Facing the future of respiratory virus surveillance: “The mosaic surveillance framework”

Abstract

It is impossible to address the many complex needs of respiratory virus surveillance with a single system. Therefore, multiple surveillance systems and complementary studies must fit together as tiles in a “mosaic” to provide a complete picture of the risk, transmission, severity, and impact of respiratory viruses of epidemic and pandemic potential. Below we present a framework (WHO Mosaic Respiratory Surveillance Framework) to assist national authorities to identify priority respiratory virus surveillance objectives and the best approaches to meet them; to develop implementation plans according to national context and resources; and to prioritize and target technical assistance and financial investments to meet most pressing needs.

Phenotype Execution and Modelling Architecture (PhEMA) to support disease surveillance and real-world evidence studies: English sentinel network evaluation

“…[33] Alongside other surveillance indicators ILI surveillance should be part of the mosaic of measures used to flag an emergent pandemic. [34,35] The RSC provides weekly ILI incidence figures to UKHSA in its weekly report.…”

Postpandemic Sentinel Surveillance of Respiratory Diseases in the Context of the World Health Organization Mosaic Framework: Protocol for a Development and Evaluation Study Involving the English Primary Care Network 2023-2024

“…Prepandemic virological testing was largely carried out in the winter season with influenza-like illness (ILI) as the key clinical indicator of community influenza infection [ 14 ]. In addition to ILI, ARI started to be used by the European Centre for Disease Prevention and Control as a surveillance indicator [ 15 , 16 ]. The WHO 2013 global epidemiological standards for influenza surveillance proposed the use of severe ARI (SARI) as an indicator.…”

“…SARI is defined as an incident ARI in a person admitted to a hospital [ 17 , 18 ]. The WHO mosaic framework suggests sentinel ILI, ARI, and SARI surveillance as the core approach for monitoring the epidemiological characteristics of respiratory viruses in interpandemic periods [ 16 ].…”

“…Subsequent to the COVID-19 pandemic, the WHO published its mosaic framework for respiratory disease surveillance [ 16 , 19 ]. It recommended that the surveillance strategies of countries include the virological monitoring of influenza, SARS-CoV-2, respiratory syncytial virus (RSV), and other viruses with pandemic potential.…”

Learning from serosurveillance for SARS-CoV-2 to inform pandemic preparedness and response

“…There are already initiatives under way to support this agenda and provide important steps to overcome methodological challenges and delays in study implementation and sharing of results. These initiatives include work by WHO on collaborative surveillance 8 and to establish an international framework and network to conduct seroepidemiological investigations and studies, 9 including an operational repository of protocols and reporting and dissemination tools that can be adapted by countries to enhance analysis. 5 There are also other for profit and non-profit efforts to visualise and analyse multi-pathogen serological investigations.…”