SUMMARY http://www.wpro.who.int/emerging_diseases/influenza/en/index.html Northern Hemisphere In the Northern Hemisphere countries, influenza-like illness (ILI) activity was variable. In Northern China, the percentage of visits for ILI at national sentinel hospitals established in 2009 was 2.5% in week 24 (9 June to 15 June 2014), lower than the previous week (2.6%) and lower than the same week in 2013. The proportion of ILI specimens positive for influenza decreased slightly; 5 of 601 positive specimens (0.8%) compared to 4 of 573 specimens (1.2%) in the previous week. Of the positive specimens, 1 was Influenza A (H3N2) and 4 were Influenza B (lineage not determined). In Mongolia, during week 24 (9 June to 15 June 2014), ILI activity based on the proportion of outpatients exhibiting ILI continued to show an overall decreasing trend. The proportion of patients with pneumonia among the hospitalized has taken a downward trend compared to recent weeks, however, still exceeding Mongolia s influenza tolerance limit. The number of ILI specimens has continued to decrease in week 23 (1 June to 7 June 2014), with 19 specimens submitted compared to 23 in the previous week. None were positive for influenza. In Japan, during week 23 (2 June to 8 June 2014), ILI activity continued to decrease; the number of ILI cases per sentinel reporting site was 0.17, compared to 0.35 in week 22 (26 May to 1 June 2014). In the Republic of Korea, during week 24 (8 June to 14 June 2014), ILI activity decreased slightly. The proportion of patients who visited sentinel physicians for ILI was 0.2%, remaining below the national baseline of 1.2%. There were 2 ILI specimens positive for Influenza B (lineage not determined). The number of specimens has remained stable from week 22 to week 25 (25 May to 14 June 2014) with the number submitted for influenza testing ranging from 187 to 186 specimens. Subtropics/Tropics Influenza Situation Update 24 June 2014 In the subtropics/tropics, overall ILI activity remained variable. In Southern China, the percentage of visits for ILI at national sentinel hospitals established in 2009 was 3.6% in week 24 (9 June to 15 June 2014), which was slightly higher than the previous week (3.7%) and higher than the same week in 2013. The proportion of ILI specimens positive for influenza increased; 265 of 2938 specimens (9.0%) compared to 174 of 2907 specimens (8.1%) in the previous week. Of the positive specimens, 228 (92.7%) were Influenza A (H3N2), 11 (4.5%) were Influenza A (H1N1)pdm09, 7 (2.9%) were an undetermined subtype of Influenza A and 19 (7.2%) were am undetermined Influenza B lineage. In Hong Kong (China), during June 8 to June 14 2014, overall influenza activity continued to increase. The proportion of samples positive for influenza increased substantially to 12.5% compared to the previous reporting period where 6.1% of samples tested positive. 12 were influenza A(H1N1)pdm09, 191 were influenza A(H3), 63 were influenza B viruses, and 6 were influenza C viruses. Hospital admission rates with principal diagnosis of influenza for children aged 0 4 years, persons aged 5 64 years and persons aged 65 years and above were 0.96, 0.08
and 0.57 cases per 10 000 people, respectively. This is an increase of 0.38, 0.03 and 0.41 per 10 000 people, respectively. Additionally, weekly number of deaths with any diagnosis of influenza in public hospitals has continued to increase. In Singapore, acute upper respiratory infection (ARI*) activity during 8 June to 14 June 2014 was further decreased to 2448 from 2512 in the previous week.. The proportion of cases with ILI among the polyclinic ARI cases remained low at 1%. Of 247 ILI samples collected in the past 4 weeks in the community, 62.6% were positive for influenza virus. Of all the influenza virus isolates in May 2014, 19.8% were influenza A(H1N1)pdm09, 19.8% were influenza A(H3N2), and 60.4% were influenza B. Mekong region In the Mekong region the ILI activity remained variable. In Lao PDR, influenza activity increased slightly. During 8 June to 14 June 2014, 2 of 39 (5%)ILI specimens was positive for influenza, a decrease compared to the previous reporting period (15): 1 influenza A(H3) and 1 was undetermined influenza B. In Viet Nam, influenza activity decreased. During the same period, 8 specimens we reprocessed and 1 returned positive for undetermined influenza B. Southern Hemisphere In the Southern Hemisphere, overall ILI activity is low, despite the beginning of the flu season. In Australia, ILI activity remained at low level. During the week 8 June to 14 June 2014, 12 of 39 ILI specimens tested positive for influenza: 1 was positive for an unsubtyped influenza A, 8 were A(H1N1)pdm09 and 3 were positive for undetermined influenza B.. In New Zealand, during 9 June to 15 June 2014, influenza activity remained below the baseline threshold. Of 35 samples received, 8 were positive for influenza: 6 were influenza A(H1N1)pdm09, 2 were influenza A (not subtyped). Pacific Islands In the Pacific Islands, ILI activity was variable with a decreasing trend observed in a number of islands. During the week ending 15 June 2014, ILI activity increased with Fiji, French Polynesia, Guam and Tuvalu reporting weekly ILI case numbers above the threshold of 90% of their historical values. Global influenza situation Epidemiological update: http://www.who.int/influenza/surveillance_monitoring/updates/latest_update_gip_surveillanc e/ Virological update: http://www.who.int/influenza/gisrs_laboratory/updates/summaryreport *ARI defined as clinical diagnosis of acute upper respiratory tract infection (ICD9 460 465: Acute Nasopharyngitis (common cold); 461 Acute Sinusitis; 462 Acute Pharyngitis; 463 Acute Tonsillitis; 464 Acute Laryngitis and Tracheitis; 465 Acute Upper Respiratory Infections of Multiple or Unspecified Sites; 466 Acute Bronchitis and Bronchiolitis). ILI defined as temperature >38C with cough or sore throat
Percentage of visits for ILI at sentinel hospitals in north China up to 15 June 2014, 2010 2014 (Source: Chinese National Influenza Center) Proportion of outpatients that were ILI (per 10000) Mongolia up to 15 June 2014 (Source: National Influenza Center of Mongolia)
Proportion of patients with pneumonia among hospitalized Mongolia, up to 15 June 2014 (Source: National Influenza Center of Mongolia) Influenza cases reported per sentinel weekly Japan up to 25 May in 2014 (Source: National Institute of Infectious Diseases)
The weekly proportion of ILI visits per 1,000 patients Republic of Korea up to 14 June 2014 (Source: Korean Center for Disease Control and Prevention) Percentage of visits for ILI at sentinel hospitals in south China, up to 15 June, 2010 2014 (Source: Chinese National Influenza Center)
Consultation rates at sentinel general outpatient clinics, Hong Kong (China) up to 14 June 2014 (Source: Centre for Health Protection) ILI consultation rates at sentinel private doctors Hong Kong (China) up to 14 June 2014 (Source: Centre for Health Protection)
Influenza associated hospital admission rates and deaths Hong Kong (China) up to 14 June 2014 (Source: Centre for Health Protection) Singapore average daily attendances for ARI up to 14 June 2014 (Source: Ministry of Health)
New Zealand consultation rate up to 15 June 2014 (Source: Ministry of Health and Institute of Environmental Science & Research Ltd.) Pacific Islands reported cases of diarrhea, influenza-like illness and prolonged fever by year, month and week number up to 15 June 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.