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Respiratory Virusreport Surveillance Symposium Report Inside! See page 2. Respiratory Virus Report spring 2009 isirv International Symposium on Immune Correlates of Protection Against Influenza: Reassessing licensing requirements for seasonal and pandemic influenza vaccines 2-5 March 2010 Miami, Florida, United States In this issue: SPECIAL isirv International Symposium on Viral BULLETIN Respiratory Disease Surveillance ............ 2 In response to the ongoing John Watson recounts highlights from the meeting in Seville. influenza A (H1N1) outbreak, isirv has posted two new resource lists on In the Loop.................................................. 5 its website. These lists will facilitate Summaries of recent key literature in viral respiratory disease. access to current guidance and background information relative to isirv news ................................................... 6 this new public health threat. Immune Correlates Symposium announcement, updates on the Transmission and Mitigation Symposium, and Options VII. isirv is committed to providing Obituary: Graeme Laver, PhD, FRS .......... 8 accurate information to its Robert Webster eulogizes Australian researcher Graeme Laver, who made membership. Visit www.isirv.org for major contributions to our current understanding of influenza ecology more information and authoritative and antigenic drift, and to the development of subunit vaccines and sources of key professional influenza antiviral drugs information on the influenza A (H1N1) outbreak. Respiratory Virus Report spring 2009 Highlights of the isirv International Symposium on Viral Respiratory Disease Surveillance by John Watson, MB BS, MSc, FRCP, FFPH The surveillance symposium was a great success. Pilar Perez viral respiratory disease Brena of the National Centre for Microbiology at the Instituto surveillance, seasonal de Salud Carlos III, welcomed delegates to the “charming, and pandemic influenza mysterious, and warm” city of Seville, Spain. The city, and the surveillance, and viral Melia Sevilla Hotel, provided an ideal setting for the meeting, respiratory pathogens and a comfortable venue for networking with colleagues other than influenza were from around the globe. presented. Three stimulating keynote lectures were also Over 170 delegates from 43 countries representing various delivered. David Heymann government, academic institutions, and commercial of the WHO spoke on organisations participated in the two and a half day meeting, “Recognizing the Next SARS John Watson opening the symposium a new initiative developed and organised by isirv. Significant and the Role of Surveillance,” Credit: Greg Gray financial support for the symposium was provided by the US Ilaria Capua of the Istituto Centers for Disease Control and Prevention, the US Armed Zooprofilattico Sperimentale delle Venezie addressed Forces Health Surveillance Center, the US Department “Influenza at the Human-Animal Interface: The Need for of Health and Human Services, Roche, sanofi pasteur, Collaborative Surveillance and Research,” and Thomas Briese bioMérieux, the US National Institutes of Health, and TIB of Columbia University presented “Respiratory Pathogen MOLBIOL. Discovery: A Staged Strategy and Recent Developments.” All of the presentations were warmly received. Unlike most scientific meetings, the Surveillance Symposium was run like a WHO meeting, with lectures followed by structured discussions to produce action-oriented meeting outcomes. A total of 30 lectures on national and Panelists for “Seasonal Influenza Activity Surveillance,” from left to right, Andrea global approaches to Ammon (chair), Caroline Brown, Ousmane Diop, Krongkaew Supawat, Akhilesh Entrance at Plaza de Espana, Seville Chandra Mishra, Talat Mokhtari Azad Credit: Marge Tamas Credit: Greg Gray 2 Respiratory Virus Report spring 2009 Highlights of the isirv International Symposium on Viral Respiratory Disease Surveillance, Continued by John Watson, MB BS, MSc, FRCP, FFPH [email protected] The principal With regard to influenza, it is clear that much more can be recommendations from Dr done to improve seasonal surveillance. Although much Heymann’s superb keynote planning work for pandemic influenza has already been address are to recognize the done, risk communication during a pandemic will be a existence of many types of major challenge in view of the discontinuation of major surveillance systems and newspapers and other media outlets in a number of cities to use them all. Dr Capua’s around the world. With regard to respiratory viruses other keynote showed there than influenza, there is a lack of understanding of their are significant gaps at the epidemiology and even of their existence, but considerable interface of animal and impact of infection with these