Preparing for an influenza season 2021/22 with a likely co-circulation of influenza virus and SARS-CoV-2

EditorialN

Desarrollo de sistemas de vigilancia centinela de Infección Respiratoria Aguda leve y grave en atención primaria y hospitales en España

Sesión 2. Sistemas de Vigilancia Epidemiológica de COVID-19Sistemas de vigilancia de gripe: . Vigilancia centinela en Atención Primaria Vigilancia de gripe en hospitales . Información que proporcionan . Situación ante la pandemia de COVID-19 . Recomendaciones Internacionales . Propuesta de implementación. Experiencias piloto . Consideraciones ECDC/OMS . Ventajas de la vigilancia centinela de IRA/IRAG Retos y perspectivas . ConclusionesN

La vigilancia de la gripe. Nuevas soluciones a un viejo problema

ResumenEl potencial pandémico de la gripe ha convertido a esta enfermedad en el objetivo preferente de los sistemas de vigilancia nacionales e internacionales. Los sistemas centinela, por sus características, permiten una integración de información virológica y epidemiológica de esta enfermedad de elevada incidencia, ayudando a detectar y caracterizar precozmente los virus de la gripe circulantes y evaluando su capacidad de propagación en la población.La creación en España, hace más de 10 años, de un sistema centinela, que cubre actualmente el 75% de la población nacional, supuso una forma diferente de abordar la vigilancia de la gripe humana, a través de la declaración individualizada de los casos de la enfermedad y la unión de datos clínicos, epidemiológicos y microbiológicos, y ha contribuido a una evaluación más correcta de la actividad de la gripe en el territorio español.A pesar de las limitaciones de este sistema centinela, derivadas fundamentalmente de los problemas de representatividad que todo sistema de vigilancia basado en muestras de población puede presentar, los datos que aporta se han revelado útiles para el seguimiento y el control de la gripe. La rapidez en la transmisión de la información es uno de los principales atributos del sistema, que posibilita su integración en las redes de vigilancia internacional de la enfermedad y ayuda a lograr una mejor oportunidad en la difusión de la información y formulación de recomendaciones.AbstractThe pandemic potential of influenza has made this disease the principal target of both national and international surveillance systems. The intrinsic characteristics of sentinel networks enable them to integrate epidemiological and virological information of a high incidence disease such as influenza, so helping in the early detection and characterization of the circulating influenza viruses and in evaluating their spread capacity in the population.A sentinel network, which covers 75% of the population, was created in Spain more than ten years ago. This provides a new approach to human influenza surveillance based on the individualized reporting of each case and the linkage of clinical, epidemiological and virological data. This system has contributed to a more accurate evaluation of influenza activity in Spain.In spite of the limitations of this sentinel system, which mainly derive from the lack of representativeness that any surveillance system based on population samples can encounter, it provides data which have proved useful for the follow-up and control of influenza. Rapid information transmission is one of the main advantages of the system, allowing its integration in the international disease surveillance networks and improving the timeliness of both information spread and formulation of recommendations

Using the social ecologic framework to improve the influenza vaccination strategy among the Portuguese elderly

Background: In a context of lower than targeted influenza vaccination (IV) coverage, identifying factors associated IV uptake is essential to improve population coverage. Although extensive work has been done in this field, scarcer studies focused on framing these factors within a multifactorial model. Having the social ecological model (SEM) as framework, this study intended to identify and quantify the SEM levels associated to seasonal IV uptake in the Portuguese population aged 65 and more years. Methods: Data from the Portuguese 2014 National Health Survey was restricted to individuals aged 65 and more years (n=5669). The outcome of interest was self-reported IV uptake in the 2 years previous to the interview. Twenty three independent variables were selected from the survey and were allocated in one of the five SEM levels: individual, interpersonal, organizational, community and policy. Sex stratified and age adjusted analysis using Poisson regression were performed for each SEM level. To evaluate statistical significance and marginal contribution of each SEM level for explaining IV uptake, the full model was fitted (all variables from all 5 SEM levels). To determine joint statistical significance of variables of each SEM level, the model without respective SEM level was compared with the full model using likelihood ratio test. Additionally, marginal contribution of each SEM level was measured by relative reduction in magnitude of pseudo R square. Results: For both men and women, older age groups (85 or more vs 65-69 age group; PR=1.59 for men and PR=1.56 for women); having 3 or more chronic conditions (PR=1.39 for men and PR=1.35 for women); number of GP and outpatient visits in the previous 4 weeks were associated to higher IV uptake. For men, only 2 out of the 5 SEM levels were associated to IV uptake (individual and organizational). For women 3 levels were relevant for this preventive measure (individual, organizational and community). Main marginal contribution for explaining the IV uptake, came from individual (17.9% and 16.3%) and organizational (30.7% and 22.7%) levels for both men and women respectively. Conclusions: Besides individual characteristics, like age and health status - known determinants of IV uptake - this study highlights the importance of access and use of health care services for adoption of IV preventive measure. Moreover, it evidences a sex differential behaviour that should be accounted in the definition of the IV campaign strategy.N/

Climatic Factors and Influenza Transmission, Spain, 2010-2015

The spatio-temporal distribution of influenza is linked to variations in meteorological factors, like temperature, absolute humidity, or the amount of rainfall. The aim of this study was to analyse the association between influenza activity, and meteorological variables in Spain, across five influenza seasons: 2010-2011 through to 2014-2015 using generalized linear negative binomial mixed models that we calculated the weekly influenza proxies, defined as the weekly influenza-like illness rates, multiplied by the weekly proportion of respiratory specimens that tested positive for influenza. The results showed an association between influenza transmission and dew point and cumulative precipitation. In increase in the dew point temperature of 5 degrees produces a 7% decrease in the Weekly Influenza Proxy (RR 0.928, IC: 0.891-0.966), and while an increase of 10 mm in weekly rainfall equates to a 17% increase in the Weekly Influenza Proxy (RR 1.172, IC: 1.097-1.251). Influenza transmission in Spain is influenced by variations in meteorological variables as temperature, absolute humidity, or the amount of rainfall.This study has been funded by Instituto de Salud Carlos III through the project “PI15/01398” (Co-funded by European Regional Development Fund/European Social Fund “Investing in your future”).S