Australian influenza report 2010 - 15 to 21 May 2010 (#20/10)

The Australian Influenza Report is compiled from a number of data sources, including laboratory-confirmed notifications to NNDSS, sentinel influenza-like illness reporting from general practitioners and emergency departments, workplace absenteeism, and laboratory testing. A more in-depth annual report is also published in Communicable Diseases Intelligence.

Page last updated: 01 June 2010

Report No. 20
Week ending 21 May 2010

A print friendly version of this report is available as a PDF (240 KB)

The Department of Health and Ageing acknowledges the providers of the many sources of data used in this report and greatly appreciates their contribution.

Key Indicators

The counting of every case of pandemic influenza is no longer feasible in the PROTECT phase. Influenza activity and severity in the community is instead monitored by the surveillance systems listed below.

Is the situation changing?

Indicated by laboratory confirmed cases reported to NetEpi and/or National Notifiable Diseases Surveillance System (NNDSS); GP Sentinel influenza-like illness (ILI) Surveillance; and emergency department (ED) presentations of ILI at sentinel hospitals (New South Wales and Western Australia).

Laboratory data are used to determine the proportion of pandemic (H1N1) 2009 influenza circulating in the community.
How severe is the disease, and is severity changing?
Indicated by number of hospitalisations, ICU admissions and deaths from sentinel hospital surveillance as well as emergence of more severe clinical picture in hospitalised cases and ICU admissions.
Is the virus changing?
Indicated by emergence of drug resistance or gene drift or shift from laboratory surveillance.


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Summary

  • Levels of influenza-like illness (ILI) in the community show signs of increasing through some surveillance systems (WA and NSW Emergency Departments, Flutracking).
  • Reporting from laboratories suggests that little of this community ILI is due to influenza. Respiratory syncytial virus and rhinovirus were the most common respiratory virus diagnosed by NSW sentinel laboratories in the last reporting period, rhinovirus in WA and picornavirus in VIC.
  • Of the 741 confirmed cases of influenza diagnosed during 2010 up to 21 May, 9.4% have been sub-typed as pandemic (H1N1) 2009, 75.8% as type A not sub-typed (likely to be mostly pandemic influenza), 0.9% as A/H3N2 and 9.4% have been characterised as type B.
  • Sentinel hospitals have reported no hospitalisations during this period, and ANZICS reported no ICU admissions for influenza A.
  • In 2010, there have been 70 confirmed cases of pandemic (H1N1) 2009 influenza reported in Australia, bringing the total of confirmed cases to 37,706 since May 2009. There have been no new confirmed cases of pandemic (H1N1) 2009 influenza diagnosed and reported in Australia during this reporting period.
  • Pandemic (H1N1) 2009 influenza virus accounted for 81% of all influenza A viruses subtyped globally in the last reporting period. Seasonal Influenza B viruses are now predominant in the Russian Federation, China, Cameroon, Republic of Korea and Iran.
  • In China, influenza B accounted for 91% of influenza viruses detected in the week to 16 May 2010. Of these, approximately 47% are the same strain as that in the 2010 Southern Hemisphere vaccine.
  • As at 16 May 2010, the WHO Regional Offices reported over 18,097 deaths associated with pandemic (H1N1) 2009 influenza worldwide. In the Northern Hemisphere, the areas of highest transmission are in parts of the Caribbean and Southeast Asia.
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    1. Influenza activity in Australia

    Laboratory Confirmed Cases

    Pandemic influenza activity remains low and sporadic cases of pandemic influenza continue to be reported without evidence of sustained community transmission (Figure 1). There were no laboratory confirmed pandemic (H1N1) 2009 cases diagnosed during this reporting period.

    In the same period, 14 confirmed cases of influenza have been diagnosed.1 They included 12 of type A not sub-typed (11 in Qld, 1 in WA), one of type A/H3N2 (Qld) and one untyped (WA).

