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Update of influenza metadata

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Presentation by Eeva Broberg and Cornelia Adlhoch of ECDC at the Joint WHO/Europe & ECDC Annual Influenza Surveillance Meeting, Vienna, Austria, 11–13 June 2014.
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Update of influenza metadata Joint WHO/Europe & ECDC Annual Influenza Surveillance Meeting Vienna, 11-13 June 2014 Eeva Broberg and Cornelia Adlhoch, ECDC Special thanks to: Neli Korsun (BU), Martina Havlíčková (CZ), Ramona Trebbien (DK), Niina Ikonen (FI), Vincent Enouf (FR), Istvan Jankovics (HU), Natalija Zamjatina (LV), Adam Meijer (NL), Karoline Bragstad (NO), Karolina Bednarska (PL), Raquel Guiomar (PT), Emilia Lupulescu (RO), Helena Dahl (SE), Katarina Prosenc (SI) and Edita Staronova (SK)
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Page 1: Update of influenza metadata

Update of influenza metadata

Joint WHO/Europe & ECDC Annual Influenza Surveillance Meeting

Vienna, 11-13 June 2014

Eeva Broberg and Cornelia Adlhoch, ECDC

Special thanks to: Neli Korsun (BU), Martina Havlíčková (CZ), Ramona Trebbien (DK), Niina Ikonen (FI), Vincent Enouf (FR), Istvan Jankovics (HU), Natalija

Zamjatina (LV), Adam Meijer (NL), Karoline Bragstad (NO), Karolina Bednarska (PL), Raquel Guiomar (PT), Emilia Lupulescu (RO), Helena Dahl (SE), Katarina

Prosenc (SI) and Edita Staronova (SK)

Page 2: Update of influenza metadata

Principles

1. Do not collect data if it is not used

2. Collect data for action

3. Use data to set priorities for the use of resources

Analysis

Interpretation Action

Data collection

Page 3: Update of influenza metadata

Serology

• Objective has been to provide detections by serology, e.g. for

cases with prolonged symptoms

• High numbers from non-sentinel, very few data from sentinel surveillance

• 7 - 9 countries reporting, in 2013-2014 AT, BG, FR, LV, NO, SK and UK

Page 4: Update of influenza metadata

Serology vs. detections • Seasonality detected also through serology

• All aggregated data, e.g. no age groups available

• How should the data be used? – Should we focus rather on serosurveys?

– What should be the timeline of reporting?

– How should we analyse and interpret the data?

Page 5: Update of influenza metadata

Country comments on serology

• Serology used when more time has elapsed since onset of disease

• Used only upon request of a clinician

• For detections IgM, IgA and IgG ELISA tests in use (e.g. Euroimmun)

• In some countries, not possible to differentiate between sentinel and nonsentinel

• Weekly data across countries from various laboratories

• Some countries perform serosurveys but TESSy does not capture age-groups

Page 6: Update of influenza metadata

Serology variable completeness

• A proposal:

– RSV serology variables to be inactivated

Page 7: Update of influenza metadata

Isolation • No denominator variable available

• Data collection started as a project for vaccine candidate selection

• In general, few isolations reported, 5-8 countries per season, in 2013-2014 only CZ, FI, PT, SE and SK

• How should these variables be used?

Page 8: Update of influenza metadata

Egg isolation variables

• No denominator

• 21 specimens by 3 countries over 2 seasons

• A proposal: all egg isolation variables to be inactivated

Page 9: Update of influenza metadata

Country comments on isolations • Selection of samples based on Ct value of RT-PCR / severity /

subtypes / time of season / travel history / variant strains / resistant strains / vaccine failures

• “Expertise test”, obligation of NIC

• Production of good quality viral RNA for sequencing

• Needed for vaccine composition and phenotypic characterisation

• Egg isolation rarely used, some use only for animal strains

• Important to retain the geographic distribution of data throughout the European Region

• A(H1N1)pdm09 has not been added to isolation variables separately

Page 10: Update of influenza metadata

Strain-based reporting

• Collection of antiviral susceptibility, antigenic and genetic characterisation data

• No denominator data available as not all countries report “negative” results

• Can we agree on a characterisation algorithm?

Page 11: Update of influenza metadata

Courtesy of Natalia Zamjatina, Latvian Centre of Infectious Diseases , National Microbiology Reference Laboratory, NIC of Latvia.

Page 12: Update of influenza metadata

Questions 1. Should we keep or inactivate RSV serology variables?

2. How should the serology variables be best used?

3. Should we keep influenza virus isolation variables for weekly reporting, or should we consider an end/of/season reporting? Should we keep or inactivate the influenza egg isolation variables?

4. What would be the denominator data for isolations and should such aggregate variable be added?

5. Should we add denominator variable for the influenza antiviral susceptibility testing and characterisations in aggregate reporting?

6. Do we need to add variables to strain-based data?

a. Isolated? Yes/No

b. Sent to WHO CC? Yes/No

c. Streamline with GISAID variables?

7. Volunteers to be in a metadata reference group?


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