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2015, 90, 281296 No.

23

Weekly epidemiological record


Relev pidmiologique hebdomadaire
5 JUNE 2015, 90th YEAR / 5 JUIN 2015, 90e ANNE
No. 23, 2015, 90, 281296
http://www.who.int/wer

Review of the 20142015 Analyse de la saison grippale


Contents influenza season in the 2014-2015 dans lhmisphre
281 Review of the 20142015 northern hemisphere Nord
influenza season in Aspen Hammond,a Nesreen Gusbi,a Aspen Hammond,a Nesreen Gusbi,a Paulina Sosa,a
the northern hemisphere Paulina Sosa,a Julia Fitzner,a Terry Besselaar,a Julia Fitzner,a Terry Besselaar,a Katelijn Vandemaelea
Katelijn Vandemaelea and Wenqing Zhang.a and Wenqing Zhang.a
(Author affiliations indicated at the end of the article) (Affiliations des auteurs la fin du texte)
Sommaire
This report summarizes the chronology, Le prsent rapport rcapitule la chronologie,
281 Analyse de la saison grippale epidemiology and virology of the 2014 lpidmiologie et la virologie de la saison
2014-2015 dans lhmisphre
Nord
2015 influenza season in the temperate grippale 2014-2015 dans les rgions tempres
regions of the northern hemisphere, de lhmisphre Nord et couvre les donnes
covering influenza activity data collected dactivit grippale recueillies doctobre 2014
from October 2014 until the end of April fin avril 2015. Les donnes prsentes ont
2015. The data presented have been principalement t tires des rapports publis
derived primarily from reports published par les Ministres nationaux de la sant ou par
by national ministries of health or other dautres organismes officiels, ou t commu-
official bodies, or reported to WHO niques lOMS par le canal de FluNet1 ou de
through FluNet1 or FluID.2 Transmission FluID.2 Les caractristiques de la transmission
characteristics, illness and mortality data et les donnes de morbidit et de mortalit
are presented by geographic region includ- sont indiques en fonction des rgions gogra-
ing North America, Europe, North Africa, phiques: Amrique du Nord, Europe, Afrique
the Middle East and Northern Asia. Distri- du Nord, Moyen-Orient et Asie septentrionale.
butions of virus subtypes by transmission La distribution des sous-types viraux par zone
zone are shown in Map 1. de transmission est reprsente sur la Carte 1.
Although detections of influenza in the Bien que les dtections de grippe dans lhmis-
southern hemisphere are generally phre Sud soient gnralement sporadiques et
sporadic and at low levels during the peu nombreuses pendant les mois qui corres-
northern hemisphere winter months, pondent lhiver de lhmisphre Nord, la distri-
thedistributions of the southern hemi- bution des sous-types dans lhmisphre Sud
sphere subtypes are included in Map 1, figure aussi sur la Carte 1, sans tre toutefois
but not detailed in the text of this report. aborde en dtail dans le texte du prsent rapport.
Human influenza transmission usually La transmission de la grippe humaine a gn-
occurs in the winter months in the north- ralement lieu pendant les mois dhiver dans les
ern hemisphere temperate region but the rgions tempres de lhmisphre Nord, mais
exact timing and duration of the influenza la chronologie et la dure exactes de la saison
season varies by country and by year. The grippale varient selon les pays et les annes.
influenza season can begin as early as Elle peut dbuter ds le mois doctobre et
October and typically peaks around Janu- culmine habituellement vers le mois de janvier
WORLD HEALTH
ary or February. For the purposes of this ou fvrier. Pour les besoins du prsent rapport,
ORGANIZATION report, the peak of influenza activity is the le pic de lactivit grippale est dfini comme le
Geneva month/week with the highest percentage mois/la semaine o a t relev le pourcentage
ORGANISATION MONDIALE of respiratory specimens testing positive le plus lev dchantillons respiratoires posi-
DE LA SANT for influenza viruses, and influenza activ- tifs pour les virus grippaux et, sauf mention
Genve ity is based on the positivity rate for influ- contraire, lactivit grippale est dtermine sur
enza unless otherwise specified. la base du taux de positivit pour la grippe.
Annual subscription / Abonnement annuel
Sw. fr. / Fr. s. 346.
FluNet can be accessed online at http://www.who.int/influen-
1
FluNet est accessible ladresse: http://www.who.int/influenza/
1

06.2015 za/gisrs_laboratory/flunet/en/; accessed April 2015. gisrs_laboratory/flunet/en/, consult en avril 2015.


ISSN 0049-8114 FluID can be accessed online at http://www.who.int/influenza/
2
FluID est accessible ladresse: http://www.who.int/influenza/sur-
2

Printed in Switzerland surveillance_monitoring/fluid/en/; accessed April 2015. veillance_monitoring/fluid/en/, consult en avril 2015.

281
282
Map 1 Distribution of influenza virus subtypes by influenza transmission zone, October 2014 to May 2015
Carte 1 Distribution des sous-types de virus grippaux par zones de transmission de la grippe, octobre 2014-mai 2015

Northern Europe
Europe du Nord

Eastern Europe
North America Europe de lEst
Amrique du Nord Central Asia
Southwestern Asie centrale
Europe Europe
du Sud-Ouest
Western Asia Eastern Asia
Asie de lOuest Asie de lEst
Northern Africa
Carribean and central Afrique du Nord
America Carabes et
Amrique centrale South Asia South East Asia
Western Africa
Asie du Sud Asie du Sud-Est
Afrique de lOuest

Virus subtype (%) Sous-type viral (%) Middle Africa Eastern Africa
Tropical south Afrique centrale Afrique de lEst
America Amrique
du Sud tropicale
Oceania, Melanesia
and Polynesia
Influenza A(H1N1)pdm09 Grippe A(H1N1)pdm09 Temperate south Southern Africa Ocanie, Mlansie
America Amrique Afrique australe et Polynsie
Influenza A(H3) Grippe A(H3)
du Sud tempre
WEEKLY EPIDEMIOLOGICAL RECORD, NO. 23, 5 JUNE 2015

Influenza A (not subtyped) Grippe A (non sous-type)


Influenza B Grippe B
Source: WHO Global Influenza Programme (data in WHO headquarters as of 5 May 2015). The data used come from: FluNet (www.who.int/flunet), WHO regional offices
0 1,200 2,400 4,800 km
and/or ministry of health websites. Programme mondial de lutte contre la grippe de lOMS (donnes disponibles au sige de lOMS, 5 mai 2015): les donnes utilises
proviennent de FluNet (www.who.int/flunet), des sites Internet des Bureaux rgionaux de lOMS et/ou des Ministres de la Sant.

Note: the available country data were joined in larger geographical areas with similar influenza transmission patterns to be able to give an overview (www.who.int/
influenza/surveillance_monitoring/updates/EN_GIP_Influenza_transmission_zones.pdf). Note: les donnes disponibles relatives aux pays ont t regroupes par zones
gographiques plus larges o les modalits de transmission sont similaires de manire fournir un tableau synoptique(www.who.int/influenza/surveillance_monitoring/
updates/EN_GIP_Influenza_transmission_zones.pdf).

The boundaries and names shown and the designations used on this map do not imply the expression of any opinion whatsoever on the part of the World Health Orga-
nization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on
maps represent approximate border lines for which there may not yet be full agreement. Les appellations employes dans la prsente publication et la prsentation des
donnes qui y figurent nimpliquent de la part de lOrganisation mondiale de la Sant aucune prise de position quant au statut juridique des pays, territoires, villes ou
zones, ou de leurs autorits, ni quant au trac de leurs frontires ou limites. Les lignes en pointill sur les cartes reprsentent des frontires approximatives dont le trac
peut ne pas avoir fait lobjet dun accord dfinitif.
WHO 2015. All rights reserved. OMS 2015. Tous droits rservs.
North America Amrique du Nord
Timing of the season and circulating influenza Chronologie de la saison grippale et virus grippaux
viruses circulants
In North America, the timing (beginning and peak) of En Amrique du Nord, le dbut et le pic de la saison grippale
this season was earlier than previous seasons. Influenza 2014-2015 ont t plus prcoces que lors des saisons prc-
activity generally started to increase slowly in the last dentes. Lactivit grippale a gnralement entam une lente
weeks of October until a rapid increase to the peak at progression dans les dernires semaines doctobre, puis sest
the end of December. The peak of influenza activity was amplifie rapidement jusqu culminer la fin dcembre. Cette
higher this season compared to the past few seasons. saison grippale sest caractrise par un pic dactivit plus
Influenza activity remained high until the end of Janu- intense que les saisons prcdentes. Lactivit grippale est reste
ary. Activity levels began to decrease in late January but forte jusqu la fin janvier. Elle a ensuite commenc dcliner,
remained higher at the end of the season than in previ- mais est demeure plus leve en fin de saison que lors des
ous seasons. Influenza activity was near inter-seasonal annes prcdentes. la fin avril, elle sapprochait du niveau
levels by the end of April. intersaisonnier.
Influenza A(H3N2) virus was predominant in North Cette saison, le virus grippal A(H3N2) a t prdominant en
America during this season, as in the 20122013 season, Amrique du Nord, comme cela avait t le cas en 2012-2013,
but unlike the 20132014 season when A(H1N1)pdm09 mais contrairement la saison 2013-2014 durant laquelle le
virus was predominant. Similar to the 20132014 season, virus A(H1N1)pdm09 avait t prpondrant. linstar de
influenza B activity increased in late January and lasaison 2013-2014, lactivit de la grippe B a augment vers la
continued towards the end of the season after a peak fin janvier et sest maintenue jusqu la fin de la saison aprs
activity of influenza A viruses, resulting in a prolonged le pic dactivit des virus de la grippe A, entranant une priode
period of low levels of influenza activity at the end of prolonge de faible activit grippale en fin de saison.
the season.
In Canada, as in previous seasons, influenza activity Au Canada, comme lors des saisons prcdentes, lactivit grip-
started to increase sharply in mid-November and pale a commenc crotre fortement la mi-novembre pour
peaked around the end of 2014. Influenza A(H3N2) was culminer vers la fin de lanne 2014. Le virus grippal A(H3N2)
the predominant circulating virus throughout most of a t le virus circulant prdominant tout au long de la saison.
the season. The proportion of influenza B virus detec- La proportion de virus B dtects a augment partir de la fin
tions increased from the end of January. Throughout janvier. Cette saison, la proportion de virus respiratoires syncy-
this season, there was a higher proportion of respira- tiaux (VRS) dtects parmi les virus respiratoires non grippaux
tory syncytial virus (RSV) detections among respira- tait plus leve quen 2013-2014.
tory viruses other than influenza compared to the
previous season of 20132014.
In the United States of America (USA), influenza activ- Aux tats-Unis, lactivit grippale a commenc sintensifier
ity began to increase in mid to late November with a dans la seconde quinzaine de novembre, avec un profil dactivit
pattern of activity similar to that seen during the 2012 semblable celui qui avait t observ pour la saison 2012-2013.
2013 season. Although influenza A(H1N1)pdm09, Les virus grippaux A(H1N1)pdm09, A(H3N2) et B ont tous t
A(H3N2), and influenza B viruses were all detected dtects au cours de cette saison, mais le virus A(H3N2) tait
during the season, influenza A(H3N2) virus predomi- prdominant. Comme ctait le cas au Canada et lors des saisons
nated. Similar to Canada and to previous seasons in the prcdentes aux tats-Unis, la circulation du virus de la grippe
USA, influenza B virus circulation increased as influ- B sest accentue alors que lactivit du virus A(H3N2) dclinait
enza A(H3N2) virus activity decreased later in the en fin de saison. Les dtections de VRS ont connu une volution
season. RSV detections this season followed patterns semblable aux dernires saisons, avec un pic dactivit vers la
similar to the previous few seasons with peak in activ- fin de lanne.
ity around the end of the year.
In Mexico, influenza A(H3N2) virus was predominant Au Mexique, le virus A(H3N2) a prdomin, avec une circulation
with influenza B co-circulating throughout the season, concomitante du virus de la grippe B tout au long de la saison,
different from the preceding season but similar to the la diffrence de lanne dernire mais linstar de la saison
season of 20122013. 2012-2013.