    Figure 1. Laboratory confirmed cases of pandemic (H1N1) 2009 and total influenza in Australia, to 21 May 2010

    Figure 1. Laboratory confirmed cases of pandemic (H1N1) 2009 and total influenza in Australia, to 21 May 2010

    Note: Total influenza series starts on 1 January 2010 and excludes 14 confirmed cases with no known diagnosis/onset date.
    Source: NetEpi (2009; NSW 2010) and NNDSS (2010)



    There have been 741 confirmed cases of influenza of all types diagnosed during 2010 up to 21 May.2 Of those, 70 (9.4%) have been sub-typed as pandemic (H1N1) 2009, 562 (75.8%) as influenza type A not sub-typed, 7 (0.9%) as A/H3N2 and 6 (0.8%) as type A&B. A further 70 (9.4%) have been characterised as influenza type B and 26 (3.5%) have been untyped (Figure 2).

    Influenza type A not further sub-typed is the predominant type in Australia to date this year. While it is expected that the majority of this will be pandemic (H1N1) 2009, these cases have a higher age profile (median age 44 years) than cases confirmed as the pandemic (H1N1) 2009 strain (28.5 years in 2010). The proportion of women diagnosed with Influenza type A not further sub-typed is also higher (50.5%) compared to that diagnosed with the pandemic (H1N1) 2009 strain (45.7% in 2010).

    1 This number excludes 14 non-pandemic influenza cases reported this week with no known diagnosis/onset date.

    2 See above.



    Figure 2. Laboratory confirmed cases of influenza (pandemic (H1N1) 2009 and seasonal) in Australia, 1 January 2010 to 21 May 2010, by week and type

    Figure 2. Laboratory confirmed cases of influenza (pandemic (H1N1) 2009 and seasonal) in Australia, 1 January 2010 to 21 May 2010, by week and type

    Source: NNDSS and NetEpi (NSW).
    Note: excludes 14 confirmed non-pandemic influenza cases reported this week with no known diagnosis/onset date.



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    Influenza-Like Illness

    Sentinel General Practice Surveillance

    In the week ending 16 May 2010, national ILI consultation rates to GPs remained stable (Figure 3).

    Figure 3. Weekly rate of ILI reported from GP ILI surveillance systems from 1 January 2007 to 16 May 2010*

    Figure 3. Weekly rate of ILI reported from GP ILI surveillance systems from 1 January 2007 to 16 May 2010

    * Delays in the reporting of data may cause data to change retrospectively. As data from the NT surveillance system is combined with ASPREN data for 2010, rates may not be directly comparable across 2007, 2008 and 2009.
    SOURCE: ASPREN, and NT GP surveillance system.



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    WA Emergency Departments

    The number of respiratory viral presentations reported in Western Australian EDs in the week ending 16 May 2010, continue to show an upward trend (Figure 4).

    Figure 4. Number of respiratory viral presentations to Western Australia EDs from 1 January 2007 to 16 May 2010 by week

    Figure 4. Number of respiratory viral presentations to Western Australia EDs from 1 January 2007 to 16 May 2010 by week

    Source: WA ‘Virus Watch’ Report



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    NSW Emergency Departments

    In the week ending 14 May 2010, ILI presentations to NSW ED’s were low (1.2 per 1,000 presentations). This rate is higher than that for April (0.9 per 1,000 cases) but lower than the rate for the same period last year (2.3 per 1,000 presentations). One person who presented with ILI was admitted to hospital.

    Source: NSW Health ‘Influenza Weekly Epidemiology Report


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    Geographic spread of influenza and ILI – Jurisdictional Surveillance

    In the fortnight ending 14 May 2010, influenza and ILI activity as reported by state and territory Health Departments indicated that there was ‘syndromic only’ activity in one state (NT) and ‘sporadic’ activity in all other states (Figure 5).

    ‘Syndromic only’ activity is defined as an increase in syndromic surveillance systems during the reporting period, but with no laboratory-confirmed cases. ‘Sporadic’ activity is defined as small numbers of laboratory-confirmed influenza cases or a single laboratory-confirmed influenza outbreak during the reporting period, but no increase in cases in syndromic surveillance systems.

    Figure 5. Map of influenza and ILI activity, by state and territory, during fortnight ending 14 May 2010

    Figure 5. Map of influenza and ILI activity, by state and territory, during fortnight ending 14 May 2010
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    Flutracking

    Flutracking, a national online system for collecting data on ILI in the community, reported that in the week ending 16 May 2010, ILI levels continued to increase, particularly for unvaccinated participants, however levels remain low (Figure 6).

