Nationwide surveillance of influenza during the pandemic (2009-10) and post-pandemic (2010-11) periods in Taiwan

Jen Hsiang Chuang, Angela Song En Huang, Wan Ting Huang, Ming Tsan Liu, Jih Haw Chou, Feng Yee Chang, Wen Ta Chiu

Research output: Contribution to journalArticle

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Abstract

Introduction: Although WHO declared the world moving into the post-pandemic period on August 10, 2010, influenza A(H1N1) 2009 virus continued to circulate globally. Its impact was expected to continue during the 2010-11 influenza season. This study describes the nationwide surveillance findings of the pandemic and post-pandemic influenza periods in Taiwan and assesses the impact of influenza A(H1N1) 2009 during the post-pandemic period. Methods: The Influenza Laboratory Surveillance Network consisted of 12 contract laboratories for collecting and testing samples with acute respiratory tract infections. Surveillance of emergency room visits and outpatient department visits for influenza-like illness (ILI) were conducted using the Real-Time Outbreak and Disease Surveillance system and the National Health Insurance program data, respectively. Hospitalized cases with severe complications and deaths were reported to the National Notifiable Disease Surveillance System. Results: During the 2009-10 influenza season, pandemic A(H1N1) 2009 was the predominant circulating strain and caused 44 deaths. However, the 2010-11 influenza season began with A(H3N2) being the predominant circulating strain, changing to A(H1N1) 2009 in December 2010. Emergency room and outpatient department ILI surveillance displayed similar trends. By March 31, 2011, there were 1,751 cases of influenza with severe complications; 50.1% reported underlying diseases. Of the reported cases, 128 deaths were associated with influenza. Among these, 93 (72.6%) were influenza A(H1N1) 2009 and 30 (23.4%) A(H3N2). Compared to the pandemic period, during the immediate post-pandemic period, increased number of hospitalizations and deaths were observed, and the patients were consistently older. Conclusions: Reemergence of influenza A(H1N1) 2009 during the 2010-11 influenza season had an intense activity with age distribution shift. To further mitigate the impact of future influenza epidemics, Taiwan must continue its multifaceted influenza surveillance systems, remain flexible with antiviral use policies, and revise the vaccine policies to include the population most at risk.

Original languageEnglish
Article numbere36120
JournalPLoS One
Volume7
Issue number4
DOIs
Publication statusPublished - Apr 24 2012

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Pandemics
pandemic
Emergency rooms
Taiwan
influenza
Human Influenza
monitoring
Health insurance
Viruses
Antiviral Agents
Vaccines
Testing
death
disease surveillance
National Health Programs
Hospital Emergency Service
Outpatients
notifiable disease
health insurance
H1N1 Subtype Influenza A Virus

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

Cite this

Chuang, J. H., Huang, A. S. E., Huang, W. T., Liu, M. T., Chou, J. H., Chang, F. Y., & Chiu, W. T. (2012). Nationwide surveillance of influenza during the pandemic (2009-10) and post-pandemic (2010-11) periods in Taiwan. PLoS One, 7(4), [e36120]. https://doi.org/10.1371/journal.pone.0036120

Nationwide surveillance of influenza during the pandemic (2009-10) and post-pandemic (2010-11) periods in Taiwan. / Chuang, Jen Hsiang; Huang, Angela Song En; Huang, Wan Ting; Liu, Ming Tsan; Chou, Jih Haw; Chang, Feng Yee; Chiu, Wen Ta.

In: PLoS One, Vol. 7, No. 4, e36120, 24.04.2012.

Research output: Contribution to journalArticle

Chuang, JH, Huang, ASE, Huang, WT, Liu, MT, Chou, JH, Chang, FY & Chiu, WT 2012, 'Nationwide surveillance of influenza during the pandemic (2009-10) and post-pandemic (2010-11) periods in Taiwan', PLoS One, vol. 7, no. 4, e36120. https://doi.org/10.1371/journal.pone.0036120
Chuang, Jen Hsiang ; Huang, Angela Song En ; Huang, Wan Ting ; Liu, Ming Tsan ; Chou, Jih Haw ; Chang, Feng Yee ; Chiu, Wen Ta. / Nationwide surveillance of influenza during the pandemic (2009-10) and post-pandemic (2010-11) periods in Taiwan. In: PLoS One. 2012 ; Vol. 7, No. 4.
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abstract = "Introduction: Although WHO declared the world moving into the post-pandemic period on August 10, 2010, influenza A(H1N1) 2009 virus continued to circulate globally. Its impact was expected to continue during the 2010-11 influenza season. This study describes the nationwide surveillance findings of the pandemic and post-pandemic influenza periods in Taiwan and assesses the impact of influenza A(H1N1) 2009 during the post-pandemic period. Methods: The Influenza Laboratory Surveillance Network consisted of 12 contract laboratories for collecting and testing samples with acute respiratory tract infections. Surveillance of emergency room visits and outpatient department visits for influenza-like illness (ILI) were conducted using the Real-Time Outbreak and Disease Surveillance system and the National Health Insurance program data, respectively. Hospitalized cases with severe complications and deaths were reported to the National Notifiable Disease Surveillance System. Results: During the 2009-10 influenza season, pandemic A(H1N1) 2009 was the predominant circulating strain and caused 44 deaths. However, the 2010-11 influenza season began with A(H3N2) being the predominant circulating strain, changing to A(H1N1) 2009 in December 2010. Emergency room and outpatient department ILI surveillance displayed similar trends. By March 31, 2011, there were 1,751 cases of influenza with severe complications; 50.1{\%} reported underlying diseases. Of the reported cases, 128 deaths were associated with influenza. Among these, 93 (72.6{\%}) were influenza A(H1N1) 2009 and 30 (23.4{\%}) A(H3N2). Compared to the pandemic period, during the immediate post-pandemic period, increased number of hospitalizations and deaths were observed, and the patients were consistently older. Conclusions: Reemergence of influenza A(H1N1) 2009 during the 2010-11 influenza season had an intense activity with age distribution shift. To further mitigate the impact of future influenza epidemics, Taiwan must continue its multifaceted influenza surveillance systems, remain flexible with antiviral use policies, and revise the vaccine policies to include the population most at risk.",
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