http://www.wpro.who.int/emerging_diseases/influenza/en/index.html Influenza surveillance summary This surveillance summary includes countries where routine surveillance is conducted and information is available. Countries in the temperate zone of the northern hemisphere In the countries within the temperate zone of the Northern Hemisphere, Influenza-Like Illness (ILI) activity is declining and seasonal patterns are being observed. Japan In Japan the ILI activity continues to decrease and the seasonal pattern observed over the last 10 years is being followed (Figure1). Figure 1: Influenza cases reported per sentinel weekly (Source: Japan National Institute of Infectious Diseases) Mongolia ILI activity continued to show an overall decreasing trend. The current rate of ILI sits within the 60% tolerance band which depicts the long term seasonal trend (Figure 2). Figure 2: Proportion of outpatients that were ILI (per 10,000 people) (Source: National Influenza Center of Mongolia) Influenza Situation Update 1
The proportion of patients with pneumonia among hospitalized patients has also decreased compared to recent weeks and is currently within the tolerance limit (Figure 3). Figure 3: Proportion of patients with pneumonia among hospitalized (Source: National Influenza Center of Mongolia) Northern China The percentage of patient visits due to ILI at national sentinel hospitals continues to be below the levels experienced in years 2010-2011 and 2012-2013. However, the current percentage is in line with the level experienced in 2011-2012 (Figure 4). Figure 4: Percentage of visits for ILI at sentinel hospitals in north China (Source: China National Influenza Center) Influenza Situation Update 2
Republic of Korea The proportion of patient visits to sentinel physicians due to ILI continues to remain below the baseline level and below activity at this time in 2010 to 2013 year (Figure 5). Countries in the tropical zone Figure 5: The weekly proportion of ILI visits per 1,000 patients (Source: Korean Center for Disease Control and Prevention) In the tropical zone the overall ILI activity was variable. Hong Kong (China) The ILI consultation rates at sentinel general outpatient clinics continued to decrease (Figure 6). Figure 6: Consultation rates at sentinel general outpatient clinics, (Source: Hong Kong Centre for Health Protection) Influenza Situation Update 3
Moreover, the ILI consultation rates at sentinel private doctor sites also show a decreasing trend. Currently this rate is at levels similar to those observed in 2012 and 2013 (Figure7). Figure 7: ILI consultation rates at sentinel private doctors (Source: Hong Kong Centre for Health Protection) Influenza associated hospital admission rates, among patients age group 0-4 years, have decreased while deaths remain low (Figure8). Figure 8: Influenza associated hospital admission rates and deaths (Source: Hong Kong Centre for Health Protection) Influenza Situation Update 4
Singapore Acute upper respiratory infection (ARI*) activity is slightly higher than levels observed in 2013 but remains below the mean plus 1 standard deviation level (Figure 9). Figure 9: Singapore average daily attendances for ARI (Source: Singapore Ministry of Health) Southern China The percentage of patient visits due to ILI at national sentinel hospitals is lower than the last week. However, it continues to be above levels over the same period in years 2010-2014 (Figure 10). Figure 10: Percentage of visits due to ILI at national sentinel hospitals in southern China, (Source: China National Influenza Center) Influenza Situation Update 5
Countries in the temperate zone of the southern hemisphere Overall ILI activity has started to increase which indicates that the influenza season has begun. Australia ILI activity continues to show an upward trend with variable, however, overall activity remains consistent with the expected seasonal trend (Figure 11). Figure 11: Australian weekly rate of ILI from Sentinel General Practitioner ILI surveillance systems (Source: Australia Department of Health) The notification of laboratory confirmed cases has clearly continued to increase during the last few weeks (Figure 12). Figure 12: Australian notifications of laboratory confirmed influenza (Source: Australia Department of Health) Influenza Situation Update 6