    Figure 6. Rate of ILI symptoms and absence from regular duties among Flutracking participants by week, from week ending 3 May 2009 to week ending 23 May 2010

    Figure 6. Rate of ILI symptoms and absence from regular duties among Flutracking participants by week, from week ending 3 May 2009 to week ending 23 May 2010

    Source: Flutracking Interim Weekly Report



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    National Health Call Centre Network

    The number of calls to the National Health Call Centre Network (NHCCN) decreased slightly this reporting period, and remains at baseline levels (Figure 7).

    Figure 7. Number of calls to the NHCCN related to ILI, Australia, 1 January 2009 to 21 May 2010

    Figure 7. Number of calls to the NHCCN related to ILI, Australia, 1 January 2009 to 21 May 2010

    Note: national data does not include QLD and VIC
    Source: NHCCN data



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    Deaths associated with influenza and pneumonia

    Death registration data show that as at 23 April 2010, there were 76 pneumonia or influenza deaths per 1,000 deaths in NSW, which is below the seasonal threshold of 108 per 1,000 (Figure 8).

    Figure 8. Rate of deaths classified as influenza and pneumonia from the NSW Registered Death Certificates, 2005 to 12 March 2010

    Figure 8. Rate of deaths classified as influenza and pneumonia from the NSW Registered Death Certificates, 2005 to 12 March 2010

    Source: NSW ‘Influenza Monthly Epidemiology Report’



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    Absenteeism

    In the week ending 14 May 2010, national absenteeism rates remained stable (Figure 9).

    Figure 9. Rates of absenteeism (greater than 3 days absent), national employer, from 28 January 2007 to 21 May 2010, by week



    SOURCE: Absenteeism data



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    Sentinel Laboratory Surveillance - confirmed influenza notifications

    Results from sentinel laboratory surveillance systems for this reporting period show that 1.6% (5/304) of the respiratory tests conducted over this period were positive for influenza (Table 1).

    Table 1. Laboratory respiratory tests that tested positive for influenza

      ASPREN* – national NSW NIC WA NIC NT
    (Reported by WA NIC)
    VIC NIC
    of specimens tested
    6
    64
    124
    N/A
    110
    Number tested which were Influenza A
    0
    0
    3
    0
    0
    Number tested which were pandemic (H1N1) 2009
    0
    0
    1
    0
    0
    Number tested which were seasonal A/H1N1
    0
    0
    0
    0
    0
    Number tested which were A/H3N2
    0
    0
    2
    0
    0
    Number tested which were Influenza A untyped
    0
    0
    0
    0
    0
    Number tested which were Influenza B
    0
    1
    1
    0
    0
    The most common respiratory virus detected
    N/A
    RSV & rhinovirus
    rhinovirus
    N/A
    picornavirus

    *ASPREN tests are collected every Tuesday. Results are reported for a rolling fortnight as data changes


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    2. Overview of influenza severity to 21 May 20103

    While pandemic (H1N1) 2009 is generally considered a mild disease at the community level, it has had serious consequences at the acute end of the disease. Figures of hospitalisations, ICU admissions and deaths are currently used as indicators of the severity of the disease in Australia (Table 2).

    Pandemic (H1N1) data for 2009 are currently being finalised through cleaning and validation processes. It is possible that these processes will result in some changes in the data presented here. Validated data will be progressively reported as these steps are completed.

    There have been a total of 37,706 confirmed cases of pandemic (H1N1) 2009 in Australia as at 21 May 2010, including 191 pandemic influenza-associated deaths. Of these, 37,636 cases were reported in 2009 and 70 cases were reported in 2010.