Morbidity and mortality Morbidit et mortalit


Overall in North America, influenza morbidity and Dans lensemble, lAmrique du Nord a enregistr des taux plus
mortality were greater this season than in previous levs de morbidit et de mortalit grippales que lors des
seasons. The number of weekly influenza detections saisons prcdentes. Le nombre de cas de grippe dtects
peaked at almost 15 000 detections, which was the high- chaque semaine a atteint le pic le plus lev des 4 dernires
est level reached over the preceding 4 seasons. The saisons, culminant environ 15 000 dtections hebdomadaires.
second highest peak level of influenza detections La saison 2012-2013 est en seconde place, avec un pic de
occurred in the 20122013 season with 10 000 influenza 10000dtections par semaine. Le taux de positivit pour la
detections per week. The influenza positivity rate during grippe enregistr cette saison a dpass la limite de lintervalle
RELEVE EPIDEMIOLOGIQUE HEBDOMADAIRE, No 23, 5 JUIN 2015 283
this season exceeded the 90% confidence interval (CI) de confiance 90% autour du taux moyen de positivit des
around the mean positivity rate of the previous 10 dernires saisons ( lexception de 2009-2010) (Figure 1a).
10 seasons (with exception of 20092010) (Figure 1a).
In Canada,3 the reported influenza-like illness (ILI) Au Canada,3 le taux signal de consultations pour syndromes
consultation rates were above the usual range for most grippaux tait suprieur aux valeurs habituelles pour la plupart
of the weeks of the season in comparison with the des semaines de cette saison par rapport aux saisons prc-
previous seasons (19961997 through 20122013 with dentes (de 1996-1997 2012-2013, exception faite de 2009-2010).
the exception of 20092010). This season, hospitaliza- Le nombre dhospitalisations et de dcs imputables la grippe
tions and deaths due to influenza were also higher a galement t plus lev que lors des 4 dernires saisons,
than in the preceding 4 seasons. The proportions of touchant une plus grande proportion dadultes (>20 ans) que
adults (aged >20 years) among the hospitalized les annes prcdentes. La morbidit et la mortalit taient
patients and among deaths due to influenza were particulirement prvalentes chez les personnes ges. Les
higher than in previous years. Morbidity and mortality sujets de 65 ans reprsentaient 92% de tous les dcs signals
were especially prevalent in the elderly. Adults aged parmi la population adulte (16 ans), 75% de toutes les admis-
65 years represented 92% of all reported adult (aged sions dadultes en soins intensifs et 82% de toutes les hospita-
16 years) deaths, 75% of all adult admissions in inten- lisations dadultes imputables la grippe cette saison. La grippe
sive-care units (ICU), and 82% of all adult hospitaliza- B a eu un impact plus marqu chez les adultes de <65 ans par
tions due to influenza this season. Influenza B had a rapport la grippe A(H3N2) qui a circul plus tt dans la
greater impact on adults aged <65 years compared to saison. La proportion de prescriptions dlivres pour des anti-

Figure 1 Current season approximated influenza positivity compared to historical trends based on FluNet dataa
Figure 1 Taux approximatif de positivit la grippe par rapport aux tendances historiques bases sur FluNeta

Figure 1a North America Amrique du Nord

Mean of the influenza positivity after aligning at the median peak for the seasons
20032004 to 20132014 (excluding 20092010) Moyenne de la positivit du
Influenza positivity (%) Positivit la grippe (%)

dpistage de la grippe aprs alignement sur le pic mdian pour les saisons 2003-
40

2004 2013-2014 ( lexclusion de 2009-2010)


90% confidence interval boundaries Limites de lintervalle de confiance 90%
30

20142015

The boxplot visualizes the spread of the historical peaks La bote moustaches
20

(boxplot) permet de visualiser la dispersion des pics historiques


10
0

40 43 46 49 52 03 06 09 12 15 18 21 24 27 30 33 36 39

Weeks Semaines

a
Current season approximated influenza positivity compared to historical trends based on FluNet data as of 20 May 2015. This figure includes an historical average by week of the
percentage of specimens testing positive for influenza virus over the past several years for which data are available and the same data from the 20142015 season. Influenza posi-
tivity was calculated by dividing the number of samples processed (and if this was not available, the samples received) by the total influenza positives per week. Weeks with fewer
than 15 samples and the pandemic season 20092010 were excluded. Curves were smoothed using a 3 week moving average. Curves for previous years were aligned at the median
peak week for the years analysed and the mean value for each week, and the 90% confidence interval (CI, using a t-test) was calculated. The data of 20142015 are shown by their
actual chronological week. The boxplot visualizes the spread of the historical peaks, with 50% of all peaks within the time frame of the box, the dot representing the median week
of the historical peaks and the end of the lines representing the minimum and maximum week of the historical peaks. For more details on the methods used, see appendix 8 of the
WHO interim global epidemiological surveillance standards for influenza at: http://www.who.int/influenza/surveillance_monitoring/en/ Comparaison de la positivit pour la grippe
approxime pour la saison actuelle avec les tendances historiques dgages des donnes de FluNet au 20 mai 2015. La figure prsente notamment une moyenne historique par
semaine du pourcentage dchantillons tests positifs pour un virus grippal sur les dernires annes pour lesquelles on disposait de donnes et le mme paramtre pour la saison
2014-2015. On calcule la positivit en divisant le nombre dchantillons traits (si ce nombre nest pas disponible, celui des chantillons reus) par le nombre total dchantillons
positifs pour la grippe par semaine. Les semaines o le nombre dchantillons tait infrieur 15 et la saison pandmique 2009-2010 ont t exclues. Les courbes ont t lisses
en utilisant une moyenne mobile sur 3 semaines. Les courbes pour les annes prcdentes ont t alignes au niveau de la semaine correspondant au pic mdiane pour les annes
analyses, et la valeur moyenne pour chaque semaine ainsi que lintervalle de confiance 90% (IC, laide du test t) ont t calculs. Les donnes pour 2014-2015 sont prsentes
selon leur semaine chronologique relle. La bote moustaches permet de visualiser la diffusion des pics historiques, 50% des pics se trouvant dans le cadre temporel dfini par la
bote, le point reprsentant la semaine moyenne des pics historiques et lextrmit des lignes indiquant la semaine la plus proche et la semaine la plus loigne pour les pics histo-
riques. Pour en savoir plus sur les mthodes utilises, se rfrer lappendice 8 du document WHO interim global epidemiological surveillance standards for influenza disponible sur
http://www.who.int/influenza/surveillance_monitoring/en/.

