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Please cite this paper as: Vega et al. (2012) Influenza surveillance in Europe: establishing epidemic thresholds by the moving epidemic method. Influenza and Other Respiratory Viruses 7(4), 546-558. Background Timely influenza surveillance is important to monitor influenza epidemics. Objectives (i) To calculate the epidemic threshold for influenza-like illness (ILI) and acute respiratory infections (ARI) in 19 countries, as well as the thresholds for different levels of intensity. (ii) To evaluate the performance of these thresholds. Methods The moving epidemic method (MEM) has been developed to determine the baseline influenza activity and an epidemic threshold. False alerts, detection lags and timeliness of the detection of epidemics were calculated. The performance was evaluated using a cross-validation procedure. Results The overall sensitivity of the MEM threshold was 71·8% and the specificity was 95·5%. The median of the timeliness was 1 week (range: 0-4·5). Conclusions The method produced a robust and specific signal to detect influenza epidemics. The good balance between the sensitivity and specificity of the epidemic threshold to detect seasonal epidemics and avoid false alerts has advantages for public health purposes. This method may serve as standard to define the start of the annual influenza epidemic in countries in Europe. [ABSTRACT FROM AUTHOR]

Please cite this paper as: van Gageldonk-Lafeber et al. (2011) The relative clinical impact of 2009 pandemic influenza A (H1N1) in the community compared to seasonal influenza in the Netherlands was most marked among 5-14 year olds. Influenza and Other Respiratory Viruses 5(6), e513-e520. Background So far, most pandemic influenza reports were based on case studies focusing on severe disease. For public health policy, it is essential to consider the overall impact of the pandemic, including mild diseases. Objectives The aim of our study is to gain insight into the epidemiology of 2009 pandemic influenza in the community and to estimate the relative impact of pandemic compared to seasonal influenza. Methods The relative impact of pandemic influenza in the general population was assessed as the influenza-like illness (ILI) incidence during the pandemic season compared with that during regular seasons. Influenza-like illness incidences and virus diagnostics were derived from continuous sentinel surveillance systems. The incidence of hospital admissions, based on the mandatory notification of pandemic influenza, was used to relate the impact of severe disease to that in the community. Results The overall incidence of general practitioners-attended ILI was 96 consultations per 10 000 persons. Highest incidences were reported in children and lowest in persons aged ≥65 years. For 5-14 year olds, the incidence during the pandemic was higher than during all preceding seasons. Samples originating from 5 to 19 year olds were statistically significant more often positive for pandemic influenza A (H1N1) 2009 virus as compared with samples from 0 to 4 year olds. Moreover, the incidence of hospital admission owing to pandemic influenza was highest in the youngest children. Conclusions Our study showed that while the absolute incidences of 2009 pandemic influenza were highest in children aged 0-4 years, the relative clinical impact in the community compared to seasonal influenza in previous years was most noticeable in healthy children 5-14 years of age. [ABSTRACT FROM AUTHOR]

Please cite this paper as: Moghadas et al. (2011) Canada in the face of the 2009 H1N1 pandemic. Influenza and Other Respiratory Viruses 5(2), 83-88. Initial public health responses to the 2009 influenza H1N1 pandemic were based on difficult decisions in the face of substantial uncertainty. Policy effectiveness depends critically on such decisions, and future planning for maximum protection of community health requires understanding of the impact of public health responses in observed scenarios. In alignment with the objectives of the Pandemic Influenza Outbreak Research Modelling Team (Pan-InfORM) and the Centre for Disease Modelling (CDM), a focused workshop was organized to: (i) evaluate Canada's response to the spring and autumn waves of the novel H1N1 pandemic; (ii) learn lessons from public health responses, and identify challenges that await public health planners and decision-makers; and (iii) understand how best to integrate resources to overcome these challenges. We report on key presentations and discussions that took place to achieve the objectives of the workshop. Future emerging infectious diseases are likely to bring far greater challenges than those imposed by the 2009 H1N1 pandemic. Canada must address these challenges and enhance its capacity for emergency responses by integrating modelling, surveillance, planning, and decision-making. [ABSTRACT FROM AUTHOR]

Please cite this paper as: Yavarian et al. (2012). Epidemiological aspects of pandemic influenza A(H1N1) virus from 2009 to 2011 in Iran. Influenza and Other Respiratory Viruses 6(601), e74-e76. [ABSTRACT FROM AUTHOR]

Please cite this paper as: Castilla et al. (2013) Risk factors and effectiveness of preventive measures against influenza in the community. Influenza and Other Respiratory Viruses 7(2) 177-183. Background The role of different risk exposures and preventive measures against influenza has not been well established. Objective The aim of this study was to evaluate risk factors and measures to prevent influenza infection in the community. Methods We conducted a multicenter case-control study. Cases were 481 outpatients aged 18 years or older with laboratory-confirmed influenza A(H1N1)09 in the 2009-2010 season in Spain. A control was selected for each case from outpatients from the same area matched by age and date of consultation. Information on risk situations, preventive measures and other variables was obtained by interview and review of the medical record. Results In the multivariate conditional logistic regression analysis, the risk of a diagnosis of influenza increased with the number of cohabitants (compared with <3 cohabitants, three cohabitants had an OR = 1·80, 95% CI 1·12-2·89, and ≥5 cohabitants had an OR = 2·66, 95% CI 1·31-5·41) and for health care workers (OR = 2·94, 95% CI 1·53-5·66). The use of metropolitan public transport was associated with a lower frequency of a diagnosis of influenza (OR = 0·45, 95% CI 0·30-0·68) but not the use of taxis or long-distance transport. The influenza A(H1N1)09 vaccine had a protective effect (OR = 0·13, 95% CI 0·04-0·48), unlike hand washing after touching contaminated surfaces or the use of alcohol-based hand sanitizers. Conclusion The home environment appears to play an important role in the spread of influenza in adults, but not the use of public transport. Health care workers have a higher risk of contracting influenza. Vaccination was the most effective preventive measure. [ABSTRACT FROM AUTHOR]