    Table 2. Summary of severity indicators of pandemic (H1N1) in Australia, 2009 and 2010 up to 21 May 2010

    2009# 2010a
      Confirmed pandemic
    (H1N1) 2009 cases
    Hospitalised cases ICU cases Deaths Confirmed (H1N1) 2009 cases
    Total number
    37,636
    13% (4,992/37,636) confirmed cases)
    14%
    (681/4,992 hospitalisations)
    191
    70
    Crude rate per 100,000 population
    172.1
    22.8
    3.1
    0.9
    0.3
    Median age (years)
    21
    31
    44^
    53^
    28.5
    Females
    51% (19,139/37,636)
    51% (2,528/4,992)
    53%
    (364/681)
    44%
    45.7%
    (32/70)
    Vulnerable groups (Indigenous persons, pregnant women & individuals with at least 1 co-morbidity)
    n/a
    58% (2,892/4,992)
    74%
    (504/681)
    67%
    n/a
    Indigenous people~
    11% (3,877/34,750)
    20%
    (808/4,048)
    19%
    (102/533)
    13%
    1.4%
    (1/70)
    Pregnant women*
    n/a
    27%
    (287/1,056 hospitalised females aged
    15-44 years)
    16%
    (47/289) hospitalised pregnant women)
    4%
    n/a
    Cases with at least 1 co-morbidity
    n/a
    46% (2,303/4,992)
    67%
    (457/681)
    62%
    n/a

    a Data for 2009 from NetEpi, Data for 2010 from NNDSS and NetEpi (NSW).
    #Data are extracted from a number of sources depending on the availability of information. Figures used in the analysis have been provided in parentheses. Data are not always complete for each summarised figure.
    ~The denominator for this row is the number of confirmed cases for which Indigenous status is known.
    * Includes women in the post-partum period.
    ^ Validation of data has identified anomalies affecting median ages for ICU cases and deaths in reports #28-33 2009 and report #1 2010. Correction has resulted in a change in the median ages of ICU cases and deaths from report #2, 2010.



    3. Note that while the analysis of severity is on-going, updates are presented as required when there are significant changes detected. With the current low levels of pandemic (H1N1) 2009 influenza activity in Australia it is anticipated that the indicators of pandemic severity will not vary significantly.


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    Influenza Hospitalisations

    The Influenza Complications Alert Network (FluCAN) reported no influenza hospitalisations from selected hospitals for the week ending 21 May 2010. For the period of 1 March to 21 May 2010, FluCAN has reported a total of eight influenza hospitalisations (Table 3 and Figure 10). Of those, four have been associated with pandemic (H1N1) 2009, including two with ICU admission.

    Table 3. Number of influenza hospitalisations, sentinel hospitals, Australia, 1 March to 21 May 2010

    Type of influenza Week ending
    7 May 2010
    Total
    1 March – 7 May
    Pandemic (H1N1)
    0
    4
    Type A/H3N2
    0
    1
    Type B
    0
    3
    All types
    0
    8

    Source: Influenza Complications Alert Network (FluCAN). Data are from 10 sentinel hospitals from all jurisdictions except ACT and NT.



    Figure 10. Number of influenza hospitalisations, sentinel hospitals, Australia, 1 March to 21 May 2010

    Figure 10. Number of influenza hospitalisations, sentinel hospitals, Australia, 1 March to 21 May 2010

    Source: FluCAN data from 10 sentinel hospitals in all jurisdictions except ACT and NT



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    Intensive care

    The Australian and New Zealand Intensive Care Society (ANZICS) has reported a total of seven ICU admissions for influenza in 2010, and none for this reporting period. Of these, three have been associated with pandemic (H1N1) 2009 influenza and four with Type A not further sub-typed (Figure 11).

    Figure 11. Number of ICU admissions for influenza, ANZICS, Australia, 1 January to 21 May 2010

    Figure 11. Number of ICU admissions for influenza, ANZICS, Australia, 1 January to 21 May 2010

    Source: Australian and New Zealand Intensive Care Society (ANZIC) data base


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    3. Virology

    Antigenic characteristics - WHO Collaborating Centre for Reference & Research on Influenza (WHO CC) in MelbourneFrom 1 January 2010 to 23 May 2010, there were 33 Australian influenza isolates subtyped by the WHO CC (Table 4).

