Estimating the national burden of hospitalizations for influenza-associated severe acute respiratory infection in the Lao Peoples Democratic Republic, 2016.

OBJECTIVE: Estimates of the burden of influenza are needed to inform prevention and control activities for seasonal influenza, including to support the development of appropriate vaccination policies. We used sentinel surveillance data on severe acute respiratory infection (SARI) to estimate the burden of influenza-associated hospitalizations in the Lao Peoples Democratic Republic. METHODS: Using methods developed by the World Health Organization, we combined data from hospital logbook reviews with epidemiological and virological data from influenza surveillance from 1 January to 31 December 2016 in defined catchment areas for two sentinel sites (Champasack and Luang Prabang provincial hospitals) to derive population-based estimates of influenza-associated SARI hospitalization rates. Hospitalization rates by age group were then applied to national age-specific population estimates using 2015 census data. RESULTS: We estimated the overall influenza-associated SARI hospitalization rate to be 48/100 000 population (95% confidence interval [CI]: 44-51) or 3097 admissions (95% CI: 2881-3313). SARI hospitalization rates were estimated to be as low as 40/100 000 population (95% CI: 37-43) and as high as 92/100 000 population (95% CI: 87-98) after accounting for SARI patient underascertainment in hospital logbooks. Influenza-associated SARI hospitalization rates were highest in children aged < 5 years (219; 95% CI: 198-241) and persons aged 3 65 years (106; 95% CI: 91-121). DISCUSSION: Our findings have identified age groups at higher risk for influenza-associated SARI hospitalization, which will support policy decisions for influenza prevention and control strategies, including for vaccination. Further work is needed to estimate the burdens of outpatient influenza and influenza in specific high-risk subpopulations

Antiviral Drug–Resistant Influenza B Viruses Carrying H134N Substitution in Neuraminidase, Laos, February 2016

In February 2016, three influenza B/Victoria/2/87 lineage viruses exhibiting 4- to 158-fold reduced inhibition by neuraminidase inhibitors were detected in Laos. These viruses had an H134N substitution in the neuraminidase and replicated efficiently in vitro and in ferrets. Current antiviral drugs may be ineffective in controlling infections caused by viruses harboring this mutation

The Lao Experience in Deploying Influenza A(H1N1)pdm09 Vaccine: Lessons Made Relevant in Preparing for Present Day Pandemic Threats.

The Lao PDR, as did most countries of the Mekong Region, embarked on a pandemic vaccine initiative to counter the threat posed by influenza A(H1N1)pdm09. Overall, estimated vaccine coverage of the Lao population was 14%, with uptake in targeted health care workers and pregnant women 99% and 41%, respectively. Adverse Events Following Immunization accounted for only 6% of survey driven, reported vaccination experiences, with no severe consequences or deaths. Public acceptability of the vaccine campaign was high (98%). Challenges to vaccine deployment included: 1) no previous experience in fielding a seasonal influenza vaccine, 2) safety and efficacy concerns, and 3) late arrival of vaccine 10 months into the pandemic. The Lao success in surmounting these hurdles was in large measure attributed to the oversight assigned the National Immunization Program, and national sensitivities in responding to the avian influenza A(H5N1) crisis in the years leading up to the pandemic. The Lao "lessons learned" from pandemic vaccine deployment are made even more relevant four years on, given the many avian influenza strains circulating in the region, all with pandemic potential

Reported AEFIs by Targeted Populations Surveyed.

<p>Lao PDR National Immunization Program (NIP), Anonh Xeuatvongsa, Director of National Immunization Program, Ministry of Health, Lao Peoples Democratic Republic, email address: <a href="mailto:[email protected]" target="_blank">[email protected]</a>.</p

Number of distributed influenza A(H1N1) pandemic vaccine doses by target population, 2009–2010 Lao PDR.

<p>Source: Lao PDR National Immunization Program (NIP), Annual Report on NIP 2010. Date: 20 January 2011, Anonh Xeuatvongsa, Director of National Immunization Program, Ministry of Health, Vientiane, Lao Peoples Democratic Republic, email address: <a href="mailto:[email protected]" target="_blank">[email protected]</a>; Data submitted to through WHO: <a href="http://www.who.int/influenza_vaccines_plan/resources/h1n1_deployment_report.pdf" target="_blank">http://www.who.int/influenza_vaccines_plan/resources/h1n1_deployment_report.pdf</a>.</p><p>^aOther Essential Personnel include essential government workers as designated by the GOL</p><p>^bNot Applicable</p><p>^cNo Data</p><p>Number of distributed influenza A(H1N1) pandemic vaccine doses by target population, 2009–2010 Lao PDR.</p

The Mekong Region: Lao PDR Sharing Border with Cambodia, China, Myanmar, Thailand and Vietnam.

<p>Source: <a href="https://www.cia.gov/library/publications/cia-maps-publications/Laos.html" target="_blank">https://www.cia.gov/library/publications/cia-maps-publications/Laos.html</a>.</p