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National Influenza Sentinel Surveillance Viet Nam: 2006-2007 US CDC Collaboration and WHO Global Surveillance Network Partnership Nguyen Thanh Chung, MD,

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Presentation on theme: "National Influenza Sentinel Surveillance Viet Nam: 2006-2007 US CDC Collaboration and WHO Global Surveillance Network Partnership Nguyen Thanh Chung, MD,"— Presentation transcript:

1 National Influenza Sentinel Surveillance Viet Nam: 2006-2007 US CDC Collaboration and WHO Global Surveillance Network Partnership Nguyen Thanh Chung, MD, NIHE

2 National reports of ILI 1996-2005

3 General objectives Obtain epidemiological and virological information to guide influenza prevention and control policies and activities Obtain epidemiological and virological information to guide influenza prevention and control policies and activities Establish a sustainable national influenza surveillance network in Vietnam Establish a sustainable national influenza surveillance network in Vietnam

4 Specific Objectives  Determine influenza impact and seasonality  Rapidly detect outbreaks  Monitor circulating strains  Contribute to influenza prevention and control  Contribute to global surveillance and selection of virus strains for vaccine production

5 Organization NIHE Regional Institutes VAPM PMCs MOH Sentinel Sites CDC/WHO partners

6 Organizational network of Institutes and sentinel sites NIITD dAK LAK tHAI BINH HCMc TDH HCMC PH #1 BA TRIEU Moh/CDC/who/NIHE KHANH HOA TAY NGUYEN HCMC NIHE Tt. HUE LANG SON HOA BINH NPH THANH XUAN dONG NAI TIEN GIANG DA NANG CITY NHATRANG

7 Sentinel site characteristics   Major ecological regions represented   Adult and pediatric populations served   Different levels of health services Central referral hospitals Provincial hospitals District hospitals Polyclinics / health centers

8 Case definition ILI (WHO)  Sudden onset of fever >38°C  Cough and/or sore throat  Absence of another diagnosis  Onset illness within 3 days for cases selected for PCR testing

9 ILI surveillance methods   Total patient and ILI consultations recorded weekly at each site   First 2 ILI patients each day sampled for investigation   Throat swab collected and transported to regional laboratory   RT-PCR testing at regional laboratories   Virus sub-typing and isolations made if PCR +

10 ILI surveillance Results

11 Total and ILI outpatient visits by sentinel site No.Sentinel Site Total Number Patient Visits Number ILI Patient Visits Percent ILI Visits (%) 01NIITD, Hanoi 277137752,8 02Natl. Ped. Hosp., Hanoi 2516647593830,2 03Ped. Hosp. #1, HCMC 154042131278,5 04Hosp. Trop. Dis., HCMC 1082101986218,4 05Khanh Hoa Prov. Hospital 341891044730,6 06Dac Lac Prov. Hospital 422461117226,4 07Kien Xuong Dist. Hospital 2590653209912,4 08Hoa Binh Dist. Hospital 3870328637,4 09Cao Loc Dist. Hospital 2300915636,8 10Huong Thuy Dist. Hospital 6077017762,9 11Ba Trieu Clinic, Hanoi 2020015447,6 12Thanh Xuan Clinic, Hanoi 2355514226 13Thanh Khe Dist. Hospital 3198822637,1 14Xuan Loc Dist. Hospital 5292032306,1 15Cai Be Dist. Hospital 51635644012,5 All sentinel sites 117990918452115,6 Sites no. 08, 09, 11 and 12 initiated surveillance on June, 1st 2006 Sites no. 13, 14, and 15 initiated surveillance on June, 1st 2007

