporting sentinel hospital site, Japan 2007-2017 (Source: Japan National Institute of Infectious Diseases) Influenza Situation Update | 4 Countries/areas in the tropical zone Countries/areas in the tropical zone are observing influenza activity that is consistent with previous seasons. Surveillance Hong Kong SAR (China) – ILI and hospital Surveillance In week 39, the average consultation rate for influenza-like illness (ILI) among sentinel general outpatient clinics (GOPCs) was 3.5 ILI cases per 1,000 consultations, which was the same as that recorded in the previous week (Figure 6). The average consultation rate for ILI among sentinel private doctors was 42.4 ILI cases per 1,000 consultations, which was lower than rates recorded in the previous week (47.3 ILI cases per 1,000 consultations) (Figure 7). Hong Kong SAR, China publishes a weekly report, available here: http://www.chp.gov.hk/en/guideline1_year/29/134/441/304.html Hong Kong (China) - ILI Surveillance Figure 6: ILI consultation rates at sentinel general outpatient clinics, Hong Kong 2013-2017 (Source: Hong Kong Centre for Health Protection) Figure 7: ILI consultation rates at sentinel private doctors, Hong Kong 2013-2017 (Source: Hong Kong Centre for Health Protection) China (South) - ILI Surveillance During week 38, the percentage of outpatient or emergency visits for ILI at national sentinel hospitals in southern China was 3.1%, lower than the last week (3.3%), but higher than the same week of 2014- 2016(2.5%, 2.7% and 2.7%) (Figure 6). Singapore – Acute Respiratory Infection Surveillance The average daily number of patients seeking treatment in polyclinics for acute respiratory infection increased from 2,665 per working day in week 38, to 2,686 per working day in week 39 (Figure 9). The proportion of patients with ILI among polyclinic attendances for ARI remained low at 1.7%. Singapore publishes a weekly report, available here: http://www.moh.gov.sg/content/moh_web/home/statistics/infectiousDiseasesStatistics/weekly_infectio usdiseasesbulletin.html Influenza Situation Update | 5 China (South) - ILI Surveillance Singapore – ARI Surveillance Lao PDR In week 39, influenza activity has increased compared to last week and the numer of cases is higher than numbers reported in the previous 5 years (see Figure 10). The number of severe acute respiratory infections continued to increase and was higher than numbers reported during week 39 in the past 5 years. Figure 10: Weekly number of ILI presentations at sentinel sites, 2012 to week 39, 2017, Lao PDR (Source: Lao National Center for Laboratory and Epidemiology) Figure 8: Percentage of visits due to ILI at national sentinel hospitals in South China, 2014- 2017 (Source: China National Influenza Center) Figure 9: Average daily polyclinic attendances for ARI in Singapore, 2016-2017 (Source: Singapore Ministry of Health) Influenza Situation Update | 6 Countries in the temperate zone of the southern hemisphere In the temperate zone of the southern hemisphere, influenza activity followed seasonal trends. Australia – Laboratory-confirmed influenza The number of laboratory confirmed influenza cases has decreased from a peak reached in week 33. As of 29 September 2017(week 39), a total of 195,312 notifications of laboratory confirmed influenza were reported to the National Notifiable Diseases Surveillance System (Figure 11). Sixty five percent of notifications were influenza A (59% A(unsubtyped), 5% influenza A(H3N2) and 1% influenza A(H1N1pdm09)), 35% were influenza B and less than 1% were influenza A&B co-infections or untyped. Australia publishes influenza surveillance reports on a fortnightly basis during the influenza season, typically between May and October. For more information: http://www.health.gov.au/internet/main/publishing.nsf/content/cda-surveil-ozflu-flucurr.htm#current Figure 11: Australian notifications of laboratory confirmed influenza (Source: National Notifiable Diseases Surveillance System, Australian Department of Health) New Zealand – Influenza like Illness During week 39, 80 patients with influenza-like illness consulted sentinel general practices in 20 district health boards (DHBs). The weekly ILI incidence was 19.5 per 100 000 patient population. Of the 36 laboratory tested ILI cases, 8 were positive for influenza viruses. This gives an ILI related influenza incidence (adjusted) of 4.3 per 100 000 patient population. New Zealand publishes a weekly report, available here: https://surv.esr.cri.nz/virology/influenza_weekly_update.php Influenza Situation Update | 7 Figure 12: Weekly resident ILI and influenza incidence since Week 1 of 2017 in New Zealand (Source: Institute of Environmental Science and Research Ltd (ESR), New Zealand) Pacific Island Countries and Areas (PICs) - ILI Surveillance In the Pacific Island Countries and Areas, in week 39, the number of ILI cases reported compared to previous weeks increased in several PICs, including New Caledonia, Niue and Samoa. (Figure 13). The PICs submit a report on a weekly basis, for more information: http://www.wpro.who.int/southpacific/programmes/communicable_diseases/disease_surveillance_resp onse/page/en/index2.html Influenza Situation Update | 8 Figure 13: Reported cases of influenza-like illness in Pacific Island Countries, 2017 Influenza Situation Update | 9 Global influenza situation updates Epidemiological update http://www.who.int/influenza/surveillance_monitoring/updates/latest_update_GIP_surveillance/en/ Virological update: http://www.who.int/influenza/gisrs_laboratory/updates/summaryreport/en/ Global update: http://www.who.int/influenza/surveillance_monitoring/updates/latest_update_GIP_surveillance/ Others: Recommended composition of influenza virus vaccines for use in the 2017 southern hemisphere influenza season http://www.who.int/influenza/vaccines/virus/recommendations/2017_south/en/ Antigenic and genetic characteristics of zoonotic influenza viruses and candidate vaccine viruses developed for potential use in human vaccines http://www.who.int/influenza/vaccines/virus/characteristics_virus_vaccines/en/ 4th WHO Informal Consultation on Improving Influenza Vaccine Virus Selection http://www.who.int/influenza/vaccines/virus/4thmtg_improve_vaccine_virus_selection/en/ Video on influenza on WHO's YouTube Channel Arabic: https://www.youtube.com/watch?v=PxW6Pg1AnwI Chinese: https://www.youtube.com/watch?v=xW9gDKEPitQ English: https://www.youtube.com/watch?v=yhhJfT86Bgg French: https://www.youtube.com/watch?v=8mo8rWWJZkc Russian: https://www.youtube.com/watch?v=XQO6nbkKUWQ Spanish: https://www.youtube.com/watch?v=qXr75cKxwTY Recommended composition of influenza virus vaccines for use in the 2017- 2018 northern hemisphere influenza season http://www.who.int/influenza/vaccines/virus/recommendations/201703_recommendation.pdf?ua=1
Bi-weekly Influenza Situation Update 26 September 2017 Virological Surveillance Summary The total number of specimens and number of positive specimens reported to FluNet by the Western Pacific Region countries and areas between week 1 and week 37 are presented in the table below. Influenza A(H3) is currently the predominant circulating subtype (Figure 1). Table 1: Countries and areas reporting data to FluNet, Western Pacific Region, weeks 1 to 37, 2017 Figure 1: Number of specimens positive for influenza by subtype, Western Pacific Region, week 37 2016 to week 37 2017 (Source: www.who.int/flunet) Country (most recent week of report) Total number of specimens processed Total number of influenza positive specimens Australia (week 37) 38332 7696 Cambodia (week 33) 825 74 China (week 37) 453562 67714 Fiji (week 35) 331 95 Japan (week 36) NA 7212 Lao People's Democratic Republic (week 37) 3466 511 Malaysia (week 22) 2277 298 Mongolia (week 37) 2273 414 New Caledonia (week 37) 508 54 New Zealand (week 18-36) 2069 895 Papua New Guinea (week 33) 228 24 Philippines (week 36) 899 171 Republic of Korea (week 37) 8429 747 Singapore (week 36) 1577 842 Viet Nam (week 37) 1535 389 Influenza Situation Update| 2 Influenza surveillance summary Influenza surveillance in the WHO Western Pacific Region is based on outpatient and inpatient sentinel indicator based surveillance (IBS) systems as well as event-based surveillance. Case definitions, populations under surveillance and data formats differ among countries. This influenza surveillance summary includes countries/areas where routine IBS is conducted and information is available. The WHO surveillance case definition for ILI is an acute respiratory infection with a measured fever of ≥38oC and cough, with symptom onset within the last 10 days. For SARI, it is an acute respiratory infection (ARI) with a history of fever or measured fever of ≥38oC and cough, with symptom onset within the last 10 days and requires hospitalization. Countries in the temperate zone of the Northern Hemisphere In most countries within the temperate zone of the Northern Hemisphere, ILI and influenza activity are consistent with seasonal trends Outpatient ILI Surveillance China (North) During week 37, the percentage of visits for ILI at national sentinel hospitals in northern China was 2.4%, lower than the last week and the same week of 2014 and 2016 (all 2.5%), higher than the same week of 2015 (2.1%). (Figure 2). Mongolia ILI activity remained at expected levels during week 37 of 2017 compared to the previous week and seasons. The most recent peak in ILI activity occurred in week 4 of 2017 (Figure 3). Mongolia publishes weekly reports, available here: http://www.flu.mn/eng/index.php?option=com_content&task= section&id=5&Itemid=51 China (North) Mongolia Figure 2: Percentage of visits for ILI at sentinel hospitals in north China, 2014-2017 (Source: China National Influenza Center) Figure 3: Proportion of outpatient ILI visits (per 10,000 people), 2014-2017 (Source: Mongolia National Influenza Center) Influenza Situation Update| 3 Republic of Korea In week 37, 2017, there were 5.1 ILI cases per 1,000 outpatient visits, which was higher than 4.9 per 1,000 in the previous week. ILI activity remained stable and below the established baseline (8.9 per 1,000 outpatient visits) (Figure 4). Korea publishes a weekly report, available here: http://www.cdc.go.kr/CDC/info/CdcKrInfo0301.jsp?menuIds=HOME001-MNU1154-MNU0005-MNU0037- MNU1380 Republic of Korea Figure 4: Weekly ILI incidence rate per 1000 patients, 2013-2017 (Source: Korean Centre for Disease Control and Prevention) Sentinel influenza surveillance Japan As of week 36 2017, influenza activity in Japan shows a similar seasonal pattern to previous years with few influenza cases reported weekly per reporting sentinel hospital (Figure 5). More information about historical trends are available here: https://www.niid.go.jp/niid/en/10/2096-weeklygraph/2572-trend- week-e.html Japan Figure 5: Number of influenza cases reported weekly per reporting sentinel hospital site, Japan 2007-2017 (Source: Japan National Institute of Infectious Diseases) Influenza Situation Update| 4 Countries/areas in the tropical zone Countries/areas in the tropical zone are observing influenza activity that is consistent with previous seasons. Surveillance Hong Kong SAR (China) – ILI and hospital Surveillance In week 37, the average consultation rate for influenza-like illness (ILI) among sentinel general outpatient clinics (GOPCs) was 5.3 ILI cases per 1,000 consultations, which was higher than 3.3 recorded in the previous week (Figure 6). The average consultation rate for ILI among sentinel private doctors was 48.7 ILI cases per 1,000 consultations, which was higher than rates recorded in the previous week (42.8 ILI cases per 1,000 consultations) (Figure 7). Hong Kong SAR, China publishes a weekly report, available here: http://www.chp.gov.hk/en/guideline1_year/29/134/441/304.html China (South) - ILI Surveillance During week 37, the percentage of outpatient or emergency visits for ILI at national sentinel hospitals in southern China was 3.3% which is the same as last week (3.3%) but higher than the same week of 2014- 2016(2.7%, 2.5%, 2.9%) (Figure 6). Singapore – Acute Respiratory Infection Surveillance The average daily number of patients seeking treatment in polyclinics for acute respiratory infection increased from 2,378 per working day in week 36, to 2,489 per working day in week 37 (Figure 9). The proportion of patients with ILI among polyclinic attendances for ARI remained low at 1.6%. Singapore publishes a weekly report, available here: http://www.moh.gov.sg/content/moh_web/home/statistics/infectiousDiseasesStatistics/weekly_infecti ousdiseasesbulletin.html Hong Kong (China) - ILI Surveillance Figure 6: ILI consultation rates at sentinel general outpatient clinics, Hong Kong 2013-2017 (Source: Hong Kong Centre for Health Protection) Figure 7: ILI consultation rates at sentinel private doctors, Hong Kong 2013-2017 (Source: Hong Kong Centre for Health Protection) Influenza Situation Update| 5 Lao PDR In week 36, influenza activity has increased compared to last week but the numer of cases remains similar to previous years (see Figure 10). The number of severe acute respiratory infections was slightly higher than numbers reported during week 36 in the past 5 years. Figure 10: Weekly number of ILI presentations at sentinel sites, 2012 to week 36, 2017, Lao PDR (Source: Lao National Center for Laboratory and Epidemiology) China (South) - ILI Surveillance Singapore – ARI Surveillance Figure 8: Percentage of visits due to ILI at national sentinel hospitals in South China, 2014- 2017 (Source: China National Influenza Center) Figure 9: Average daily polyclinic attendances for ARI in Singapore, 2016-2017 (Source: Singapore Ministry of Health) Influenza Situation Update| 6 Countries in the temperate zone of the southern hemisphere In the temperate zone of the southern hemisphere, influenza activity followed seasonal trends. Australia – Laboratory-confirmed influenza (no updates) The number of laboratory confirmed influenza cases has decreased from a peak reached in week 33. As of 15 September 2017, a total of 172,247 notifications of laboratory confirmed influenza were reported to the National Notifiable Diseases Surveillance System (Figure 11). Sixty seven percent of notifications were influenza A (60% A(unsubtyped), 5% influenza A(H3N2) and 1% influenza A(H1N1pdm09)), 33% were influenza B and less than 1% were influenza A&B co-infections or untyped. Australia publishes influenza surveillance reports on a fortnightly basis during the influenza season, typically between May and October. For more information: http://www.health.gov.au/internet/main/publishing.nsf/content/cda-surveil-ozflu-flucurr.htm#current Figure 11: Australian notifications of laboratory confirmed influenza (Source: National Notifiable Diseases Surveillance System, Australian Department of Health) New Zealand – Influenza like Illness During week 37, 106 patients with influenza-like illness consulted sentinel general practices in 20 district health boards (DHBs). The weekly ILI incidence was 25.8 per 100 000 patient population. Of the 58 laboratory tested ILI cases, 12 were positive for influenza viruses. This gives an ILI related influenza incidence (adjusted) of 5.3 per 100 000 patient population. New Zealand publishes a weekly report, available here: https://surv.esr.cri.nz/virology/influenza_weekly_update.php Figure 12: Weekly resident ILI and influenza incidence since Week 1 of 2017 in New Zealand (Source: Institute of Environmental Science and Research Ltd (ESR), New Zealand) Influenza Situation Update| 7 Pacific Island Countries and Areas (PICs) - ILI Surveillance In the Pacific Island Countries and Areas, in week 37, the number of ILI cases reported compared to previous weeks increased in several PICs, including Fiji, Samoa and Solomon Islands (Figure 13). The PICs submit a report on a weekly basis, for more information: http://www.wpro.who.int/southpacific/programmes/communicable_diseases/disease_surveillance_res ponse/page/en/index2.html Figure 13: Reported cases of influenza-like illness in Pacific Island Countries, 2017 Influenza Situation Update| 8 Global influenza situation updates Epidemiological update http://www.who.int/influenza/surveillance_monitoring/updates/latest_update_GIP_surveillance/en/ Virological update: http://www.who.int/influenza/gisrs_laboratory/updates/summaryreport/en/ Global update: http://www.who.int/influenza/surveillance_monitoring/updates/latest_update_GIP_surveillance/ Others: Recommended composition of influenza virus vaccines for use in the 2017 southern hemisphere influenza season http://www.who.int/influenza/vaccines/virus/recommendations/2017_south/en/ Antigenic and genetic characteristics of zoonotic influenza viruses and candidate vaccine viruses developed for potential use in human vaccines http://www.who.int/influenza/vaccines/virus/characteristics_virus_vaccines/en/ 4th WHO Informal Consultation on Improving Influenza Vaccine Virus Selection http://www.who.int/influenza/vaccines/virus/4thmtg_improve_vaccine_virus_selection/en/ Video on influenza on WHO's YouTube Channel Arabic: https://www.youtube.com/watch?v=PxW6Pg1AnwI Chinese: https://www.youtube.com/watch?v=xW9gDKEPitQ English: https://www.youtube.com/watch?v=yhhJfT86Bgg French: https://www.youtube.com/watch?v=8mo8rWWJZkc Russian: https://www.youtube.com/watch?v=XQO6nbkKUWQ Spanish: https://www.youtube.com/watch?v=qXr75cKxwTY Recommended composition of influenza virus vaccines for use in the 2017- 2018 northern hemisphere influenza season http://www.who.int/influenza/vaccines/virus/recommendations/201703_recommendation.pdf?ua=1
