Bhutan national influenza programme: influenza factsheet 2019

Bhutan Influenza Surveillance – Landscape Analysis 2019 INFLUENZA FACTSHEET 2019 BHUTAN National Influenza Programme Basic information (2019) Total population 734 3741 Children <5 years of age 57 4741 Under-5 mortality rate (per 1000 live births) 30.81 Life expectancy at birth (years) 70.62 Provinces/divisions/regions/zones - Districts 20 Total health expenditure (% of GDP) 3.711 Income level (World Bank) Lower middle3 1https://www.who.int/southeastasia/health-topics/immunization 2https://www.who.int/gho/publications/world_health_statistics/2020/en/ 3https://data.worldbank.org/ Influenza Like Illness (ILI) Surveillance Type of ILI surveillance Sentinel Sites involved in ILI surveillance Hospital (outpatients) Clinical case definition used for ILI case ascertainment WHO 2011 Is laboratory confirmation sought in ILI cases? Yes, for 42 cases per week Number of ILI surveillance sites 7 Number of states/districts covered by the surveillance system 7 % of the population covered by the surveillance system 35% Denominator used for ILI surveillance Number of outpatient visits Reporting frequency to the national level Weekly How are the data reported? Web-based or SMS Form of the reporting tool Electronic Severe Acute Respiratory Infection (SARI) Surveillance Type of SARI surveillance Sentinel Sites involved in SARI surveillance Hospitals (inpatients) Clinical case definition used for SARI case ascertainment WHO 2011 Is laboratory confirmation sought in SARI cases? Yes, for all SARI cases Number of SARI surveillance sites 11 Number of states/districts covered by the surveillance system 11 % of the population covered by the surveillance system 40% Denominator used for SARI surveillance Number of inpatient visits Reporting frequency to the national level Weekly How are the data reported? Web-based or SMS Form of the reporting tool Electronic Influenza Surveillance – Landscape Analysis 2019 Bhutan Epidemiological data (FluID) – Influenza Like Illness (ILI) surveillance 0 10 20 30 40 50 60 70 0 100 200 300 400 500 600 1 5 9 13 17 21 25 29 33 37 41 45 49 1 5 9 13 17 21 25 29 33 37 41 45 49 1 5 9 13 17 21 25 29 33 37 41 45 49 2017 2018 2019 Pr op ort ion Nu mb er of ca se s ILI cases Proportion of ILI cases per 1000 outpatients Plotted in R (ggplot2). Data source: FluMART, available at http://apps.who.int/flumart/ Epidemiological data (FluID) – Severe Acute Respiratory Infections (SARI) surveillance 0 5 10 15 20 25 0 10 20 30 40 50 60 70 80 90 1 5 9 13 17 21 25 29 33 37 41 45 49 1 5 9 13 17 21 26 30 34 38 42 46 50 2 6 10 14 18 22 26 30 34 38 42 46 50 2017 2018 2019 Pr op or tio n Nu mb er of ca se s SARI cases Proportion of SARI cases per 100 inpatients Plotted in R (ggplot2). Data source: FluMART, available at http://apps.who.int/flumart/ Intensive Care Unit (ICU) surveillance Does the country have surveillance for influenza in the ICU? Yes Is laboratory confirmation sought in ICU cases? Yes, all ICU cases Is case-based information collected? Yes Mortality surveillance Is timely all-cause mortality data (i.e. within one month) available in the country? No Virological surveillance Does the country have virological surveillance? Yes Type of virological surveillance Sentinel Bhutan Influenza Surveillance – Landscape Analysis 2019 – If sentinel, number of sites involved 11 Is epidemiological case information collected? Yes – If yes, are the laboratory results linked with epidemiological data? Yes Average number of virological samples processed per week 40 Are samples processed from ILI or SARI surveillance systems? Yes, both Does the country have virus isolation capacity? Yes Does the country have RT-PCR capacity? Yes – laboratories that perform RT-PCR 5 – RT-PCR laboratories that report to NIC 5 Does the country use rapid diagnostic testing for influenza surveillance? Yes – immunochromatography Does the country have sequencing capacity? No Does the country test for other respiratory viruses? Yes Virological data (FluNet) 0 20 40 60 80 100 0 5 10 15 20 25 30 35 40 45 50 1 5 9 13 17 21 25 29 33 37 41 45 49 1 5 9 13 17 21 25 29 33 37 41 45 49 1 5 9 13 17 21 25 29 33 37 41 45 49 2017 2018 2019 % P os itiv e Nu mb er of ca se s A/H1N1pm09 A/H1N1 A/H3N2 A/H5N1 A (Unsubtyped) B Yamagata B Victoria B (Unsubtyped) % Positive Plotted in R (ggplot2). Data source: FluMART, available at http://apps.who.int/flumart/ National Influenza Centre Does the country have a National Influenza Centre (NIC) or national laboratory? Yes – national laboratory Assays routinely performed at the NIC or national laboratory RT-PCR Does the NIC have – Virus isolation capability – Antigenic characterisation capability – Antiviral susceptibility testing capability – Sequencing capability Yes No No No Does the NIC test for other respiratory viruses? Yes – Respiratory syncytial virus (RSV), Human metapneumovirus (HMPV), parainfluenza virus I (PIVi-3) Does the country have a quality control plan? Yes Does the country follow national biosafety and biosecurity policy guidelines? Yes Does the country forward samples to a WHO Collaborating Centre (CC)? Yes – US CDC, Atlanta – How often? Quarterly Influenza Surveillance – Landscape Analysis 2019 Bhutan For technical information, please contact: Dr Pushpa Ranjan Wijesinghe, Programme Area Manager (Infectious Hazard Management). Email: wijesinghep@who.int Reporting Frequency of national reports Weekly, quarterly Are epidemiological and virological data integrated? Yes, both Reported via a website? Yes – http://www.rcdc.gov.bt Does the country report to FluID? – Year of beginning of reporting – Frequency of reporting Yes 2011 Weekly Does the country report to FluNet? – Year of beginning of reporting – Frequency of reporting Yes 2011 Weekly Are there fixed outbreak thresholds? Yes Level at which data are stored, managed and analysed National Has formal training on data reporting and analysis been provided to surveillance and laboratory staff? – If yes, when? – Has a training session been planned? If yes, when? Yes 2019 Yes – 2021 Vaccination Does the country have a formal seasonal influenza vaccination policy? Yes Has seasonal influenza been introduced in the public sector? – Year introduced – Recommended risk groups – Vaccination period – Northern/Southern hemisphere vaccine ? – Vaccine type Yes 2019 Pregnant women, people with comorbidities, children <2 years, people >65 years, health workers Dec-Feb Northern Trivalent Is seasonal influenza offered in the private sector? – Only offered to particular risk groups? – Vaccination period – Northern/Southern hemisphere vaccine ? – Vaccine type No Not applicable Not applicable Not applicable Not applicable Is vaccine offered to Hajj and Umrah pilgrims? Not applicable Vaccine production capacity No Pandemic preparedness Does the country have a National Influenza Pandemic Preparedness Plan? – Year developed – Year last updated Yes 2012 2015 Has the country performed simulation exercises? Yes, table top exercise , functional Are there laboratory testing strategies in place for different phases of an influenza pandemic? No Are there surge capacity plans? Yes Does the pandemic preparedness plan include a detailed National Pandemic Vaccine Deployment Plan? – Are there priority groups? No Not Applicable