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1 Influenza activity in the Southern Hemisphere Ian Barr WHO CC for Reference & Research on Influenza Melbourne www.influenzacentre.org The Melbourne WHO.

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Presentation on theme: "1 Influenza activity in the Southern Hemisphere Ian Barr WHO CC for Reference & Research on Influenza Melbourne www.influenzacentre.org The Melbourne WHO."— Presentation transcript:

1 1 Influenza activity in the Southern Hemisphere Ian Barr WHO CC for Reference & Research on Influenza Melbourne www.influenzacentre.org The Melbourne WHO Collaborating Centre for Reference and Research on Influenza is supported by the Australian Government Department of Health and Ageing.

2 Recap on the 2010 Australian season More normal “Influenza” season –High levels of vaccination/exposure to H1N1pdm pre-season –Season began in June-July (2009 May-June) –Peaked in September (2009 Aug) –Late season cases seen in Dec 10 and Jan 11 Characteristics of season –Mainly Pandemic H1N1 viruses in Aus/ (& NZ) –Milder than 2009 season –Fewer admissions to ICU and deaths – Some vaccine breakthroughs recorded

3 Pandemic H1N1 severity up to November 5 2010 Australian Influenza Surveillance Report

4 Influenza vaccines used in Australia and NZ in 2010 H1N1pdm – A/California/7/2009 –(circulating strain: A/California/7/2009-like) H3 – A/Perth/16/2009 (circulating strain: A/Perth/16/2009-like) B - B/Brisbane/60/2008 (B/Victoria lineage) (circulating strain: B/Brisbane/60/2008-like – B/Victoria lineage)

5 Vaccine breakthroughs in 2010 in Australia Pandemic H1N1 2009 cases –Outbreak at HMS Cerebus (Victoria) in October 2010 –>30 cases (24 influenza proven positive H1N1pdm) –First 30 hospitalized (precautionary), no deaths, ICU –All vaccinated (?seasonal or pandemic) –Formed a distinct genetic clade (only one other virus seen in this group from Canberra) –Unable to determine antigenic characteristics as only RNA available H3N2 cases –Multiple reports (Nov/Dec) from Qld aboriginal settlements eg Townsville –? Hospital admissions, ? ICU, ? deaths –All vaccinated with 2010 seasonal vaccine –Genetically fell into A/Perth/10/2010 group (same as most Aus, H3’s) –Antigenically similar to A/Perth/16/2009 viruses (ie vaccine strain) B cases –None reported –n

6 Google flu trends mapping world influenza As at 3.6.11 www.google.org/flutrends www.google.org/flutrends Sth Hemisphere 7 Sth American Sth Africa Australia New Zealand

7 Google flu trends Australia and NZ As at 3.6.11 www.google.org/flutrends

8 Google flu trends South Africa As at 6.6.11 www.google.org/flutrends

9 Also now Google Dengue Trends As at 6.6.11 www.google.org/fdenguetrends Brazil Brazilian data Google Dengue trends Currently: Brazil Bolivia Indonesia India Singapore

10 ILI in Australia (2008-11)

11 ILI in NZ (2009-11) Source: ESR: Influenza Weekly Update 23-29 May 2011

12 Lab confirmed influenza cases in Australia 2005-11 (NNDSS) November 2010-May 2011 x4 influenza cases of 2010

13 Flunet data for Southern Hemisphere

14 Samples types received by Melbourne CC YearOCSVirus Isolates Ratio Isolates:OCS 20062218023.6 200744013553.1 200828014135.1 2009194412100.62 2010123510130.82 20112783691.32

15 Influenza viruses received and analysed at WHO CC for influenza 1.1.2011 – 31.5.2011 Type B Type A(H3) Type A(H1) Countries supplying samples in 2011 n=393 n=3 n=25 n=18 n=6 Pandemic (H1N1) 2009 n=27 n=16

16 A/California/7/2009 - Vaccine strain A/Brisbane/70/2011-like Main group in 2011 A/Christchurch/16/2010-like Main group in 2010 A/Perth/30/2011-like Regional group in 2011 H1N1pdm HA genes