Bi-weekly Influenza Situation Update 29 August 2017 Virological Surveillance Summary The number of specimens reported to FluNet by the Western Pacific Region countries and areas between week 1 and week 33, and the number of influenza positive specimens, are presented in the table below. Influenza A(H3) is currently the predominant circulating subtype (Figure 1). Table 1: Countries and areas reporting data to FluNet, Western Pacific Region, weeks 1 to 33, 2017 Figure 1: Number of specimens positive for influenza by subtype, Western Pacific Region, week 35 2016 to week 33 2017 (Source: www.who.int/flunet) Country (most recent week of report) Total number of specimens processed Total number of influenza positive specimens Australia (week 33) 25998 2936 Cambodia (week 31) 763 55 China (week 32) 389484 56158 Fiji (week 28) 288 92 Japan (week 32) NA 7060 Lao People's Democratic Republic (week 31) 2554 246 Malaysia (week 17) 1848 236 Mongolia (week 26) 2136 412 New Caledonia (week 31) 313 9 New Zealand (week 18-30) 1316 660 Papua New Guinea (week 25) 180 23 Philippines (week 32) 776 172 Republic of Korea (week 33) 7604 741 Singapore (week 32) 1466 803 Viet Nam (week 31) 1281 223 Influenza Situation Update | 2 Influenza surveillance summary Influenza surveillance in the WHO Western Pacific Region is based on outpatient and inpatient sentinel surveillance systems. Case definitions, populations under surveillance and data formats differ among these countries. This influenza surveillance summary includes countries where routine surveillance is conducted and information is available. The WHO surveillance case definition for ILI is an acute respiratory infection with a measured fever of ≥38oC and cough, with symptom onset within the last 10 days. For SARI, it is an acute respiratory infection (ARI) with a history of fever or measured fever of ≥38oC and cough, with symptom onset within the last 10 days and requires hospitalization. Countries in the temperate zone of the Northern Hemisphere In most countries within the temperate zone of the Northern Hemisphere, ILI and influenza activity are consistent with seasonal trends but indicate an earlier start to the influenza season compared to the 2015-2016 season. Outpatient ILI Surveillance China (North) During week 33, the percentage of visits for ILI at national sentinel hospitals in northern China was 2.5 % of total visits, which is lower than last week (2.6%). The ILI activity was higher than during the same week of 2014-2016 (2.3% - 2.2%) (Figure 2). Mongolia (no updates) ILI activity remained at expected tolerance levels during week 28 of 2017 compared to the previous week and seasons. The most recent peak in ILI activity occurred in week 4 of 2017 (Figure 3). Mongolia publishes weekly reports, available here: http://www.flu.mn/eng/index.php?option=com_content&task= section&id=5&Itemid=51 China (North) Mongolia Figure 2: Percentage of visits for ILI at sentinel hospitals in north China, 2014-2017 (Source: China National Influenza Center) Figure 3: Proportion of outpatient ILI visits (per 10,000 people), 2014-2017 (Source: Mongolia National Influenza Center) Influenza Situation Update | 3 Republic of Korea In week 33, 2017, there were 3.8 ILI cases per 1,000 outpatient visits, which was lower than 4.5 per 1000 reported in the previous week. ILI activity remained stable and below the established baseline (8.9 pe 1,000 outpatient visits) (Figure 4). Korea publishes a weekly report, available here: http://www.cdc.go.kr/CDC/eng/info/CdcEngInfo0101.jsp?menuIds=HOME002-MNU0576-MNU0586 Republic of Korea Figure 4: Weekly ILI incidence rate per 1000 patients, 2013-201 (Source: Korean Centre for Disease Control and Prevention) Sentinel influenza surveillance Japan As of week 33 2017, influenza activity in Japan shows a similar seasonal pattern to previous years with few influenza cases reported weekly per reporting sentinel hospital (Figure 5). More information about historical trends are available here: https://www.niid.go.jp/niid/en/10/2096-weeklygraph/2572-trend- week-e.html Figure 5: Number of influenza cases reported weekly per reporting sentinel hospital site, Japan 2007-2017 (Source: Japan National Institute of Infectious Diseases) Influenza Situation Update | 4 Countries/areas in the tropical zone Countries /areas in the tropical zone are observing increased ILI and ARI activity in recent weeks in 2017. Surveillance Hong Kong SAR (China) – ILI and hospital Surveillance Outpatient surveillance data showed that the local influenza activity has decreased significantly from its peak that occurred several weeks ago but some indicators still remain elevated from inter-seasonal levels. In week 33, the average consultation rates for ILI among sentinel general outpatient clinics and sentinel private doctors were 4.7 and 53.6 ILI cases per 1,000 consultations, which were lower than 6.6 and 57.0 in the previous week. Hong Kong SAR, China publishes a weekly report, available here: http://www.chp.gov.hk/en/guideline1_year/29/134/441/304.html China (South) - ILI Surveillance During week 33, the percentage of outpatient or emergency visits for ILI at national sentinel hospitals in southern China was 3.6%, same as the last week and higher than the same week of 2014-2016 (2.9%, 3.1%, 2.8%) (Figure 6). Singapore – Acute Respiratory Infection Surveillance The average daily number of patients seeking treatment in polyclinics for acute respiratory infection decreased from an average of 618 per working day in week 32, to an average of 526 per working day in week 33 (Figure 9). The proportion of patients with ILI among polyclinic attendances for ARI remainedlow at 1.9%. Singapore publishes a weekly report, available here: http://www.moh.gov.sg/content/moh_web/home/statistics/infectiousDiseasesStatistics/weekly_infectio usdiseasesbulletin.html Hong Kong (China) - ILI Surveillance Figure 6: ILI consultation rates at sentinel general outpatient clinics, Hong Kong 2013-2017 (Source: Hong Kong Centre for Health Protection) Figure 7: ILI consultation rates at sentinel private doctors, Hong Kong 2013-2017 (Source: Hong Kong Centre for Health Protection) Influenza Situation Update | 5 China (South) - ILI Surveillance Singapore – ARI Surveillance Lao PDR In week 33, influenza activity has decreased compared to last week but the number of ILI presentations remains similar to previous years (see Figure 10). The number of severe acute respiratory infections increased this year and remains higher than numbers reported during week 33 in the past 5 years. However, the number of cases has decreased over the past two weeks. Figure 10: Weekly number of ILI presentations at sentinel sites, 2012 to week 33, 2017, Lao PDR (Source: Lao National Center for Laboratory and Epidemiology Countries in the temperate zone of the southern hemisphere In the temperate zone of the southern hemisphere, influenza activity followed seasonal trends. Australia – Laboratory-confirmed influenza As of 18 August 2017, a total of 93,711 notifications of laboratory confirmed influenza were reported to the National Notifiable Diseases Surveillance System (Figure 11). Many surveillance indicators are comparable to or exceeding the seasonal peak in 2016. Seventy-one percent of notifications were influenza A (65% A(unsubtyped), 5% influenza A(H3N2) and 1% influenza A(H1N1)pdm09, 28% were influenza B and less than 1% were influenza C, influenza A and B co‐infections or untyped. Australia Figure 8: Percentage of visits due to ILI at national sentinel hospitals in South China, 2014-2017 (Source: China National Influenza Center) Figure 9: Average daily polyclinic attendances for ARI in Singapore, 2016-2017 (Source: Singapore Ministry of Health) Influenza Situation Update | 6 publishes influenza surveillance reports on a fortnightly basis during the influenza season, typically between May and October. For more information: http://www.health.gov.au/internet/main/publishing.nsf/content/cda-surveil-ozflu-flucurr.htm#current Figure 11: Australian notifications of laboratory confirmed influenza (Source: National Notifiable Diseases Surveillance System, Australian Department of Health) New Zealand – Influenza like Illness During week 33, 182 patients with influenza-like illness consulted sentinel general practices in 20 district health boards (DHBs). The weekly ILI incidence was 44.3 per 100 000 patient population. Of the 136 laboratory tested ILI cases, 37 were positive for influenza viruses. This gives an ILI related influenza incidence (adjusted) of 12.0 per 100 000 patient population. New Zealand publishes a weekly report, available here: https://surv.esr.cri.nz/virology/influenza_weekly_update.php Figure 12: Weekly resident ILI and influenza incidence since Week 1 of 2017 in New Zealand (Source: Institute of Environmental Science and Research Ltd (ESR), New Zealand) Pacific Island Countries and Areas (PICs) - ILI Surveillance In the Pacific Island Countries and Areas, in week 33, the number of ILI cases reported in Fiji, Samoa, Solomon Islands, Tonga and Tuvalu increased compared to previous weeks (Figure 13). The Solomon Islands continues to show greater increase in ILI activity.The PICs submit a report on a weekly basis, for more information: http://www.wpro.who.int/southpacific/programmes/communicable_diseases/disease_surveillance_resp onse/page/en/index2.html Influenza Situation Update | 7 Figure 13: Reported cases of influenza-like illness in Pacific Island Countries, 2017 Influenza Situation Update | 8 Global influenza situation updates Epidemiological update http://www.who.int/influenza/surveillance_monitoring/updates/latest_update_GIP_surveillance/en/ Virological update: http://www.who.int/influenza/gisrs_laboratory/updates/summaryreport/en/ Global update: http://www.who.int/influenza/surveillance_monitoring/updates/latest_update_GIP_surveillance/ Others: Recommended composition of influenza virus vaccines for use in the 2017 southern hemisphere influenza season http://www.who.int/influenza/vaccines/virus/recommendations/2017_south/en/ Antigenic and genetic characteristics of zoonotic influenza viruses and candidate vaccine viruses developed for potential use in human vaccines http://www.who.int/influenza/vaccines/virus/characteristics_virus_vaccines/en/ 4th WHO Informal Consultation on Improving Influenza Vaccine Virus Selection http://www.who.int/influenza/vaccines/virus/4thmtg_improve_vaccine_virus_selection/en/ Video on influenza on WHO's YouTube Channel Arabic: https://www.youtube.com/watch?v=PxW6Pg1AnwI Chinese: https://www.youtube.com/watch?v=xW9gDKEPitQ English: https://www.youtube.com/watch?v=yhhJfT86Bgg French: https://www.youtube.com/watch?v=8mo8rWWJZkc Russian: https://www.youtube.com/watch?v=XQO6nbkKUWQ Spanish: https://www.youtube.com/watch?v=qXr75cKxwTY Recommended composition of influenza virus vaccines for use in the 2017- 2018 northern hemisphere influenza season http://www.who.int/influenza/vaccines/virus/recommendations/201703_recommendation.pdf?ua=1
Bi-weekly Influenza Situation Update 15 August 2017 Virological Surveillance Summary The number of specimens reported to FluNet by the Western Pacific Region countries and areas between week 1 and week 31, and the number of influenza positive specimens, are presented in the table below. Influenza A(H3) is currently the predominant circulating subtype (Figure 1). Table 1: Countries and areas reporting data to FluNet, Western Pacific Region, weeks 1 to 31, 2017 Figure 1: Number of specimens positive for influenza by subtype, Western Pacific Region, week 33 2016 to week 31 2017 (Source: www.who.int/flunet) Country (most recent week of report) Total number of specimens processed Total number of influenza positive specimens Australia (week 31) 25041 2750 Cambodia (week 31) 763 55 China (week 31) 385072 55286 Fiji (week 28) 288 92 Japan (week 30) NA 7046 Lao People's Democratic Republic (week 31) 2554 246 Malaysia (week 17) 1848 236 Mongolia (week 26) 2136 412 New Caledonia (week 31) 313 9 New Zealand (week 18-30) 1316 660 Papua New Guinea (week 25) 180 23 Philippines (week 31) 740 160 Republic of Korea (week 31) 7331 740 Singapore (week 31) 1456 800 Viet Nam (week 22) 834 145 Influenza Situation Update| 2 Influenza surveillance summary Influenza surveillance in the WHO Western Pacific Region is based on outpatient and inpatient sentinel surveillance systems. Case definitions, populations under surveillance and data formats differ among these countries. This influenza surveillance summary includes countries where routine surveillance is conducted and information is available. The WHO surveillance case definition for ILI is an acute respiratory infection with a measured fever of ≥38oC and cough, with symptom onset within the last 10 days. For SARI, it is an acute respiratory infection (ARI) with a history of fever or measured fever of ≥38oC and cough, with symptom onset within the last 10 days and requires hospitalization. Countries in the temperate zone of the Northern Hemisphere In most countries within the temperate zone of the Northern Hemisphere, ILI and influenza activity are consistent with seasonal trends but indicate an earlier start to the influenza season compared to the 2015-2016 season. Outpatient ILI Surveillance China (North) During week 31, the percentage of visits for ILI at national sentinel hospitals in northern China was 2.5 % of total visits, which is higher than last week. The ILI activity was approximately the same during the same week of 2014-2016 (2.3% - 2.5%) (Figure 2). Mongolia (no updates) ILI activity remained at expected tolerance levels during week 28 of 2017 compared to the previous week and seasons. The most recent peak in ILI activity occurred in week 4 of 2017 (Figure 3). Mongolia publishes weekly reports, available here: http://www.flu.mn/eng/index.php?option=com_content&task= section&id=5&Itemid=51 China (North) Mongolia Figure 2: Percentage of visits for ILI at sentinel hospitals in north China, 2014-2017 (Source: China National Influenza Center) Figure 3: Proportion of outpatient ILI visits (per 10,000 people), 2014-2017 (Source: Mongolia National Influenza Center) Influenza Situation Update| 3 Republic of Korea In week 31, 2017, there were 4.5 ILI cases per 1,000 outpatient visits, which was higher than 3.9 per 1,000 in the previous week. ILI activity remained stable and below the established baseline (8.9 per 1,000 outpatient visits) (Figure 4). Korea publishes a weekly report, available here:http://www.cdc.go.kr/C DC/eng/info/CdcEngInfo0101.jsp?menuIds=HOME002-MNU0576-MNU0586 Republic of Korea Figure 4: Weekly ILI incidence rate per 1000 patients, 2013-2017 (Source: Korean Centre for Disease Control and Prevention) Sentinel influenza surveillance Japan As of week 31 2017, influenza activity in Japan shows a similar seasonal pattern to previous years with few influenza cases reported weekly per reporting sentinel hospital (Figure 5). More information about historical trends are available here: https://www.niid.go.jp/niid/en/10/2096-weeklygraph/2572-trend- week-e.html Figure 5: Number of influenza cases reported weekly per reporting sentinel hospital site, Japan 2007-2017 (Source: Japan National Institute of Infectious Diseases) Influenza Situation Update| 4 Countries/areas in the tropical zone Countries /areas in the tropical zone are observing increased ILI and ARI activity in recent weeks in 2017. Surveillance Hong Kong SAR (China) – ILI and hospital Surveillance Outpatient surveillance data showed that the local influenza activity has decreased significantly from its peak in the past two weeks but still remained elevated. In week 31 the average consultation rates for ILI among sentinel general outpatient clinics and sentinel private doctors were 7.3 and 63.9 ILI cases per 1,000 consultations, which were lower than 10.0 and 72.4 in the previous week. Admission rates in public hospitals with principal diagnosis of influenza for persons aged 0-4 years and 65 years or above has decreased significantly from week 30; 3.72 and 2.73 cases (per 10,000 people in the age group) respectively compared to 5.72 and 5.71 cases in the previous week. As of 9 August, 508 severe cases including 351 deaths have been recorded since the activation of the enhanced surveillance for severe influenza infection on May 5. The majority (489/508) of the severe cases are adults above the age of 18 years, of these 186 (38.0%) were known to have received the influenza vaccine. Additionally there have been 19 cases of severe paediatric influenza (including 3 deaths) associated with complications. Hong Kong SAR, China publishes a weekly report, available here: http://www.chp.gov.hk/en/guideline1_ year/29/134/441/304.html China (South) - ILI Surveillance During week 31, the percentage of outpatient or emergency visits for ILI at national sentinel hospitals in southern China was 3.6%, lower than the last week and the same week of 2015 (4.0%, 3.8%), but higher than the same week of 2014 and 2016 (3.4%, 2.8%) (Figure 6). Singapore – Acute Respiratory Infection Surveillance The average daily number of patients seeking treatment in polyclinics for acute respiratory infection decreased from 569 per working day in week 30, to 521 per working day in week 31 (Figure 9). The proportion of patients with ILI among polyclinic attendances for ARI remained low at 2.0%. Singapore publishes a weekly report, available here: http://www.moh.gov.sg/content/moh_web/home/statistic s/infectiousDiseasesStatistics/weekly_infectiousdiseasesbulletin.html Hong Kong (China) - ILI Surveillance Figure 6: ILI consultation rates at sentinel general outpatient clinics, Hong Kong 2013-2017 (Source: Hong Kong Centre for Health Protection) Figure 7: ILI consultation rates at sentinel private doctors, Hong Kong 2013-2017 (Source: Hong Kong Centre for Health Protection) Influenza Situation Update| 5 China (South) - ILI Surveillance Figure 8: Percentage of visits due to ILI at national sentinel hospitals in South China, 2014-2017 (Source: China National Influenza Center) Singapore - ARI Surveillance Figure 9: Average daily polyclinic attendances for ARI in Singapore, 2016-2017 (Source: Singapore Ministry of Health) Lao PDR In week 31, influenza activity has increased compared to last week but the number of ILI presentations remains similar to previous years (see Figure 10). The number of severe acute respiratory infections increased this year and remains significantly higher than numbers reported during week 31 in the past 5 years. However, the trend remains similar. Figure 10: Weekly number of ILI presentations at sentinel sites, 2012 to week 31, 2017, Lao PDR (Source: Lao National Center for Laboratory and Epidemiology) Influenza Situation Update| 6 Countries in the temperate zone of the southern hemisphere In