See FluWatch, http://www.phac-aspc.gc.ca/fluwatch/index-eng.php; accessed May


3 3
Voir FluWatch, http://www.phac-aspc.gc.ca/fluwatch/index-eng.php; consult en mai 2015.
2015.
284 WEEKLY EPIDEMIOLOGICAL RECORD, NO. 23, 5 JUNE 2015
influenza A(H3N2), which circulated earlier in the viraux contre la grippe a atteint un pic de 950 sur 100000 pres-
season. The peak in the proportion of prescriptions criptions cette saison, soit beaucoup plus que lors des saisons
sold for influenza antivirals was approximately 950per prcdentes 2012-2013 et 2011-2012 pour lesquelles ce pic tait
100000 prescriptions this season, much higher than in infrieur 400 pour 100000 prescriptions. Les patients 65 ans
the previous seasons when the proportions peaked at sont ceux qui ont fait lusage le plus frquent dantiviraux pres-
under 400 per 100000 prescriptions in 20122013 and crits au cours de cette saison.
20112012. Usage of prescribed antivirals was most
frequent in those aged 65 years throughout the
season.
In the USA, ILI activity followed the same pattern as in Aux tats-Unis, lactivit des syndromes grippaux a prsent le
the 20122013 season and activity rates were greater mme profil que pour la saison 2012-2013, avec des taux dacti-
than those in the 20132014 and 20112012 seasons.4 vit plus levs que les saisons 2013-2014 et 2011 2012.4 Par
Compared to previous seasons, the cumulative hospi- rapport aux saisons prcdentes, le taux cumul dhospitalisa-
talization rate per 100000 population was slightly higher tions pour 100 000 habitants tait lgrement plus lev pour
for all age groups combined but considerably higher for toutes les tranches dge confondues, mais nettement plus lev
the group aged 65 years (296 for 20142015; previous chez les sujets de 65 ans (taux de 296 en 2014-2015, par rapport
4 seasons between 37 and 185 per 100000 population). des taux compris entre 37 et 185 pour les 4 saisons prc-
Adults aged 65 years accounted for 61% of influenza dentes). Les adultes de 65 ans reprsentaient 61% des hospi-
hospitalizations this season the highest proportion talisations dues la grippe cette saison, ce qui est la proportion
reported over the preceding 4seasons.5 All other age la plus forte signale au cours des 4 dernires saisons.5 Pour
groups were affected similarly or to a lesser degree toutes les autres tranches dge, limpact a t comparable, voire
compared to previous seasons.6 Among all influenza- infrieur, aux saisons prcdentes.6 La majorit des hospitalisa-
associated hospitalizations, most were associated with tions lies la grippe taient dues aux virus grippaux A. Vers
influenza A viruses. Towards the end of the season, la fin de la saison, la grippe B a t lorigine de quelques
influenza B caused a few hospitalizations. The most hospitalisations. Les pathologies sous-jacentes les plus frquem-
commonly reported underlying medical conditions ment signales chez les adultes hospitaliss taient: maladies
among hospitalized adults were: cardiovascular disease, cardiovasculaires, pneumopathies chroniques, troubles mtabo-
chronic lung disease, metabolic disorder, obesity, and liques, obsit et affections rnales. Environ le tiers des femmes
renal disease. About one third of females hospitalized de 15 44 ans hospitalises pour une grippe taient enceintes.
for influenza in the 1544 year age group were pregnant. Une grande part (42%) des enfants hospitaliss pour une grippe
Most children (42%) hospitalized due to influenza had navaient pas daffection sous-jacente connue et 27% souffraient
no known underlying condition and 27% had asthma. dasthme. Le pourcentage de tous les dcs attribuables la
The percentage of all deaths due to pneumonia and pneumonie et la grippe a franchi le seuil pidmique pendant
influenza surpassed the epidemic threshold during plusieurs semaines cette saison, avec un pic suprieur ceux
several weeks this season and the peak value was higher des prcdentes saisons postpandmiques, lexception de la
than in the preceding post-pandemic seasons with the saison 2012-2013. Le nombre de dcs pdiatriques lis la
exception of the 20122013 season. The number of grippe tait lgrement suprieur celui de la saison 2013-2014
paediatric deaths associated with influenza was slightly et comparable celui de 2012-2013.
higher compared to the 201314 season, and similar to
that in 20122013.
In Mexico, acute respiratory illness (ARI) activity was Au Mexique, lactivit des infections respiratoires aigus a t
not as high as the last season, but was near the moins forte que la saison dernire, mais sest toutefois appro-
epidemic threshold. Pneumonia activity was similar to che du seuil pidmique. Lactivit de la pneumonie, compa-
that in the 20132014 season and surpassed the thresh- rable celle de la saison 2013-2014, a franchi ce seuil. Comme
old. Influenza activity was greater in the northern pour les 2 dernires saisons, lactivit grippale a t plus intense
regions of Mexico compared to the southern regions, dans le nord du Mexique que dans le sud. Dans lensemble, le
similar to the previous 2 seasons. Overall, Mexico Mexique a enregistr moins de cas de grippe cette saison (2731)
reported fewer influenza cases (2731) this season que la saison dernire (9021) et moins de dcs dus la grippe
compared to the previous season (9021) and fewer (71 cette saison contre 1107 la saison dernire).7
deaths due to influenza (71 this season compared to
1107 last season).7

See CDC FLUVIEW-interactive at http://www.cdc.gov/flu/weekly/fluviewinteractive.


4 4
Voir CDC FLUVIEW-interactive ladresse: http://www.cdc.gov/flu/weekly/fluviewinteractive.
htm; accessed May 2015. htm; consult en mai 2015.
See http://gis.cdc.gov/GRASP/Fluview/FluHospRates.html; accessed May 2015.
5 5
Voir http://gis.cdc.gov/GRASP/Fluview/FluHospRates.html; consult en mai 2015.
See http://gis.cdc.gov/grasp/fluview/FluHospChars.html; accessed May 2015.
6 6
Voir http://gis.cdc.gov/grasp/fluview/FluHospChars.html; consult en mai 2015.
See
7
http://www.epidemiologia.salud.gob.mx/informes/2015/influenza/influen- 7
Voir http://www.epidemiologia.salud.gob.mx/informes/2015/influenza/influenza15_14.html,
za15_14.html; accessed May 2015. consult en mai 2015.

RELEVE EPIDEMIOLOGIQUE HEBDOMADAIRE, No 23, 5 JUIN 2015 285


Europe Europe
Timing of the season and circulating influenza Chronologie de la saison grippale et virus grippaux
viruses circulants
In Europe, the timing of influenza detections during the En Europe, la chronologie des dtections de grippe au cours de
season was similar to previous years. Influenza activity la saison tait semblable celle des annes prcdentes. Lacti-
started to increase in the last few weeks of 2014, similar vit grippale a commenc crotre dans les dernires semaines
to the pattern in the 20132014 and 20112012 seasons.8 de 2014, selon une volution comparable celle des saisons
In general, influenza activity increased from December 2013-2014 et 2011-2012.8 De manire gnrale, lactivit grippale
and peaked towards the end of February. Influenza a progress partir de dcembre jusqu atteindre son pic vers
activity steadily decreased through March and April. la fin fvrier. Elle a ensuite accus un dclin rgulier durant les
The timing of the peaks in 2015 varied between coun- mois de mars et avril. Les pics ont t atteints diffrentes
tries, but was most often between weeks 6 and 9. dates selon les pays, le plus souvent entre les semaines 6 et 9
However, the influenza percent positivity was still above de 2015. Toutefois, dans de nombreux pays, le taux de positivit
the threshold in many countries in April. pour la grippe tait encore au-dessus du seuil pidmique en
avril.
Influenza A(H3N2) virus was generally predominant De manire gnrale, le virus grippal prdominant de cette
this season.1, 9 However, the proportion of influenza saison tait le A(H3N2).1, 9 Cependant, la proportion de virus
A(H1N1)pdm09 virus detections increased during the A(H1N1)pdm09 dtects a augment au cours de la priode
peak of activity and the proportion of influenza B virus dactivit la plus intense, et celle du virus B a connu une
detections increased following the peak in activity in progression aprs le pic, en fvrier. En Slovnie, cest le virus
February. In Slovenia, influenza A (H1N1)pdm09 was the A(H1N1)pdm09 qui a prdomin, et en Gorgie et en Ukraine,
predominant virus, and in Georgia and Ukraine, influ- le virus de la grippe B.
enza B predominated this season.
Between week 40 in 2014 and week 19 in 2015, Entre la semaine 40 de 2014 et la semaine 19 de 2015,
>41000samples from sentinel sources were tested for >41000chantillons provenant de sites sentinelles ont fait lob-
influenza and 37% (15 663) were positive for influenza.10 jet dun dpistage de la grippe, 37% (15 663) dentre eux donnant
Influenza A viruses accounted for 67% of the influenza un rsultat positif.10 Parmi les cas de grippe dtects, 67%
detections while 33% were positive for influenza B. taient dus aux virus grippaux A et 33% au virus B. Le virus
Influenza A(H3N2) virus accounted for 77% of those grippal A(H3N2) reprsentait 77% des virus grippaux A qui
influenza A viruses that were subtyped, and 98% of avaient t sous-typs, et 98% des virus grippaux B caractriss
the characterized influenza B viruses belong to the appartenaient la ligne B/Yamagata.
B/Yamagata lineage.

Morbidity and mortality Morbidit et mortalit


Although influenza activity in the 20142015 season Bien que prsentant des variations dune sous-rgion et dun
varied by subregion and country, overall it was more pays lautre, lactivit grippale a dans lensemble t plus
intense compared to previous years. In contrast to last intense pendant la saison 2014-2015 que lors des annes prc-
year, many countries reported periods of high intensity dentes. la diffrence de lan dernier, de nombreux pays ont
this season including Albania, Austria, Azerbaijan, signal des priodes de forte intensit, notamment lAlbanie,
Belgium, Finland, France, Germany, Greece, Hungary, lAllemagne, lAutriche, lAzerbadjan, la Belgique, lEspagne, la
Iceland, Italy, Latvia, Luxembourg, Portugal, Serbia, Finlande, la France, la Grce, la Hongrie, lIslande, lItalie, laLetto-
Slovakia, Spain, Sweden, Switzerland, and Ukraine.11 Two nie, le Luxembourg, le Portugal, la Serbie, la Slovaquie, la Sude,
countries, Luxembourg and the Republic of Moldova, la Suisse et lUkraine.11 Deux pays, le Luxembourg et la Rpu-
experienced very high intensity. The remaining coun- blique de Moldova, ont enregistr une activit grippale de trs
tries had low or medium influenza activity throughout grande intensit. Dans les autres pays, lactivit sest maintenue
the season. un niveau faible ou modr tout au long de la saison.
This season, the percent of influenza positivity peaked Cette saison, le taux de positivit pour la grippe a culmin
at a rate below the mean value of previous 10 seasons un niveau en dessous de la moyenne des 10 dernires saisons
(with the exception of 20092010) for northern and ( lexception de 2009-2010) en Europe du Nord et du Sud-Ouest

