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Evaluation of severe influenza surveillance in europe
1. Julien Beauté, ECDC
Joint WHO/Europe & ECDC Annual Influenza Surveillance Meeting
Vienna, 11-13 June 2014
Evaluation of severe influenza
surveillance in Europe
2. Background
• 2009 influenza pandemic
− First attempt to monitor severe cases at EU level
− Rapid development of surveillance – July 2009
• 2010-to the present date
− Six to ten EU/EEA countries reporting (seven for the
2013/14 season)
− Thirteen countries reported SARI data to EuroFlu for
the 2013/14 season (including two EU countries)
− Cases admitted to intensive care units or any ward
− Sentinel or comprehensive surveillance
Joint WHO/Europe & ECDC Annual Influenza Surveillance Meeting
Vienna, 11-13 June 2014
4. Evaluation of severe influenza surveillance
• To provide ECDC with:
− Clear statement on epidemiological and public health
usefulness
− Future scenarios and recommendations
• Requested deliverables:
− Description of the surveillance of severe influenza in
all the EU/EEA states
− Review of the surveillance at the EU/EEA level
− Comparison with systems elsewhere
− Guidance for future
Joint WHO/Europe & ECDC Annual Influenza Surveillance Meeting
Vienna, 11-13 June 2014
5. Evaluation of severe influenza surveillance
• Findings:
− Heterogeneity of systems in
place hinders any significant
added value from an European
perspective
− Example of federally organised
countries (e.g. U.S.) strongly
argues in favour of more
harmonised systems
Joint WHO/Europe & ECDC Annual Influenza Surveillance Meeting
Vienna, 11-13 June 2014
6. Key features of severe influenza
surveillance systems in EU/EEA countries
Joint WHO/Europe & ECDC Annual Influenza Surveillance Meeting
Vienna, 11-13 June 2014
7. 37th ECDC Advisory Forum, 27 Feb 2014
• Options
− Abandon severe influenza surveillance
− Proceed with the current strategy aiming at
improving harmonisation and increasing the number
of participating countries
− Proceed with the current system, but restrict severe
influenza surveillance to intensive care units
− Establish a new surveillance system based on a
European network of sentinel hospitals
− …
Joint WHO/Europe & ECDC Annual Influenza Surveillance Meeting
Vienna, 11-13 June 2014
8. Recommendations
• 37th ECDC Advisory Forum, 27 Feb 2014
– Proceed with the current system, but restrict severe
influenza surveillance to intensive care units
– Clarify the objectives of severe influenza surveillance
at the European level
• EISN Coordination Committee meeting, 19 Mar 2014
– Convince countries collecting data to participate
– Agree on denominator data
– Explore alternative monitoring systems
– Estimate risk factors for severe disease
Joint WHO/Europe & ECDC Annual Influenza Surveillance Meeting
Vienna, 11-13 June 2014