Influenza activity in Europe during eight seasons (1999–2007): an evaluation of the indicators used to measure activity and an assessment of the timing, length and course of peak activity (spread) across Europe

<p>Abstract</p> <p>Background</p> <p>The European Influenza Surveillance Scheme (EISS) has collected clinical and virological data on influenza since 1996 in an increasing number of countries. The EISS dataset was used to characterise important epidemiological features of influenza activity in Europe during eight winters (1999–2007). The following questions were addressed: 1) are the sentinel clinical reports a good measure of influenza activity? 2) how long is a typical influenza season in Europe? 3) is there a west-east and/or south-north course of peak activity ('spread') of influenza in Europe?</p> <p>Methods</p> <p>Influenza activity was measured by collecting data from sentinel general practitioners (GPs) and reports by national reference laboratories. The sentinel reports were first evaluated by comparing them to the laboratory reports and were then used to assess the timing and spread of influenza activity across Europe during eight seasons.</p> <p>Results</p> <p>We found a good match between the clinical sentinel data and laboratory reports of influenza collected by sentinel physicians (overall match of 72% for +/- 1 week difference). We also found a moderate to good match between the clinical sentinel data and laboratory reports of influenza from non-sentinel sources (overall match of 60% for +/- 1 week). There were no statistically significant differences between countries using ILI (influenza-like illness) or ARI (acute respiratory disease) as case definition. When looking at the peak-weeks of clinical activity, the average length of an influenza season in Europe was 15.6 weeks (median 15 weeks; range 12–19 weeks). Plotting the peak weeks of clinical influenza activity reported by sentinel GPs against the longitude or latitude of each country indicated that there was a west-east spread of peak activity (spread) of influenza across Europe in four winters (2001–2002, 2002–2003, 2003–2004 and 2004–2005) and a south-north spread in three winters (2001–2002, 2004–2005 and 2006–2007).</p> <p>Conclusion</p> <p>We found that: 1) the clinical data reported by sentinel physicians is a valid indicator of influenza activity; 2) the length of influenza activity across the whole of Europe was surprisingly long, ranging from 12–19 weeks; 3) in 4 out of the 8 seasons, there was a west-east spread of influenza, in 3 seasons a south-north spread; not associated with type of dominant virus in those seasons.</p

General Practice and Pandemic Influenza: A Framework for Planning and Comparison of Plans in Five Countries

BACKGROUND: Although primary health care, and in particular, general practice will be at the frontline in the response to pandemic influenza, there are no frameworks to guide systematic planning for this task or to appraise available plans for their relevance to general practice. We aimed to develop a framework that will facilitate planning for general practice, and used it to appraise pandemic plans from Australia, England, USA, New Zealand and Canada. METHODOLOGY/PRINCIPAL FINDINGS: We adapted the Haddon matrix to develop the framework, populating its cells through a multi-method study that incorporated the peer-reviewed and grey literature, interviews with general practitioners, practice nurses and senior decision-makers, and desktop simulation exercises. We used the framework to analyse 89 publicly-available jurisdictional plans at similar managerial levels in the five countries. The framework identifies four functional domains: clinical care for influenza and other needs, public health responsibilities, the internal environment and the macro-environment of general practice. No plan addressed all four domains. Most plans either ignored or were sketchy about non-influenza clinical needs, and about the contribution of general practice to public health beyond surveillance. Collaborations between general practices were addressed in few plans, and inter-relationships with the broader health system, even less frequently. CONCLUSIONS: This is the first study to provide a framework to guide general practice planning for pandemic influenza. The framework helped identify critical shortcomings in available plans. Engaging general practice effectively in planning is challenging, particularly where governance structures for primary health care are weak. We identify implications for practice and for research

Corporate philanthropy through the lens of ethical subjectivity

The dynamic organisational processes in businesses dilute the boundaries between the individual, organisational, and societal drivers of corporate philanthropy. This creates a complex framework in which charitable project selection occurs. Using the example of European tour operators, this study investigates the mechanisms through which companies invest in charitable projects in overseas destinations. Inextricably linked to this is the increasing contestation by local communities as to how they are able to engage effectively with tourism in order to realise the benefits tourism development can bring. This research furthers such debates by exploring the processes through which tour operators facilitate community development through charitable giving. Findings show, with no formal frameworks in existence, project selection depends upon emergent strategies that connect the professional with the personal, with trust being positioned as a central driver of these informal processes. Discretionary responsibilities are reworked through business leaders’ commitment to responsible business practises and the ethical subjectivity guiding these processes

Influenza surveillance using data from a telemedicine centre.

OBJECTIVES: This study aimed at investigating whether data from medical teleconsultations may contribute to influenza surveillance. METHODS: International Classification of Primary Care 2nd Edition (ICPC-2) codes were used to analyse the proportion of teleconsultations due to influenza-related symptoms. Results were compared with the weekly Swiss Sentinel reports. RESULTS: When using the ICPC-2 code for fever we could reproduce the seasonal influenza peaks of the winter seasons 07/08, 08/09 and 09/10 as depicted by the Sentinel data. For the pandemic influenza 09/10, we detected a much higher first peak in summer 2009 which correlated with a potential underreporting in the Sentinel system. CONCLUSIONS: ICPC-2 data from medical teleconsultations allows influenza surveillance in real time and correlates very well with the Swiss Sentinel system

"REFSDAL" MEETS POPPER: COMPARING PREDICTIONS OF THE RE-APPEARANCE OF THE MULTIPLY IMAGED SUPERNOVA BEHIND MACSJ1149.5+2223

Supernova "Refsdal," multiply imaged by cluster MACS1149.5+2223, represents a rare opportunity to make a true blind test of model predictions in extragalactic astronomy, on a timescale that is short compared to a human lifetime. In order to take advantage of this event, we produced seven gravitational lens models with five independent methods, based on Hubble Space Telescope (HST) Hubble Frontier Field images, along with extensive spectroscopic follow-up observations by HST, the Very Large and the Keck Telescopes. We compare the model predictions and show that they agree reasonably well with the measured time delays and magnification ratios between the known images, even though these quantities were not used as input. This agreement is encouraging, considering that the models only provide statistical uncertainties, and do not include additional sources of uncertainties such as structure along the line of sight, cosmology, and the mass sheet degeneracy. We then present the model predictions for the other appearances of supernova "Refsdal." A future image will reach its peak in the first half of 2016, while another image appeared between 1994 and 2004. The past image would have been too faint to be detected in existing archival images. The future image should be approximately one-third as bright as the brightest known image (i.e., H-AB approximate to 25.7 mag at peak and H-AB approximate to 26.7 mag six months before peak), and thus detectable in single-orbit HST images. We will find out soon whether our predictions are correct