Table 4 Overview of the comparative framework of influenza surveillance systems
France | Germany | Italy | Spain | United Kingdom (England & Wales) | |||
|---|---|---|---|---|---|---|---|
Surveillance sub-system | Outcome | Santé publique France | RKI Arbeitsgemeinschaft für Influenza | Istituto Superiore di Sanita | Instituto de Salud Carlos III | Public Health England | Public Health Wales |
1. Non-medically attended community surveillance | 1.1. ARI/ILI cases and/or incidence rates | Web-survey (Grippe.net) & Phone advice line (SOS Médecins) | Web-survey (GrippeWeb) | Web-survey (InfluWeb) | Web-survey (GripeNet) | Web-survey (Flusurvey.net), web queries (Fludetector) & Phone advice line (NHS 111 Calls) | Web-survey (Flusurvey.net), Phone advice line (NHS Direct Wales) |
1.2. Proportion of ARI/ILI cases attending a physician | |||||||
2. Virological surveillance | 2.1. ARI / ILI specimens for virus typing & subtyping | 1 WHO NIC with 3 labs (including 1 WHO H5 and isolates from Réseau Sentinelles & RENAL) | 1 WHO NIC (NRZ) (including isolates from regional labs) | 1 WHO NIC & InfluNet-Vir (20 labs) | 3 WHO NIC & sentinel labs (ReLEG) | 1 WHO CC, 1 WHO ERL, NIC & Sentinel labs (Respiratory Datamart) | Public Health Wales Microbiology services |
2.2. ARI / ILI specimens for virus genome sequencing | 1 WHO NIC | 3 WHO NIC | 1 WHO CC, 1 WHO ERL & 1 NIC | ||||
2.3. ARI / ILI specimens for antiviral drug resistance | |||||||
3. Community surveillance | 3.1.. Notified biologically/laboratory-confirmed cases | Sentinel labs (RENAL) | Mandatory notification (IfSG) | None or unpublished | Sentinel Labs (ReLEG) | Sentinel labs (Respiratory Datamart) | |
4. Outbreak surveillance | 4.1. ARI/ILI outbreaks in closed settings | Care homes (Ehpad) | None | Unpublished | Schools, care homes, medical settings | Schools (MOSA) & care homes (PHE surveillance scheme) | PH Wales Health Protection team |
4.2. Biologically/laboratory-confirmed outbreaks in closed settings | Mandatory notification (IfSG) | Unpublished | |||||
5. Primary care surveillance | 5.1. ARI/ILI GP visits and/or incidence rates | 1450 ARI & ILI Sentinel GPs (Réseau Sentinelles) & Phone advice line (SOS Médecins) | 830 ARI sentinel GPs (AGI-Sentinel) | 1000 ILI sentinel GPs (Influnet-Epi & Vir) | 770 Sentinel GPs & mandatory notification (EDOs) | 200–500 ILI sentinel GPs (RCGP RSC) | GP Sentinel Surveillance of Infections Scheme |
5.2. Biologically/laboratory-confirmed GP visits and/or incidence rates | 300 ARI & ILI Sentinel GPs | 770 Sentinel GPs (SVGE) | |||||
5.3. Influenza-associated excess GP visits | None | Statistical modelling (RKI model) | None | None | None | None | |
5.4. Influenza-associated excess work loss cases | None | None | None | None | None | ||
6. Hospital surveillance | 6.1. ILI or biologically/laboratory-confirmed emergency department visits | ~ 700 ARI sentinel hospitals (OSCOUR) | None | Unpublished | None | 25 ARI sentinel hospitals (EDSSS) | ARI Sentinel hospitals |
6.2. SARI/ILI hospital admissions | ~ 73 SARI sentinel hospitals (ICOSARI) | Unpublished | ARI (Chosp) & 100 SARI (CGHCG) sentinel hospitals | 44 ARI sentinel hospitals (USISS) | |||
6.3. Biologically/laboratory-confirmed hospital admissions | Mandatory notification (IfSG) | Unpublished | |||||
6.4. Influenza-associated excess hospital admissions | None | Statistical modelling (RKI model) | None | None | None | None | |
6.5 Biologically/laboratory-confirmed ICU admissions | ~ 192 SARI Sentinel hospitals (SpF) | None | SARI sentinel hospitals | ARI (Chosp) & 100 SARI (CGHCG) sentinel hospitals | All ICUs (USISS mandatory) | PH Wales Health Protection team | |
7. Mortality surveillance | 7.1 Diagnosed or biologically/laboratory-confirmed influenza deaths | ~ 192 SARI Sentinel hospitals (SpF) & death registries (SurSaUD & CépiDc) | Mandatory notification (IfSG) | SARI sentinel hospitals | ARI (Chosp) & 100 SARI (CGHCG) sentinel hospitals | All ICUs (USISS mandatory) | PH Wales Health Protection team |
7.2. Influenza-associated excess deaths | Statistical modelling (SurSaUD, CépiDc, SpF algorithm & FluMOMO) | Statistical modelling (RKI algorithm + FluMOMO in Berlin & Hesse) | Statistical modelling (Sismg EuroMOMO) | Statistical modelling (EuroMOMO) | Statistical modelling (FluMOMO) | Statistical modelling (EuroMOMO) | |