René Snacken

Specific serology for emerging human coronaviruses by protein microarray

The influenza season 2014/15 started in Europe in week 50 2014 with influenza A(H3N2) viruses predominating. The majority of the A(H3N2) viruses characterised antigenically and/or genetically differ from the northern hemisphere vaccine component which may result in reduced vaccine effectiveness for the season. We therefore anticipate that this season may be more severe than the 2013/14 season. Treating influenza with antivirals in addition to prevention with vaccination will be important.

Influenza immunization policies in Europe and the United States

Influenza vaccination policies of 28 European countries were compared with those of the US Immunization Practices Advisory Committee. Twenty-four of 28 (86%) European countries had immunization policies for influenza. European and US recommendations were in complete agreement concerning immunization of those with heart and lung disease. Within Europe there was 81-86% agreement concerning immunization of the elderly, irrespective of their health status, and patients with diabetes, renal dysfunction and immunosuppression, and 71% agreement concerning those in residential care and occupational groups that can transmit influenza to high-risk patients. Unlike the US, 62-71% of European countries did not target those with haemoglobinopathies, children and teenagers taking salicylates or household members of those at high risk. Few recommendations were endorsed by relevant medical or patient organizations. The observed variation in vaccination policies in Europe and North America possibly reflect uncertainties concerning risks from influenza and benefits from vaccination, and differences in public health systems and attitudes towards preventive medicine.

Influenza vaccination in 22 developed countries: An update to 1995

This study expands and updates through 1995 our earlier report on influenza vaccine use in 18 developed countries. Five of the six countries with high levels of vaccine use in 1992 (> or = 130 doses/1000 population) showed little change or slight declines over the subsequent 3 years. The exception was the United States, where a new federal program for vaccination reimbursement for the elderly helped to increase vaccine distribution from 144 to 239 doses/1000 population. The six countries with medium levels of vaccine use in 1992 (76-96 doses/1000 population) increased to > or = 100 doses/1000 population by 1995. Among the six low-use countries in 1992 (< or = 65 doses/1000 population), only Finland showed substantial improvement (96 doses/1000 population) in 1995. Four new countries were added to the study. In Germany, vaccine use increased to 80 doses/1000 population in 1995, but in Ireland it remained at a low level (48 doses/1000 population). In Korea, vaccine use increased from 17 to 95 doses/ 1000 population during the period 1987-1995. In Japan, very high levels of vaccine use (approximately 280 doses/1000 population) in the early 1980s were associated with vaccination programs for school children. However, vaccine use fell precipitously when these programs were discontinued, and only 2 and 8 doses/1000 population were used in 1994 and 1995, respectively. In all 22 countries, higher levels of vaccine use were associated with vaccination reimbursement programs under national or social health insurance and were not correlated with different levels of economic development. Excluding Japan, in 1995 there was still a greater than fourfold difference between the highest and lowest levels of vaccine use among the other 21 countries in the study. Given its well established clinical effectiveness and cost-effectiveness, none of these countries has yet achieved the full benefits of its programs for influenza vaccination.

Influenza surveillance in Europe: establishing epidemic thresholds by the Moving Epidemic Method

Please cite this paper as: Vega et al. (2012) Influenza surveillance in Europe: establishing epidemic thresholds by the moving epidemic method. Influenza and Other Respiratory Viruses 7(4), 546–558.

Lessons learnt from pandemic A(H1N1) 2009 influenza vaccination. Highlights of a European workshop in Brussels (22 March 2010).

This European workshop identified a number of lessons learnt in the field of vaccine licensure, prioritization of target groups, communication on pandemic vaccines, implementation of vaccination and safety monitoring. The mild severity of the pandemic A(H1N1) 2009 influenza virus influenced the perception of pandemic vaccines, as previous pandemic preparedness had anticipated a more virulent virus. This vaccination experience provides an important opportunity for research on the long-term immunogenicity and safety of pandemic vaccines in pregnant women and children, as well as on the long-term safety of adjuvants. Preparedness for future pandemics could involve improved decision-making on target groups and increased communication on vaccine safety.

