Eurosurveillance - Volume 14, Issue 39, 01 October 2009

The 2009 pandemic influenza A(H1N1) virus has a higher incidence in children and young adults, a pattern that has also been reported in seasonal influenza caused by the influenza A(H1N1) virus. We analysed age at infection in symptomatic patients with influenza in the Basque Country (northern Spain), reported through the sentinel influenza surveillance system which monitors 2.2-2.5% of the population. Between September 1999 and August 2009, influenza A(H3N2) or seasonal influenza A(H1N1) was detected in 941 patients, and from April to August 2009, pandemic influenza A(H1N1) was detected in 112 patients. The H3/H1 seasonal influenza ratio was between 3.3 and 3.4 in the under 60 year-olds, but 9.8 in older individuals, suggesting that people born before 1950 have residual immunity against the influenza A H1N1 subtype (both seasonal and pandemic). Introduction In 1957, the Asian influenza pandemic was caused by influenza A(H2N2) virus, which circulated until 1968 when it was displaced by the influenza A(H3N2) virus which was responsible for the Hong Kong pandemic. Before 1957, direct descendants of the influenza A(H1N1) virus that had caused the 1918 pandemic (Spanish flu) had circulated. In 1977, an influenza A(H1N1) strain re-emerged, which, together with the dominant influenza A(H3N2) strain, has been the cause of seasonal human influenza for more than three decades [1]. Despite the prolonged co-circulation of both subtypes, few studies have analysed their ability to affect distinct age groups. The current pandemic influenza A(H1N1) virus, influenza A(H1N1)v, which emerged in the spring of 2009, has spread throughout the world. The aim of this study was to compare the distribution in distinct age groups of infections caused by the two subtypes of seasonal influenza in the past 10 seasons and refer therelate this to recent infections due to influenza A(H1N1)v.

In the end of August 2009, an unusually elevated level of influenza-like illness (ILI) activity was reported to the French Sentinel Network. We quantified the observed excess in ILI cases in France during summer 2009 and characterised age patterns in reported cases. An excess of cases has been observed since 5 July, with a time increasing trend. The cumulated estimated excess number of ILI cases was 269,935 [179,585; 316,512], corresponding to 0.5% French population over the period. Compared to the same period in the past years, relative cumulated incidence was greater among young subjects and lower among subjects over 65 years-old. Compared to past epidemics, the relative cumulated incidence was greater in children less than five years-old. This excess of cases may reflect the current spread of the A(H1N1) virus in France, subject to the following limitations: estimates were based on clinical cases consulting a GP; large media coverage may have led to a non specific increase in consultation rates.

Between 24 March and 31 July 2009, 342 clinically diagnosed cases of rubella were notified in five municipalities in Republika Srpska, Bosnia and Herzegovina. Fourteen cases were laboratory-confirmed by positive IgG against rubella virus. Four virus isolates were obtained and identified as genotype 2B strains, with one isolate differing by a single mutation in the region of the E1 gene. This ongoing outbreak revealed gaps in the immunisation programme during the war in BiH (1992-1995) and highlights the need to revise legislation to permit immunisation of children above 14 years of age with measles, mumps, rubella (MMR) vaccine and to introduce supplemental immunisation activities.

Sexually transmitted diseases caused by human papillomavirus (HPV) are being diagnosed more frequently than others. It is accepted that HPV infection is a necessary cause for all cases of cervical carcinoma and a large number of other anogenital and oral cancers. Two vaccines have been developed and were licensed in 2007, which can prevent infections and pre-cancerous lesions due to HPV. In Italy pre-adolescent age (12 years-old) was identified as the ideal age for vaccination against HPV. In Liguria, the first free HPV vaccination campaign was started on 8 March 2008 in 12 year-old girls. We assessed the adherence to the vaccination during the 2008 campaign as 80.6%, 79.0% and 64.1%, respectively, for the first, second and third dose of vaccine in the target population.

This report outlines the proceedings of the 4th Annual Meeting of the Eastern European Network for Sexual and Reproductive Health (EE SRH Network) [1,2], which took place at Uppsala University in Uppsala, Sweden between 30 May and 3 June, 2009.