the temperate zone of the southern hemisphere, influenza activity followed seasonal trends. Australia – Laboratory-confirmed influenza (no updates) As of 21 July 2017, a total of 35,774 notifications of laboratory confirmed influenza were reported to the National Notifiable Diseases Surveillance System (Figure 11). Seventy-four percent of notifications were influenza A (65% A(unsubtyped), 7% influenza A(H3N2) and 3% influenza A(H1N1pdm09), 26% were influenza B and less than 1% were influenza C, influenza A and B co‐infections or untyped. Australia publishes influenza surveillance reports on a fortnightly basis during the influenza season, typically between May and October. For more information: http://www.health.gov.au/internet/main/publishing.nsf /content/cda-surveil-ozflu-flucurr.htm#current Figure 11: Australian notifications of laboratory confirmed influenza (Source: National Notifiable Diseases Surveillance System, Australian Department of Health) New Zealand – Influenza like Illness During week 31, 194 patients with influenza-like illness consulted sentinel general practices in 20 district health boards (DHBs). The weekly ILI incidence was 47.2 per 100 000 patient population. Of the 141 laboratory tested ILI cases, 63 were positive for influenza viruses. This gives an ILI related influenza incidence (adjusted) of 21.1 per 100 000 patient population. New Zealand publishes a weekly report, available here: https://surv.esr.cri.nz/virology/influenza_weekly_update.php Figure 12: Weekly resident ILI and influenza incidence since Week 1 of 2017 in New Zealand (Source: Institute of Environmental Science and Research Ltd (ESR), New Zealand) Influenza Situation Update| 7 Pacific Island Countries and Areas (PICs) - ILI Surveillance In the Pacific Island Countries and Areas, in week 31, the number of ILI cases reported in Federated Staes of Micronesia, Kiribati, Solomon Islands, Tonga and Vanuatu increased compared to previous weeks (Figure 13). The PICs submit a report on a weekly basis, for more information: http://www.wpr o.who.int/southpacific/programmes/communicable_diseases/disease_surveillance_response/page/en/i ndex2.html Figure 13: Reported cases of influenza-like illness in Pacific Island Countries, 2017 Influenza Situation Update| 8 Global influenza situation updates Epidemiological update http://www.who.int/influenza/surveillance_monitoring/updates/latest_update_GIP_surveillance/en/ Virological update: http://www.who.int/influenza/gisrs_laboratory/updates/summaryreport/en/ Global update: http://www.who.int/influenza/surveillance_monitoring/updates/latest_update_GIP_surveillance/ Others: Recommended composition of influenza virus vaccines for use in the 2017 southern hemisphere influenza season http://www.who.int/influenza/vaccines/virus/recommendations/2017_south/en/ Antigenic and genetic characteristics of zoonotic influenza viruses and candidate vaccine viruses developed for potential use in human vaccines http://www.who.int/influenza/vaccines/virus/characteristics_virus_vaccines/en/ 4th WHO Informal Consultation on Improving Influenza Vaccine Virus Selection http://www.who.int/influenza/vaccines/virus/4thmtg_improve_vaccine_virus_selection/en/ Video on influenza on WHO's YouTube Channel Arabic: https://www.youtube.com/watch?v=PxW6Pg1AnwI Chinese: https://www.youtube.com/watch?v=xW9gDKEPitQ English: https://www.youtube.com/watch?v=yhhJfT86Bgg French: https://www.youtube.com/watch?v=8mo8rWWJZkc Russian: https://www.youtube.com/watch?v=XQO6nbkKUWQ Spanish: https://www.youtube.com/watch?v=qXr75cKxwTY Recommended composition of influenza virus vaccines for use in the 2017- 2018 northern hemisphere influenza season http://www.who.int/influenza/vaccines/virus/recommendations/201703_recommendation.pdf?ua=1
Bi-weekly Influenza Situation Update 1 August 2017 Virological Surveillance Summary The number of specimens reported to FluNet by the Western Pacific Region countries and areas between week 1 and week 29, and the number of influenza positive specimens, are presented in the table below. Influenza A(H3) is currently the predominant circulating subtype (Figure 1). Table 1: Countries and areas reporting data to FluNet, Western Pacific Region, weeks 1 to 29, 2017 Figure 1: Number of specimens positive for influenza by subtype, Western Pacific Region, week 31 2016 to week 29 2017 (Source: www.who.int/flunet) Country (most recent week of report) Total number of specimens processed Total number of influenza positive specimens Australia (week 29) 20462 1370 Cambodia (week 29) 702 40 China (week 29) 358607 47745 Fiji (week 24) 251 87 Japan (week 28) NA 6987 Lao People's Democratic Republic (week 29) 2463 235 Malaysia (week 17) 1848 236 Mongolia (week 26) 2136 412 New Caledonia (week 28) 258 4 New Zealand (week 18-27) 809 404 Papua New Guinea (week 25) 180 23 Philippines (week 28) 603 69 Republic of Korea (week 29) 6997 737 Singapore (week 27) 1385 777 Viet Nam (week 22) 834 145 Influenza Situation Update | 2 Influenza surveillance summary Influenza surveillance in the WHO Western Pacific Region is based on outpatient and inpatient sentinel surveillance systems. Case definitions, populations under surveillance and data formats differ among these countries. This influenza surveillance summary includes countries where routine surveillance is conducted and information is available. The WHO surveillance case definition for ILI is an acute respiratory infection with a measured fever of ≥38oC and cough, with symptom onset within the last 10 days. For SARI, it is an acute respiratory infection (ARI) with a history of fever or measured fever of ≥38oC and cough, with symptom onset within the last 10 days and requires hospitalization. Countries in the temperate zone of the Northern Hemisphere In most countries within the temperate zone of the Northern Hemisphere, ILI and influenza activity are consistent with seasonal trends but indicate an earlier start to the influenza season compared to the 2015-2016 season. Outpatient ILI Surveillance China (North) During week 29, the percentage of visits for ILI at national sentinel hospitals in northern China was 2.5 % of total visits, which is lower than last week. The ILI activity was approximately the same during the same week of 2014-2016 (2.3% - 2.7%) (Figure 2). Mongolia ILI activity remained at expected tolerance levels during week 28 of 2017 compared to the previous week and seasons. The most recent peak in ILI activity occurred in week 4 of 2017 (Figure 3). Mongolia publishes weekly reports, available here: http://www.flu.mn/eng/index.php?option=com_content&task=section&id=5&Itemid=51 China (North) Mongolia Figure 2: Percentage of visits for ILI at sentinel hospitals in north China, 2014-2017 (Source: China National Influenza Center) Figure 3: Proportion of outpatient ILI visits (per 10,000 people), 2014-2017 (Source: Mongolia National Influenza Center) Influenza Situation Update | 3 Republic of Korea In week 29, 2017, there were 6.3 ILI cases per 1,000 outpatient visits, which was higher than 6.0 per 1,000 in the previous week. ILI activity remained stable and below the established baseline (8.9 per 1,000 outpatient visits) (Figure 4). Korea publishes a weekly report, available here: http://www.cdc.go.kr/CDC/eng/info/CdcEngInfo0101.jsp?menuIds=HOME002-MNU0576-MNU0586 Republic of Korea Figure 4: Weekly ILI incidence rate per 1000 patients, 2013-2017 (Source: Korean Centre for Disease Control and Prevention) Sentinel influenza surveillance Japan As of week 28 2017, influenza activity in Japan shows a similar seasonal pattern to previous years with few influenza cases reported weekly per reporting sentinel hospital (Figure 5). More information about historical trends are available here: https://www.niid.go.jp/niid/en/10/2096-weeklygraph/2572-trend- week-e.html Figure 5: Number of influenza cases reported weekly per reporting sentinel hospital site, Japan 2007-2017 (Source: Japan National Institute of Infectious Diseases) Influenza Situation Update | 4 Countries/areas in the tropical zone Countries /areas in the tropical zone are observing increased ILI and ARI activity in recent weeks in 2017. Surveillance Hong Kong SAR (China) – ILI and hospital Surveillance Outpatient surveillance data showed that the local influenza activity remained at a very high level in the past week. In week 29 , the average consultation rate for ILI among sentinel private doctors was 76.4 ILI cases per 1,000 consultations, which was higher than 65.5 in the previous week. Admission rates in public hospitals with principal diagnosis of influenza for persons aged 0-4 years and 65 years or above remains high, although slightly decreased from week 28; 7.16, and 5.27 cases (per 10,000 people in the age group) respectively compared to 9.80 and 6.40 cases in the previous week. As of 26 Jul, 379 severe cases including 255 deaths have been recorded since the activation of the enhanced surveillance for severe influenza infection on May 5. The majority (361/379) of the severe cases are adults above the age of 18 years, of these 131 (36.3%) were known to have received the influenza vaccine. Additionally there have been 18 cases of severe paediatric influenza (including 3 deaths) associated with complications. Hong Kong SAR, China publishes a weekly report, available here: http://www.chp.gov.hk/en/guideline1_year/29/134/441/304.html China (South) - ILI Surveillance During week 29, the percentage of outpatient or emergency visits for ILI at national sentinel hospitals in southern China was 4.1%, lower than the last week (4.3%) but higher than the same week of 2014-2016 (3.1-3.6%) (Figure 6). Singapore – Acute Respiratory Infection Surveillance The average daily number of patients seeking treatment in polyclinics for acute respiratory infection increased from 580 per working day in week 28, to 610 per working day in week 29(Figure 9). The proportion of patients with ILI among polyclinic attendances for ARI remained low at 2.6%. Singapore publishes a weekly report, available here: http://www.moh.gov.sg/content/moh_web/home/statistics/infectiousDiseasesStatistics/weekly_infecti ousdiseasesbulletin.html Hong Kong (China) - ILI Surveillance Figure 6: ILI consultation rates at sentinel general outpatient clinics, Hong Kong 2013-2017 (Source: Hong Kong Centre for Health Protection) Figure 7: ILI consultation rates at sentinel private doctors, Hong Kong 2013-2017 (Source: Hong Kong Centre for Health Protection) Influenza Situation Update | 5 China (South) - ILI Surveillance Figure 8: Percentage of visits due to ILI at national sentinel hospitals in South China, 2014-2017 (Source: China National Influenza Center) Singapore - ARI Surveillance Figure 9: Average daily polyclinic attendances for ARI in Singapore, 2016-2017 (Source: Singapore Ministry of Health) Lao PDR In week 29, influenza activity has increased compared to last week but the number of ILI presentations remains similar to previous years (see Figure 10). The number of severe acute respiratory infections increased this year and remains higher than numbers reported during week 29 in the past 5 years. However, the trend remains similar. Figure 10: Weekly number of ILI presentations at sentinel sites, 2012 to week 29, 2017, Lao PDR (Source: Lao National Center for Laboratory and Epidemiology) Influenza Situation Update | 6 Countries in the temperate zone of the southern hemisphere In the temperate zone of the southern hemisphere, influenza activity followed seasonal trends. Australia – Laboratory-confirmed influenza As of 21 July 2017, a total of 35,774 notifications of laboratory confirmed influenza were reported to the National Notifiable Diseases Surveillance System (Figure 11). Seventy-four percent of notifications were influenza A (65% A(unsubtyped), 7% influenza A(H3N2) and 3% influenza A(H1N1)pdm09), 26% were influenza B and less than 1% were influenza C, influenza A and B co‐infections or untyped. Australia publishes influenza surveillance reports on a fortnightly basis during the influenza season, typically between May and October. For more information: http://www.health.gov.au/internet/main/publishing.nsf/Content/cda-surveil-ozflu- flucurr.htm/$File/ozflu-surveil-no02-2017.pdf Figure 11: Australian notifications of laboratory confirmed influenza (Source: National Notifiable Diseases Surveillance System, Australian Department of Health) Influenza Situation Update | 7 New Zealand – Influenza like Illness During week 29, 194 patients with influenza-like illness consulted sentinel general practices in 20 district health boards (DHBs). The weekly ILI incidence was 47.2 per 100 000 patient population. Of the 159 laboratory tested ILI cases, 76 were positive for influenza viruses. This gives an ILI related influenza incidence (adjusted) of 22.6 per 100 000 patient population. New Zealand publishes a weekly report, available here: https://surv.esr.cri.nz/virology/influenza_weekly_update.php Figure 12: Weekly resident ILI and influenza incidence since Week 1 of 2017 in New Zealand (Source: Institute of Environmental Science and Research Ltd (ESR), New Zealand) Influenza Situation Update | 8 Pacific Island Countries and Areas (PICs) - ILI Surveillance In the Pacific Island Countries and Areas, in week 29, the number of ILI cases reported in Solomon Islands and Samoa increased compared to previous weeks (Figure 13). The PICs submit a report on a weekly basis, for more information: http://www.wpro.who.int/southpacific/programmes/communicable_diseases/disease_surveillance_res ponse/page/en/index2.html Figure 13: Reported cases of influenza-like illness in Pacific Island Countries, 2017 Influenza Situation Update | 9 Global influenza situation updates Epidemiological update http://www.who.int/influenza/surveillance_monitoring/updates/latest_update_GIP_surveillance/en/ Virological update: http://www.who.int/influenza/gisrs_laboratory/updates/summaryreport/en/ Global update: http://www.who.int/influenza/surveillance_monitoring/updates/latest_update_GIP_surveillance/ Others: Recommended composition of influenza virus vaccines for use in the 2017 southern hemisphere influenza season http://www.who.int/influenza/vaccines/virus/recommendations/2017_south/en/ Antigenic and genetic characteristics of zoonotic influenza viruses and candidate vaccine viruses developed for potential use in human vaccines http://www.who.int/influenza/vaccines/virus/characteristics_virus_vaccines/en/ 4th WHO Informal Consultation on Improving Influenza Vaccine Virus Selection http://www.who.int/influenza/vaccines/virus/4thmtg_improve_vaccine_virus_selection/en/ Video on influenza on WHO's YouTube Channel Arabic: https://www.youtube.com/watch?v=PxW6Pg1AnwI Chinese: https://www.youtube.com/watch?v=xW9gDKEPitQ English: https://www.youtube.com/watch?v=yhhJfT86Bgg French: https://www.youtube.com/watch?v=8mo8rWWJZkc Russian: https://www.youtube.com/watch?v=XQO6nbkKUWQ Spanish: https://www.youtube.com/watch?v=qXr75cKxwTY Recommended composition of influenza virus vaccines for use in the 2017-2018 northern hemisphere influenza season http://www.who.int/influenza/vaccines/virus/recommendations/201703_recommendation.pdf?ua=1
Virological Surveillance Summary The number of specimens reported to FluNet by the Western Pacific Region countries and areas between week 1 and week 27, and the number of influenza posiGve specimens, are presented in the table below. Influenza A(H3) is currently the predominant circulaGng subtype (Figure 1). Table 1: Countries and areas reporGng data to FluNet, Western Pacific Region, weeks 1 to 27, 2017 Country (most recent week of report) Total number of specimens processed Total number of influenza posiGve specimens Australia (week 27) 18520 1028 Cambodia (week 27) 602 21 China (week 27) 331689 40839 Fiji (week 24) 251 87 Japan (week 26) NA 6717 Lao People's DemocraGc Republic (week 27) 2287 225 Malaysia (week 17) 1848 236 Mongolia (week 26) 2136 412 New Caledonia (week 20) 161 3 New Zealand (week 18-27) 809 404 Papua New Guinea (week 25) 180 23 Philippines (week 27) 558 56 Republic of Korea (week 27) 6613 732 Singapore (week 27) 1283 732 Viet Nam (week 22) 834 145 Influenza SituaGon Update | 1 Bi-weekly Influenza SituaGon Update 18 July 2017 Figure 1: Number of specimens posiGve for influenza by subtype, Western Pacific Region, week 29 2016 to week 27 2017 (Source: www.who.int/flunet) Influenza surveillance summary Influenza surveillance in the WHO Western Pacific Region is based on outpaGent and inpaGent senGnel surveillance systems. Case definiGons, populaGons under surveillance and data formats differ among these countries. This influenza surveillance summary includes countries where rouGne surveillance is conducted and informaGon is available. The WHO surveillance case definiGon for ILI is an acute respiratory infecGon with a measured fever of ≥38oC and cough, with symptom onset within the last 10 days. For SARI, it is an acute respiratory infecGon (ARI) with a history of fever or measured fever of ≥38oC and cough, with symptom onset within the last 10 days and requires hospitalizaGon. Countries in the temperate zone of the Northern Hemisphere In most countries within the temperate zone of the Northern Hemisphere, ILI and influenza acGvity are consistent with seasonal trends but indicate an earlier start to the influenza season compared to the 2015-2016 season. OutpaGent ILI Surveillance China (North) During week 27, the percentage of visits for ILI at naGonal senGnel hospitals in northern China was 2.5 % of total visits. The ILI acGvity was approximately the same during the same week of 2014-2016 (2.3% - 2.6%) (Figure 2). Mongolia ILI acGvity remained at expected tolerance levels during week 23 of 2017 compared to the previous week and seasons. The most recent peak in ILI acGvity occurred in week 4 of 2017 (Figure 3). Influenza SituaGon Update | 2 Republic of Korea In week 26, 2017, there were 5.3 ILI cases per 1,000 outpaGent visits, which was lower than 5.7 per 1,000 in the previous week. ILI acGvity remained stable and below the baseline (8.9 per 1,000 outpaGent visits) (Figure 4). Republic of Korea Figure 4: Weekly ILI incidence rate per 1000 paGents, 2013-2017 (Source: Korean Centre