See WHO Regional Office for Europe influenza season summaries. Available at
8 8
Voir les comptes rendus sur les saisons grippales du Bureau rgional OMS de lEurope (dispo-
http://www.euro.who.int/en/health-topics/communicable-diseases/influenza/sur- nibles ladresse: http://www.euro.who.int/en/health-topics/communicable-diseases/influen-
veillance-and-lab-network/influenza-surveillance-bulletins-and-seasonal-summa- za/surveillance-and-lab-network/influenza-surveillance-bulletins-and-seasonal-summaries/
ries/influenza-season-summaries2, accessed April 2015. influenza-season-summaries2; consult en avril 2015).
See Flu News Europe. Available at http://www.flunewseurope.org/; accessed April
9 9
Voir Flu News Europe. Disponible ladresse http://www.flunewseurope.org/; consult en avril
2015. 2015.
10
See Flu News Europe. Available at http://www.flunewseurope.org/PrimaryCareDa- 10
Voir Flu News Europe. Disponible ladresse http://www.flunewseurope.org/PrimaryCareData;
ta; accessed May 2015. consult en mai 2015.
11
See European Centre for Disease Prevention and Control Weekly Influenza activity 11
Voir les cartes dactivit grippale hebdomadaire du Centre europen de prvention et de
maps. Available at ecdc.europa.eu/en/healthtopics/seasonal_influenza/epidemiolo- contrle des maladies. Disponible sur: ecdc.europa.eu/en/healthtopics/seasonal_influenza/epi-
gical_data/Pages/influenza_activity_EU_EEA_activity_maps.aspx; accessed April demiological_data/Pages/influenza_activity_EU_EEA_activity_maps.aspx; consult en avril
2015. 2015.
286 WEEKLY EPIDEMIOLOGICAL RECORD, NO. 23, 5 JUNE 2015
south-west Europe (Figure 1b) but higher than the (Figure 1b) mais au-dessus de la limite suprieure de lintervalle
upper 90% confidence interval for eastern Europe de confiance 90% en Europe de lEst (Figure 1c).
(Figure 1c).
In general, the 20142015 season was associated with De manire gnrale, la saison 2014-2015 a t associe un
higher laboratory-confirmed influenza hospitalizations, plus grand nombre dhospitalisations dues la grippe, dadmis-
admissions to ICUs, and deaths, as compared to the sions en soins intensifs et de dcs de cas confirms en labo-
previous season. According to Flu News Europe, between ratoire que la saison prcdente. Selon Flu News Europe,
week 40 of 2014 and week 19 of 2015, there were 6033 hospitalisations de cas confirms en laboratoire, dont
6033laboratory-confirmed hospitalized influenza cases, 3764admis en soins intensifs, ont t signales entre la semaine
including 3764 patients admitted to ICUs as reported 40 de 2014 et la semaine 19 de 2015 par 8 pays (Espagne,
from 8 countries (Finland, France, Ireland, Romania, Finlande, France, Irlande, Roumanie, Royaume-Uni, Slovaquie et
Slovakia, Spain, Sweden and the United Kingdom).12 Of Sude).12 Parmi les cas confirms en laboratoire (6033), 79%
the laboratory-confirmed cases (6033), 79% (4738) were (4738) taient positifs pour les virus grippaux A et 21% (1265)
positive for influenza A viruses and 21% (1265) pour le virus grippal B. Sur les 2296 virus grippaux A de patients
were positive for influenza B virus. Of the 2296 hospitaliss qui ont t sous-typs ( la semaine 18), 73% (1687)

Figure 1b Northern Europe and Southwestern Europe Europe du Nord et Europe du Sud-Ouest

Mean of the influenza positivity after aligning at the median peak for the seasons
Influenza positivity (%) Positivit la grippe (%)

20032004 to 20132014 (excluding 20092010) Moyenne de la positivit du


60

dpistage de la grippe aprs alignement sur le pic mdian pour les saisons 2003-
2004 2013-2014 ( lexclusion de 2009-2010)
50

90% confidence interval boundaries Limites de lintervalle de confiance 90%


40

20142015
30

The boxplot visualizes the spread of the historical peaks La bote moustaches
(boxplot) permet de visualiser la dispersion des pics historiques
20
10
0

40 43 46 49 52 03 06 09 12 15 18 21 24 27 30 33 36 39

Weeks Semaines

Figure 1c Eastern Europe Europe de lEst


Mean of the influenza positivity after aligning at the median peak for the seasons
20032004 to 20132014 (excluding 20092010) Moyenne de la positivit du
Influenza positivity (%) Positivit la grippe (%)

50

dpistage de la grippe aprs alignement sur le pic mdian pour les saisons 2003-
2004 2013-2014 ( lexclusion de 2009-2010)
90% confidence interval boundaries Limites de lintervalle de confiance 90%
40

20142015
30

The boxplot visualizes the spread of the historical peaks La bote moustaches
(boxplot) permet de visualiser la dispersion des pics historiques
20
10
0

40 43 46 49 52 03 06 09 12 15 18 21 24 27 30 33 36 39
Weeks Semaines

See Flu News Europe. Available at http://www.flunewseurope.org/HospitalData;


12
Voir Flu News Europe. Disponible ladresse: http://www.flunewseurope.org/HospitalData;
12

accessed May 2015. consult en mai 2015.


RELEVE EPIDEMIOLOGIQUE HEBDOMADAIRE, No 23, 5 JUIN 2015 287
influenza A viruses from hospitalized patients that were taient des virus A(H3N2) et 27% (609) des virus A(H1N1)
subtyped (as of week 18), 73% (1687) were influenza pdm09. La moiti environ des hospitalisations associes la
A(H3N2) and 27% (609) were influenza A(H1N1)pdm09. grippe concernaient des patients gs de 65 ans.
Approximately half of the influenza-associated hospital-
izations were in patients aged 65 years.
From week 40 of 2014 to week 19 of 2015, 579 deaths De la semaine 40 de 2014 la semaine 19 de 2015, 579 dcs
have been reported among laboratory-confirmed hospi- ont t signals parmi les cas hospitaliss confirms en labo-
talized cases from the 8 countries with France and Spain ratoire par les 8 pays cits, France et Espagne en tte; 66% (380)
reporting the most deaths among laboratory-confirmed de ces dcs concernaient des patients de 65 ans. La majorit
hospitalized patients; 66% (380) of the deaths were in des cas mortels (83%) taient attribuables aux virus grippaux
patients aged 65 years. Most of the fatal cases (83%) A et 17% au virus grippal B. Parmi les 256 virus grippaux A
were infected with influenza A viruses and 17% were responsables de ces cas mortels qui ont t sous-typs, 70%
infected with influenza B. Of the 256 influenza A viruses (180) taient des virus A(H3N2) et 30% (78) des virus A(H1N1)
from these fatal cases that were subtyped, 70% (180) pdm09.
were A(H3N2) and 30% (78) were influenza A(H1N1)
pdm09.
According to the European system for monitoring Selon le Rseau de surveillance de la mortalit lchelle euro-
excess mortality for public health action, there was penne (European system for monitoring excess mortality for
excess all-cause mortality for the 20142015 season public health action), 11 des 14 pays participants ont enregistr
among persons aged 65 years in 11 of the 14 reporting une surmortalit toutes causes confondues des personnes ges
countries: Denmark, England, France, Ireland, the Neth- de 65 ans pendant la saison 2014-2015: lAngleterre, le Dane-
erlands, Portugal, Scotland, Spain, Sweden, Switzerland mark, lcosse, lEspagne, la France, lIrlande, les Pays Bas, le Pays
and Wales.13 The excess mortality may have been asso- de Galles, le Portugal, la Sude et la Suisse.13 Il est possible que
ciated with circulating influenza viruses, but other cette surmortalit soit imputable aux virus grippaux circulants,
factors may have been involved. The pooled analysis mais dautres facteurs pourraient galement tre en cause. Une
indicated that this winter season, excess all-cause mta-analyse a indiqu que, pendant cette saison hivernale, la
mortality among the elderly was higher than during the surmortalit toutes causes confondues des personnes ges tait
preceding 4 winter seasons. In the 20132014 and 2012 suprieure celle des 4 derniers hivers. Lors des saisons 2013-
2013 seasons, no excess all-cause mortality was detected 2014 et 2012-2013, aucune surmortalit toutes causes confondues
in the 16 countries reporting data.12, 14 In the 20112012 na t dtecte dans les 16 pays notifiant des donnes.12, 14
season, a moderate excess mortality was observed in Pendant la saison 2011-2012, une surmortalit modre a t
12 countries, all in the 65 years age group.15 observe dans 12 pays, touchant exclusivement la tranche dge
65 ans.15

North Africa and the Middle East Afrique du Nord et Moyen-Orient


Timing of the season and circulating influenza Chronologie de la saison grippale et virus grippaux
viruses circulants
In the Middle East and North Africa, the timing of the Au Moyen-Orient et en Afrique du Nord, la chronologie de la
season was variable. Increases in activity were already saison grippale a t variable. Une progression de lactivit
seen in early December in Egypt, peaking in mid- grippale a t observe ds le dbut dcembre en gypte, avec
December and in early January for Morocco. In Libya, un pic la mi-dcembre et au dbut janvier au Maroc. En Libye,
influenza activity was increased from December to lactivit grippale sest intensifie de dcembre janvier. Dans
January. In most countries (Algeria, Georgia, Islamic la plupart des pays (Algrie, Gorgie, Isral, Rpublique isla-
Republic of Iran, Israel, and Tunisia) the number of mique dIran et Tunisie), les pics de dtection de la grippe ont
influenza detections peaked in late January or February. t atteints vers la fin janvier ou en fvrier. Certains pays ont
Countries experiencing peak activity later in the season vu lactivit grippale culminer plus tard dans la saison, notam-
included Iraq (FebruaryMarch), Palestine (March), ment lIraq (fvrier-mars), la Palestine (mars), la Turquie (mars),
Turkey (March), Jordan (MarchApril), and Kuwait la Jordanie (mars-avril) et le Kowet (avril).
(April).
Influenza A(H1N1)pdm09, A(H3N2), and influenza B Les virus grippaux A(H1N1)pdm09, A(H3N2) et B ont tous t
viruses were detected in the Middle East and North dtects au Moyen-Orient et en Afrique du Nord, le virus prdo-
Africa. The predominant virus varied by country. Over- minant tant variable selon le pays. De manire gnrale, la

