Wrap-up of Day 1

Plenary One: Regional and Global Update Update of global situation and response to pandemic (H1N1) Dr Wenqing Zhang Regional situation and repose update on the pandemic (H1N1) 2009 – Dr Takeshi Kasai WPRO regional activities report and preparation for the upcoming season – Dr Weigong Zhou

Summary of Plenary One (1) Global situation of pandemic (H1N1) – Southern / Northern / Tropical – Virological surveillance (genetic / antiviral susceptibility) – Vaccine development (availability / strategies / SAGE recommendations) Regional situation and response to pandemic (H1N1) – Regional situation (epidemiology including fatal cases) – Action-oriented risk assessment (assessment – mangament) – Monitoring pandemic impact – Framework for action (Command / Surveillance / Health care system response / PH Intervention / Communication)

Summary of Plenary One (2) Regional activities – Work-plan by 2010: For Comprehensive National Influenza Surveillance System – Influenza surveillance guidance developed – Preparing upcoming influenza seasons in the middle of pandemic Surveillance – Disease / virological / sARI / outbreak events – Pandemic H1N1 / H5N1 / Seasonal influenza / others? Response – Appropriate public health interventions

Plenary Two: Influenza Surveillance (Seasonal and Pandemic) Influenza surveillance in China - Dr Shu Yuelong Update on surveillance findings in season in Southern Hemisphere – Dr Ian Barr Update on surveillance findings in season in Northern Hemisphere – Dr Takato Odagiri WHO guidelines on pandemic surveillance and FluID – Dr Tim Nguyen

Summary of Plenary Two (1) Surveillance in China – National network incl. 411 labs and 556 sentinel hospitals – Internet Based Surveillance Information System – Detailed analysis on large number of isolates – Pandemic H1N1 situation in China Update of findings in Southern Hemisphere – Majority of isolates: Pandemic H1N1 – Hospitalizations / ICU cases / deaths – Excess mortality lower than normal

Summary of Plenary Two (2) Update of findings in Northern Hemisphere – Analysis of Seasonal H1N1, H3N2, and B Antigenic characteristics Genetic characteristics Antiviral susceptibility Pandemic surveillance and FluID – Shifting Information Needs (Early detection / Description and assessment / Monitoring) – Tool for data collection and dissemination (IHR notification / Reporting form / FluNet) – FluID: New tool for data collection and motoring

Plenary Three: NIC’s roles in pandemic preparedness and response NIC’s roles during pandemic and NIC contingency plan - Dr Wenqing Zhang Update on monitoring antiviral resistance – Dr Aeron Hurt Update on WHO EQAP – Dr Wilina Lim Update on WPRO NIC database development – Dr Aeron Hurt

Summary of Plenary Three (1) NIC Roles during pandemic and contingency plan – NIC role during pandemic Phase 4 Phases 5-6 After pandemic – NIC Contingency Plan Surge capacity / Availability of premises, staff and equipment / Stockpiling supplies / Testing strategies, protocols, algorithms / Lab bio-safety and transport of specimens/ Communication Monitoring of antiviral Resistance – Increasing oseltamivir resistance of seasonal H1N1 – Oseltamivir resistance H1N1 pandemic virus: Sporadic cases / No evidence of further transmission – Current testing : Phonotypic assay / Genetic analysis – Adamantanes resistance

Summary of Plenary Three (2) EQAP – Methodology – Participatinglabs are increasing. – Results: improving performance – GLP Survey: Some factors for low performance – Regular EQAP required NIC Database – New tool for NIC – Three NICs are currently using (CHN, PHP, VTN) – Useful and easy to use – Some country adaption required

Plenary Discussions Severity index in global plan Protective immunity in elderly Sero-prevalnce studies Bio-safety (BSL3 vs. BSL2)

Key Point from Day 1

Expanding Roles of NIC sARI Surveillance Virological Surveillance Disease Surveillance H5N1 Response Event Based Surveillance Pandemic Preparedness Communication Pandemic Response (NIC’s role during pandemic) Contingency Plan

Models tell us that a pandemic is look like: 8 Weeks

sARI Surveillance Virological Surveillance Disease Surveillance H5N1 Response Event Based Surveillance Pandemic Preparedness Communication

Pandemic Response (NIC role during pandemic) Contingency Plan

sARI Surveillance Virological Surveillance Disease Surveillance H5N1 Response Event Based Surveillance Pandemic Preparedness Communication

Real H1N1 Pandemic Seasonal Influenza H5N1 Threat

sARI Surveillance Virological Surveillance Disease Surveillance H5N1 Response Event Based Surveillance Pandemic Preparedness Pandemic Surveillance Pandemic Response Communication Contingency Plan

Influenza Surveillance Key to Success Influenza Virus Outbreak Events Influenza Disease sARI

Influenza DiseaseInfluenza Virus Outbreak EventssARI FluID Lab Database EQAS Contingency Plan Supporting Tools / Systems Comprehensive National Influenza Surveillance System Seasonal Influenza H5N1 Others Pandemic H1N1

Comprehensive National Influenza Surveillance System