Influenza surveillance in Europe: comparing intensity levels calculated using the moving epidemic method

Although influenza‐like illnesses (ILI) and acute respiratory illnesses (ARI) surveillance are well established in Europe, the comparability of intensity among countries and seasons remains an unresolved challenge. The objective is to compare the intensity of ILI and ARI in some European countries.

Influenza season 2012–2013 in Europe: moderate intensity, mixed (sub)types

SUMMARY This paper summarizes influenza activity in the European Union/European Economic Area (EU/EEA) in 2012–2013. The influenza season 2012–2013 in Europe lasted from early December to late April. Overall the severity of the season could be described as moderate, based on the ILI/ARI consultation rates and the percentage of sentinel specimens positive for influenza compared to previous seasons. Both influenza A and B viruses circulating accounted for 47% and 53% of positive sentinel specimens, respectively, with both A(H1) and A(H3) varying for dominance. Compared to outpatients, the proportion of laboratory-confirmed influenza hospitalized cases infected by A(H1N1)pdm09 was significantly higher in middle-aged patients (33% vs. 17%, χ2 = 66·6, P < 0·01). Despite a relatively good match between vaccine and circulating strains, vaccine effectiveness was estimated to be moderate.

Surveillance of hospitalised severe cases of influenza A(H1N1)pdm09 and related fatalities in nine EU countries in 2010–2011

Please cite this paper as: Snacken et al. (2012) Surveillance of hospitalised severe cases of Influenza A(H1N1)pdm09 and related fatalities in nine EU countries in 2010–2011. Influenza and Other Respiratory Viruses 6(601), e93–e96.

Influenza season 2013/14 has started in Europe with influenza A(H1)pdm09 virus being the most prevalent subtype.

The 2013/14 influenza season has started in Europe. Four countries have reported medium intensity influenza activity, with children under 15 years being the most affected age group. A growing number of countries see increasing rates of influenza-like illness or acute respiratory infection and increasing proportions of specimens positive for influenza A(H1)pdm09 virus. In previous seasons, this subtype was associated with higher reported numbers of severe and fatal cases. Clinicians should offer influenza vaccination to unvaccinated persons belonging to risk groups.

Biosafety Risk Assessment of the Severe Acute Respiratory Syndrome (SARS) Coronavirus and Containment Measures for the Diagnostic and Research Laboratories

At the end of 2002, an outbreak of a new viral respiratory illness, called SARS (Severe Acute Respiratory Syndrome virus), occurred in China. The disease spread over Asia, North America, Europe, and Africa. In response to the SARS outbreak, the World Health Organization (WHO) coordinated an international collaboration that included clinical, epidemiologic, and laboratory investigations, and initiated efforts to control the spread of SARS. As in other countries, Belgium has been decided to establish biosafety guidelines and recommendations with particular emphasis on handling clinical specimens associated with SARS for research, production, and clinical laboratories. Taking into account that there is so far no SARS case reported in Belgium as well as in other countries in the world, and based on a scientific risk assessment related to the contained use of biological agents, the SARS-CoV was classified as a Risk Group 3 agent. In relation to the reported biosafety assessment, the SARS-CoV should be handled in appropriate biosafety containment levels to avoid laboratory-acquired infections and spread of the disease in the human population and the environment. Therefore, diagnostic activities with inactivated clinical specimens associated with SARS cases and with specimens originating in countries where SARS is documented but not associated with SARS cases should be performed under Biosafety Level 2 (BSL-2) conditions. Diagnostic activities involving non inactivated clinical specimens associated with SARS should be carried out under BSL-2 containment with BSL-3 safety equipment and work practices. Culture of SARS-CoV and all research activities involving SARS-CoV require a BSL-3 containment.