Start of influenza season
Signs of increasing influenza activity in a number of countries indicate the start of the influenza season in the WHO European Region. Both influenza A and B viruses are circulating, and both pandemic A(H1N1) 2009 and A(H3N2) have been detected. In addition, reports of severe and fatal cases, causing strains on critical care services, have been received.
Preliminary information indicates that high-risk groups for severe or fatal illness identified during the pandemic remain at heightened risk, and that most of the fatal cases had not been vaccinated. Virological analyses performed so far indicate that the currently circulating influenza A(H1N1) 2009 virus corresponds with the strain included in the vaccine for the 2010/2011 season in the northern hemisphere.
As mentioned in the WHO Director General’s post-pandemic announcement in August 2010, the pandemic A(H1N1) 2009 virus was expected to continue to circulate and cause local outbreaks and epidemics, as well as severe disease and deaths in the recognized higher-risk groups and in previously healthy people.
WHO/Europe recommends that health ministries in countries ensure high rates of uptake of seasonal influenza vaccine by individuals who might be at risk of developing complications. In particular, authorities should reach out to pregnant women, as seasonal influenza vaccination campaigns have not traditionally targeted this group. Health care workers need to be motivated to vaccinate themselves, and mobilized to help boost vaccine acceptance among individuals at risk for severe disease. Lessons learned over the past 12–18 months show that health care workers play a significant role in responding to influenza in communities.
WHO advises national authorities to start or enhance awareness-raising activities among individuals at risk for complications due to influenza, emphasizing their need to seek medical advice or care early in the course of infection. While awareness campaigns are a normal feature of the influenza season, care should be taken not to create panic. In addition, governments need to alert family doctors, hospitals and intensive care units to the expected increase in influenza patients, so that they can start triage and early treatment of pneumonia patients, especially in resource-poor environments. Clinicians should start treatment for influenza when they suspect the illness, without relying on rapid diagnostic tests or waiting for laboratory confirmation.
Vaccination against 2010/2011 seasonal influenza
The vaccine against seasonal influenza in the northern hemisphere in 2010/2011 includes all three viruses currently circulating in the European Region. National authorities should ensure risk groups are vaccinated against all three strains, as described in WHO’s recommendations for the 2010/2011 winter season, last updated on 17 December 2010.
Member States should determine the priority given to target groups on the basis of national surveillance data and local vaccination capacities. The priority groups will depend on the objectives of vaccination, but any strategy should reflect the country’s epidemiological situation, resources and ability to access vaccine, and ability to implement vaccination campaigns in the targeted groups. Priority groups that should be considered for immunization include:
- pregnant women;
- individuals aged 6 months and older with chronic heart or lung diseases, metabolic or renal disease, chronic liver disease, chronic neurological conditions or immunodeficencies;
- health care workers, including those that work in institutions that care for older people or those with disabilities;
- elderly people over a nationally defined age limit, irrespective of other risk factors;
- residents of institutions for older and disabled people;
- other groups defined on the basis of national data and capacities.