12 RT-PCR positive ILI cases, by sentinel sites No. Sentinel site Number ILI patients tested Number (%) A/H1 positive Number (%) A/H3 positive Number (%) A undeter- mined Number (%) Influenza B positive Number (%) total Influenza Positive 01NIITD, Hanoi 62247 (7.6)56 (9)063 (10.1)166 (26.7) 02Natl. Ped. Hosp., Hanoi 86976 (8.7)97 (11.2)169(7.9)243(28.0) 03Ped. Hosp. #1, HCMC 100069(6.9)90(9.0)077(7.7)236(23.6) 04Hosp. Trop. Dis., HCMC 99939(3.9)23(2.3)052(5.2)114(11.4) 05Khanh Hoa Prov. Hospital 100053(5.3)88(8.8)256(5.6)199(19.9) 06Dac Lac Prov. Hospital 100127(2.7)63(6.3)062(6.2)152(15.2) 07Kien Xuong Dist. Hospital 100037(3.7)58(5.8)059(5.9)154(15.4) 08Hoa Binh Dist. Hospital 80154(6.7)71(8.9)012(1.5)137(17.1) 09Cao Loc Dist. Hospital 68242(6.2)43(6.3)012(1.8)97(14.2) 10Huong Thuy Dist. Hospt. 83555(6.6)81(9.7)044(5.3)180(21.6) 11Ba Trieu Clinic, Hanoi 62840(6.4)60(9.6)014(2.2)114(18.2) 12Thanh Xuan Clinic, Hanoi 77843(5.5)105(13.5)012(1.5)160(20.6) 13Thanh Khe Dist. Hospital 3098(2.6)47(15.2)014(4.5)69(22.3) 14Xuan Loc Dist. Hospital 2780(0.0)33(11.9)025(9.0)58(20.9) 15Cai Be Dist. Hospital 2800(0.0)19(6.8)014(5.0)33(11.8) All sites 11082590(5.3)934(8.4)3585(5.3)2112(19.1) Sites no. 08, 09, 11 and 12 initiated surveillance on June, 1st 2006 Sites no. 13, 14, and 15 initiated surveillance on June, 1st 2007

13 Influenza percent positive by region

14 Influenza types/subtypes circulating in Viet Nam, 2006-2007 (N=2112 virus detections)

15 Percent of ILI testing positive for influenza A/H1N1, by month and region

16 H1N1 subtype, 2007 Results of Sequencing H1N1 subtype in 2007 had 99% homology with A/Solomon Islands/3/2006 subtype H1N1 subtype in 2007 had 99% homology with A/Solomon Islands/3/2006 subtype H1N1 subtypes isolated in Vietnam were homologous with the subtype selected for flu vaccine production in 2007 H1N1 subtypes isolated in Vietnam were homologous with the subtype selected for flu vaccine production in 2007

17 Percent of ILI testing positive for influenza A/H3N2, by month and region

18 H3N2 subtype, 2007 H3N2 subtype in 2007 showed 99% sequencing homology with A/California/UR06-0463/2007 subtype H3N2 subtype in 2007 showed 99% sequencing homology with A/California/UR06-0463/2007 subtype H3N2 subtypes isolated in 2007 in Vietnam differed from the subtype used for flu vaccine production in 2007. H3N2 subtypes isolated in 2007 in Vietnam differed from the subtype used for flu vaccine production in 2007.

19 Percent of ILI testing positive for influenza B, by month and region

20 B flu virus subtype, 2007 B subtype in 2007 showed 99% sequencing homology with B/Florida/02/2006 subtype B subtype in 2007 showed 99% sequencing homology with B/Florida/02/2006 subtype B subtypes isolated in Vietnam in 2007 were homologous with the virus used for vaccine production in 2007. B subtypes isolated in Vietnam in 2007 were homologous with the virus used for vaccine production in 2007.

21 ILI results summary  ILI is a major health care burden  High proportion ILI cases are influenza  Influenza detected all times of year, in all regions, at all sites  All common subtypes endemic  Seasonal fluctuations occur in subtype activity  Regional synchrony subtype activity observed

22 Challenges  Achieve greater efficiency, sustainability  Apply results to policies and practices  Capabilities strengthening needed all levels  Strengthen lab and epidemiology ties  Strengthen links human and animal sectors  Increase scientific collaborations, publications  Increase role in WHO Global Network

23 Thank You

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