Surveillance of Influenza in Indonesia, 2003-2007

Abstract

Background Longitudinal data are limited about the circulating strains of influenza viruses and their public health impact in Indonesia. We conducted influenza surveillance among outpatients and hospitalized patients with influenza‐like illness (ILI) across the Indonesian archipelago from 2003 through 2007. Methodology Demographic, clinical data, and respiratory specimens were collected for 4236 ILI patients tested for influenza virus infection by RT‐PCR and viral culture. Principal Findings Influenza A and B viruses co‐circulated year‐round with seasonal peaks in influenza A virus activity during the rainy season (December–January). During 2003–2007, influenza viruses were identified in 20·1% (4236/21 030) of ILI patients, including 20·1% (4015/20 012) of outpatients, and 21·7% (221/1018) of inpatients. One H5N1 case was identified retrospectively in an outpatient with ILI. Antigenic drift in circulating influenza A and B virus strains was detected during the surveillance period in Indonesia. In a few instances, antigenically drifted viruses similar to the World Health Organization (WHO) vaccine strains were detected earlier than the date of their designation by WHO. Conclusions Influenza A and B virus infections are an important cause of influenza‐like illness among outpatients and hospitalized patients in Indonesia. While year‐round circulation of influenza viruses occurs, prevention and control strategies should be focused upon the seasonal peak during rainy season months. Ongoing virologic surveillance and influenza disease burden studies in Indonesia are important priorities to better understand the public health impact of influenza in South‐East Asia and the implications of influenza viral evolution and global spread.

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“…[8][9][10][11][21][22][23][24][25][26][27][28][29][30][31][32] Our findings regarding the usefulness of the composite variable agree with those from a temperate region in Australia 19 and highlight the importance of using multiple sources of information to guide assessment. Considering similar surveillance systems in Cambodia and those in other tropical and subtropical countries, [21][22][23][24][25][26][27][28] our approach may be adapted to fit each country's context. For Cambodia, eight sentinel sites with approximately 35 samples per week nationwide were enough to describe influenza activity.…”

“…[14][15][16]19 Lack of apparent ILI seasonality could be unique in the tropics and subtropics with various pathogens circulating year-round that cause acute respiratory illnesses. [8][9][10][11][21][22][23][24][25][26][27][28][29][30][31][32] Instead, use of proportion positive and composite approaches may be suggested given recent studies with laboratory information indicating that most countries, including non-temperate countries, exhibit distinct seasonal patterns. [8][9][10][11][21][22][23][24][25][26][27][28][29][30][31][32] Our findings regarding the usefulness of the composite variable agree with those from a temperate region in Australia 19 and highlight the importance of using multiple sources of information to guide assessment.…”

“…[8][9][10][11][21][22][23][24][25][26][27][28][29][30][31][32] Instead, use of proportion positive and composite approaches may be suggested given recent studies with laboratory information indicating that most countries, including non-temperate countries, exhibit distinct seasonal patterns. [8][9][10][11][21][22][23][24][25][26][27][28][29][30][31][32] Our findings regarding the usefulness of the composite variable agree with those from a temperate region in Australia 19 and highlight the importance of using multiple sources of information to guide assessment. Considering similar surveillance systems in Cambodia and those in other tropical and subtropical countries, [21][22][23][24][25][26][27][28] our approach may be adapted to fit each country's context.…”

“…21 In addition to the leadership of respective ministries of health, global efforts by WHO, the Centers for Disease Control and Prevention and other organizations have supported the establishment of national influenza surveillance systems in many resource-limited countries in non-temperate climates. 10,11,[21][22][23][24][25][26][27][28][29][30][31][32][33][34] We believe it is time to maximize utilization of influenza surveillance data for routine actions for domestic and global public health assessment and response.…”

Hubungan Status Frailty dengan Serokonversi dan Seroproteksi Vaksin Influenza pada Populasi Usia Lanjut

“…4 Hasil ini sejalan dengan penelitian yang dilaporkan sebelumnya oleh Kosasih, dkk. 5 yang menyatakan terdapat 20,1% kasus influenza.…”