agents, in hospital and Conversation during a break human disease surveillance community settings. Credit: Marge Tamas that will require collaboration to overcome. Dr Briese described a highly sophisticated During this meeting, 8 laboratory system for detecting novel viral respiratory significant themes for future pathogens, and invited the audience to collaborate with his research were identified institution. and are shown below. Appropriate follow-up Panel discussions following each of the 6 symposium activities to the Surveillance sessions were instrumental in developing prioritised lists Symposium will be of interventions that could be implemented to improve discussed with the Scientific viral respiratory disease surveillance. The questions and Programme Committee and answers during the panels were highly informative, and the WHO. did much to reveal the nature and depth of the gaps in Lance Jennings describing the symposium proceedings John Watson opening the symposium current disease surveillance systems. A number of points Credit: Greg Gray Credit: Greg Gray were repeatedly addressed by the symposium participants. Themes for future research identified at theisirv International Symposium on Viral Respiratory Disease 1. Case definition standardization 2. Specimen collection and transport 3. Effective pandemic plan exercises 4. Effective pandemic plan communication 5. Mathematical modeling of disease burden 6. Motivating surveillance development in different parts of the world 7. Collaboration of the private healthcare sector in surveillance 8. Better, faster, cheaper multipathogen diagnosis 3 Respiratory Virus Report spring 2009 Notable and quotable comments from the Surveillance Symposium: “The most important lesson learned from the SARS outbreak is to build a surveillance culture in which disease reporting is expected and respected.”—David Heymann, WHO “Discussion must lead to action or nothing will change.”—Wenqing Zhang, WHO “We need to find out more about what we don’t fully understand.”—Lance Jennings, University of Otago, on the need for research into respiratory viruses other than influenza “Stamp collecting!”—Arnold Monto, University of Michigan, describing critics’ perspective on diagnosing respiratory viruses other than influenza “Subtyping viruses is not just an academic exercise.”—Tracy DuVernoy, US Armed Forces Health Surveillance Center, countering the critics’ perspective “Thailand has a remarkable system for outbreak follow-up.”—Douglas Holtzman, Gates Foundation “Why didn’t we think of that before?”—Dan Miller, US HHS, on the most common refrain after pandemic simulation exercises Key Themes in Surveillance System Development—Joe Bresee • Look for opportunities for expanding or improving surveillance • Address pandemic/avian influenza surveillance • Capture multiple outcomes to be successful • Only collect data needed for action • Recognise that needs of countries will differ • International cooperation on surveillance systems is critical for influenza Selected Surveillance Symposium Evaluation Results Percentage of respondents planning to use information learned 97% at symposium where they work Percentage of respondents who believe information learned 97% from the symposium will improve the quality of their work Top research priority Developing low-cost disease surveillance technologies Most important new information learned at symposium Disease burden of noninfluenza respiratory viruses, especially adenovirus Most memorable speaker Ilaria Capua Professor Watson was Chair for the isirv International Symposium on Viral Respiratory Disease Surveillance, and is the Chair of isirv. He is also Deputy Director, Respiratory and Systemic Infections Department, at the Health Protection Agency Centre for Infections, UK. 4 Respiratory Virus Report spring 2009 Recent publications In the and news items of special interest to Loop isirv members by Marge Tamas [email protected] CLINICAL MEDICINE United States influenza management guidelines now recommend rimantadine-oseltamivir combination therapy for first- line treatment in the absence of diagnostic testing for influenza subtypes. Source: Centers for Disease Control and Prevention. CDC issues interim recommendations for the use of influenza antiviral medication in the setting of oseltamivir resistance among circulating influenza A (H1N1) viruses, 2008-09 influenza season. 19 December 2008. http://www2a. cdc.gov/HAN/Archive Sys/viewMesgV.asp?AltertNum=00279. EMERGING INFECTIOUS DISEASES Isolated case of influenza A(H9N2) infection reported in Hong Kong, first since March 2007. Source: Schnirring L. Hong Kong reports baby has H9N2 virus. CIDRAP News. 30 December 2008. http://www.cidrap.umn.edu/cidrap/content/ influenza/avianflu/news/dec3008influenza.html.
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