    Table 4. Typing of influenza isolates from the WHO Collaborating Centre, from 1 January 2010 to 23 May 2010</strong>]

    Type/Subtype
    ACT NSW NT Qld SA Tas Vic WA TOTAL
    A(H1N1)
    0
    0
    0
    0
    0
    0
    0
    0
    0
    Pandemic (H1N1) 2009
    1
    0
    3
    7
    0
    1
    6
    2
    20
    A(H3N2)
    0
    0
    0
    0
    0
    0
    4
    0
    4
    B
    0
    0
    0
    0
    0
    0
    9
    0
    9
    Total
    1
    0
    3
    7
    0
    1
    19
    2
    33

    Source: WHO CC
    Please note: There may be up to a month delay on reporting of samples.
    Isolates tested by the WHO CC are not necessarily a random sample of all those in the community, hence proportions of pandemic (H1N1) 2009 to seasonal are not representative of the proportions circulating.



    Antigenic characterisation of 11 Pandemic (H1N1) 2009 isolates has shown 10 to be the A/California/7/2009-like strain and one a low reactor version of this strain.

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    International updates

    Pandemic (H1N1) 2009 influenza virus accounted for 80.9% of all influenza A viruses subtyped globally by the WHO Collaborating Centres in the week ending 21 May 2010. Sporadic influenza A(H1N1) and A(H3N2) was reported from China, the Russian Federation, Ghana, Kenya and Thailand. Seasonal Influenza B viruses are now the predominant influenza virus accounting for 89.6% of all influenza detections in the Russian Federation, 90.8% in China, 90.9% in Republic of Korea, and 100% in Cameroon and Iran. 1

    In China, influenza B accounted for 90.8% of all influenza viruses detected in the week to 16 May 2010. From 1 September 2009 to 16 May 2010, 3731 influenza B viruses have been antigenically characterised. Of those, 3349 (89.8%) were B/Victoria viruses, including 47.9% (1604) related to B/Malaysia/2506/2004-like and 52.1% (1745) related to B/Brisbane/60/2008 (included in 2010 Southern Hemisphere seasonal influenza vaccine). The remaining 382 (9.1%) were B/Yamagata viruses related to B/Florida/4/2006-like. 2

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    Antiviral resistance

    Pandemic (H1N1) 2009

    The WHO has reported that 289 oseltamivir resistant pandemic (H1N1) 2009 viruses have been detected and characterised worldwide. All but one of these isolates showed the same H275Y mutation but were sensitive to zanamivir.8

    The WHO Collaborating Centre in Melbourne has reported that from 1 January 2010 to 23 May 2010, 10 isolates were tested and none have shown resistance to oseltamivir by enzyme inhibition assay (EIA) and two out of 13 clinical specimens collected in Australia have shown the H275Y mutation known to confer resistance to oseltamivir (Table 5).

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    4. International Influenza Surveillance

    WHO Summary as at 16 May 2010
    • There have been over 18,097 deaths associated with pandemic (H1N1) 2009 worldwide.
    • Northern Hemisphere
      • The most active areas of pandemic influenza virus transmission are in parts of the Caribbean and Southeast Asia.
      • Overall pandemic influenza activity remains low to sporadic.
      • Seasonal influenza type B viruses:
      • Continue to circulate at low levels, and
      • are the predominant influenza virus in China, Russian Federation, the Republic of Korea, Cameroon and Iran.
    • Southern Hemisphere
      • Pandemic and seasonal influenza activity is sporadic.
      • Australia and New Zealand have reported slight increases in ILI activity
      • Chile continues to report localized areas of increased ILI activity associated with pandemic influenza and other respiratory viruses.
    Recent influenza activity in selected areas of the Northern and Southern Hemispheres is shown in Table 5.