for Disease Control and PrevenGon) Figure 2: Percentage of visits for ILI at senGnel hospitals in north China, 2014-2017 (Source: China NaGonal Influenza Center) Figure 3: ProporGon of outpaGent ILI visits (per 10,000 people), 2014-2017 (Source: Mongolia NaGonal Influenza Center) China (North) Mongolia Influenza SituaGon Update | 3 SenGnel influenza surveillance Japan As of week 26 2017, influenza acGvity in Japan shows a similar seasonal palern to previous years with few influenza cases reported weekly per reporGng senGnel hospital. (Figure 5). Figure 5: Number of influenza cases reported weekly per reporGng senGnel hospital site, Japan 2007-2017 (Source: Japan NaGonal InsGtute of InfecGous Diseases) Countries/areas in the tropical zone Countries /areas in the tropical zone are observing increased ILI and ARI acGvity in recent weeks in 2017. OutpaGent Surveillance Hong Kong (China) - ILI Surveillance Surveillance data indicate an increase in local influenza acGvity in recents weeks. In weeks 26 and 27 of 2017, the consultaGon rate for ILI among senGnel general outpaGent clinics was 10.6 and 9.3 ILI cases per 1,000 consultaGons respecGvely. The average consultaGon rate for ILI among senGnel private doctors was 67.3 and 59.8 ILI cases per 1000 consultaGons in week 26 and 27 (Figure 6 & Figure 7). Since the acGvaGon of enhanced surveillance for severe influenza infecGon on May 5, 2017, a total of 236 severe cases including 157 deaths) were recorded cumulaGvely (as of July 12). The majority (223/236) of the severe cases were adults above the age of 18 years. Of the 223 fatal cases 189 (84.8%) cases were posiGve for A(H3N2). Of 155 fatal cases, 63 (40.6%)were known to have received the influenza vaccine. China (South) - ILI Surveillance During week 27, the percentage of outpaGent or emergency visits for ILI at naGonal senGnel hospitals in southern China was 4.2%, which was higher than previous seasons (Figure 8). Singapore – Acute Respiratory InfecGon Surveillance The average daily number of paGents seeking treatment in polyclinics for acute respiratory infecGon increased from 475 per working day in week 25, to 621 per working day in week 26. (Figure 9). The proporGon of paGents with ILI among polyclinic alendances for ARI remained low at 3.1%. Influenza SituaGon Update | 4 Hong Kong (China) - ILI Surveillance Countries in the temperate zone of the southern hemisphere In the temperate zone of the southern hemisphere, influenza acGvity followed seasonal trends. Australia – Laboratory-confirmed influenza As of 23 June 2017, a total of 17,978 noGficaGons of laboratory confirmed influenza were reported to the NaGonal NoGfiable Diseases Surveillance System (Figure 10). Seventy-seven percent of noGficaGons were influenza A (66% A(unsubtyped), 8% influenza A(H3N2) and 2% influenza A(H1N1)pdm09), 23% were influenza B and less than 1% were influenza C, influenza A&B co-infecGons or untyped. Australia publishes influenza surveillance reports on a fortnightly basis during the influenza season, typically between May and October. For more informaGon: hlp://www.health.gov.au/internet/main/publishing.nsf/Content/cda-surveil-ozflu-flucurr.htm/$File/ ozflu-surveil-no02-2017.pdf Figure 6: ILI consultaGon rates at senGnel general outpaGent clinics, Hong Kong 2013-2017 (Source: Hong Kong Centre for Health ProtecGon) Figure 7: ILI consultaGon rates at senGnel private doctors, Hong Kong 2013-2017 (Source: Hong Kong Centre for Health ProtecGon) China (South) - ILI Surveillance Figure 8: Percentage of visits due to ILI at naGonal senGnel hospitals in South China, 2014-2017 (Source: China NaGonal Influenza Center) Singapore - ARI Surveillance Figure 9: Average daily polyclinic alendances for ARI in Singapore, 2016-2017 (Source: Singapore Ministry of Health) Influenza SituaGon Update | 5 Figure 10: Australian noGficaGons of laboratory confirmed influenza (Source: NaGonal NoGfiable Diseases Surveillance System, Australian Department of Health) New Zealand – Influenza like Illness During week 27, 213 paGents with influenza-like illness consulted senGnel general pracGces in 20 DHBs. The weekly ILI incidence was 51.8 per 100 000 paGent populaGon. Of the 153 tested ILI cases, 90 were posiGve for influenza viruses. This gives an ILI related influenza incidence (adjusted) of 30.5 per 100 000 paGent populaGon. Figure 11: Weekly resident ILI and influenza incidence since Week 1 of 2017 in New Zealand (Source: InsGtute of Environmental Science and Research Ltd (ESR), New Zealand) Influenza SituaGon Update | 6 Pacific Island Countries and Areas (PICs) - ILI Surveillance In the Pacific Island Countries and Areas, in week 27, the number of ILI cases reported in KiribaG and Tonga increased compared to previous weeks (Figure 12). Figure 12: Reported cases of influenza-like illness in Pacific Island Countries, 2017 Influenza SituaGon Update | 7 Global influenza situaGon updates Epidemiological update hlp://www.who.int/influenza/surveillance_monitoring/updates/latest_update_GIP_surveillance/en/ Virological update: hlp://www.who.int/influenza/gisrs_laboratory/updates/summaryreport/en/ Global update: hlp://www.who.int/influenza/surveillance_monitoring/updates/latest_update_GIP_surveillance/ Others: Recommended composiGon of influenza virus vaccines for use in the 2017 southern hemisphere influenza season hlp://www.who.int/influenza/vaccines/virus/recommendaGons/2017_south/en/ AnGgenic and geneGc characterisGcs of zoonoGc influenza viruses and candidate vaccine viruses developed for potenGal use in human vaccines hlp://www.who.int/influenza/vaccines/virus/characterisGcs_virus_vaccines/en/ 4th WHO Informal ConsultaGon on Improving Influenza Vaccine Virus SelecGon hlp://www.who.int/ influenza/vaccines/virus/4thmtg_improve_vaccine_virus_selecGon/en/ Video on influenza on WHO's YouTube Channel Arabic: hlps://www.youtube.com/watch?v=PxW6Pg1AnwI Chinese: hlps://www.youtube.com/watch?v=xW9gDKEPitQ English: hlps://www.youtube.com/watch?v=yhhJfT86Bgg French: hlps://www.youtube.com/watch?v=8mo8rWWJZkc Russian: hlps://www.youtube.com/watch?v=XQO6nbkKUWQ Spanish: hlps://www.youtube.com/watch?v=qXr75cKxwTY Recommended composiGon of influenza virus vaccines for use in the 2017-2018 northern hemisphere influenza season hlp://www.who.int/influenza/vaccines/virus/recommendaGons/201703_recommendaGon.pdf?ua=1 Influenza SituaGon Update | 8
Virological Surveillance Summary The number of specimens reported to FluNet by the Western Pacific Region countries and areas between week 1 and week 26, and the number of influenza posiGve specimens, are presented in the table below. Influenza A(H3) is currently the predominant circulaGng subtype (Figure 1). Table 1: Countries and areas reporGng data to FluNet, Western Pacific Region, weeks 1 to 26, 2017 Country (most recent week of report) Total number of specimens processed Total number of influenza posiGve specimens Australia (week 25) 15976 772 Cambodia (week 23) 553 18 China (week 25) 313613 38307 Fiji (week 24) 251 87 Japan (week 24) NA 6699 Lao People's DemocraGc Republic (week 25) 2130 215 Malaysia (week 17) 1848 236 Mongolia (week 26) 2136 412 New Caledonia (week 20) 161 3 New Zealand (week 18-25) 485 214 Papua New Guinea (week 25) 180 23 Philippines (week 25) 523 44 Republic of Korea (week 26) 6421 730 Singapore (week 24) 1137 652 Viet Nam (week 22) 834 145 Influenza SituaGon Update | 1 Bi-weekly Influenza SituaGon Update 4 July 2017 Figure 1: Number of specimens posiGve for influenza by subtype, Western Pacific Region, week 27 2016 to week 25 2017 (Source: www.who.int/flunet) Influenza surveillance summary Influenza surveillance in the WHO Western Pacific Region is based on outpaGent and inpaGent senGnel surveillance systems. Case definiGons, populaGons under surveillance and data formats differ among these countries. This influenza surveillance summary includes countries where rouGne surveillance is conducted and informaGon is available. The WHO surveillance case definiGon for ILI is an acute respiratory infecGon with a measured fever of ≥38oC and cough, with symptom onset within the last 10 days. For SARI, it is an acute respiratory infecGon (ARI) with a history of fever or measured fever of ≥38oC and cough, with symptom onset within the last 10 days and requires hospitalizaGon. Countries in the temperate zone of the Northern Hemisphere In most countries within the temperate zone of the Northern Hemisphere, ILI and influenza acGvity are consistent with seasonal trends but indicate an earlier start to the influenza season compared to the 2015-2016 season. OutpaGent ILI Surveillance China (North) During weeks 24 and 25, the percentage of visits for ILI at naGonal senGnel hospitals in northern China was 2.5 % and 2.6% of total visits. The ILI acGvity is similar to same weeks of 2014-2016 (2.4% ~ 2.6%) (Figure 2). Influenza SituaGon Update | 2 Mongolia ILI acGvity remained at expected tolerance levels during week 23 of 2017 compared to the previous week and seasons. The most recent peak in ILI acGvity occurred in week 4 of 2017 (Figure 3). Republic of Korea In week 24, 2017, there were 5.6 ILI cases per 1,000 outpaGent visits, which was higher than 5.1 per 1000 in the previous week. ILI acGvity remained stable and belowr the baseline (8.9 per 1000) (Figure 4). Republic of Korea Figure 4: Weekly ILI incidence rate per 1000 paGents, 2013-2017 (Source: Korean Centre for Disease Control and PrevenGon) Figure 2: Percentage of visits for ILI at senGnel hospitals in north China, 2014-2017 (Source: China NaGonal Influenza Center) Figure 3: ProporGon of outpaGent ILI visits (per 10,000 people), 2014-2017 (Source: Mongolia NaGonal Influenza Center) China (North) Mongolia Influenza SituaGon Update | 3 SenGnel influenza surveillance Japan As of week 24 2017, influenza acGvity in Japan shows a similar seasonal pamern to previous years with few influenza cases reported weekly per reporGng senGnel hospital. (Figure 5). Figure 5: Number of influenza cases reported weekly per reporGng senGnel hospital site, Japan 2007-2017 (Source: Japan NaGonal InsGtute of InfecGous Diseases) Countries/areas in the tropical zone In weeks 1 to 25 of 2017, ILI and ARI acGvity followed previous seasonal trends in countries/areas in the tropical zone. OutpaGent Surveillance Hong Kong (China) - ILI Surveillance Surveillance data indicate an increase in local influenza acGvity in recents weeks, consistent with the summer influenza season. In weeks 24 and 25 of 2017, the consultaGon rate for ILI among senGnel general outpaGent clinics was 6.3 and 7.9 ILI cases per 1,000 consultaGons respecGvely. The average consultaGon rate for ILI among senGnel private doctors was 51.5 and 57.3 ILI cases per 1000 consultaGons in week 24 and 25 (Figure 6 & Figure 7). China (South) - ILI Surveillance During weeks 24 and 25, the percentage of outpaGent or emergency visits for ILI at naGonal senGnel hospitals in southern China was 3.5% and 3.8% respecGvely, which was similar to previous seasons (Figure 8). Singapore – Acute Respiratory InfecGon Surveillance The average daily number of paGents seeking treatment in the polyclinics for acute respiratory infecGon increased from 2,476(over 5.5 working days) in week 24 to 2,374 (over 5.5 working days) in week 25. (Figure 9). The proporGon of paGents with ILI among polyclinic amendances for ARI remained low at 3.8%. Influenza SituaGon Update | 4 Hong Kong (China) - ILI Surveillance Countries in the temperate zone of the southern hemisphere In the temperate zone of the southern hemisphere, influenza acGvity followed seasonal trends. Australia – Laboratory-confirmed influenza As of 9 June 2017, a total of 14,568 noGficaGons of laboratory confirmed influenza were reported to the NaGonal NoGfiable Diseases Surveillance System (Figure 10). Eighty percent of noGficaGons were influenza A (68% A(unsubtyped), 10% influenza A(H3N2) and 2% influenza A(H1N1)pdm09), 20% were influenza B and less than 1% were influenza C, influenza A&B co-infecGons or untyped. Australia publishes influenza surveillance reports on a fortnightly basis during the influenza season, typically between May and October. For more informaGon: hmp://www.health.gov.au/internet/main/publishing.nsf/Content/cda-surveil-ozflu-flucurr.htm/$File/ ozflu-surveil-no02-2017.pdf Figure 6: ILI consultaGon rates at senGnel general outpaGent clinics, Hong Kong 2013-2017 (Source: Hong Kong Centre for Health ProtecGon) Figure 7: ILI consultaGon rates at senGnel private doctors, Hong Kong 2013-2017 (Source: Hong Kong Centre for Health ProtecGon) China (South) - ILI Surveillance Figure 8: Percentage of visits due to ILI at naGonal senGnel hospitals in South China, 2014-2017 (Source: China NaGonal Influenza Center) Singapore - ARI Surveillance Figure 9: Average daily polyclinic amendances for ARI in Singapore, 2016-2017 (Source: Singapore Ministry of Health) Influenza SituaGon Update | 5 Figure 10: Australian noGficaGons of laboratory confirmed influenza (Source: NaGonal NoGfiable Diseases Surveillance System, Australian Department of Health) New Zealand – Influenza like Illness In week 25, influenza acGvity was low among consultaGon-seeking paGents naGonwide, but increased slightly as per normal seasonal trends; 179 paGents with ILI consulted senGnel general pracGces in 20 District Health Boards. The weekly ILI incidence was 43.5 ILI cases per 100 000 paGents (Figure 11). Figure 11: Weekly resident ILI and influenza incidence since Week 1 of 2017 in New Zealand (Source: InsGtute of Environmental Science and Research Ltd (ESR), New Zealand) Influenza SituaGon Update | 6 Pacific Island Countries and Areas (PICs) - ILI Surveillance In the Pacific Island Countries and Areas, in week 25, the number of ILI cases reported in Solomon Islands and French Polynesiaincreased compared to previous weeks (Figure 12). Figure 12: Reported cases of influenza-like illness in Pacific Island Countries, 2017 Influenza SituaGon Update | 7 Global influenza situaGon updates Epidemiological update hmp://www.who.int/influenza/surveillance_monitoring/updates/ latest_update_GIP_surveillance/en/ Virological update: hmp://www.who.int/influenza/gisrs_laboratory/updates/summaryreport/en/ Global update: hmp://www.who.int/influenza/surveillance_monitoring/updates/latest_update_GIP_surveillance/ Others: Recommended composiGon of influenza virus vaccines for use in the 2017 southern hemisphere influenza season hmp://www.who.int/influenza/vaccines/virus/recommendaGons/2017_south/en/ AnGgenic and geneGc characterisGcs of zoonoGc influenza viruses and candidate vaccine viruses developed for potenGal use in human vaccines hmp://www.who.int/influenza/vaccines/virus/characterisGcs_virus_vaccines/en/ 4th WHO Informal ConsultaGon on Improving Influenza Vaccine Virus SelecGon hmp://www.who.int/ influenza/vaccines/virus/4thmtg_improve_vaccine_virus_selecGon/en/ Video on influenza on WHO's YouTube Channel Arabic: hmps://www.youtube.com/watch?v=PxW6Pg1AnwI Chinese: hmps://www.youtube.com/watch?v=xW9gDKEPitQ English: hmps://www.youtube.com/watch?v=yhhJfT86Bgg French: hmps://www.youtube.com/watch?v=8mo8rWWJZkc Russian: hmps://www.youtube.com/watch?v=XQO6nbkKUWQ Spanish: hmps://www.youtube.com/watch?v=qXr75cKxwTY Recommended composiGon of influenza virus vaccines for use in the 2017-2018 northern hemisphere influenza season hmp://www.who.int/influenza/vaccines/virus/recommendaGons/201703_recommendaGon.pdf?ua=1 Influenza SituaGon Update | 8
Bi-weekly Influenza Situation Update 20 June 2017 Virological Surveillance Summary The number of specimens reported to FluNet by the Western Pacific Region countries and areas between week 1 and week 23, and the number of influenza positive specimens, are presented in the table below. Influenza A(H1) and B are currently the predominant circulating subtypes (Figure 1). Table 1: Countries and areas reporting data to FluNet, Western Pacific Region, weeks 1 to 23, 2017 Figure 1: Number of specimens positive for influenza by subtype, Western Pacific Region, week 25 2016 to week 23 2017 (Source: www.who.int/flunet,accessed on 20 June 2017) Country (most recent week) Total number of specimens processed Total number of influenza positive specimens Australia (week 23) 14177 657 Cambodia (week 22) 530 15 China (week 23) 280612 34546 Fiji (week 22) 220 83 Japan (week 22) NA 5999 Lao People's Democratic Republic (week 23) 1950 202 Malaysia (week 13) 1062 170 Mongolia (week 22) 2020 410 New Caledonia (week 20) 161 3 New Zealand (week 18-21) 117 29 Papua New Guinea (week 13) 111 21 Philippines (week 23) 478 27 Republic of Korea (week 23) 5793 715 Singapore (week 23) 1038 585 Viet Nam (week 22) 834 145 Influenza Situation Update | 2 Influenza surveillance summary Influenza surveillance in the WHO Western Pacific Region is based on outpatient and inpatient sentinel surveillance systems. Case definitions, populations under surveillance and data formats differ among these countries. This influenza surveillance summary includes countries where routine surveillance is conducted and information is available. The WHO surveillance case definition for ILI is an acute respiratory infection with a measured fever of ≥38oC and cough, with symptom onset within the last 10 days. For SARI, it is an acute respiratory infection (ARI) with a history of fever or measured fever of ≥38oC and cough, with symptom onset within the last 10 days and requires hospitalization. Countries in the temperate zone of the Northern Hemisphere In most countries within the temperate zone of the Northern Hemisphere, ILI and influenza activity are consistent with seasonal trends but indicate an earlier start to the influenza season compared to the 2015-2016 season. Outpatient ILI Surveillance China (North) During weeks 22 and 23, the percentage of visits for ILI at national sentinel hospitals in northern China was 2.8 % and 2.5%. Compared to previous years, ILI activity was slightly higher than the same weeks of the 2014-2016 (2.3% ~ 2.6%)(Figure 2). Mongolia ILI activity remained at expected tolerance levels during week 23 of 2017 compared to the previous week and seasons. The most recent peak in ILI activity occurred in week four of 2017 (Figure 3). Republic of Korea In week 