13
European Mortality Monitoring Project at http://www.euromomo.eu/; accessed 13
European Mortality Monitoring Project. Disponible ladresse: http://www.euromomo.eu/;
April 2015. consult en avril 2015.
Summary of the 20122013 influenza season in the WHO European Region, Copenhagen,
14
Rsum de la saison grippale 2012-2013 dans la Rgion Europe de lOMS, Copenhague, Bureau r-
14

WHO Regional Office for Europe. Available at http://www.euro.who.int/__data/assets/ gional de lOMS pour lEurope [Document disponible uniquement en langue anglaise]. Dispo-
pdf_file/0011/195824/Summary-of-the-20122013-influenza-season-in-the-WHO-Euro- nible ladresse: http://www.euro.who.int/__data/assets/pdf_file/0011/195824/Summary-of-the-
pean-Region-final.pdf?ua=1; accessed April 2015. 20122013-influenza-season-in-the-WHO-European-Region-final.pdf?ua=1; consult en avril 2015.
15
See European Centre for Disease Prevention and Control influenza surveillance 15
Voir le rapport de surveillance de la grippe du Centre europen de prvention et de contrle des
report. Available at http://ecdc.europa.eu/en/publications/Publications/Influenza- maladies. Disponible ladresse: http://ecdc.europa.eu/en/publications/Publications/Influenza-
Europe-2011-2012-surveillance-report.pdf; accessed April 2015. Europe-2011-2012-surveillance-report.pdf; consult en avril 2015.
288 WEEKLY EPIDEMIOLOGICAL RECORD, NO. 23, 5 JUNE 2015
all, the season seemed to start with a predominance of saison semble avoir t marque tout dabord par la prdomi-
influenza A(H3N2) virus in early December, followed by nance du virus A(H3N2) au dbut dcembre, puis du virus B
influenza B virus in the beginning of January and influ- au dbut janvier et, enfin, du virus A(H1N1)pdm09 en fvrier.
enza A(H1N1)pdm09 virus in February. Influenza Le virus A(H1N1)pdm09 a prdomin en Algrie, au Bahren,
A(H1N1)pdm09 was predominant in Algeria, Bahrain, en Cisjordanie et dans la Bande de Gaza, en Jordanie, au Kowet,
the Islamic Republic of Iran (with co-circulation of en Libye, en Rpublique islamique dIran (avec cocirculation du
H3N2), Jordan, Kuwait, Libya, Turkey and the West Bank virus H3N2) et en Turquie. Le virus prdominant en Gorgie
and Gaza strip. Influenza B was predominant in Georgia. tait celui de la grippe B.
In Morocco and Tunisia, the influenza season started Au Maroc et en Tunisie, la saison grippale a dmarr par la
with influenza B virus circulation followed by influenza circulation du virus grippal B suivi par la circulation du virus
A(H1N1)pdm09 virus circulation. Influenza A(H3N2) was A(H1N1)pdm09. En Isral, cest le virus A(H3N2) qui a t
predominant in Israel this season. As well as experienc- prdominant cette saison. Lgypte a non seulement t confron-
ing seasonal influenza infections with mainly influenza te la grippe saisonnire, cause principalement par le virus
A(H3N2) virus, Egypt experienced an unprecedented A(H3N2), mais aussi une augmentation sans prcdent du
increase in the number of human infections with avian nombre dinfections humaines par les virus A(H5N1) de la
influenza A(H5N1) viruses since December 2014. grippe aviaire depuis dcembre 2014.

Morbidity and mortality Morbidit et mortalit


Countries throughout these regions experienced differ- Les pays de la rgion ont enregistr des activits grippales
ent levels of activity. Overall the peak number of influ- dintensit variable. Globalement, le nombre de cas dtects
enza detections seemed to be lower than the previous semble avoir culmin un niveau infrieur aux 2 dernires
2 seasons, 20122013 and 20132014, but activity was saisons, 2012-2013 et 2013-2014, mais la Turquie a connu une
particularly higher in Turkey compared to previous activit nettement plus intense que lors des saisons prcdentes.
seasons. The influenza percent positivity for northern Le taux de positivit pour la grippe en Afrique du Nord a
Africa peaked at a rate between the mean and the upper culmin un niveau compris entre la moyenne et la limite
90% confidence boundary (Figure 1d). suprieure de lintervalle de confiance 90% (Figure 1d).

Northern Asia Asie septentrionale


Timing of the season and circulating influenza Chronologie de la saison grippale et virus grippaux
viruses circulants
In general, in this region, influenza activity started to De manire gnrale, lactivit grippale a commenc progres-
increase slightly earlier than last year, except in the ser lgrement plus tt que lan dernier dans cette rgion, sauf
Republic of Korea, and reached a peak in February, en Rpublique de Core, et a atteint son pic en fvrier, lins-
similar to past seasons. Of the influenza viruses that tar des saisons passes. Parmi les virus qui ont t sous-typs,
were subtyped, the majority were A(H3N2) virus, as in la plupart taient des virus A(H3N2), comme en 2012-2013. Dans
the 20122013 season. In most countries, influenza B la plupart des pays, les virus grippaux B ont t plus souvent
viruses were more commonly detected at the end of the dtects en fin de saison, comme les annes prcdentes.
influenza season, as seen in previous years.

Figure 1d Northern Africa Afrique du Nord Mean of the influenza positivity after aligning at the median peak for the seasons
20032004 to 20132014 (excluding 20092010) Moyenne de la positivit du
dpistage de la grippe aprs alignement sur le pic mdian pour les saisons 2003-
2004 2013-2014 ( lexclusion de 2009-2010)
90% confidence interval boundaries Limites de lintervalle de confiance 90%
20142015
Influenza positivity (%) Positivit la grippe (%)

60

The boxplot visualizes the spread of the historical peaks La bote moustaches
(boxplot) permet de visualiser la dispersion des pics historiques
50
40
30
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40 43 46 49 52 03 06 09 12 15 18 21 24 27 30 33 36 39
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RELEVE EPIDEMIOLOGIQUE HEBDOMADAIRE, No 23, 5 JUIN 2015 289


In northern China, the influenza season started earlier En Chine du Nord, la saison grippale a dmarr plus tt que
than in the previous year and influenza detections lan dernier et les dtections ont culmin vers la fin de lanne
peaked at the end of 2014, slightly later than the peak 2014, lgrement plus tard que la saison dernire. Pendant la
in the previous season. Influenza detections were almost majeure partie de la saison, les virus dtects taient presque
exclusively A(H3N2) viruses through most of this exclusivement des virus A(H3N2), la diffrence de la saison
season, differing from the last season when there was dernire, caractrise par une cocirculation des virus A(H1N1)
co-circulation of A(H1N1)pdm09 and influenza B pdm09 et B. partir de fvrier, une lgre progression des cas
viruses. Since February, influenza detections increased de grippe dtects a t observe, accompagne dune augmen-
slightly with a corresponding increase in the proportion tation correspondante de la proportion de virus grippal B
of influenza B virus detections. dtect.
Influenza activity in the Republic of Korea started to En Rpublique de Core, lactivit grippale sest amorce plus
increase later compared to last season. Influenza tard que la saison dernire. Le virus A(H3N2) a t prdominant
A(H3N2) virus predominated from the beginning of the entre le dbut de la saison, la fin de lanne 2014, et le dbut
season at the end of 2014 until early March when the mars, moment o la proportion de virus B a commenc
proportion of influenza B viruses began to increase. augmenter.
As in previous years in Japan, influenza activity started Au Japon, linstar des annes prcdentes, lactivit grippale
to increase in November 2014 and peaked by early a commenc de progresser en novembre 2014 pour culminer
February, slightly earlier than in previous seasons. au dbut fvrier, lgrement plus tt que pour les dernires
A(H3N2) virus predominated this season, unlike last saisons. Le virus A(H3N2) tait prdominant, contrairement
years season where A(H1N1)pdm09 virus was predom- la saison dernire, marque par la prpondrance du virus
inant. A(H1N1)pdm09.
A(H3N2) virus predominated among influenza detec- En Mongolie, le virus A(H3N2) tait prdominant parmi les cas
tions in Mongolia this season with a peak occurring de grippe dtects, avec un pic atteint lgrement plus tt que
slightly earlier than in last season. pour la saison dernire.

Morbidity and mortality Morbidit et mortalit


While the peak in influenza activity this season occurred Cette anne, le pic de lactivit grippale a t atteint peu prs
around the same time as in previous seasons, the au mme moment que lors des saisons prcdentes, mais il tait
magnitude was lower compared to previous seasons. dune moindre amplitude. Le taux de positivit pour la grippe
The influenza percent positivity peaked at a rate below a culmin un niveau infrieur la limite de lintervalle de
the 90% confidence boundary around the mean value confiance 90%, autour de la valeur moyenne des saisons prc-
of previous seasons (Figure 1e). dentes (Figure 1e).
In northern China, the proportion of visits due to ILI En Chine du Nord, le pourcentage des consultations dues aux
at national sentinel hospitals peaked at just above 4% syndromes grippaux dans les hpitaux sentinelles nationaux a
at the end of 2014, followed by another peak around connu un pic dun peu plus de 4% la fin de lanne 2014, suivi
3.8% at the end of February. ILI activity during this dun second pic denviron 3,8% la fin fvrier. Lactivit des
season was at or just below levels seen in previous years, syndromes grippaux sest maintenue un niveau comparable

Figure 1e Central Asia and Eastern Asia Asie centrale et Asie orientale

Mean of the influenza positivity after aligning at the median peak for the seasons
20032004 to 20132014 (excluding 20092010) Moyenne de la positivit du
Influenza positivity (%) Positivit la grippe (%)

dpistage de la grippe aprs alignement sur le pic mdian pour les saisons 2003-
2004 2013-2014 ( lexclusion de 2009-2010)
50