17 A/Perth/16/2009 - Vaccine strain A/Perth/10/2010-like Main group in 2010-11 A/Victoria/2008-like Common in 2010 A/Perth/16/2009-like Few viruses in 2010 0.01 SriLanka/7/10 May Nauru/17/11 Feb Guadeloupe/202/10e Aug Victoria/552/10 Aug Victoria/506/11 Jan Victoria/650/10 Oct Brisbane/1/11 Jan Singapore/630/10 May vax Singapore/616/10 Jul vax Perth/49/10 Aug cdc Wisconsin/15/09e Jun Brisbane/217/10 Aug SriLanka/9/09 Jul Townsville/105/10 Nov Townsville/34/11 Feb SuratThani/269/10 Mar Victoria/103510 Oct NewYork/05/10cdc Mar 11S0802 Sep Brisbane/210/10e Singapore/11/11 Jan Perth/501/10e May Brisbane/220/10e NewCaledonia/2/11 Feb Chrischurch/25/10 Aug Victoria/210/09e Jun cdc Bolivia/317/10 May Alaska/5/10e Aug Nothaburi/488/10 Aug cdcMaine/02/10 Dec VICTORIA/208/09e Jun Perth/56/10 Aug Brisbane/258/10 Oct Singapore/516/10 Apr Fiji/52/10 Dec Townsville/3/11 Jan PERTH/16/09e Apr WestSepik/12/09 Aug SthAuckland/15/10 Jul Darwin/6/11 Jan Brunei/204/10 Nauru/19/11 Feb PortMoresby/2/09e Jun Townsville/60/10 Philippines/5229/10 Nov Nauru/5/11 Jan Canberra/11/10 Aug Townsville/87/10e Nov cdc Italy/540/10 May Victoria/1031/10 Oct Christchurch/1/11 Feb Victoria/8/10e Aug PHILIPPINES/16/09 Mar Singapore/521/10 Apr Townsville/7/11 Jan Kiribati/6/09 Jul Sydney/13/10 Aug Iowa/19/10e Dec SriLanka/3/10 Jul Brunei/203/10 Brisbane/253/10 Sep NewCaledonia/3/11 Feb Tasmania/2/11 Feb Townsville/97/10vax Dec Bangkok/132/09 May Johannesburg/50/10 Jul BRISBANE/10/07e Feb cdc Panama/307149/10 Jun NewCaledonia/4/11 Feb Darwin/14/11 Feb NewCaledonia/5/11 Feb cdc Iowa/07/10 Jul Arizona/13/10e Jun Townsville/20/11 Jan Cambodia/1/10 Jun Townsville/100/vax Dec PERTH/10/10e Brisbane/31/10 Jul Fiji/41/10 Nov Canberra/20/09 Jul Canberra/2/10 Jun Townsville/98/10 Dec cdc Honduras/6065/10 Apr 2010 H3 Consensus Singapore/13/11 Jan SuratThani/116/10 Feb Brunei/208/10 Victoria/500/11 Jan Townsville/93/10 Dec Victoria/1034/10 Oct Singapore/512/10 Apr Victoria/563/10e Chrischurch/49/10 Sept RhodeIsland/1/10e Jan Cambodia/15/09 Jun Victoria/4/10 May Townsville/106/10 Nov Townsville/48/11 Mar BRISBANE/11/10e May Townsville/104/10 Nov Fiji/38/10 Oct cdc Kenya/1632/10 Apr Perth/673/09 Nov Christchurch/3/11 Feb cdcWyoming/09/10 Dec Townsville/117/10vax Dec Nauru/3/11 Jan Newcastle/4/10 Jun Townsville/92/10vax Dec Perth/324/09 Jul Chuuk/3/09 Jun Darwin/25/11 Feb WestSepik/20/09 Sep Christchurch/50/10 Sep cdc Alabama/5/10 Jul Singapore/534/09 Nov Tasmania/8/09 Jun Townsville/102/10 Nov Victoria/1201/10vax Sep Singapore/617/10 jul Townsville/86/10 Nov Brisbane/252/10 Sept SthAustralia/414/10 Oct Brisbane/100/09 Jul H3 4May11 H3N2 HA genes

18 B Viruses 2010-2011 Virus type20112010 B/Brisbane/60/2008-like52387 B/Brisbane/60/2008-like Low Reactor 120 B/Malaysia/2506/2004-like116 B/Malaysia/2506/2004-like Low Reactor 050 B/Florida/4/2006-like13 Low Reactor 614

19 Summary of Southern Hemisphere influenza activity in 2011 2011 early in the SH season so far (peaks June-August) Increased out of season activity in Australia in early 2011 Increased H3N2 activity in 2011 vs 2010 in Australia –Mostly A/Perth/10/2010 genetically, still A/Perth/16/2009-like antigenically Pandemic H1N1 still common –Mostly A/Brisbane/70/2011 genetically, still A/California/7/2009-like antigenically Few B viruses (mainly B/Brisbane/60/2008-like – B/Victoria lineage) Currently 100% of H3N2H1N1pdm viruses are adamantane resistant Low levels of neuraminidase inhibitor resistance –<1% viruses currently oseltamivir (Tamiflu) resistant – mainly treatment/prophylactic use Little activity in NZ, Sth Africa or Sth America so far 2011 vaccine match so far so good……………….

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