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Problem The emergence of Zika virus has challenged outbreak surveillance systems in many at-risk, low-resource countries. As the virus has been linked with Guillain-Barre syndrome, routine data on the incidence of acute flaccid paralysis (AFP) may provide a useful early warning system for the emergence of Zika virus. Approach We documented all Zika virus outbreaks and cases in 21 Pacific Islands and territories for the years 2007 to 2015. We extracted data from the Global Polio Eradication Initiative database on the reported and expected annual incidence of AFP in children younger than 15 years. Using a Poisson probability test, we tested the significance of unexpected increases in AFP in years correlating with Zika virus emergence. Data were analysed separately for each Pacific Island country and territory. Local setting In most Pacific Island countries, early warning surveillance for acute public health threats such as Zika virus is hampered by poor health infrastructure, insufficient human resources and geographical isolation. Relevant changes Only one example was found (Solomon Islands in 2015) of a significant increase in reported AFP cases correlating with Zika virus emergence. Lessons learnt We found no conclusive evidence that routinely reported AFP incidence data in children were useful for detecting emergence of Zika virus in this setting. More evidence may be needed from adult populations, who are more likely to be affected by Guillain-Barre syndrome. Reporting of AFP may be deficient in regions certified as polio-free. Probleme L'emergence du virus Zika pose un probleme pour les systemes de surveillance des epidemies dans de nombreux pays a faibles ressources et a risque. Etant donne qu'un lien a ete etabli entre ce virus et le syndrome de Guillain-Barre, les donnees systematiquement collectees sur l'incidence de la paralysie flasque aigue (PFA) pourraient peut-etre aider a etablir un systeme d'alerte anticipee pour l'emergence du virus Zika. Approche Nous avons documente toutes les flambees de virus Zika et tous les cas d'infection a virus Zika dans 21 iles et territoires du Pacifique, sur la periode 2007 a 2015. A partir de la base de donnees de l'Initiative mondiale pour l'eradication de la poliomyelite, nous avons extrait des donnees sur l'incidence annuelle signalee et l'incidence annuelle prevue de la PFA chez les enfants de moins de 15 ans. En utilisant un test de probabilite de Poisson, nous avons teste la significativite de la correlation entre les augmentations annuelles Imprevues des cas de PFA et l'emergence du virus Zika. Les donnees ont ete analysees separement pour chaque territoire et chaque ile du Pacifique. Environnement local Dans la plupart des ilesdu Pacifique, les activites de surveillance et d'alerte anticipee des menaces aigues de sante publique (telles que celle representee par le virus Zika) sont rendues difficiles par les deficiences des Infrastructures de sante, l'Insuffisance des ressources humaines et l'isolement geographique des populations. Changements significatifs Nous n'avons constate qu'un seul exemple (iles Salomon, 2015) d'une augmentation significative des cas signales de PFA coincidant avec une emergence du virus Zika. Lecons tirees Nous n'avons trouve aucune preuve concluante permettant d'affirmer que les donnees systematiquement signalees sur l'incidence de la PFA chez les enfants ont ete utiles, dans ces contextes, pour detecter une emergence du virus Zika. Des donnees complementaires pourraient etre necessaires en lien avec les populations adultes, qui sont plus susceptibles d'etre affectees par le syndrome de Guillain-Barre. Il est egalement possible que le signalement des PFA soit defaillant dans ces regions certifiees exemptes de poliomyelite. Situacion La aparicion del virus de Zika ha puesto en peligro los sistemas de control del brote en muchos paises en riesgo con escasos, recursos. Dado que el virus se ha relacionado con el sindrome de Guillain-Barre, los datos rutinarios sobre la Incidencia de paralisis flacida aguda (PFA) pueden proporcionar un sistema de advertencia temprana util para la aparicion del virus de Zika. Enfoque Se documentaron todos los brotes y casos del virus de Zika en 21 islas y territorios del Pacifico entre los anos 2007 y 2015. Se recopilo Informacion de la base de datos de la Iniciativa de Erradicacion Mundial de la Poliomielitis sobre la incidencia anual de PFA Informada y prevista en ninos menores de 15 anos. Utilizando una prueba de probabilidad de Poisson, se demostro la importancia de los aumentos inesperados de PFA en los anos correlacionados con la aparicion del virus de Zika. Se analizaron los datos por separado por cada pais y territorio de las Islas del Pacifico. Marco regional En la mayoria de los paises de las Islas del Pacifico, el control de aviso temprano para amenazas sanitarias publicas agudas como el virus de Zika se ve obstaculizado por una infraestructura sanitaria pobre, escasos recursos humanos y aislamiento geografico. Cambios importantes Unicamente se encontro un ejemplo (Islas Salomon en 2015) de un gran aumento en los casos de PFA informada que se correlacionaron con la aparicion del virus de Zika. Lecciones aprendidas No se encontraron pruebas concluyentes de que los datos de incidencia de PFA informada de forma rutinaria en ninos fueran utiles para detectar la aparicion del virus de Zika en esta region. Es posible que se necesiten mas pruebas de la poblacion adulta, ya que esta tiene mas probabilidades de ser afectada por el sindrome de Guillain-Barre. La notificacion de casos de PFA puede ser deficiente en algunas regiones sin incidencias de poliomielitis., Introduction In February 2016, in response to outbreaks in several Pacific and South American countries, (1) Zika virus was declared a Public Health Emergency of International Health Concern by the [...]