90% confidence interval boundaries Limites de lintervalle de confiance 90%


20142015
40

The boxplot visualizes the spread of the historical peaks La bote moustaches
30

(boxplot) permet de visualiser la dispersion des pics historiques


20
10
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Weeks Semaines

290 WEEKLY EPIDEMIOLOGICAL RECORD, NO. 23, 5 JUNE 2015


except for early in the season when ILI activity was ou lgrement infrieur celui des annes prcdentes, lex-
higher than in previous seasons. ception du dbut de la saison, caractris par une activit des
syndromes grippaux plus importante que lors des saisons
passes.
In the Republic of Korea, the proportion of visits due En Rpublique de Core, le pourcentage des consultations dues
to ILI at sentinel health-care facilities peaked at just aux syndromes grippaux dans les tablissements de soins senti-
below 50% in mid-February and ILI activity was still nelles a culmin un peu <50% la mi-fvrier. En avril, le taux
above the national threshold in April. The peak of ILI dactivit des syndromes grippaux demeurait au-dessus du seuil
activity this season was lower than in the past few pidmique national. Le pic dactivit des syndromes grippaux
seasons. a t moins intense que les dernires saisons.
In Mongolia, the proportion of visits due to ILI at senti- En Mongolie, le pourcentage des consultations dues aux
nel health-care facilities peaked at just under 60% in syndromes grippaux dans les tablissements de soins senti-
early February, slightly lower than the peak last season. nelles a culmin un peu <60% au dbut fvrier, un taux lg-
This is consistent with previous years where the peak rement plus faible que la saison passe. Ce rsultat concorde
in ILI activity in Mongolia typically occurs between avec les observations des annes prcdentes, durant lesquelles
January and March.16 The proportion of hospitalized lactivit des syndromes grippaux en Mongolie atteignait gn-
patients with pneumonia peaked at around 25%, higher ralement son pic entre janvier et mars.16 Le taux de patients
than last seasons peak of 20% and the peak of just hospitaliss pour une pneumonie a culmin environ 25%,
below 15% in 20122013. contre 20% la saison prcdente et un peu <15% en 2012-2013.

Antigenic and genetic testing Analyse antignique et gntique


For the 20142015 season, the recommendations for the Pour la saison 2014-2015, les recommandations relatives la
influenza trivalent vaccine included an A/Califor- composition du vaccin antigrippal trivalent taient les suivantes:
nia/7/2009 (H1N1)pdm09-like virus, an A/Texas/50/2012 virus analogue A/California/7/2009 (H1N1)pdm09, virus
(H3N2)-like virus and a B/Massachusetts/2/2012-like analogue A/Texas/50/2012 (H3N2) et virus analogue
(from the B/Yamagata lineage) virus. It was recom- B/Massachusetts/2/2012 (provenant de la ligne B/Yamagata).
mended that quadrivalent vaccines (containing 2 influ- Pour les vaccins quadrivalents (contenant 2 virus grippaux B),
enza B viruses) should contain the aforementioned la composition recommande comprenait les 3 virus susmen-
3viruses plus a B/Brisbane/60/2008-like virus (from the tionns, plus un virus analogue B/Brisbane/60/2008 (issu de
B/Victoria lineage).17 Antigenically and genetically, the la ligne Victoria).17 Sur le plan antignique et gntique, le
circulating A(H1N1)pdm09 virus was closely related to virus circulant A(H1N1)pdm09 tait troitement apparent au
the selected vaccine virus. Of the B viruses circulating virus vaccinal choisi. Parmi les virus B circulant durant la
during the 20142015 northern hemisphere influenza saison grippale 2014 2015 de lhmisphre Nord, la plupart
season, the majority belonged to B/Yamagata lineage, appartenaient la ligne B/Yamagata. La proportion de ces
with varied proportions of the B viruses in different virus B prsentant une ractivit croise rduite avec les virus
parts of the world having reduced cross-reactivity with vaccinaux analogues B/Massachusetts/2/2012 tait variable
the B/Massachusetts/2/2012-like vaccine viruses. dune rgion lautre du monde. Une proportion considrable
Asignificant proportion of circulating A(H3N2) viruses des virus A(H3N2) circulants prsentait des drives gntiques
showed antigenic and genetic drift from the et antigniques par rapport aux virus vaccinaux analogues
A/Texas/50/2012 (H3N2)-like vaccine viruses. A/Texas/50/2012 (H3N2).
Throughout the season, the majority of A(H1N1)pdm09 La majorit des virus A(H1N1)pdm09 caractriss au cours de
viruses that were characterized were antigenically simi- cette saison taient semblables sur le plan antignique au virus
lar to the selected vaccine virus A/California/7/2009. In vaccinal A/California/7/2009 choisi. En Chine,18 en Europe19, 20 et
China,18 Europe19, 20 and the USA,21 all A(H1N1)pdm09 aux tats-Unis,21 tous les virus A(H1N1)pdm09 qui ont t anti-
viruses that were characterized antigenically through- gniquement caractriss taient apparents au virus vaccinal.
out the season were similar to the vaccine virus. Viruses Des virus provenant de centres nationaux de lutte contre la
received from the National Influenza Centres (NICs) in grippe en Afrique, en Asie, en Amrique centrale, en Amrique
Africa, Asia, Central and South America, and the Middle du Sud et au Moyen-Orient ont t caractriss par analyse

Members of the Western Pacific Region Global Influenza Surveillance and Response
16
Membres du systme mondial OMS de surveillance de la grippe et de riposte de la Rgion du
16

System (2012) Epidemiological and Virological Characteristics of of Influenza in the Pacifique occidental (2012). Caractristiques pidmiologiques et virologiques de la grippe
Western Pacific Region of the World Health Organization, 20062010. PLoS ONE dans la Rgion du Pacifique occidental de lOrganisation mondiale de la Sant, 2006-2010. PLoS
7(5): e37568. doi:10.1371/Influenza in the Western Pacific Region of the World ONE 7(5): e37568. doi:10.1371/Influenza in the Western Pacific Region of the World Health
Health journal.pone.0037568 journal.pone.0037568
See
17
http://www.who.int/influenza/vaccines/virus/recommendations/2014_15_ Voir
17
http://www.who.int/influenza/vaccines/virus/recommendations/2014_15_north/en/;
north/en/; accessed May 2015. consult en mai 2015.
See http://cnic.org.cn/eng/show.php?contentid=751; accessed May 2015.
18
Voir http://cnic.org.cn/eng/show.php?contentid=751; consult en mai 2015.
18

See https://www.flunewseurope.org/VirusCharacteristics; accessed May 2015.


19
Voir https://www.flunewseurope.org/VirusCharacteristics; consult en mai 2015.
19

See http://ecdc.europa.eu/en/healthtopics/seasonal_influenza/epidemiological_
20
Voir http://ecdc.europa.eu/en/healthtopics/seasonal_influenza/epidemiological_data/Pages/In-
20

data/Pages/Influenza_virus_characterisation.aspx; accessed May 2015. fluenza_virus_characterisation.aspx; consult en mai 2015.


See http://www.cdc.gov/flu/weekly/; accessed May 2015.
21
Voir http://www.cdc.gov/flu/weekly/; consult en mai 2015.
21

RELEVE EPIDEMIOLOGIQUE HEBDOMADAIRE, N 23, 5 JUIN 2015 291


o
East, and characterized antigenically at WHO Collabo- antignique dans des centres collaborateurs de lOMS, et leur
rating Centres (CCs), were confirmed to be similar to analogie avec le virus vaccinal a t confirme.22
the vaccine virus.22
During the 20142015 season, the majority of A(H3N2) Durant la saison 2014-2015, la majorit des virus A(H3N2) qui
viruses that were characterized were antigenically ont t caractriss prsentaient une divergence antignique
dissimilar to the vaccine virus A/Texas/50/2012-like par rapport au virus vaccinal A/Texas/50/2012 (appartenant au
(belonging to haemagglutinin (HA) genetic clade 3C.1), clade gntique 3C.1 de lhmagglutinine) et une analogie anti-
and were antigenically similar to A/Switzer- gnique avec le virus A/Switzerland/9715293/2013, le virus
land/9715293/2013, the virus selected in September 2014 choisi en septembre 2014 pour le vaccin 2015 destin lhmis-
for the 2015 southern hemisphere and in February 2015 phre Sud et en fvrier 2015 pour le vaccin 2015-2016 destin
for the 20152016 northern hemisphere vaccines. In lhmisphre Nord. En Europe, la fin mars 2015, >70% des
Europe, by the end of March 2015, >70% of the A(H3N2) virus A(H3N2) antigniquement caractriss divergeaient par
viruses antigenically characterized were distinct from the rapport au virus vaccinal.20 Ce taux tait de 77,9% aux tats-
vaccine virus.20 In the USA as of mid-April 2015, 77.9% Unis la mi-avril 201521 et de 84% en Chine au dbut avril
of the A(H3N2) viruses tested were antigencially distinct 2015.18 La majorit des virus A(H3N2) provenant des centres
from the vaccine virus.21 In China, as of the beginning nationaux de lutte contre la grippe en Afrique et au Moyen-
of April 2015, 84% of the A(H3N2) viruses tested were Orient qui ont t caractriss par analyse antignique dans
antigenically distinct from the vaccine virus.18 The major- des centres collaborateurs de lOMS divergeaient galement du
ity of A(H3N2) viruses received from NICs in Africa and virus vaccinal.22 Le squenage gntique de lhmagglutinine
the Middle East and characterized antigenically at WHO des virus A(H3N2) provenant du Canada, dEurope et du
CCs were also antigenically distinct from the vaccine Royaume-Uni a indiqu que la plupart de ces virus apparte-
virus.22 Genetic sequencing of the HA of A(H3N2) viruses naient au clade gntique 3C.2a, seule une petite partie dentre
from Canada, Europe and the UK indicated that most eux appartenant au clade 3C.1.19, 20, 23, 24 En Chine, dans dautres
A(H3N2) viruses belonged to the genetic clade 3C.2a, rgions dAsie et dans certaines rgions dAfrique et dEurope
while only a very small proportion belonged to the de lEst, la plupart des virus A(H3N2) analyss par squenage
genetic clade 3C.1.19, 20, 23, 24 In China, other parts of Asia, gntique appartenaient au clade 3C.3a.25 La majorit des virus
and parts of Africa and eastern Europe, the majority of A(H3N2) du clade 3C.2a ont bien ragi aux tests dinhibition
the sequenced A(H3N2) viruses belonged to clade 3C.3a.25 de lhmagglutination avec le virus du vaccin 2015 A/Switzer-
Most of the clade 3C.2a A(H3N2) viruses reacted well on land/9715293/2013 (clade 3C.3a), indiquant une parent antig-
HI assays to the 2015 vaccine virus A/Switzer- nique entre les virus des clades 3C.2a et 3C.3a.
land/9715293/2013 (clade 3C.3a), indicating antigenic
relatedness between clade 3C.2a and 3C.3a viruses.
Influenza viruses of the B/Yamagata lineage predomi- Parmi les virus grippaux B dtects cette saison, ceux de la
nated among the influenza B viruses detected this season ligne B/Yamagata taient prdominants. Ils taient semblables,
and were antigenically similar to B/Phuket/3073/2013, sur le plan antignique, au virus B/Phuket/3073/2013, sauf au
except in Canada,3 China and the USA where most B/ Canada,3 en Chine et aux tats-Unis, o la majorit des virus
Yamagata lineage viruses were similar to B/Massachu- de la ligne B/Yamagata taient semblables B/Massachu-
setts/2/2012 (the vaccine virus included in trivalent setts/2/2012 (le virus inclus dans les vaccins trivalents). En
vaccines). In Europe, almost all the influenza B viruses Europe, la quasi-totalit des virus grippaux B antigniquement
antigenically characterized through March 2015 were of caractriss jusqu mars 2015 appartenaient la ligne
the B/Yamagata lineage. Approximately 70% of these were B/Yamagata. Environ 70% dentre eux taient antigniquement
antigenically similar to B/Phuket/3073/2013 while approx- apparents au virus B/Phuket/3073/2013 et 20% au virus
imately 20% were similar to B/Massachusetts/2/2012.19, 20 B/Massachusetts/2/2012.19, 20 Aux tats-Unis, la proportion de
In the USA, the proportion of characterized influenza B virus B caractriss appartenant la ligne B/Yamagata tait
viruses that belonged to the B/Yamagata lineage was lgrement plus faible (72%) et la majorit dentre eux (>90%)
slightly lower (72%) and the majority (>90%) of these taient antigniquement apparents B/Massachusetts/2/2012.21
were antigenically similar to B/Massachusetts/2/2012.21 In Dans la plupart des pays notifiant des donnes antigniques, la
most countries reporting antigenic data, the majority of majorit des virus appartenant la ligne B/Victoria taient
the B/Victoria lineage viruses were antigenically similar analogues B/Brisbane/60/2008 sur le plan antignique.
to B/Brisbane/60/2008.

