Influenza sentinel surveillance in Rwanda, 2008-2010. 2012

Thierry Nyatanyi, and Richard Nkunda, and Joseph Rukelibuga, and Rakhee Palekar, and Marie Aimée Muhimpundu, and Adeline Kabeja, and Alice Kabanda, and David Lowrance, and Stefano Tempia, and Jean Baptiste Koama, and David McAlister, and Odette Mukabayire, and Justin Wane, and Pratima Raghunathan, and Mark Katz, and Corine Karema
Rwanda Biomedical Center, Ministry of Health, Kigali, Rwanda.

BACKGROUND In 2008, Rwanda established an influenza sentinel surveillance (ISS) system to describe the epidemiology of influenza and monitor for the emergence of novel influenza A viruses. We report surveillance results from August 2008 to July 2010. METHODS We conducted ISS by monitoring patients with influenza-like illness (ILI) and severe acute respiratory infection (SARI) at 6 hospitals. For each case, demographic and clinical data, 1 nasopharyngeal specimen, and 1 oropharyngeal specimen were collected. Specimens were tested by real-time reverse-transcription polymerase chain reaction for influenza A and B viruses at the National Reference Laboratory in Rwanda. RESULTS A total of 1916 cases (945 ILI and 971 SARI) were identified. Of these, 29.2% (n = 276) of ILI and 10.4% (n = 101) of SARI cases tested positive for influenza. Of the total influenza-positive cases (n = 377), 71.8% (n = 271) were A(H1N1) pdm09, 5.6% (n = 21) influenza A(H1), 7.7% (n = 29) influenza A(H3), 1.6% (n = 6) influenza A (unsubtyped), and 13.3% (n = 50) influenza B. The percentage of positivity for influenza viruses was highest in October-November and February-March, during peaks in rainfall. CONCLUSIONS The implementation of ISS enabled characterization of the epidemiology and seasonality of influenza in Rwanda for the first time. Future efforts should determine the population-based influenza burden to inform interventions such as targeted vaccination.

UI MeSH Term Description Entries
D007223 Infant A child between 1 and 23 months of age. Infants
D007251 Influenza, Human An acute viral infection in humans involving the respiratory tract. It is marked by inflammation of the NASAL MUCOSA; the PHARYNX; and conjunctiva, and by headache and severe, often generalized, myalgia. Grippe,Human Flu,Human Influenza,Influenza in Humans,Influenza,Flu, Human,Human Influenzas,Influenza in Human,Influenzas,Influenzas, Human
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009305 Nasopharynx The top portion of the pharynx situated posterior to the nose and superior to the SOFT PALATE. The nasopharynx is the posterior extension of the nasal cavities and has a respiratory function. Rhinopharynx,Choanae,Nasopharynges,Nasopharynxes,Rhinopharynges,Rhinopharynxes
D009960 Oropharynx The middle portion of the pharynx that lies posterior to the mouth, inferior to the SOFT PALATE, and superior to the base of the tongue and EPIGLOTTIS. It has a digestive function as food passes from the mouth into the oropharynx before entering ESOPHAGUS. Oropharynxs
D009980 Influenza A virus The type species of the genus ALPHAINFLUENZAVIRUS that causes influenza and other diseases in humans and animals. Antigenic variation occurs frequently between strains, allowing classification into subtypes and variants. Transmission is usually by aerosol (human and most non-aquatic hosts) or waterborne (ducks). Infected birds shed the virus in their saliva, nasal secretions, and feces. Alphainfluenzavirus influenzae,Avian Orthomyxovirus Type A,FLUAV,Fowl Plague Virus,Human Influenza A Virus,Influenza Virus Type A,Influenza Viruses Type A,Myxovirus influenzae-A hominis,Myxovirus influenzae-A suis,Myxovirus pestis galli,Orthomyxovirus Type A,Orthomyxovirus Type A, Avian,Orthomyxovirus Type A, Human,Orthomyxovirus Type A, Porcine,Pestis galli Myxovirus,Fowl Plague Viruses,Influenza A viruses,Myxovirus influenzae A hominis,Myxovirus influenzae A suis,Myxovirus, Pestis galli,Myxoviruses, Pestis galli,Pestis galli Myxoviruses,Plague Virus, Fowl,Virus, Fowl Plague
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D002675 Child, Preschool A child between the ages of 2 and 5. Children, Preschool,Preschool Child,Preschool Children
D005260 Female Females

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