    Table 5. International influenza surveillance by country/region for the most recent reporting week

    Country/region End date of most recent reporting week in 2010 Overall influenza activity level & trend Proportion of GP visits that were for ILI Respiratory tests positive for influenza Influenza which was influenza A Influenza A which was pandemic (H1N1) 2009 Influenza A which was untyped Influenza which was influenza B
    Northern Hemisphere
    USA3
    15 May
    Low & decreasing
    0.8%
    0.9% (14/1,621)
    100%
    (14)
    28.6%
    (4)
    71.4%
    (10)
    0%
    (0)
    Canada4
    15 May
    Low & stable
    1.1%
    0.15% (2/1,365)
    0^
    0^
    0^
    2^
    Europe5
    16 May
    Low & stable or decreasing
    Not reported
    5.2%
    (6/115)
    4^
    3^
    1^
    2^
    UK6
    16 May
    Low & stable
    ≤0.03
    0%
    (0/31)
    N/A
    N/A
    N/A
    N/A
    China2
    16 May
    Low & stable
    3. 4–3.9%
    6.9% (187/2,717)
    21.9%
    (41)
    39.0%
    (16)
    0.0%
    (0)
    78.1%
    (146)
    Southern Hemisphere*
    NZ7
    16 May
    Low & increasing
    0.03%
    3.9%
    (2/51)
    2^
    2^
    0^
    0^
    Chile8
    20 May
    Low & increasing
    N/A
    9%
    (18/647)
    100%
    (18)
    55.6%
    (10/18)
    44.4%
    (8/18)
    Australia
    21 May
    Low & increasing
    0.5%
    1.6%**
    (5/304)
    60%**
    (3/5)
    1^**
    0^**
    2%**
    (2/5)

    ^ Numbers only. Percentages not calculated due to small numbers.
    * Chile and Argentina have not been included in this table this reporting period, because the online influenza surveillance reports for these countries have not been updated since January and February, respectively.
    **Source: Sentinel Laboratory Surveillance (see Table 1)


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    5. Data considerations

    The information in this report is reliant on the surveillance sources available to the Department of Health and Ageing. As access to sources increase and improve, this report will be refined and additional information will be included.

    This report aims to increase awareness of pandemic (H1N1) 2009 and seasonal influenza in Australia by providing an analysis of the various surveillance data sources throughout Australia. While every care has been taken in preparing this report, the Commonwealth does not accept liability for any injury or loss or damage arising from the use of, or reliance upon, the content of the report. Delays in the reporting of data may cause data to change retrospectively. For further details about information contained in this report please contact the Influenza Team through flu@health.gov.au

    On 17 June 2009 Australia commenced the transition to a new response phase called PROTECT, in which laboratory testing is directed towards people with moderate or severe illness; those more vulnerable to severe illness; and those in institutional settings. This means that the number of confirmed cases does not reflect how many people in the community have acquired pandemic (H1N1) 2009 infection.

    NetEpi

    In 2009, NetEpi, a web-based outbreak case reporting system for pandemic (H1N1) 2009, was used as the primary source of enhanced data on confirmed cases, hospitalisations and ICU admissions in all jurisdictions. In 2010, only data for NSW are sourced from NetEpi.

    Analyses of Australian cases are based on the diagnosis date, which is the earliest of the onset date, specimen date or notification date.

    National Notifiable Diseases Surveillance System (NNDSS)

    Laboratory confirmed influenza (all types) is notifiable in all jurisdictions in Australia. Confirmed cases of influenza are notified through NNDSS by all jurisdictions except NSW. NSW data are sourced from NetEpi.

    Data Analysis

    Analysis of confirmed influenza cases is conducted on combined NetEpi and NNDSS data. Analysis of morbidity (hospitalisations and ICU admissions) and mortality data in 2009 has been conducted on combined NetEpi and QLD hospitalisation data.

    Laboratory Surveillance data

    Laboratory testing data are extracted from the ‘NSW Influenza Report,’ and the ‘The 2009 Victorian Influenza Vaccine Effectiveness Audit Report’ (VIDRL) ‘South Australian Seasonal Influenza Report’. These reports are provided weekly.

    WHO Collaborating Centre for Reference & Research on Influenza (WHO CC)

    Data are provided weekly to the Surveillance Branch from the WHO CC.

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    Sentinel General Practice Surveillance

    The Australian Sentinel Practices Research Network (ASPREN) has Sentinel GPs who report ILI presentation rates in NSW, SA, ACT, VIC, QLD, TAS and WA. As jurisdictions joined ASPREN at different times and the number of GPs reporting has changed over time, the representativeness of ASPREN data in 2009 may be different from that of previous years. ASPREN data are sent to the Surveillance Branch on a weekly basis. Northern Territory GP surveillance data are sent to the Surveillance Branch on a weekly basis. VIDRL influenza surveillance data are sent to the Surveillance Branch on a weekly basis.