Data presented in February 2015 by WHO Collaborating Center in London and WHO
22
Donnes prsentes en fvrier 2015 par les centres collaborateurs de lOMS Londres et
22

Collaborating Center in Atlanta at the vaccine composition meetings (VCMs). Atlanta lors des runions sur la composition des vaccins.
Pebody, R et al. Low effectiveness of seasonal influenza vaccine in preventing labo-
23
Pebody, R et al. Low effectiveness of seasonal influenza vaccine in preventing laboratory-confir-
23

ratory-confirmed influenza in primary care in the United Kingdom: 2014/15 mid- med influenza in primary care in the United Kingdom: 2014/15 mid-season results. Eurosurveil-
season results. Eurosurveillance. 2015. lance. 2015.
Skowronski, D et al. Interim estimates of 2014/15 vaccine effectiveness against
24
Skowronski, D et al. Interim estimates of 2014/15 vaccine effectiveness against influenza
24

influenza A(H3N2) from Canadas Sentinel Physician Surveillance Network, January A(H3N2) from Canadas Sentinel Physician Surveillance Network, January 2015. Eurosurveil-
2015. Eurosurveillance. 2015. lance. 2015.
A proportion of the A(H3N2) viruses this season, especially those in the genetic
25
Cette saison, un certain nombre de virus A(H3N2), en particulier ceux appartenant au
25

clade 3C.2a were difficult to characterize antigenically by the hemaglutination inhi- clade3C.2a, ont t difficiles caractriser par des tests dinhibition de lhmagglutination
bition assay in multiple laboratories. Therefore, other means of characterizing these raliss dans plusieurs laboratoires. Il a donc fallu employer dautres mthodes de caractrisa-
viruses, especially modified HI and virus neutralization assays and genetic sequen- tion des virus, en particulier des tests modifis dinhibition de lhmagglutination, des preuves
cing, were employed. de neutralisation du virus et le squenage gntique.
292 WEEKLY EPIDEMIOLOGICAL RECORD, NO. 23, 5 JUNE 2015
Antiviral susceptibility Sensibilit aux antiviraux
Of almost 3300 influenza viruses tested in the USA for Aux tats-Unis, prs de 3300 virus grippaux ont t analyss
resistance to neuraminidase (NA) inhibitors this season, pour valuer leur rsistance aux inhibiteurs de la neuramini-
only one A(H1N1)pdm09 virus showed reduced sensi- dase. Parmi eux, seul un virus A(H1N1)pdm09 prsentait une
tivity to oseltamivir and peramivir. The NA gene was sensibilit rduite loseltamivir et au pramivir. Il a t dter-
found to have a rare substitution at N142S.21 min que son gne de la neuraminidase tait porteur dune rare
substitution N142S.21
In Canada, at the end of the season, approximately Au Canada, la sensibilit aux antiviraux denviron 1300 virus a
1300 viruses were tested for antiviral susceptibility. All t analyse en fin de saison. Tous les virus grippaux tests
influenza viruses tested were resistant to amantadine taient rsistants lamantadine, lexception dun virus
except for one virus A(H3N2) virus. All influenza viruses A(H3N2). Ils taient tous sensibles au zanamivir et, lexception
tested were sensitive to oseltamivir except for one dun virus A(H3N2), loseltamivir.
A(H3N2) virus and all viruses tested were sensitive to
zanamivir.
Of the approximately 1300 A(H3N2) viruses tested in En Europe, sur les quelque 1300 virus A(H3N2) tests, 4 prsen-
Europe, 4 viruses showed reduced sensitivity to oselta- taient une sensibilit rduite loseltamivir (en raison dune
mivir (due to a E119V substitution in the NA gene) and substitution E119V du gne de la neuraminidase) et un virus
one virus showed reduced sensitivity to oseltamivir avait une sensibilit rduite loseltamivir et au zanamivir (du
and zanamivir (due to a R292K substitution in the NA fait dune substitution R292K du gne de la neuraminidase).
gene). Two influenza A(H1N1)pdm09 viruses showed Deux virus A(H1N1)pdm09 prsentaient une sensibilit rduite
reduced susceptibility to oseltamivir. No reduction in loseltamivir. Pour ce qui est des virus B, les analyses nont
susceptibility to neuraminidase inhibitors was seen mis en vidence aucune rduction de la sensibilit aux inhibi-
in testing of the influenza B viruses.19 teurs de la neuraminidase.19
In Japan, none of >300 viruses tested showed antiviral Au Japon, aucun des >300 virus analyss ne prsentait de rsis-
resistance and none of the A(H1N1)pdm09 viruses had tance aux antiviraux et aucun des virus A(H1N1)pdm09 ntait
the H275Y mutation, which is associated with clinical porteur de la mutation H275Y, associe une rsistance clinique
resistance to neuraminidase inhibitors.26 aux inhibiteurs de la neuraminidase.26
Of all the influenza viruses tested for antiviral resis- En Chine, tous les virus grippaux dont la rsistance aux anti-
tance in China during this season, all viruses were viraux a t analyse cette saison taient sensibles aux inhibi-
sensitive to neuraminidase inhibitors except 4 influenza teurs de la neuraminidase, lexception de 4 virus A(H3N2) et
A(H3N2) viruses and 2 influenza B viruses which de 2 virus B prsentant une sensibilit rduite.27
showed reduced susceptibility to neuraminidase inhi-
bitors.27

Vaccine effectiveness Efficacit vaccinale


Interim vaccine effectiveness (VE) estimates were Des estimations provisoires de lefficacit vaccinale ont t
assessed in several countries in the northern hemi- ralises dans divers pays de lhmisphre Nord partir des
sphere with data obtained early in the season. Most of donnes obtenues en dbut de saison. La plupart de ces esti-
the studies focused on VE estimates of preventing medi- mations portaient sur lefficacit vaccinale contre les infections
cally-associated laboratory confirmed infections with confirmes en laboratoire par les virus grippaux A(H3N2), ces
influenza A(H3N2) viruses as these were the predomi- derniers tant les virus circulants qui prdominaient en dbut
nant circulating viruses during the early to middle parts et en milieu de saison. Linterprtation de ces estimations prli-
of the season. While there are limitations in interpreting minaires comporte des limites, mais plusieurs tudes ont indi-
these early estimates, several studies have found that qu que les estimations de lefficacit vaccinale obtenues en fin
the final VE estimates from the end of the season have de saison concordent bien avec les estimations provisoires
been in good agreement with the interim estimates tires des donnes recueillies dans la premire partie de la
from data obtained up to the early to middle part of saison grippale, bien que les donnes de fin de saison permettent
the influenza season, although end of the season esti- dtablir des estimations plus prcises en fonction des sous-
mates allow for more precise subtype-specific and age- types et selon les tranches dge.28, 29, 30 Cette saison, les estima-
specific estimates.28, 29, 30 This season, early VE estimates tions prliminaires indiquaient une efficacit vaccinale gnra-

See http://www.nih.go.jp/niid/en/influ-resist-e.html; accessed May 2015.


26
Voir http://www.nih.go.jp/niid/en/influ-resist-e.html; consult en mai 2015.
26

See http://cnic.org.cn/eng/show.php?contentid=751; accessed May 2015.