23 2017, there were 5.1 ILI cases per 1,000, which was higher than 4.9 per 1000 in the previous week. ILI activity was on a downward trend. (Figure 4). China (North) Mongolia Figure 2: Percentage of visits for ILI at sentinel hospitals in north China, 2012-2017 (Source: China National Influenza Center) Figure 3: Proportion of outpatient ILI visits (per 10,000 people), 2014-2017 (Source: Mongolia National Influenza Center) Influenza Situation Update | 3 Republic of Korea Figure 4: Weekly ILI incidence rate per 1000 patients, 2013-2017 (Source: Korean Centre for Disease Control and Prevention) Sentinel influenza surveillance Japan As of week 22 2017, influenza activity in Japan is following a similar seasonal pattern to pervious years. (Figure 5). Figure 5: Number of influenza cases reported weekly per reporting sentinel hospital site, Japan 2007-2017 (Source: Japan National Institute of Infectious Diseases) Influenza Situation Update | 4 Countries/areas in the tropical zone In weeks 1 to 23 of 2017, ILI and ARI activity followed previous seasonal trends in countries/areas in the tropical zone. Outpatient Surveillance Hong Kong (China) - ILI Surveillance Surveillance data indicate an increase in local influenza activity in recents weeks, consistent with the summer influenza season. In weeks 22 and 23 of 2017, the consultation rate for ILI among sentinel general outpatient clinics was 7.6 and 5.7 ILI cases per 1,000 consultations respectively. The average consultation rate for ILI among sentinel private doctors was 55.8 and 44.3 ILI cases per 1000 consultations in week 22 and 23 (Figure 6 & Figure 7). China (South) - ILI Surveillance During weeks 22 and 23, the percentage of outpatient or emergency visits for ILI at national sentinel hospitals in southern China was 3.6% and 3.4% respectively, which was similar to previous seasons (Figure 8). Singapore – Acute Respiratory Infection Surveillance The average daily number of patients seeking treatment in the polyclinics for acute respiratory infection increased from 3,440(over 5.5 working days) in week 21 to 3,241 (over 5.5 working days) in week 22. (Figure 9). The proportion of patients with ILI among polyclinic attendances for ARI remained low at 3.8%. Hong Kong (China) - ILI Surveillance Figure 6: ILI consultation rates at sentinel general outpatient clinics, Hong Kong 2012-2017 (Source: Hong Kong Centre for Health Protection) Figure 7: ILI consultation rates at sentinel private doctors, Hong Kong 2012-2017 (Source: Hong Kong Centre for Health Protection) Influenza Situation Update | 5 China (South) - ILI Surveillance Figure 8: Percentage of visits due to ILI at national sentinel hospitals in South China, 2012-2017 (Source: China National Influenza Center) Singapore - ARI Surveillance Figure 9: Average daily polyclinic attendances for ARI in Singapore, 2016-2017 (Source: Singapore Ministry of Health) Countries in the temperate zone of the southern hemisphere In the temperate zone of the southern hemisphere, influenza activity followed seasonal trends. Australia – Laboratory-confirmed influenza As of 26 May 2017, a total of 12,772 notifications of laboratory confirmed influenza were reported to the National Notifiable Diseases Surveillance System (Figure 10). Eighty two percent of notifications were influenza A(70% A(unsubtyped), 10% influenza A(H3N2) and 2% influenza A(H1N1)pdm09), 18% were influenza B and less than 1% were influenza A&B co‐infections or untyped. Australia publishes influenza surveillance reports on a fortnightly basis during the influenza season, typically between May and October. For more information: http://www.health.gov.au/internet/main/publishing.nsf/Content/140401215A7B4139CA258141000167 F9/$File/ozflu-surveil-no01-2017.pdf Figure 10: Australian notifications of laboratory confirmed influenza (Source: National Notifiable Diseases Surveillance System, Australian Department of Health) Influenza Situation Update | 6 New Zealand – Influenza like Illness In week 23, influenza activity was low among conulstaion-seeking patients nationwide, but increased slightly as per normal seasonal trends; 70 patients with ILI consulted sentinel general practices in 20 District Health Boards. The weekly ILI incidence was 17.0 ILI cases per 100 000 patients (Figure 11). Figure 11: Weekly resident ILI and influenza incidence since Week 1 of 2017 in New Zealand (Source: Institute of Environmental Science and Research Ltd (ESR), New Zealand) Pacific Island Countries and Areas (PICs) - ILI Surveillance (no update) In the Pacific Island Countries and Areas, in week 23, the number of ILI cases reported in Kiribati increased compared to previous weeks (Figure 12). Influenza Situation Update | 7 Figure 12: Reported cases of influenza-like illness in Pacific Island Countries, 2017 Global influenza situation updates Epidemiological update http://www.who.int/influenza/surveillance_monitoring/updates/latest_update_GIP_surveillance/en/ Virological update: http://www.who.int/influenza/gisrs_laboratory/updates/summaryreport/en/ Global update: http://www.who.int/influenza/surveillance_monitoring/updates/latest_update_GIP_surveillance/ Others: Recommended composition of influenza virus vaccines for use in the 2017 southern hemisphere influenza season http://www.who.int/influenza/vaccines/virus/recommendations/2017_south/en/ Antigenic and genetic characteristics of zoonotic influenza viruses and candidate vaccine viruses developed for potential use in human vaccines http://www.who.int/influenza/vaccines/virus/characteristics_virus_vaccines/en/ 4th WHO Informal Consultation on Improving Influenza Vaccine Virus Selection http://www.who.int/influenza/vaccines/virus/4thmtg_improve_vaccine_virus_selection/en/ Video on influenza on WHO's YouTube Channel Arabic: https://www.youtube.com/watch?v=PxW6Pg1AnwI Chinese: https://www.youtube.com/watch?v=xW9gDKEPitQ English: https://www.youtube.com/watch?v=yhhJfT86Bgg French: https://www.youtube.com/watch?v=8mo8rWWJZkc Russian: https://www.youtube.com/watch?v=XQO6nbkKUWQ Spanish: https://www.youtube.com/watch?v=qXr75cKxwTY Recommended composition of influenza virus vaccines for use in the 2017-2018 northern hemisphere influenza season http://www.who.int/influenza/vaccines/virus/recommendations/201703_recommendation.pdf?ua=1
Bi-weekly Influenza Situation Update 6 June 2017 Virological Surveillance Summary The number of specimens reported to FluNet by the Western Pacific Region countries and areas between week 1 and week 21, and the number of influenza positive specimens, are presented in the table below. Influenza A(H1) and B are currently the predominant circulating subtypes (Figure 1). Table 1: Countries and areas reporting data to FluNet, Western Pacific Region, weeks 1 to 21, 2017 Country (most recent week) Total number of specimens processed Total number of influenza positive specimens Australia (week 21) 12 471 600 Cambodia (week 20) 486 10 China (week 21) 265 061 33 357 Fiji (week 17) 179 78 Japan (week 20) NA 5 992 Lao People's Democratic Republic (week 21) 1 718 189 Malaysia (week 8) 692 99 Mongolia (week 17) 1 758 403 New Caledonia (week 20) 161 3 New Zealand (week 18-21) 117 29 Papua New Guinea (week 13) 111 21 Philippines (week 21) 416 21 Republic of Korea (week 21) 5 365 707 Singapore (week 21) 917 500 Viet Nam (week 14) 496 63 Influenza Situation Update | 2 Figure 1: Number of specimens positive for influenza by subtype, Western Pacific Region, week 23 2016 to week 21 2017 (Source: www.who.int/flunet,accessed on 6 June 2017) Influenza surveillance summary Influenza surveillance in the WHO Western Pacific Region is based on outpatient and inpatient sentinel surveillance systems. Case definitions, populations under surveillance and data formats differ among these countries. This influenza surveillance summary includes countries where routine surveillance is conducted and information is available. The WHO surveillance case definition for ILI is an acute respiratory infection with a measured fever of ≥38oC and cough, with symptom onset within the last 10 days. For SARI, it is an acute respiratory infection (ARI) with a history of fever or measured fever of ≥38oC and cough, with symptom onset within the last 10 days and requires hospitalization. Countries in the temperate zone of the Northern Hemisphere In most countries within the temperate zone of the Northern Hemisphere, ILI and influenza activity are consistent with seasonal trends but indicate an earlier start to the influenza season compared to the 2015-2016 season. Outpatient ILI Surveillance China (North) During weeks 20 and 21, the percentage of visits for ILI at national sentinel hospitals in northern China was 3.5% and 3.0%. Compared to previous years, ILI activity was slightly higher than the same weeks of the 2014-2016 (2.4% ~ 2.6%)(Figure 2). Influenza Situation Update | 3 Mongolia ILI activity remained at the normal level during week 20 of 2017 compared to the previous week and seasons. The most recent peak in ILI activity occurred in week four of 2017 (Figure 3). Republic of Korea In week 21 2017, there were 6.7 ILI cases per 1000, which was lower than 7.6per 1000 in the previous week. ILI activity was on a downward trend. (Figure 4). China (North) Figure 2: Percentage of visits for ILI at sentinel hospitals in north China, 2012-2017 (Source: China National Influenza Center) Mongolia Figure 3: Proportion of outpatient ILI visits (per 10,000 people), 2014-2017 (Source: Mongolia National Influenza Center) Republic of Korea Figure 4: Weekly ILI incidence rate per 1000 patients, 2013-2017 (Source: Korean Centre for Disease Control and Prevention) Influenza Situation Update | 4 Sentinel influenza surveillance Japan As of week 20 2017, influenza activity in Japan is following a similar seasonal pattern to pervious years. (Figure 5). Figure 5: Number of influenza cases reported weekly per reporting sentinel hospital site, Japan 2007-2017 (Source: Japan National Institute of Infectious Diseases) Countries/areas in the tropical zone In weeks 1 to 21 of 2017, ILI and ARI activity followed previous seasonal trends in countries/areas in the tropical zone. Outpatient Surveillance Hong Kong (China) - ILI Surveillance Surveillance data indicate an increase in local influenza activity in recents weeks. In weeks 20 and 21 of 2017, the consultation rate for ILI among sentinel general outpatient clinics was 5.8 and 5.3 ILI cases per 1,000 consultations respectively. The average consultation rate for ILI among sentinel private doctors was 55.7 and 50.8 ILI cases per 1000 consultations in week 20 and 21 (Figure 6 & Figure 7). China (South) - ILI Surveillance During weeks 20 and 21, the percentage of outpatient or emergency visits for ILI at national sentinel hospitals in southern China was 3.3% and 3.4% respectively, which was similar to previous seasons (Figure 8). Singapore – Acute Respiratory Infection Surveillance The average daily number of patients seeking treatment in the polyclinics for acute respiratory infection increased from 3,500 (over 5.5 working days) in week 20 to 3,440 (over 5.5 working days) in week 21. (Figure 9). The proportion of patients with ILI among polyclinic attendances for ARI remained low at 3.7%. Influenza Situation Update | 5 Hong Kong (China) - ILI Surveillance Figure 6: ILI consultation rates at sentinel general outpatient clinics, Hong Kong 2012-2017 (Source: Hong Kong Centre for Health Protection) Figure 7: ILI consultation rates at sentinel private doctors, Hong Kong 2012-2017 (Source: Hong Kong Centre for Health Protection) China (South) - ILI Surveillance Figure 8: Percentage of visits due to ILI at national sentinel hospitals in South China, 2012-2017 (Source: China National Influenza Center) Singapore - ARI Surveillance Figure 9: Average daily polyclinic attendances for ARI in Singapore, 2016-2017 (Source: Singapore Ministry of Health) Countries in the temperate zone of the southern hemisphere In the temperate zone of the southern hemisphere, influenza activity followed seasonal trends. Australia – Laboratory-confirmed influenza (no update) As of 28 October 2016, a total of 83,092 notifications of laboratory confirmed influenza were reported to the National Notifiable Diseases Surveillance System (Figure 10). Ninety percent of notifications were influenza A (73% A (unsubtyped), 6% influenza A(H1N1)pdm09 and 11% influenza A(H3N2), 10% were influenza B and less than 1% were influenza C, influenza A&B co-infections or untyped. Australia publishes influenza surveillance reports on a fortnightly basis during the influenza season, typically between May and October. (Source: http://www.health.gov.au/internet/main/publishing.nsf/Content/cda-surveil-ozflu- flucurr.htm/$File/Australian-Influenza-Surveillance-Report.pdf) Influenza Situation Update | 6 Figure 10: Australian notifications of laboratory confirmed influenza (Source: National Notifiable Diseases Surveillance System, Australian Department of Health) New Zealand – Influenza like Illness In week 21, influenza activity was low among conulstaion-seeking patients nationwide, but increased slightly as per normal seasonal trends; 58 patients with ILI consulted sentinel general practices in 20 District Health Boards. The weekly ILI incidence was 14.1 ILI cases per 100 000 patients (Figure 11). Figure 11: Weekly resident ILI and influenza incidence since Week 1 of 2017 in New Zealand (Source: Institute of Environmental Science and Research Ltd (ESR), New Zealand) Influenza Situation Update | 7 Pacific Island Countries and Areas (PICs) - ILI Surveillance (no update) In the Pacific Island Countries and Areas, in week 15, the number of ILI cases reported in American Samoa increased compared to previous weeks (Figure 12). Figure 12: Reported cases of influenza-like illness in Pacific Island Countries, 2017 Global influenza situation updates Epidemiological update http://www.who.int/influenza/surveillance_monitoring/updates/latest_update_GIP_surveillance/en/ Virological update: http://www.who.int/influenza/gisrs_laboratory/updates/summaryreport/en/ Global update: http://www.who.int/influenza/surveillance_monitoring/updates/latest_update_GIP_surveillance/ Influenza Situation Update | 8 Others: Recommended composition of influenza virus vaccines for use in the 2017 southern hemisphere influenza season http://www.who.int/influenza/vaccines/virus/recommendations/2017_south/en/ Antigenic and genetic characteristics of zoonotic influenza viruses and candidate vaccine viruses developed for potential use in human vaccines http://www.who.int/influenza/vaccines/virus/characteristics_virus_vaccines/en/ 4th WHO Informal Consultation on Improving Influenza Vaccine Virus Selection http://www.who.int/influenza/vaccines/virus/4thmtg_improve_vaccine_virus_selection/en/ Video on influenza on WHO's YouTube Channel Arabic: https://www.youtube.com/watch?v=PxW6Pg1AnwI Chinese: https://www.youtube.com/watch?v=xW9gDKEPitQ English: https://www.youtube.com/watch?v=yhhJfT86Bgg French: https://www.youtube.com/watch?v=8mo8rWWJZkc Russian: https://www.youtube.com/watch?v=XQO6nbkKUWQ Spanish: https://www.youtube.com/watch?v=qXr75cKxwTY Recommended composition of influenza virus vaccines for use in the 2017-2018 northern hemisphere influenza season http://www.who.int/influenza/vaccines/virus/recommendations/201703_recommendation.pdf?ua=1
Bi-weekly Influenza Situation Update 23 May 2017 Virological Surveillance Summary The number of specimens reported to FluNet by the Western Pacific Region countries and areas between week 1 and week 19, and the number of influenza positive specimens, are presented in the table below. Influenza A(H1) and B are currently the predominant circulating subtype (Figure 1). Table 1: Countries and areas reporting data to FluNet, Western Pacific Region, weeks 1 to 19, 2017 Figure 1: Number of specimens positive for influenza by subtype, Western Pacific Region, week 21 2016 to week 17 2017 (Source: www.who.int/flunet,accessed on 22 May 2017) Country (most recent week) Total number of specimens processed Total number of influenza positive specimens Australia (week 19) 9950 521 Cambodia (week 18) 441 9 China (week 19) 241176 31215 Fiji (week 17) 179 78 Japan (week 19) NA 5603 Lao People's Democratic Republic (week 19) 1572 177 Malaysia (week 8) 692 99 Mongolia (week 17) 1758 403 New Caledonia (week 14) 114 3 New Zealand (week 2) 53 14 Papua New Guinea (week 13) 111 21 Philippines (week 19) 372 21 Republic of Korea (week 19) 4861 689 Singapore (week 19) 719 369 Viet Nam (week 14) 496 63 Influenza Situation Update | 2 Influenza surveillance summary Influenza surveillance in the WHO Western Pacific Region is based on outpatient and inpatient sentinel surveillance systems. Case definitions, populations under surveillance and data formats differ among these countries. This influenza surveillance summary includes countries where routine surveillance is conducted and information is available from syndromic surveillance systems for influenza-like-illness (ILI) and Severe Acute Respiratory Infections (SARI). The WHO surveillance case definition for ILI is an acute respiratory infection with a measured fever of ≥38oC and cough, with symptom onset within the last 10 days. For SARI, it is an acute respiratory infection (ARI) with a history of fever or measured fever of ≥38oC and cough, with symptom onset within the last 10 days and requires hospitalization. Countries in the temperate zone of the Northern Hemisphere In most countries within the temperate zone of the Northern Hemisphere, ILI and influenza activity are consistent with seasonal trends but indicate an earlier start to the influenza season compared to the 2015-2016 season. Outpatient ILI Surveillance China (North) During weeks 18 and 19, the percentage of visits for ILI at national sentinel hospitals in northern China was 3.4% and 3.0%. Compared to previous years, ILI activity was slightly higher than the same weeks of the 2014-2016 (2.4% ~ 2.6%)(Figure 2). Mongolia ILI activity remained at the normal level during week 18 of 2017 compared to the previous week and seasons. The most recent peak in ILI activity occurred in week four of 2017 (Figure 3). Republic of Korea In week 