Shivers Update: Kiwi Flu Experts

Shivers Update: Kiwi Flu Experts Say Incidence of Hospitalised Patients
Higher than Anticipated

On the 7th and 8th of November, international flu experts from the United States Centers for Disease Control and Prevention (CDC) and St Jude Children’s Research Hospital in Memphis will attend a briefing in Auckland to hear what the Northern Hemisphere should expect, and how it can plan, for its forthcoming flu season.

At the briefing a team of scientists from New Zealand’s Institute of Environmental Science & Research (ESR) and researchers from The Universities of Auckland and Otago, Auckland District Health Board (ADHB), Counties Manukau District Health Board (CMDHB) and Centre for Clinical Research and effective practice (CCRep) will present their findings following the completion of Year One of the five-year, multi-million dollar international Southern Hemisphere Influenza Vaccine Effectiveness Research and Surveillance (SHIVERS) contract to study influenza.

Led by ESR, the study commenced in September 2011 and will study five autumn and winter ‘flu seasons’ amongst the Auckland population using New Zealand’s world leading sentinel surveillance systems.

SHIVERS Principal Investigator, Dr. Sue Huang from ESR, says that after real time surveillance of New Zealand’s flu season, the SHIVERS team has some good insights into how Northern Hemisphere countries, which are just entering their flu season, can better plan for and protect against potential flu epidemics and pandemics.

“We were surprised that the incidence of hospitalised patients with influenza-related Severe Acute Respiratory Infections (SARI) is much higher than we previously thought, particularly in very young children (0-4 years) and those over 65 years,” says Dr. Huang.

Dr. Adrian Trenholme, a Paediatrician at Middlemore Hospital says that uniform and intensive testing showed that young children harbour more than one respiratory pathogen.

The study is extending existing influenza surveillance systems by establishing two enhanced realtime surveillance systems in the Auckland region - one hospitalbased and one communitybased. Year One of the study focused on patients hospitalised in Auckland with SARI, including ICU admissions and deaths caused by influenza and other respiratory pathogens.

“Within a four month period, our productive collaboration has already resulted in world-class SARI surveillance in both ADHB and CMDHB, and has generated a lot of useful information for vaccine strain selection,” says Clinical Head of Microbiology at Auckland City Hospital, Dr. Sally Roberts.

The community-based surveillance system will build on the current sentinel GP surveillance already in place, and commences during Year Two of the study in May 2013.

“Over the next six months we will consult with primary and secondary care networks across the Auckland region to determine how we can work together to achieve the study’s objectives,” says Dr. Huang.

New Zealand’s response to the Swine Flu pandemic, combined with its geographic location, unique healthcare and data management infrastructure and world class influenza surveillance systems makes it an ideal location for this type of ground-breaking, population-based research.

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About the SHIVERS project:

ESR is the host institute for the SHIVERS project. The project is funded by the US Department of Health and Human Services for the Influenza Division of the National Center for Immunization and Respiratory Diseases (NCIRD) of the United States Centers for Disease Control and Prevention (CDC). The Principal Investigator for the study is Dr Sue Huang from ESR. Dr Huang is a virologist and WHO National Influenza Centre (NIC) Director who is working with a number of collaborators on the project including ESR’s Dr Don Bandaranayke, Associate Professor Michael Baker from the University of Otago, Drs Nikki Turner and Cameron Grant at The University of Auckland, Drs Sally Roberts, Colin McArthur and Debbie Williamson from the Auckland District Health Board (ADHB) and Drs Adrian Trenholme and Conroy Wong from the Counties Manukau District Health Board (CMDHB) and the Centre for Clinical Research and effective practice (CCRep). The New Zealand team are also collaborating with Dr Marc-Alain Widdowson, team leader of International Epidemiology and response at Influenza Division of the Centres for Disease Control and Prevention, Atlanta, USA, and Dr Richard Webby, Director at the WHO Collaborating Centre (WHOCC) at St. Jude Children’s Research Hospital in the United States.

For information about Shivers: www.esr.cri.nz/shivers

About ESR

ESR is one of eight Crown Research Institutes owned by the government on behalf of the people of New Zealand. ESR’s work underpins the health and justice systems in New Zealand through the provision of science services and research, primarily to government clients.

The Health Programme in ESR includes the public health reference laboratory, disease surveillance and the National Influenza Centre (NIC). The NIC was recognised by the WHO in 1954 and serves as the key point of contact for both the WHO and the New Zealand Ministry of Health for the virology and epidemiologic surveillance of influenza.

The NIC provides influenza virus isolates to the WHO Global Influenza Surveillance Network on a regular basis. ESR has made a recent and very significant investment in infrastructure that will support this research, in particular the newly built and refurbished laboratories, a new laboratory information management system a platform for web-based surveillance of notifiable infectious diseases, and other information management and surveillance tools and systems. The NIC is situated at a newly purpose-built PC2 facility attached to a PC3+ facility and is fully equipped to conduct the proposed laboratory testing.

ESR is also linked to the Kiwi Advanced Research and Education Network (KAREN) enabling the transfer of large datasets between research and education organisations involved in this study. ESR is committed to ethical research and the research team has considerable experience with ethics and privacy issues, processes and compliance.

All ESR laboratories are IANZ accredited to the ISO 15189 quality standard. Health and safety are organisational priorities.

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