Data from several influenza surveillance systems are integrated in Australia each year (1-3) to create a timely and accurate picture of influenza activity. Each surveillance method has its strengths and [...]

Flutracking is a national online community influenza-like illness (ILI) surveillance system that monitors weekly ILI activity and impact in the Australian community. This article reports on the 2015 findings from Flutracking. From 2014 to 2015 there was a 38.5% increase in participants to 27,824 completing at least 1 survey with a peak weekly response of 25,071 participants. The 2015 Flutracking national ILI weekly fever and cough percentages peaked in late August at 5.0% in the unvaccinated group, in the same week as the national counts of laboratory confirmed influenza peaked. A similar percentage of Flutracking participants took two or more days off from work or normal duties in 2015 (peak level 2.3%) compared with 2014 (peak level 2.5%) and the peak weekly percentage of participants seeking health advice was 1.6% in both 2014 and 2015. Flutracking fever and cough peaked in the same week as Influenza Complications Alert Network surveillance system influenza hospital admissions. The percentage of Flutracking participants aged 5 to 19 years with cough and fever in 2015 was the highest since 2011. The 2015 season was marked by a transition to predominantly influenza B strain circulation, which particularly affected younger age groups. However, for those aged 20 years and over, the 2015 national Flutracking influenza season was similar to 2014 in community ILI levels and impact.

Flutracking is a national online community influenza-like illness (ILI) surveillance system that monitors weekly ILI activity and field vaccine effectiveness. This article reports on the 2013 and 2014 findings from Flutracking. From 2013 to 2014 there was a 14.0% increase in participants who completed at least 1 survey to 21,021 participants. By the end of the 2013 and 2014 seasons, respectively 59.7% and 59.1% of all participants had received the seasonal influenza vaccine. The 2013 Flutracking national ILI weekly incidence peaked in late August at 4.3% in the unvaccinated group, 1 week earlier than national counts of laboratory confirmed influenza. The 2014 Flutracking national ILI weekly incidence also peaked in late August at 4.7% in the unvaccinated group, in the same week as national counts of laboratory confirmed influenza. A lower percentage of Flutracking participants took two or more days off from work or normal duties in 2013 (peak level 1.6%) compared with 2014 (peak level 2.5%) and sought health advice in 2013 (peak level of 1.1%) compared with 2014 (peak of 1.6%). Flutracking ILI surveillance suggests that 2014 was a moderately more intense season than 2013 and similar to 2012.

Flutracking is a national online community influenza-like illness (ILI) surveillance system that monitors weekly ILI activity and field vaccine effectiveness (FVE). This article reports on the 2011 and 2012 findings from Flutracking. There was a 22% increase in participants to 16,046 who completed at least one survey in 2012, compared with 2011 (13,101). By October 2012 (the end of the 2012 season), 54.2% of participants had received the 2012 seasonal vaccine, while by the end of the 2011 season, 55.9% of participants had received the 2011 seasonal vaccine. From 2007 to 2012 the FVE calculation for New South Wales participants demonstrated that the seasonal vaccine was effective except in 2009 when a novel H1N1 virus was dominant. The 2012 Flutracking ILI weekly incidence peaked in mid-July at 4.9% in the unvaccinated group, 1 month earlier than laboratory confirmed influenza. The 2011 Flutracking ILI weekly incidence peaked in mid-August at 4.1% in the unvaccinated group, 1 week later than laboratory confirmed influenza. Similar to laboratory notifications, there was an increase in ILI activity from 2010 to 2012, with the peak weekly ILI prevalence for 2012 Flutracking data, (unstratified by vaccination status), being higher (4.7%) than the peak weekly prevalence for 2011 (3.8%) and 2010 (3.7%). The 2012 Flutracking influenza season showed moderate levels of ILI, compared with lower levels of ILI seen in 2011 and 2010, and consistent with the increase in national influenza laboratory notifications., (This work is copyright. Apart from any use as permitted under the Copyright Act 1968, no part may be reproduced by any process without prior written permission from the Commonwealth. Requests and inquiries concerning reproduction and rights should be addressed to the Commonwealth Copyright Administration, Attorney General's Department, Robert Garran Offices, National Circuit, Barton ACT 2600 or posted at http://www.ag.gov.au/cca.)