18 2017, there were 9.5 ILI cases per 1000, which was lower than 13.3 per 1000 in the previous week. ILI activity was on a downward trend. (Figure 4). China (North) Figure 2: Percentage of visits for ILI at sentinel hospitals in north China, 2012-2017 (Source: China National Influenza Center) Mongolia Figure 3: Proportion of outpatient ILI visits (per 10,000 people), 2014-2017 (Source: Mongolia National Influenza Center) Influenza Situation Update | 3 Republic of Korea Figure 4: Weekly ILI incidence rate per 1000 patients, 2013-2017 (Source: Korean Centre for Disease Control and Prevention) Sentinel influenza surveillance Japan As of week 18 2017, influenza activity in Japan is following a similar seasonal pattern to pervious years. (Figure 5). Figure 5: Number of influenza cases reported weekly per reporting sentinel hospital site, Japan 2007-2017 (Source: Japan National Institute of Infectious Diseases) Influenza Situation Update | 4 Countries/areas in the tropical zone In weeks 1 to 19 of 2017, ILI and ARI activity followed previous seasonal trends in countries/areas in the tropical zone. Outpatient Surveillance Hong Kong (China) - ILI Surveillance Surveillance data indicate an increase in local influenza activity in recents weeks. In weeks 18 and 19 of 2017, the consultation rate for ILI among sentinel general outpatient clinics was 4.1 and 5.5 ILI cases per 1,000 consultations respectively. The average consultation rate for ILI among sentinel private doctors was 54.2 and 50.7 ILI cases per 1000 consultations in week 18 and 19 (Figure 6 & Figure 7). China (South) - ILI Surveillance During weeks 18 and 19, the percentage of outpatient or emergency visits for ILI at national sentinel hospitals in southern China was 3.6% and 3.3% respectively, which was similar to previous seasons (Figure 8). Singapore – Acute Respiratory Infection Surveillance The average daily number of patients seeking treatment in the polyclinics for acute respiratory infection increased from 3,452 (over 4.5 working days) in week 18 to 3,645 (over 4.5 working days) in week 19. (Figure 9). The proportion of patients with ILI among polyclinic attendances for ARI remained low at 3.0%. Hong Kong (China) - ILI Surveillance Figure 6: ILI consultation rates at sentinel general outpatient clinics, Hong Kong 2012-2017 (Source: Hong Kong Centre for Health Protection) Figure 7: ILI consultation rates at sentinel private doctors, Hong Kong 2012-2017 (Source: Hong Kong Centre for Health Protection) China (South) - ILI Surveillance Figure 8: Percentage of visits due to ILI at national sentinel hospitals in South China, 2012-2017 (Source: China National Influenza Center) Singapore - ARI Surveillance Figure 9: Average daily polyclinic attendances for ARI in Singapore, 2016-2017 (Source: Singapore Ministry of Health) Influenza Situation Update | 5 Countries in the temperate zone of the southern hemisphere In the temperate zone of the southern hemisphere, influenza activity followed seasonal trends. Australia – Laboratory-confirmed influenza (no update) As of 28 October 2016, a total of 83,092 notifications of laboratory confirmed influenza were reported to the National Notifiable Diseases Surveillance System (Figure 10). Ninety percent of notifications were influenza A (73% A (unsubtyped), 6% influenza A(H1N1)pdm09 and 11% influenza A(H3N2), 10% were influenza B and less than 1% were influenza C, influenza A&B co-infections or untyped. Australia publishes influenza surveillance reports on a fortnightly basis during the influenza season, typically between May and October. (Source: http://www.health.gov.au/internet/main/publishing.nsf/Content/cda-surveil-ozflu- flucurr.htm/$File/Australian-Influenza-Surveillance-Report.pdf) Figure 10: Australian notifications of laboratory confirmed influenza (Source: National Notifiable Diseases Surveillance System, Australian Department of Health) New Zealand – Influenza like Illness In week 19, influenza activity was low among conulstaion-seeking patients nationwide, but increased slightly as per normal seasonal trends; 44 patients with ILI consulted sentinel general practices in 20 District Health Boards. The weekly ILI incidence was 2.6 ILI cases per 100 000 patients (Figure 11). Figure 11: Weekly resident ILI and influenza incidence since Week 1 of 2017 in New Zealand (Source: Institute of Environmental Science and Research Ltd (ESR), New Zealand) Influenza Situation Update | 6 Pacific Island Countries and Areas (PICs) - ILI Surveillance (no update) In the Pacific Island Countries and Areas, in week 15, the number of ILI cases reported was at a relatively high level in Kinbati (Figure 12). Figure 12: Reported cases of influenza-like illness (red line) in Pacific Island Countries, 2017 Influenza Situation Update | 7 Global influenza situation updates Epidemiological update http://www.who.int/influenza/surveillance_monitoring/updates/latest_update_GIP_surveillance/en/ Virological update: http://www.who.int/influenza/gisrs_laboratory/updates/summaryreport/en/ Global update: http://www.who.int/influenza/surveillance_monitoring/updates/latest_update_GIP_surveillance/ Others: Recommended composition of influenza virus vaccines for use in the 2017 southern hemisphere influenza season http://www.who.int/influenza/vaccines/virus/recommendations/2017_south/en/ Antigenic and genetic characteristics of zoonotic influenza viruses and candidate vaccine viruses developed for potential use in human vaccines http://www.who.int/influenza/vaccines/virus/characteristics_virus_vaccines/en/ 4th WHO Informal Consultation on Improving Influenza Vaccine Virus Selection http://www.who.int/influenza/vaccines/virus/4thmtg_improve_vaccine_virus_selection/en/ Video on influenza on WHO's YouTube Channel Arabic: https://www.youtube.com/watch?v=PxW6Pg1AnwI Chinese: https://www.youtube.com/watch?v=xW9gDKEPitQ English: https://www.youtube.com/watch?v=yhhJfT86Bgg French: https://www.youtube.com/watch?v=8mo8rWWJZkc Russian: https://www.youtube.com/watch?v=XQO6nbkKUWQ Spanish: https://www.youtube.com/watch?v=qXr75cKxwTY Recommended composition of influenza virus vaccines for use in the 2017- 2018 northern hemisphere influenza season http://www.who.int/influenza/vaccines/virus/recommendations/201703_recommendation.pdf?ua=1
Bi-weekly Influenza Situation Update 9 May 2017 Virological Surveillance Summary The number of specimens reported to FluNet by the Western Pacific Region countries and areas between week 1 and week 17, and the number of influenza positive specimens, are presented in the table below. Influenza A(H1) is currently the predominant circulating subtype (Figure 1). Table 1: Countries and areas reporting data to FluNet, Western Pacific Region, weeks 1 to 17, 2017 Figure 1: Number of specimens positive for influenza by subtype, Western Pacific Region, week 17 2016 to week 17 2017 (Source: www.who.int/flunet,accessed on 08 May 2017) Country (most recent week) Total number of specimens processed Total number of influenza positive specimens Australia (week 17) 9424 490 Cambodia (week 16) 374 8 China (week 16) 214133 28559 Fiji (week 12) 137 66 Japan (week 16) NA 5214 Lao People's Democratic Republic (week 17) 1379 162 Malaysia (week 8) 692 99 Mongolia (week 17) 1758 403 New Caledonia (week 14) 114 3 New Zealand (week 39/2016) 942 298 Papua New Guinea (week 13) 111 21 Philippines (week 15) 285 20 Republic of Korea (week 17) 4493 655 Singapore (week 16) 528 262 Viet Nam (week 14) 496 63 Influenza Situation Update | 2 Influenza surveillance summary Influenza surveillance in the WHO Western Pacific Region is based on outpatient and inpatient sentinel surveillance systems. Case definitions, populations under surveillance and data formats differ among these countries. This influenza surveillance summary includes countries where routine surveillance is conducted and information is available from syndromic surveillance systems for influenza-like-illness (ILI) and Severe Acute Respiratory Infections (SARI). The WHO surveillance case definition for ILI is an acute respiratory infection with a measured fever of ≥38oC and cough, with symptom onset within the last 10 days. For SARI, it is an acute respiratory infection (ARI) with a history of fever or measured fever of ≥38oC and cough, with symptom onset within the last 10 days and requires hospitalization. Countries in the temperate zone of the Northern Hemisphere In most countries within the temperate zone of the Northern Hemisphere, ILI and influenza activity are consistent with seasonal trends but indicate an earlier start to the influenza season compared to the 2015-2016 season. Outpatient ILI Surveillance China (North) During weeks 16 and 17, the percentage of visits for ILI at national sentinel hospitals in northern China was 3.1% and 3.2%. Compared to previous years, ILI activity was a little higher than the same weeks of the 2014-2016 (2.4% ~ 2.6%)(Figure 2). Mongolia ILI activity remained low during week 17 of 2017 compared to the previous week and seasons. The most recent peak in ILI activity occurred in week four of 2017 (Figure 3). Republic of Korea In week 17 2017, there were 13.3 ILI cases per 1000, which was lower than 14.5 per 1000 in the previous week. ILI activity was on a downward trend. (Figure 4). China (North) Figure 2: Percentage of visits for ILI at sentinel hospitals in north China, 2012-2017 (Source: China National Influenza Center) Mongolia Figure 3: Proportion of outpatient ILI visits (per 10,000 people), 2014-2017 (Source: Mongolia National Influenza Center) Influenza Situation Update | 3 Republic of Korea Figure 4: Weekly ILI incidence rate per 1000 patients, 2013-2017 (Source: Korean Centre for Disease Control and Prevention) Sentinel influenza surveillance Japan As of week 15 2017, influenza activity in Japan is following a similar seasonal pattern to the pervious years. (Figure 5). Figure 5: Number of influenza cases reported weekly per reporting sentinel hospital site, Japan 2007-2017 (Source: Japan National Institute of Infectious Diseases) Influenza Situation Update | 4 Countries/areas in the tropical zone In weeks 1 to 17 of 2017, ILI and ARI activity followed previous seasonal trends in countries/areas in the tropical zone. Outpatient Surveillance Hong Kong (China) - ILI Surveillance Surveillance data infdicate an increase in local influenza activity in recents weeks. In weeks 16 and 17 of 2017, the consultation rate for ILI among sentinel general outpatient clinics was 3.6 and 4.0 ILI cases per 1,000 consultations respectively. The average consultation rate for ILI among sentinel private doctors was 31.6 ILI cases per 1000 consultations in week 16 and 49.9 per 1000 consultations in week 17 (Figure 6 & Figure 7). China (South) - ILI Surveillance During weeks 16 and 17, the percentage of outpatient or emergency visits for ILI at national sentinel hospitals in southern China was 3.2% and 3.1% respectively, which was similar to previous seasons (Figure 8). Singapore – Acute Respiratory Infection Surveillance The average daily number of patients seeking treatment in the polyclinics for acute respiratory infection decreased from 3,202 (over 5.5 working days) in week 16 to 3,189 (over 5.5 working days) in week 17. (Figure 9). The proportion of patients with ILI among polyclinic attendances for ARI remained low at 2.8%. Hong Kong (China) - ILI Surveillance Figure 6: ILI consultation rates at sentinel general outpatient clinics, Hong Kong 2012-2017 (Source: Hong Kong Centre for Health Protection) Figure 7: ILI consultation rates at sentinel private doctors, Hong Kong 2012-2017 (Source: Hong Kong Centre for Health Protection) China (South) - ILI Surveillance Figure 8: Percentage of visits due to ILI at national sentinel hospitals in South China, 2012-2017 (Source: China National Influenza Center) Singapore - ARI Surveillance Figure 9: Average daily polyclinic attendances for ARI in Singapore, 2016-2017 (Source: Singapore Ministry of Health) Influenza Situation Update | 5 Countries in the temperate zone of the southern hemisphere In the temperate zone of the southern hemisphere, influenza activity followed seasonal trends. Australia – Laboratory-confirmed influenza (no update) As of 28 October 2016, a total of 83,092 notifications of laboratory confirmed influenza were reported to the National Notifiable Diseases Surveillance System (Figure 10). Ninety percent of notifications were influenza A (73% A (unsubtyped), 6% influenza A(H1N1)pdm09 and 11% influenza A(H3N2), 10% were influenza B and less than 1% were influenza C, influenza A&B co-infections or untyped. Australia publishes influenza surveillance reports on a fortnightly basis during the influenza season, typically between May and October. (Source: http://www.health.gov.au/internet/main/publishing.nsf/Content/cda-surveil-ozflu- flucurr.htm/$File/Australian-Influenza-Surveillance-Report.pdf) Figure 10: Australian notifications of laboratory confirmed influenza (Source: National Notifiable Diseases Surveillance System, Australian Department of Health) New Zealand – Influenza like Illness In week 17, influenza activity was very low among conulstaion-seeking patients nationwide; 15 patients with ILI consulted sentinel general practices in 20 District Health Boards. The weekly ILI incidence was 3.1 ILI cases per 100 000 patients (Figure 11). Figure 11: Weekly resident ILI and influenza incidence since Week 1 of 2017 in New Zealand (Source: Institute of Environmental Science and Research Ltd (ESR), New Zealand) Influenza Situation Update | 6 Pacific Island Countries and Areas (PICs) - ILI Surveillance In the Pacific Island Countries and Areas, in week 15, the number of ILI cases reported was at a relatively high level in Kinbati (Figure 12). Figure 12: Reported cases of influenza-like illness (red line) in Pacific Island Countries, 2017 Influenza Situation Update | 7 Global influenza situation updates Epidemiological update http://www.who.int/influenza/surveillance_monitoring/updates/latest_update_GIP_surveillance/en/ Virological update: http://www.who.int/influenza/gisrs_laboratory/updates/summaryreport/en/ Global update: http://www.who.int/influenza/surveillance_monitoring/updates/latest_update_GIP_surveillance/ Others: Recommended composition of influenza virus vaccines for use in the 2017 southern hemisphere influenza season http://www.who.int/influenza/vaccines/virus/recommendations/2017_south/en/ Antigenic and genetic characteristics of zoonotic influenza viruses and candidate vaccine viruses developed for potential use in human vaccines http://www.who.int/influenza/vaccines/virus/characteristics_virus_vaccines/en/ 4th WHO Informal Consultation on Improving Influenza Vaccine Virus Selection http://www.who.int/influenza/vaccines/virus/4thmtg_improve_vaccine_virus_selection/en/ Video on influenza on WHO's YouTube Channel Arabic: https://www.youtube.com/watch?v=PxW6Pg1AnwI Chinese: https://www.youtube.com/watch?v=xW9gDKEPitQ English: https://www.youtube.com/watch?v=yhhJfT86Bgg French: https://www.youtube.com/watch?v=8mo8rWWJZkc Russian: https://www.youtube.com/watch?v=XQO6nbkKUWQ Spanish: https://www.youtube.com/watch?v=qXr75cKxwTY Recommended composition of influenza virus vaccines for use in the 2017-2018 northern hemisphere influenza season http://www.who.int/influenza/vaccines/virus/recommendations/201703_recommendation.pdf?ua=1
Bi-weekly Influenza Situation Update 25 April 2017 Virological Surveillance Summary The number of specimens reported to FluNet by the Western Pacific Region countries and areas between week 1 and week 15, and the number of influenza positive specimens, are presented in the table below. Influenza A(H3) is currently the predominant circulating subtype (Figure 1). Table 1: Countries and areas reporting data to FluNet, Western Pacific Region, weeks 1 to 15, 2017 Figure 1: Number of specimens positive for influenza by subtype, Western Pacific Region, week 17 2016 to week 15 2017 (Source: www.who.int/flunet,accessed on 25 April 2017) Country (most recent week) Total number of specimens processed Total number of influenza positive specimens Australia (week 15) 7153 449 Cambodia (week 15) 353 15 China (week 14) 192357 165941 Fiji (week 12) 137 66 Japan (week 14) NA 4569 Lao People's Democratic Republic (week 12) 1249 154 Malaysia (week 8) 692 99 Mongolia (week 15) 1662 399 New Caledonia (week 51/2016) 1,459 302 New Zealand (week 39/2016) 942 298 Papua New Guinea (week 13) 111 21 Philippines (week 15) 285 20 Republic of Korea (week 15) 3908 575 Singapore (week 14) 451 226 Viet Nam (week 14) 496 63 Influenza Situation Update| 2 Influenza surveillance summary Influenza surveillance in the WHO Western Pacific Region is based on outpatient and inpatient sentinel surveillance systems. Case definitions, populations under surveillance and data formats differ among these countries. This influenza surveillance summary includes countries where routine surveillance is conducted and information is available from syndromic surveillance systems for influenza-like-illness (ILI) and Severe Acute Respiratory Infections (SARI). The WHO surveillance case definition for ILI is an acute respiratory infection with a measured fever of ≥38oC and cough, with symptom onset within the last 10 days. For SARI, it is an acute respiratory infection (ARI) with a history of fever or measured fever of ≥38oC and cough, with symptom onset within the last 10 days and requires hospitalization. Countries in the temperate zone of the Northern Hemisphere In most countries within the temperate zone of the Northern Hemisphere, ILI and influenza activity are consistent with seasonal trends but indicate an earlier start to the influenza season compared to the 2015-2016 season. Outpatient ILI Surveillance China (North) During weeks 13 and 14, the percentage of visits for ILI at national sentinel hospitals in northern China was 3.1% and 3.4%. Compared to previous years, ILI activity was similar to the same weeks of the 2015- 2016 season(Figure 2). Mongolia ILI activity remained low during week 15 of 2017 compared to the previous week and seasons. The most recent peak in ILI activity occurred in week four of 2017 (Figure 3). Republic of Korea In week 15 