Centre for Health Security and Communicable Disease Control, Directorate of Health in Iceland, Seltjarnarnes, Iceland.
Euro Surveill. 2010 Dec 9;15(49):19742. doi: 10.2807/ese.15.49.19742-en.
In a pandemic setting, surveillance is essential to monitor the spread of the disease and assess its impact. Appropriate mitigation and healthcare preparedness strategies depend on fast and accurate epidemic surveillance data. During the 2009 influenza A(H1N1) pandemic, rapid improvements in influenza surveillance were made in Iceland. Here, we describe the improvements made in influenza surveillance during the pandemic , which could also be of great value in outbreaks caused by other pathogens. Following the raised level of pandemic influenza alert in April 2009, influenza surveillance was intensified. A comprehensive automatic surveillance system for influenza-like illness was developed, surveillance of influenza-related deaths was established and laboratory surveillance for influenza was strengthened. School absenteeism reports were also collected and compared with results from the automatic surveillance system. The first case of 2009 pandemic influenza A(H1N1) was diagnosed in Iceland in May 2009, but sustained community transmission was not confirmed until mid-August. The pandemic virus circulated during the summer and early autumn before an abrupt increase in the number of cases was observed in October. There were large outbreaks in elementary schools for children aged 6–15 years throughout the country that peaked in late October. School absenteeism reports from all elementary schools in Iceland gave a similar epidemiological curve as that from data from the healthcare system. Estimates of the proportion of the population infected with the pandemic virus ranged from 10% to 22%. This study shows how the sudden need for improved surveillance in the pandemic led to rapid improvements in data collection in Iceland. This reporting system will be improved upon and expanded to include other notifiable diseases, to ensure accurate and timely collection of epidemiological data.
在大流行背景下，监测对于监测疾病传播和评估其影响至关重要。适当的缓解和医疗保健准备策略取决于快速准确的疫情监测数据。在 2009 年甲型 H1N1 流感大流行期间，冰岛在流感监测方面取得了快速改进。在这里，我们描述了大流行期间流感监测的改进，这对于由其他病原体引起的暴发也具有重要意义。2009 年 4 月大流行流感警戒级别提高后，加强了流感监测。开发了一个全面的自动流感样疾病监测系统，建立了与流感相关的死亡监测，并加强了流感实验室监测。还收集了学校缺课报告，并与自动监测系统的结果进行了比较。2009 年甲型 H1N1 大流行的首例病例于 2009 年 5 月在冰岛确诊，但直到 8 月中旬才确认社区持续传播。大流行病毒在夏季和初秋传播，然后在 10 月观察到病例数突然增加。全国各地的 6-15 岁儿童小学爆发了大规模疫情，于 10 月底达到高峰。冰岛所有小学的缺课报告与医疗系统数据的流行病学曲线相似。估计感染大流行病毒的人群比例在 10%至 22%之间。这项研究表明，大流行期间对改进监测的突然需求如何导致冰岛数据收集的快速改进。该报告系统将得到改进和扩展，以包括其他应报告的疾病，以确保准确和及时地收集流行病学数据。