    Further information on Sentinel GPs’ Influenza Surveillance and ASPREN activities are available at www.dmac.adelaide.edu.au/aspren

    Sentinel ED data

    WA - ED surveillance data are extracted from the ‘Virus Watch’ Report. This report is provided weekly. The Western Australia Influenza Surveillance Program collects data from eight Perth EDs.
    NSW - ED surveillance data are extracted from the ‘Influenza Monthly Epidemiology Report, NSW’. This report is provided monthly. The New South Wales Influenza Surveillance Program collects data from 49 EDs across New South Wales.

    Absenteeism

    A national organisation provides data on the number of employees who have been on sick leave for a continuous period of more than three days. These data are not influenza or ILI specific and absenteeism may be a result of other illnesses.

    National Health Call Centre Network

    A national organisation provides call centre data for calls relating to ILI or influenza. Data are provided daily and are collated weekly and have been presented in this report to show the pattern of calls to this Call Centre over the 2009 season. Data is available for all jurisdictions other than QLD and VIC.

    FluTracking

    FluTracking is a project of the University of Newcastle, the Hunter New England Area Health Service and the Hunter Medical Research Institute. FluTracking is an online health surveillance system to detect epidemics of influenza. It involves participants from around Australia completing a simple online weekly survey, which collects data on the rate of ILI symptoms in communities.
    Data have been provided weekly and have been presented in this report to show the pattern of self reported ILI in the community over the 2009 season.

    Further information on FluTracking is available at www.flutracking.net/index.html

    FluCAN

    The Influenza Complications Network (FluCAN) collects detailed clinical information on all hospitalised cases of influenza and pneumonia from a sample of 13 sentinel hospitals across Australia. The data for this reporting period are sourced only from ten hospitals and do not include ACT and NT.

    Australian and New Zealand Intensive Care Society data (ANZICS data)

    The Australian and New Zealand Intensive Care Society provides data from a `near real time` registry of patients admitted to Australian ICUs. This documents the key factors influencing mortality, as well as the need for hospitalisation and mechanical ventilation. Information collected includes person characteristics and information on relevant co-morbidities, nature of the clinical syndrome associated with pandemic (H1N1) 2009, major therapeutic interventions from which organ failure outcomes can be imputed, vaccination status and vital status at time of ICU discharge and hospital discharge.

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    6. References

    1. WHO Pandemic (H1N1) 2009 - Update 101 & Virological Surveillance Weekly Update. Available from http://www.who.int/csr/don/en/ Accessed 26 May 2010.
    2. Chinese National Influenza Centre Influenza Weekly Report 16 May 2010. Available from: http://www.cnic.org.cn/eng/ Accessed 26 May 2010.
    3. CDC FluView Weekly report, Week 19 ending 15 May 2010. Available from: http://www.cdc.gov/flu/weekly/ Accessed 26 May 2010.
    4. Canada FluWatch Weekly report, week 19 ending 15 May 2010. Available from: http://www.phac-aspc.gc.ca/fluwatch/09-10/index-eng.php Accessed 26 May 2010.
    5. ECDC pandemic update, week 19 ending 16 May 2010. Available from: http://ecdc.europa.eu/en/activities/surveillance/EISN/Pages/EISN_Bulletin.aspx Accessed 26 May 2010.
    6. HPA weekly pandemic flu media update. Week 20, ending 16 May. Available from: http://www.hpa.org.uk/web/HPAweb&Page&HPAwebAutoListName/Page/1243928258560 Accessed 26 May 2010.
    7. New Zealand Ministry of Health Influenza Weekly Update. Week 19, ending 16 May 2010. Available from: http://www.surv.esr.cri.nz/virology/influenza_weekly_update.php Accessed 26 May 2010
    8. Chile Ministry of Health, Influenza A(H1N1) Weekly Report as at 20 May. Available at http://www.pandemia.cl/ Accessed 20 April 2010