2017, there were 15.8 ILI cases per 1000, which was lower than 16.7 per 1000 in the previous week. ILI activity was on a downward trend. (Figure 4). China (North) Figure 2: Percentage of visits for ILI at sentinel hospitals in north China, 2012-2017 (Source: China National Influenza Center) Mongolia Figure 3: Proportion of outpatient ILI visits (per 10,000 people), 2014-2017 (Source: Mongolia National Influenza Center) Influenza Situation Update| 3 Republic of Korea Figure 4: Weekly ILI incidence rate per 1000 patients, 2013-2017 (Source: Korean Centre for Disease Control and Prevention) Sentinel influenza surveillance Japan As of week 14 2017, influenza activity in Japan is following a similar seasonal pattern to the pervious years. (Figure 5). Figure 5: Number of influenza cases reported weekly per reporting sentinel hospital site, Japan 2007-2017 (Source: Japan National Institute of Infectious Diseases) Influenza Situation Update| 4 Countries/areas in the tropical zone In weeks 1 to 15 of 2017, ILI and ARI activity followed previous seasonal trends in countries/areas in the tropical zone. Outpatient Surveillance Hong Kong (China) - ILI Surveillance In weeks 14 and 15 of 2017, the consultation rate for ILI among sentinel general outpatient clinics was 4.9 and 4.7 ILI cases per 1,000 consultations respectively. The average consultation rate for ILI among sentinel private doctors was 56.9 ILI cases per 1000 consultations in week 14 and 39.2 per 1000 consultations in week 15. The ILI activities were normal as previous seasons (Figure 6 & Figure 7). China (South) - ILI Surveillance During weeks 13 and 14, the percentage of outpatient or emergency visits for ILI at national sentinel hospitals in southern China was 3.1% and 3.39% respectively, which was similar to previous seasons(Figure 8). Singapore – Acute Respiratory Infection Surveillance The average daily number of patients seeking treatment in the polyclinics for acute respiratory infection increased from 3,023 (over 5.5 working days) in week 14 to 3164 (over 4.5 working days) in week 15. (Figure 9). The proportion of patients with ILI among polyclinic attendances for ARI remained low at 2.1%. Hong Kong (China) - ILI Surveillance Figure 6: ILI consultation rates at sentinel general outpatient clinics, Hong Kong 2012-2017 (Source: Hong Kong Centre for Health Protection) Figure 7: ILI consultation rates at sentinel private doctors, Hong Kong 2012-2017 (Source: Hong Kong Centre for Health Protection) Influenza Situation Update| 5 China (South) - ILI Surveillance Figure 8: Percentage of visits due to ILI at national sentinel hospitals in South China, 2012-2017 (Source: China National Influenza Center) Singapore - ARI Surveillance Figure 9: Average daily polyclinic attendances for ARI in Singapore, 2016-2017 (Source: Singapore Ministry of Health) Countries in the temperate zone of the southern hemisphere In the temperate zone of the southern hemisphere, influenza activity followed seasonal trends. Australia – Laboratory-confirmed influenza (no update) As of 28 October 2016, a total of 83,092 notifications of laboratory confirmed influenza were reported to the National Notifiable Diseases Surveillance System (Figure 10). Ninety percent of notifications were influenza A (73% A (unsubtyped), 6% influenza A(H1N1)pdm09 and 11% influenza A(H3N2), 10% were influenza B and less than 1% were influenza C, influenza A&B co-infections or untyped. Australia publishes influenza surveillance reports on a fortnightly basis during the influenza season, typically between May and October. (Source: http://www.health.gov.au/internet/main/publishing.nsf/Content/cda-surveil-ozflu- flucurr.htm/$File/Australian-Influenza-Surveillance-Report.pdf) Figure 10: Australian notifications of laboratory confirmed influenza (Source: National Notifiable Diseases Surveillance System, Australian Department of Health) Influenza Situation Update| 6 New Zealand – Influenza like Illness In week 15, 4 patients with ILI consulted sentinel general practices in 20 District Health Boards. The weekly ILI incidence was 0.8 ILI cases per 100 000 patients (Figure 11). Figure 11: Weekly resident ILI and influenza incidence since (Week 18) 2 May 2016 in New Zealand (Source: Institute of Environmental Science and Research Ltd (ESR), New Zealand) Pacific Island Countries and Areas (PICs) - ILI Surveillance In the Pacific Island Countries and Areas, in week 13, the number of ILI cases reported increased in the Vanuatu (Figure 12). Figure 12: Reported cases of influenza-like illness (red line) in Pacific Island Countries, 2017 Influenza Situation Update| 7 Global influenza situation updates Epidemiological update http://www.who.int/influenza/surveillance_monitoring/updates/latest_update_GIP_surveillance/en/ Virological update: http://www.who.int/influenza/gisrs_laboratory/updates/summaryreport/en/ Global update: http://www.who.int/influenza/surveillance_monitoring/updates/latest_update_GIP_surveillance/ Others: Recommended composition of influenza virus vaccines for use in the 2017 southern hemisphere influenza season http://www.who.int/influenza/vaccines/virus/recommendations/2017_south/en/ Antigenic and genetic characteristics of zoonotic influenza viruses and candidate vaccine viruses developed for potential use in human vaccines http://www.who.int/influenza/vaccines/virus/characteristics_virus_vaccines/en/ 4th WHO Informal Consultation on Improving Influenza Vaccine Virus Selection http://www.who.int/influenza/vaccines/virus/4thmtg_improve_vaccine_virus_selection/en/ Video on influenza on WHO's YouTube Channel Arabic: https://www.youtube.com/watch?v=PxW6Pg1AnwI Chinese: https://www.youtube.com/watch?v=xW9gDKEPitQ English: https://www.youtube.com/watch?v=yhhJfT86Bgg French: https://www.youtube.com/watch?v=8mo8rWWJZkc Russian: https://www.youtube.com/watch?v=XQO6nbkKUWQ Spanish: https://www.youtube.com/watch?v=qXr75cKxwTY Recommended composition of influenza virus vaccines for use in the 2017-2018 northern hemisphere influenza season http://www.who.int/influenza/vaccines/virus/recommendations/201703_recommendation.pdf?ua=1
Bi-weekly Influenza Situation Update 04 April 2017 Virological Surveillance Summary The number of specimens reported to FluNet by the Western Pacific Region countries and areas between week 1 and week 12, and the number of influenza positive specimens, are presented in the table below. Influenza A(H3) is currently the predominant circulating subtype (Figure 1). Table 1: Countries and areas reporting data to FluNet, Western Pacific Region, weeks 1 to 12, 2017 Figure 1: Number of specimens positive for influenza by subtype, Western Pacific Region, week 11 2016 to week 10 2017 (Source: www.who.int/flunet,accessed 3 April 2017) Country (most recent week) Total number of specimens processed Total number of influenza positive specimens Australia (week 12) 6084 389 Cambodia (week 11) 267 8 China (week 11) 114282 15877 Fiji (week 38 /2016) 349 120 Japan (week 11) NA 3169 Lao People's Democratic Republic (week 12) 1023 144 Malaysia (week 30 /2016) 2,461 212 Mongolia (week 12) 1489 397 New Caledonia (week 51/2016) 1,459 302 New Zealand (week 39/2016) 942 298 Papua New Guinea (week 51/2016) 410 144 Philippines (week 11) 201 10 Republic of Korea (week 12) 2986 441 Singapore (week 12) 380 189 Viet Nam (week 10) 326 37 Influenza Situation Update | 2 Influenza surveillance summary Influenza surveillance in the WHO Western Pacific Region is based on outpatient and inpatient sentinel surveillance systems. Case definitions, populations under surveillance and data formats differ among these countries. This influenza surveillance summary includes countries where routine surveillance is conducted and information is available from syndromic surveillance systems for influenza-like-illness (ILI) and Severe Acute Respiratory Infections (SARI). The WHO surveillance case definition for ILI is an acute respiratory infection with a measured fever of ≥38oC and cough, with symptom onset within the last 10 days. For SARI, it is an acute respiratory infection (ARI) with a history of fever or measured fever of ≥38oC and cough, with symptom onset within the last 10 days and requires hospitalization. Countries in the temperate zone of the Northern Hemisphere In most countries within the temperate zone of the Northern Hemisphere, ILI and influenza activity are consistent with seasonal trends but indicate an earlier start to the influenza season compared to the 2015-2016 season. Outpatient ILI Surveillance China (North) During weeks 11 and 12, the percentage of visits for ILI at national sentinel hospitals in northern China was 3.0%, slightly lower than week 10 (3.2%). Compared to previous years, ILI activity was slightly higher than the same week of 2015 (2.8%), but lower than the same week of 2016 (4.1% )(Figure 2). Mongolia ILI activity increased slightly during week 12 of 2017 compared to the previous week but remained low. The most recent peak in ILI activity occurred in week four of 2017 (Figure 3). Republic of Korea In week 11 2017, there were 9.3 ILI cases per 1000, which was higher than 7 per 1000 in the previous week. ILI cases peaked at 86 per 1000 patients in the last week of 2016. (Figure 4). China (North) Figure 2: Percentage of visits for ILI at sentinel hospitals in north China, 2012-2017 (Source: China National Influenza Center) Mongolia Figure 3: Proportion of outpatient ILI visits (per 10,000 people), 2014-2017 (Source: Mongolia National Influenza Center) Influenza Situation Update | 3 Republic of Korea Figure 4: Weekly ILI incidence rate per 1000 patients, 2013-2017 (Source: Korean Centre for Disease Control and Prevention) Sentinel influenza surveillance Japan As of week 112017, influenza activity is following seasonal trends with 10.3 cases per sentinel site in week 11. This is a decrease compared to week 9, 2017 when 13.6 cases were reported per sentinel. (Figure 5). Figure 5: Number of influenza cases reported weekly per reporting sentinel hospital site, Japan 2007-2017 (Source: Japan National Institute of Infectious Diseases) Influenza Situation Update | 4 Countries/areas in the tropical zone In weeks 1 to 8 of 2017, ILI or ARI activity followed previous seasonal trends in countries/areas in the tropical zone. Outpatient Surveillance Hong Kong (China) - ILI Surveillance In weeks 11 and 12 of 2017, the consultation rate for ILI among sentinel general outpatient clinics (GOPCs) was 4.8 and 4.7 ILI cases per 1,000 consultations respectively, which was lower than the previous fortnight (Figure 6). The average consultation rate for ILI among sentinel private doctors was 58.1 ILI cases per 1000 consultations in week 11 and 55.7 per 1000 consultations in week 12., which was higher than the previous fortnight (Figure 7). Among the respiratory specimens received in weeks 11 and 12, 7.2% tested positive for seasonal influenza viruses, which was lower than 8.4% and 9.4% in the previous fortnight. Influenza A(H3) was the predominant subtype detected in week 12, comprising 74.5% of respiratory specimens. Other viruses detected were influenza A(H1) (12.6%), influenza B (10.5%), and influenza C (2.4%). China (South) - ILI Surveillance During weeks 11 and 12, the percentage of outpatient or emergency visits for ILI at national sentinel hospitals in southern China was 3.0%, which was unchanged from weeks nine and ten. This percentage is slightly higher than the same week of 2015 (2.8%) but lower than the same week of 2016 (4.1%). Singapore – Acute Respiratory Infection Surveillance The average daily number of patients seeking treatment in the polyclinics for acute respiratory infections (ARI) increased from 2711 (over 5.5 working days) in week 11 to 2977 (over 5.5 working days) in week 12 (Figure 9). The proportion of patients with ILI among polyclinic attendances for ARI remained low at 1.8%. The overall positivity rate for influenza virus among 142 ILI samples in the community was 50% in the past four weeks. Of influenza-positive specimens in February 2017, the majority were influenza A(H3N2) (39.4%), followed by influenza B (36.6%) and influenza A(H1N1)pdm09 (19.7%). Hong Kong (China) - ILI Surveillance Figure 6: ILI consultation rates at sentinel general outpatient clinics, Hong Kong 2012-2017 (Source: Hong Kong Centre for Health Protection) Figure 7: ILI consultation rates at sentinel private doctors, Hong Kong 2012-2017 (Source: Hong Kong Centre for Health Protection) Influenza Situation Update | 5 China (South) - ILI Surveillance Figure 8: Percentage of visits due to ILI at national sentinel hospitals in South China, 2012-2017 (Source: China National Influenza Center) Singapore - ARI Surveillance Figure 9: Average daily polyclinic attendances for ARI in Singapore, 2016-2017 (Source: Singapore Ministry of Health) Countries in the temperate zone of the southern hemisphere In the temperate zone of the southern hemisphere, influenza activity followed seasonal trends. Australia – Laboratory-confirmed influenza (no update) As of 28 October 2016, a total of 83,092 notifications of laboratory confirmed influenza were reported to the National Notifiable Diseases Surveillance System (Figure 10). Ninety percent of notifications were influenza A (73% A (unsubtyped), 6% influenza A(H1N1)pdm09 and 11% influenza A(H3N2), 10% were influenza B and less than 1% were influenza C, influenza A&B co-infections or untyped. Australia publishes influenza surveillance reports on a fortnightly basis during the influenza season, typically between May and October. (Source: http://www.health.gov.au/internet/main/publishing.nsf/Content/cda-surveil-ozflu- flucurr.htm/$File/Australian-Influenza-Surveillance-Report.pdf) Figure 10: Australian notifications of laboratory confirmed influenza (Source: National Notifiable Diseases Surveillance System, Australian Department of Health) Influenza Situation Update | 6 New Zealand – Influenza like Illness (no update) In week 39, ending 2 October 2016, 24 patients with ILI consulted sentinel general practices in 20 District Health Boards. The weekly ILI incidence was 4.4 ILI cases per 100,000 patients. Of the 14 tested ILI cases, 4 were positive for influenza viruses, yielding an influenza-associated ILI incidence rate of 1.3 ILI cases per 100,000 patients (adjusted). Figure 11: Weekly resident ILI and influenza incidence since (Week 18) 2 May 2016 in New Zealand (Source: Institute of Environmental Science and Research Ltd (ESR), New Zealand) Pacific Island Countries and Areas (PICs) - ILI Surveillance In the Pacific Island Countries and Areas, in week 12, the number of ILI cases reported increased in the Federated States of Micronesia and Vanuatu (Figure 12). Figure 12: Reported cases of influenza-like illness (red line) in Pacific Island Countries, 2017 Influenza Situation Update | 7 Global influenza situation updates Epidemiological update http://www.who.int/influenza/surveillance_monitoring/updates/latest_update_GIP_surveillance/en/ Virological update: http://www.who.int/influenza/gisrs_laboratory/updates/summaryreport/en/ Global update: http://www.who.int/influenza/surveillance_monitoring/updates/latest_update_GIP_surveillance/ Others: Recommended composition of influenza virus vaccines for use in the 2017 southern hemisphere influenza season http://www.who.int/influenza/vaccines/virus/recommendations/2017_south/en/ Antigenic and genetic characteristics of zoonotic influenza viruses and candidate vaccine viruses developed for potential use in human vaccines http://www.who.int/influenza/vaccines/virus/characteristics_virus_vaccines/en/ 4th WHO Informal Consultation on Improving Influenza Vaccine Virus Selection http://www.who.int/influenza/vaccines/virus/4thmtg_improve_vaccine_virus_selection/en/ Video on influenza on WHO's YouTube Channel Arabic: https://www.youtube.com/watch?v=PxW6Pg1AnwI Chinese: https://www.youtube.com/watch?v=xW9gDKEPitQ English: https://www.youtube.com/watch?v=yhhJfT86Bgg French: https://www.youtube.com/watch?v=8mo8rWWJZkc Russian: https://www.youtube.com/watch?v=XQO6nbkKUWQ Spanish: https://www.youtube.com/watch?v=qXr75cKxwTY Recommended composition of influenza virus vaccines for use in the 2017- 2018 northern hemisphere influenza season http://www.who.int/influenza/vaccines/virus/recommendations/201703_recommendation.pdf?ua=1
