#18,776
A year ago, in the wake of the discovery of 3 (now > 6 dozen) human infections with H5N1 in the United States, the ECDC issued guidance for member nations on Enhanced Influenza Surveillance to Detect Avian Influenza Virus Infections in the EU/EEA During the Inter-Seasonal Period.In that summary, the ECDC pointed out:
Sentinel surveillance systems are important for the monitoring of respiratory viruses in the EU/EEA, but these systems are not designed and are not sufficiently sensitive to identify a newly emerging virus such as avian influenza in the general population early enough for the purpose of implementing control measures in a timely way.A conclusion not unlike what we saw in the 2023's UKHSA Technical Briefing #3, which found that it might take weeks - and hundreds of cases - before community spread of a novel flu could be confirmed using standard surveillance (see UK Novel Flu Surveillance: Quantifying TTD).
The ECDC uses EpiPulse - an online portal for European public health authorities to collect, analyze, and share infectious disease data - integrating several previously independent surveillance platforms; (The European Surveillance System (TESSy), the five Epidemic Intelligence Information System (EPIS) platforms and the Threat Tracking Tool (TTT).
Over the weekend the ECDC published an updated, 28-page protocol for reporting zoonotic influenza infections to the TESSy database. I've reproduced the introduction below:
An event of a human case infected with an influenza virus deriving from an animal source should be reported within 24 hours to the Early Warning and Response System (EWRS) which will cover the International Health Regulations (IHR) notification for EU/EEA countries.
To complement the eventbased surveillance, TESSy reporting allows for a long-term collection of key indicators. Data to TESSy can be uploaded retrospectively when more information becomes available but should be done as soon as feasible to avoid major reporting delays.
This reporting protocol describes data collection for zoonotic influenza viruses. With the data collected, the aim is to support situational risk assessment and trends over time.
For the reporting of case-based data, the record type INFLZOO should be used. Case-based data is the preferential record type for reporting confirmed cases to TESSy. Aggregate data on zoonotic influenza (number of tested samples and number of detected cases by NA and HA subtype) can be uploaded to INFLZOOAGGR. This record type should ideally be used mainly for reported testing data.
If a country is not able to report to the case-based record type above, then numerator data can also be reported to this record type.
Aim
To support the timely and complete reporting on number of samples tested, number of detected cases and key information of zoonotic influenza cases
Objectives
• To collect data on number of tested people.
• To help assess the onset of the disease, confirmation of the subtype of infection and severity.
• To provide information on exposure, treatment and outcome.
• To provide additional contextual information to help understand the case identification.
• To analyse trends over time.
Record types
The following record types exist for reporting of zoonotic influenza virus in TESSy:
1. INFLZOO for reporting of case-based data of zoonotic influenza virus
2. INFLZOOAGGR for reporting of aggregated data of zoonotic influenza virus
Variables for each record type are outlined in the annex of this reporting protocol.
Among the changes in this update are expansions to the metadata and codes used in these reports. A list of changes (which includes animal exposures, exposure activities, and consumption of raw or unpasteurized animal products) follows:
But as far as what is happening across much of the rest of the world, infectious disease reporting remains sparse, and - for varied economic and political reasons - only seems to be getting worse (see From Here To Impunity).
A reminder that `no news' isn't necessarily `good news'.
