WHO mission to review influenza surveillance in Kazakhstan

Influenza surveillance and the use of collected data to inform prevention and control measures were the focus of a recent WHO mission to Kazakhstan conducted from 30 May to 7 June 2012. 

Kazakhstan is one of approximately 15 countries in the WHO European Region that performs hospital surveillance of severe disease caused by influenza. Such routine hospital surveillance allows identification of persons at risk of developing severe disease as a result of influenza infection, as well as information on the relative severity of seasonal and pandemic influenza. This type of surveillance was identified as a gap during the 2009 pandemic. 

A system of 19 sentinel hospitals has been established in the country that report and test cases of severe acute respiratory-tract infections (SARI) according to guidance provided by WHO/Europe. During the 2011-2012 influenza season, SARI surveillance detected cases of both the seasonal A(H3N2) and A(H1N1)pdm09 viruses, mainly in children of the 0-4 and 5-14 age groups. 

Mission recommendations

WHO staff discussed the data being collected in the country with national and regional focal points from the Ministry of Health and Sanitary Epidemiological Stations located in the cities of Astana and Almaty, and Taldikorgan in the Almaty region. Recommendations provided by WHO during the mission focused on ensuring that cases of severe influenza are detected also in older age groups. In addition, a review was performed of the laboratory network and outpatient surveillance, as recently a sentinel system for influenza-like illness (ILI) was established at 22 sites in 7 cities, which operates in parallel with the surveillance of acute respiratory infections. 

Discussions with the Ministry of Health focused on effective collection and use of surveillance data to inform influenza prevention and control measures, in particular the benefits of performing influenza testing among only those patients presenting at sentinel sites in order to use resources most efficiently. A similar recommendation was made during an inter-country meeting in 2011 involving 12 newly independent states of the former USSR (as recorded in the meeting report Taking stock of influenza surveillance in the newly independent states.)