Bi-weekly Influenza Situation Update 21 March 2017 Virological Surveillance Summary The number of specimens reported to FluNet by the Western Pacific Region countries and areas between week 1 and week 10, and the number of influenza positive specimens are presented in the table below. Influenza A (H3) is currently the predominant circulating subtype (Figure 1). Table 1: Countries and areas reporting data to FluNet, Western Pacific Region, weeks 1 to 10, 2017 Figure 1: Number of influenza positive specimens by subtype and week, Western Pacific Region, 2016-17 (accessed 20 March 2017) Country (most recent week) Total number of specimens processed Total number of influenza positive specimens Australia (week 10) 5027 329 Cambodia (week 10) 244 8 China (week 9) 105,893 15,220 Fiji (week 38 /2016) 349 120 Japan (week 97) NA 2,389 Lao People's Democratic Republic (week 10) 878 139 Malaysia (week 30 /2016) 2,461 212 Mongolia (week 10) 1310 395 New Caledonia (week 51/2016) 1,459 302 New Zealand (week 39/2016) 942 298 Papua New Guinea (week 51/2016) 410 144 Philippines (week 10) 184 8 Republic of Korea (week 10) 2,406 393 Singapore (week 10) 304 147 Viet Nam (week 6) 191 22 Influenza Situation Update | 2 Influenza surveillance summary Influenza surveillance in the WHO Western Pacific Region is based on outpatient and inpatient sentinel surveillance systems. Case definitions, populations under surveillance and data formats differ among these countries. This influenza surveillance summary includes countries where routine surveillance is conducted and information is available from syndromic surveillance systems for Influenza-like-illness (ILI) and Severe Acute Respiratory Infections (SARI). The WHO surveillance case definition for ILI is an acute respiratory infection with a measured fever of ≥38oC and cough, with symptom onset within the last 10 days. For SARI, it is an acute respiratory infection (ARI) with a history of fever or measured fever of ≥38oC and cough, with symptom onset within the last 10 days and requires hospitalization. Countries in the temperate zone of the Northern Hemisphere In most countries within the temperate zone of the Northern Hemisphere, ILI and influenza activity are consistent with seasonal trends but indicate an earlier start to the influenza season compared to 2016. Outpatient ILI Surveillance China (North) During week 10, the percentage of visits for ILI at national sentinel hospitals in northern China was 3.2%, higher than last week and the same week of 2015 (3.0% and 2.6% respectively), but lower than the same week of 2016 (3.8% ).(Figure 2). Mongolia ILI activity in Mongolia increased around week 30 of 2016, following seasonal trends. During week 10 of 2017, the ILI activity increased compared to the previous week (Figure 3). Republic of Korea In December 2016, the number of ILI cases was higher than usual (152.2 per 1,000 outpatient consultations from 11 – 17 December) and ILI cases peaked at 86.2 per 1,000 patients in week 52; this was in part due to an increase in the number of ILI cases from elementary, middle and high schools. In week 10, 2017, there were 7.0 ILI cases per 1,000, which was higher than 6.1 ILI cases per 1,000 patients reported in the previous week. (Figure 4). China (North) Figure 2: Percentage of visits for ILI at sentinel hospitals in north China, 2012-2017 (Source: China National Influenza Center) Mongolia Figure 3: Proportion of outpatient ILI visits (per 10,000 people), 2014-2017 (Source: Mongolia National Influenza Center) Influenza Situation Update | 3 Republic of Korea Figure 4: Weekly proportion of ILI visits per 1,000 patients 2013-2017 (Source: Korean Centre for Disease Control and Prevention) Sentinel influenza surveillance Japan As of 3 March 2017 (week 9), influenza activity is following seasonal trends with 13.55 cases per sentinel site in week 9. This is a decrease compared to week 8, 2017 when 16.87 cases were reported per sentinel. (Figure 5). Figure 5: Number of influenza cases reported weekly per reporting sentinel hospital site, Japan 2007-2017 (Source: Japan National Institute of Infectious Diseases) Influenza Situation Update | 4 Countries/areas in the tropical zone In weeks 1 to 8 of 2017, ILI or ARI activity followed previous seasonal trends in countries/areas in the tropical zone. Outpatient Surveillance Hong Kong (China) - ILI Surveillance In week 10, the average consultation rate for ILI among sentinel general outpatient clinics (GOPCs) was 5.4 ILI cases per 1,000 consultations, which was lower than 5.7 recorded in the previous week (Figure 6). The average consultation rate for ILI among sentinel private doctors was 59.1 ILI cases per 1,000 consultations, which was higher than 54.5 recorded in the previous week (Figure 7). Among the respiratory specimens received in week 10, 8.43% tested positive for seasonal influenza viruses, which was lower than 9.38% recorded in the previous week. Influenza A(H3) was the predominant subtype detected comprising 86.5% of respiratory specimens. Other viruses detected were influenza A(H1) (4.5%), influenza B (7.9%), and influenza C (1.1%). China (South) - ILI Surveillance During week 10, the percentage of outpatient or emergency visits for ILI (ILI %) at national sentinel hospitals in southern China was 3.0%, same as last week (3.0%), higher than the same week of 2015 (2.4%), lower than the same week of 2016 (3.6%). Singapore – ARI Surveillance The average daily number of patients seeking treatment in the polyclinics for ARI decreased from 3,008 (over 5.5 working days) in week 9 to 3,038 (over 5.5 working days) in week 10 (Figure 9). The proportion of patients with ILI among polyclinic attendances for ARI remained low at 2.2%. The overall positivity rate for influenza virus among ILI samples (n=136) in the community was 42.6% in the past 4 weeks. Of influenza-positive specimens in February 2017, the majority were influenza A(H3N2) (39.4%), followed by influenza B (36.6%) and influenza A(H1N1)pdm09 (19.7%). Hong Kong (China) - ILI Surveillance Figure 6: ILI consultation rates at sentinel general outpatient clinics, Hong Kong 2012-2017 (Source: Hong Kong Centre for Health Protection) Figure 7: ILI consultation rates at sentinel private doctors, Hong Kong 2012-2017 (Source: Hong Kong Centre for Health Protection) Influenza Situation Update | 5 China (South) - ILI Surveillance Figure 8: Percentage of visits due to ILI at national sentinel hospitals in South China, 2012-2017 (Source: China National Influenza Center) Singapore - ARI Surveillance Figure 9: Average daily polyclinic attendances for ARI, Singapore 2015-2017 (Source: Singapore Ministry of Health) Countries in the temperate zone of the southern hemisphere In the temperate zone of the southern hemisphere, influenza activity followed seasonal trends. Australia – Laboratory-confirmed influenza (no update) As of 28 October 2016, a total of 83,092 notifications of laboratory confirmed influenza were reported to the National Notifiable Diseases Surveillance System (Figure 10). Ninety percent of notifications were influenza A (73% A (unsubtyped), 6% influenza A(H1N1)pdm09 and 11% influenza A(H3N2), 10% were influenza B and less than 1% were influenza C, influenza A&B co-infections or untyped. Australia publishes influenza surveillance reports on a fortnightly basis during the influenza season, typically between May and October. Source: http://www.health.gov.au/internet/main/publishing.nsf/Content/cda-surveil-ozflu- flucurr.htm/$File/Australian-Influenza-Surveillance-Report.pdf Figure 10: Australian notifications of laboratory confirmed influenza (Source: National Notifiable Diseases Surveillance System, Australian Department of Health) Influenza Situation Update | 6 New Zealand – Influenza like Illness (no update) In week 39, ending 2 October 2016, 24 patients with ILI consulted sentinel general practices in 20 District Health Boards. The weekly ILI incidence was 4.4 ILI cases per 100,000 patients. Of the 14 tested ILI cases, 4 were positive for influenza viruses, yielding an influenza-associated ILI incidence rate of 1.3 ILI cases per 100,000 patients (adjusted). Figure 11: Weekly resident ILI and influenza incidence since (Week 18) 2 May 2016 in New Zealand (Source: Institute of Environmental Science and Research Ltd (ESR), New Zealand) Pacific Island Countries and Areas (PICs)- ILI Surveillance In the Pacific Island Countries and Areas, in week 10, the number of ILI cases reported increased in Solomon Islands and Vanuatu (Figure 12). Figure 12: Reported cases of influenza-like illness (red line) in Pacific Island Countries, 2017 Influenza Situation Update | 7 Global influenza situation updates Epidemiological update:http://www.who.int/influenza/surveillance_monitoring/updates/latest_update_GIP_surveillance/en/ Virological update: http://www.who.int/influenza/gisrs_laboratory/updates/summaryreport/en/ Global update: http://www.who.int/influenza/surveillance_monitoring/updates/latest_update_GIP_surveillance/ Others: Recommended composition of influenza virus vaccines for use in the 2017 southern hemisphere influenza season http://www.who.int/influenza/vaccines/virus/recommendations/2017_south/en/ Antigenic and genetic characteristics of zoonotic influenza viruses and candidate vaccine viruses developed for potential use in human vaccines http://www.who.int/influenza/vaccines/virus/characteristics_virus_vaccines/en/ 4th WHO Informal Consultation on Improving Influenza Vaccine Virus Selection http://www.who.int/influenza/vaccines/virus/4thmtg_improve_vaccine_virus_selection/en/ Video on influenza on WHO's YouTube Channel Arabic: https://www.youtube.com/watch?v=PxW6Pg1AnwI Chinese: https://www.youtube.com/watch?v=xW9gDKEPitQ English: https://www.youtube.com/watch?v=yhhJfT86Bgg French: https://www.youtube.com/watch?v=8mo8rWWJZkc Russian: https://www.youtube.com/watch?v=XQO6nbkKUWQ Spanish: https://www.youtube.com/watch?v=qXr75cKxwTY Recommended composition of influenza virus vaccines for use in the 2017- 2018 northern hemisphere influenza season http://www.who.int/influenza/vaccines/virus/recommendations/201703_recommendation.pdf?ua=1
Virological Surveillance Summary The number of specimens reported to FluNet by the Western Pacific Region countries and areas between week 1 and week 8, and the number of influenza posiFve specimens are presented in the table below. Influenza A(H3) is currently the predominant circulaFng subtype (Figure 1). Table 1: Countries and areas reporFng data to FluNet, Western Pacific Region, weeks 1 to 8, 2017 Figure 1: Number of influenza posiFve specimens by subtype and week, Western Pacific Region, 2016-17 (accessed 3 March 2017) Country (most recent week) Total number of specimens processed Total number of influenza posiFve specimens Australia (week 8) 3913 276 Cambodia (week 7) 178 8 China (week 7) 97,469 14,446 Fiji (week 38 /2016) 349 120 Japan (week 7) NA 1705 Lao People's DemocraFc Republic (week 84) 707 126 Malaysia (week 30 /2016) 2,461 212 Mongolia (week 7) 1073 374 New Caledonia (week 51/2016) 1,459 302 New Zealand (week 39/2016) 942 298 Papua New Guinea (week 51/2016) 410 144 Philippines (week 8) 152 7 Republic of Korea (week 8) 1,934 368 Singapore (week 7) 206 104 Viet Nam (week 6) 191 22 Influenza SituaFon Update | 1 Bi-weekly Influenza SituaFon Update 7 March 2017 Influenza surveillance summary Influenza surveillance in the WHO Western Pacific Region is based on outpaFent and inpaFent senFnel surveillance systems. Case definiFons, populaFons under surveillance and data formats differ among these countries. This influenza surveillance summary includes countries where rouFne surveillance is conducted and informaFon is available from syndromic surveillance systems for Influenza-like-illness (ILI) and Severe Acute Respiratory InfecFons (SARI). The WHO surveillance case definiFon for ILI is an acute respiratory infecFon with a measured fever of ≥38oC and cough, with symptom onset within the last 10 days. For SARI, it is an acute respiratory infecFon (ARI) with a history of fever or measured fever of ≥38oC and cough, with symptom onset within the last 10 days and requires hospitalizaFon. Countries in the temperate zone of the Northern Hemisphere In most countries within the temperate zone of the Northern Hemisphere, ILI and influenza acFvity are consistent with seasonal trends but indicate an earlier start to the influenza season compared to 2016. OutpaFent ILI Surveillance China (North) During week 8, the percentage of visits for ILI at naFonal senFnel hospitals in northern China was 2.9%, lower than last week (3.0%) and the same week of 2015 and 2016 (3.8 and 3.5% ).(Figure 2). Mongolia ILI acFvity in Mongolia increased around week 30 of 2016, following seasonal trends. During week 8 of 2017, the ILI acFvity decreased compared to the previous week (Figure 3). Republic of Korea In December 2016, the number of ILI cases was higher than usual (152.2 per 1,000 outpaFent consultaFons from 11 – 17 December) and ILI cases peaked at 86.2 per 1,000 paFents in week 52; this was in part due to an increase in the number of ILI cases from elementary, middle and high schools. In week 8, 2017, there were 6.7 ILI cases per 1,000, which was lower than 7.1 ILI cases per 1,000 paFents reported in the previous week. (Figure 4). China (North) Figure 2: Percentage of visits for ILI at senFnel hospitals in north China, 2012-2017 (Source: China NaFonal Influenza Center) Mongolia Figure 3: ProporFon of outpaFent ILI visits (per 10,000 people), 2014-2017 (Source: Mongolia NaFonal Influenza Center) Influenza SituaFon Update | 2 Republic of Korea Figure 4: Weekly proporFon of ILI visits per 1,000 paFents 2013-2017 (Source: Korean Centre for Disease Control and PrevenFon) SenFnel influenza surveillance Japan As of 22 February 2017 (week 8), influenza acFvity is following seasonal trends with 16.87 cases per senFnel site in week 8. This is a decrease compared to week 7, 2017 when 23.92 cases were reported per senFnel. (Figure 5). Figure 5: Number of influenza cases reported weekly per reporFng senFnel hospital site, Japan 2007-2017 (Source: Japan NaFonal InsFtute of InfecFous Diseases) Influenza SituaFon Update | 3 Countries/areas in the tropical zone In weeks 1 to 8 of 2017, ILI or ARI acFvity followed previous seasonal trends in countries/areas in the tropical zone. OutpaFent Surveillance Hong Kong (China) - ILI Surveillance In week 8, the average consultaFon rate for ILI among senFnel general outpaFent clinics (GOPCs) was 4.6 ILI cases per 1,000 consultaFons, which was lower than 5.3 recorded in the previous week (Figure 6). The average consultaFon rate for ILI among senFnel private doctors was 51.9 ILI cases per 1,000 consultaFons, which was lower than 56.0 recorded in the previous week (Figure 7). Among the respiratory specimens received in week 8, 398 (9.21%) tested posiFve for seasonal influenza viruses, which was similar to 9.12% recorded in the previous week. Influenza A(H3) was the predominant subtype detected comprising 86.4% of respiratory specimens. Other viruses detected were influenza A(H1) (7.0%), influenza B (5.5%), and influenza C (1.0%). China (South) - ILI Surveillance During week 8, the percentage of outpaFent or emergency visits for ILI (ILI %) at naFonal senFnel hospitals in southern China was 2.8%, which was higher than the previous week (2.7%), lower than week of 2015 (3.7%) and 2016 (3.0%). Singapore – ARI Surveillance The average daily number of paFents seeking treatment in the polyclinics for ARI decreased from 3,316 (over 5.5 working days) in week 7 to 2,993 (over 5.5 working days) in week 8 (Figure 9). The proporFon of paFents with ILI among polyclinic amendances for ARI remained low at 2.2%. The overall posiFvity rate for influenza virus among ILI samples (n=137) in the community was 45.3% in the past 4 weeks. Of influenza-posiFve specimens in January 2017, the majority were influenza A(H3N2) (66.0%), followed by influenza B (26.4%) and influenza A(H1N1)pdm09 (7.5%). Hong Kong (China) - ILI Surveillance Figure 6: ILI consultaFon rates at senFnel general outpaFent clinics, Hong Kong 2012-2017 (Source: Hong Kong Centre for Health ProtecFon) Figure 7: ILI consultaFon rates at senFnel private doctors, Hong Kong 2012-2017 (Source: Hong Kong Centre for Health ProtecFon) Influenza SituaFon Update | 4 Countries in the temperate zone of the southern hemisphere In the temperate zone of the southern hemisphere, influenza acFvity followed seasonal trends. Australia – Laboratory-confirmed influenza (no update) As of 28 October 2016, a total of 83,092 noFficaFons of laboratory confirmed influenza were reported to the NaFonal NoFfiable Diseases Surveillance System (Figure 10). Ninety percent of noFficaFons were influenza A (73% A (unsubtyped), 6% influenza A(H1N1)pdm09 and 11% influenza A(H3N2), 10% were influenza B and less than 1% were influenza C, influenza A&B co-infecFons or untyped. Australia publishes influenza surveillance reports on a fortnightly basis during the influenza season, typically between May and October. Source: hmp://www.health.gov.au/internet/main/publishing.nsf/Content/cda-surveil-ozflu-flucurr.htm/ $File/Australian-Influenza-Surveillance-Report.pdf Figure 10: Australian noFficaFons of laboratory confirmed influenza (Source: NaFonal NoFfiable Diseases Surveillance System, Australian Department of Health) China (South) - ILI Surveillance Figure 8: Percentage of visits due to ILI at naFonal senFnel hospitals in South China, 2012-2017 (Source: China NaFonal Influenza Center) Singapore - ARI Surveillance Figure 9: Average daily polyclinic amendances for ARI, Singapore 2015-2017 (Source: Singapore Ministry of Health) Influenza SituaFon Update | 5 New Zealand – Influenza like Illness (no update) In week 39, ending 2 October 2016, 24 paFents with ILI consulted senFnel general pracFces in 20 District Health Boards. The weekly ILI incidence was 4.4 ILI cases per 100,000 paFents. Of the 14 tested ILI cases, 4 were posiFve for influenza viruses, yielding an influenza-associated ILI incidence rate of 1.3 ILI cases per 100,000 paFents (adjusted). Figure 11: Weekly resident ILI and influenza incidence since (Week 18) 2 May 2016 in New Zealand (Source: InsFtute of Environmental Science and Research Ltd (ESR), New Zealand) Pacific Island Countries and Areas (PICs)- ILI Surveillance In the Pacific Island Countries and Areas, in week 8, the number of ILI cases reported increased in Niue (Figure 12). Figure 12: Reported cases of influenza-like illness (red line) in Pacific Island Countries, 2017 Influenza SituaFon Update | 6 Global influenza situaFon updates Epidemiological update: hmp://www.who.int/influenza/surveillance_monitoring/updates/latest_update_GIP_surveillance/en/ Virological update: hmp://www.who.int/influenza/gisrs_laboratory/updates/summaryreport/en/ Global update: hmp://www.who.int/influenza/surveillance_monitoring/updates/latest_update_GIP_surveillance/ Others: Recommended composiFon of influenza virus vaccines for use in the 2017 southern hemisphere influenza season hmp://www.who.int/influenza/vaccines/virus/recommendaFons/2017_south/en/ AnFgenic and geneFc characterisFcs of zoonoFc influenza viruses and candidate vaccine viruses developed for potenFal use in human vaccines hmp://www.who.int/influenza/vaccines/virus/characterisFcs_virus_vaccines/en/ 4th WHO Informal ConsultaFon on Improving Influenza Vaccine Virus SelecFon hmp://www.who.int/influenza/vaccines/virus/4thmtg_improve_vaccine_virus_selecFon/en/ Video on influenza on WHO's YouTube Channel Arabic: hmps://www.youtube.com/watch?v=PxW6Pg1AnwI Chinese: hmps://www.youtube.com/watch?v=xW9gDKEPitQ English: hmps://www.youtube.com/watch?v=yhhJfT86Bgg French: hmps://www.youtube.com/watch?v=8mo8rWWJZkc Russian: hmps://www.youtube.com/watch?v=XQO6nbkKUWQ Spanish: hmps://www.youtube.com/watch?v=qXr75cKxwTY Recommended composiFon of influenza virus vaccines for use in the 2017-2018 northern hemisphere influenza season hmp://www.who.int/influenza/vaccines/virus/recommendaFons/201703_recommendaFon.pdf?ua=1 Influenza SituaFon Update | 7