New Zealand The weekly ILI consultation rate remained with variable during the last few weeks. The ILI consultation rate is slightly above the seasonal threshold but remains well below the New Zealand average epidemic curve (Figure 13). Figure 13: Weekly consultation rates for influenza-like illness in New Zealand in 2014 in comparison to the average epidemic curve in 2000 2013 (excluding 2009) (Source: New Zealand Ministry of Health and Institute of Environmental Science & Research) Pacific Islands In the Pacific Islands, ILI activity was variable with a decreasing trend observed in a number of islands. In the current reporting period, ILI activity continues to increase in American Samoa, Fiji, Niue, Kiribati and Vanuatu (Figure 14) Figure 14: Pacific Islands reported cases of diarrhea, influenza-like illness and prolonged fever by year, month and week number, up to 27 July 2014. *Note: Numbers of reported cases are not comparable between countries. The purpose of the charts is to show trends over time within each country/area. Influenza Situation Update 7
Virological Surveillance Summary Country Japan Reporting period Figure 15: Data from WHO FluNet and Global Influenza Surveillance and Response System, WHO Countries in the temperate zone of the northern hemisphere Mongolia Samples received H1 (H1N1)pd m09 H3 H5 H7 unknown Yamagata unknown Mongolia w30 7 0 0 0 0 0 0 0 0 0 Northern China Jul 21-Jul 27 643 0 0 8 0 0 0 0 0 0 Korea 20-26 July 2093 0 346 639 0 0 0 0 1108 0 Hong Kong 20-26 Jul 30123 0 0 102 0 0 0 0 17 1 Singapore June 0 31.1% 26.2% 0 0 0 0 42.2% 0 Southern China Jul 21-Jul 27 2680 0 2 599 0 0 11 0 19 0 Lao PDR w28 45 0 0 2 0 0 0 0 2 0 Viet Nam w30 3 0 0 1 0 0 0 0 0 0 Australia 6 July-20 July 192 0 13.5% 2.1% 0 0 9.9% 0 1.1% 0 New Zealand Northern Hemisphere Temperate zone Northern Hemisphere Tropical zone Northern Hemisphere Mekong area Southern Hemisphere Temperate zone A Influenza 21-27 July 207 0 90 13 0 0 95 0 9 0 Influenza virus continues to circulate at low levels. The number of specimens is low, similar to numbers tested in the same period in 2013 (Figure 16). B C Figure 16 : Viruses detected (Source: National Influenza Center of Mongolia) Influenza Situation Update 8
Northern China The number of tests positive for Influenza subtype A(H3N2)strains has continued to decrease (Figure 17). Figure 17: Influenza Positive Tests Reported by Northern China Laboratories (Data from China National Influenza Center) Republic of Korea In recent weeks, the number of isolates positive for Influenza B serotype, remains low in the current reporting period (Figure 18). Figure 18: Data from Korean Center for Disease Control and Prevention Influenza Situation Update 9
Countries in the tropical zone Hong Kong (China) The Influenza Type A, subtype H3, continues to be dominant in Hong Kong. (Figure 19). Figure 19: Data from Hong Kong Centre for Health Protection Singapore The distribution of influenza A(H1N1-2009) and influenza A(H3N2) continues to increase, while that of influenza B continue to decrease during the last few weeks. (Figure 20). Figure 20: Data from Singapore Ministry of Health Influenza Situation Update 10
Southern China In Southern China, subtype A(H3N2) continues to be the dominant strain (Figure 21). Figure 21: Influenza Positive Test Reported by Southern China Laboratories (Data from China National Influenza Center) Countries in the temperate zone of the southern hemisphere Australia Influenza A is the predominant influenza virus type. Of those viruses where subtyping data are available, A(H1N1)pdm09 is most common. (Figure22). Figure 22: Australian proportion of respiratory viral tests positive for influenza (Source: Australia Department of Health) Influenza Situation Update 11
Global influenza situation updates Epidemiological update: http://www.who.int/influenza/surveillance_monitoring/updates/latest_update_gip_surveillance/ Virological update: http://www.who.int/influenza/gisrs_laboratory/updates/summaryreport Influenza Situation Update 12