27
Voir http://cnic.org.cn/eng/show.php?contentid=751; consult en mai 2015.
27

Jimnez-Jorge, S et al. Interim influenza vaccine effectiveness: a good proxy for final
28
Jimnez-Jorge, S et al. Interim influenza vaccine effectiveness: a good proxy for final estimates
28

estimates in Spain in the last four seasons 2010-2014. Vaccine [In press]. in Spain in the last four seasons 2010-2014. Vaccine [In press].
Sullivan, SG, Kelly, H. Late season interim estimates of influenza vaccine effective-
29
Sullivan, SG, Kelly, H. Late season interim estimates of influenza vaccine effectiveness reliably
29

ness reliably predict end of season estimates in Victoria, Australia, 20072012. predict end of season estimates in Victoria, Australia, 20072012. Eurosurveillance. 2013.
Eurosurveillance. 2013.
Belongia, EA et al. Influenza vaccine effectiveness in Wisconsin during the 2007
30
Belongia, EA et al. Influenza vaccine effectiveness in Wisconsin during the 20072008 season:
30

2008 season: comparison of interim and final results. Vaccine. 2011. comparison of interim and final results. Vaccine. 2011.
RELEVE EPIDEMIOLOGIQUE HEBDOMADAIRE, No 23, 5 JUIN 2015 293
were generally low as a result of the previously discussed lement faible en raison de la non-concordance dj voque
mismatch between the circulating influenza A(H3N2) entre les virus circulants A(H3N2) et les virus vaccinaux. De
viruses and the vaccine virus. In general, mid-season manire gnrale, lefficacit vaccinale estime la mi-saison
vaccine effectiveness estimates for 20142015 were pour 2014-2015 tait plus faible quen milieu ou en fin de saison
lower than those reported mid-season or end-of-season 2013 2014 (environ 50-70%), priode caractrise par la prdo-
for 20132014 (around 5070%) when influenza A(H1N1) minance du virus A(H1N1)pdm09 et une bonne concordance
pdm09 virus predominated and there was good genetic gntique et antignique entre les virus circulants et vaccinaux.
and antigenic match between the circulating and the
vaccine viruses.
In the USA, the interim, adjusted VE estimate from data Aux tats-Unis, lestimation ajuste provisoire de lefficacit
obtained from a research network of 5 academic centres vaccinale, dtermine partir des donnes recueillies par un
from November 2014 through January 2015 was 19% rseau de recherche de 5 centres universitaires entre novembre
(95%, CI: 729%) for preventing laboratory-confirmed 2014 et janvier 2015, tait de 19% (IC 95%: 7-29%) pour la
influenza infection in patients with medically-attended prvention des infections grippales confirmes en laboratoire
ARI and 18% (95%, CI: 629%) for preventing specifi- chez les patients prsentant des infections respiratoires aigus
cally A(H3N2) virus infections, in all age groups. ncessitant une assistance mdicale et de 18% (IC 95%: 6-29%)
Adjusted VE estimates against A(H3N2) infection were pour la prvention des infections dues spcifiquement au virus
similar in adults (age 1864 years), at 18% (95%, CI: A(H3N2), dans toutes les tranches dge. Les estimations ajus-
-233%), children (aged 6 months17 years), at 14% tes de lefficacit vaccinale contre linfection par le virus
(95%, CI: -631%), and the elderly (65 years) at 29% A(H3N2) taient comparables chez ladulte de 18 64 ans (18%,
(95%, CI: -1657), however none of the age group- IC 95%: -2-33%), chez lenfant de 6 mois 17 ans (14%, IC
specific VE estimates were statistically significant. 95%: -6-31%) et chez les personnes ges de 65 ans (29%, IC
Greater than 80% of the sequenced A(H3N2) viruses 95%: -16-57%), mais aucune des estimations selon la tranche
belonged to genetic group 3C.2a and the sentinel dge ntait significative sur le plan statistique. Plus de 80%
A(H3N2) virus isolates showed antigenic drift from the des virus A(H3N2) squencs appartenaient au groupe gn-
vaccine virus, accounting for the lower than expected tique 3C.2a, et les isolats des virus A(H3N2) provenant de sites
VE.31 sentinelles prsentaient une drive antignique par rapport au
virus vaccinal, expliquant la valeur plus faible quescompte de
lefficacit vaccinale.31
The interim, adjusted VE estimate from data obtained Au Canada, lestimation ajuste provisoire de lefficacit vacci-
from November 2014 to mid-January 2015 from a nale, dtermine partir des donnes recueillies dans plusieurs
primary care Sentinel Physician Surveillance Network provinces par un rseau de surveillance de mdecins sentinelles
in several provinces in Canada was -4% (95%, CI: de soins primaires entre novembre 2014 et la mi-janvier 2015,
-4525%) for preventing laboratory-confirmed infection tait de -4% (IC 95%: -45-25%) pour la prvention des infec-
with influenza A and -8% (95%, CI: -5023%) for tions confirmes en laboratoire par les virus grippaux A, et de
A(H3N2) virus infections in patients with medically -8% (IC 95%: -50-23%) pour la prvention des infections par
attended ILI. In adults aged 2064 years, the adjusted le virus A(H3N2) chez les patients prsentant des syndromes
VE estimate was 6% (95%, CI: -4338%) against influ- grippaux ncessitant une assistance mdicale. Chez les adultes
enza A and 2% (95%, CI: -4936%) for influenza de 20 64 ans, lestimation ajuste de lefficacit vaccinale tait
A(H3N2). Most (92%) of the viruses isolated from the de 6% (IC 95%: -43-38%) contre les virus grippaux A et de
influenza-positive cases in this study were A(H3N2) 2% (IC 95%: -49-36%) contre le virus A(H3N2). La majeure
viruses; a small subset of the A(H3N2) viruses were partie (92%) des virus isols parmi les cas positifs pour la
characterized antigenically and were distinct from the grippe relevs dans cette tude taient des virus A(H3N2);
vaccine virus. A larger subset of these sentinel A(H3N2) lacaractrisation antignique dun petit sous-ensemble de ces
viruses were sequenced and none belonged to the virus A(H3N2) a montr quils diffraient du virus vaccinal. Le
vaccine virus clade (3C.1); most (90%) belonged to clade squenage gntique dun autre sous-ensemble, plus impor-
3C.2a. The exception was in British Columbia where a tant, de ces virus A(H3N2) a permis de dterminer quaucun
smaller proportion belonged to clade 3C.2a and there dentre eux nappartenait au clade du virus vaccinal (3C.1), la
was more equal contribution from another emerging majorit (90%) appartenant au clade 3C.2a. La seule exception
clade variant that authors provisionally labelled clade tait la Colombie-Britannique, o une proportion moins impor-
3C.3x, but aligned phylogenetically with viruses belong- tante des virus appartenait au clade 3C.2a, avec une contribu-
ing to clade 3C.3b.24 tion plus quilibre dun autre clade mergeant, que les auteurs
ont provisoirement dsign sous le nom de 3C.3x mais dont les
virus sapparentaient phylogntiquement ceux du
clade 3C.3b.24
The interim, adjusted VE estimate from data obtained Au Royaume-Uni, lestimation ajuste provisoire de lefficacit
from October 2014 to mid-January 2015 from a primary vaccinale, dtermine partir des donnes recueillies par un

See
31
http://www.cdc.gov/flu/news/updated-vaccine-effectiveness-2014-15.htm; Voir http://www.cdc.gov/flu/news/updated-vaccine-effectiveness-2014-15.htm; consult en
31

accessed May 2015. 2015.

294 WEEKLY EPIDEMIOLOGICAL RECORD, NO. 23, 5 JUNE 2015


care surveillance network in the United Kingdom was 3% rseau de surveillance de soins primaires entre octobre 2014 et
(95%, CI: -4535%) for preventing laboratory-confirmed la mi-janvier 2015, tait de 3% (IC 95%: -45-35%) pour la
infection with influenza A overall and -2% (95%, CI: prvention des infections confirmes en laboratoire par les virus
-5633%) for A(H3N2), in patients with medically attended grippaux A et de -2% (IC 95%: -56-33%) pour la prvention des
ILI. From this surveillance network, A(H3N2) viruses were infections par le virus A(H3N2) chez les patients prsentant des
the predominant subtype detected and 21% of the A(H3N2) syndromes grippaux ncessitant une assistance mdicale. Parmi
viruses that were characterized antigenically showed les virus issus de ce rseau de surveillance, le sous-type A(H3N2)
reduced reactivity (>4-fold reduction in haemagglutina- tait prdominant, et 21% des virus A(H3N2) qui ont t soumis
tion inhibition (HI) titre) to the vaccine virus une caractrisation antignique avaient une ractivit rduite
(A/Texas/50/2012), providing evidence of significant anti- (diminution dun facteur >4 du titre dinhibition de lhmagglu-
genic drift of the circulating A(H3N2) viruses compared tination (IH)) avec le virus vaccinal (A/Texas/50/2012), mettant
to the vaccine virus. Genetic sequencing of a subset of en vidence la drive antignique significative des virus A(H3N2)
A(H3N2) viruses indicated that the circulating viruses circulants par rapport au virus vaccinal. Le squenage gntique
were genetically distinct from the vaccine virus.23 dun sous-ensemble des virus A(H3N2) a montr que les virus
circulants taient gntiquement distincts du virus vaccinal.23
The interim, adjusted VE from the national influenza En Espagne, lestimation ajuste provisoire de lefficacit vacci-
sentinel surveillance system (primary care sentinel nale, dtermine partir des donnes recueillies par le systme
network) in Spain was 55% (95%, CI: 2573%) for national de surveillance de la grippe (rseau sentinelle de soins
preventing infection with A(H3N2) influenza in patients primaires), tait de 55% (IC 95%: 25-73%) pour la prvention
6 months of age and older with medically-attended ILI. des infections par le virus grippal A(H3N2) chez les patients de
In Spain, a higher proportion of the sequenced sentinel 6 mois ou plus prsentant des syndromes grippaux ncessitant
A(H3N2) viruses were genetically similar to the vaccine une assistance mdicale. En Espagne, une plus grande propor-
virus, possible explaining the higher interim VE.22, 32 tion des virus sentinelles A(H3N2) squencs prsentait une
similitude gntique avec le virus vaccinal, ce qui pourrait
expliquer la valeur plus leve de lestimation provisoire de
lefficacit vaccinale.22, 32
There is less available information on vaccine effective- On ne dispose que de peu de donnes sur lefficacit du vaccin
ness against influenza A(H1N1)pdm09 and influenza B contre les virus grippaux A(H1N1)pdm09 et B en dbut de
viruses early in the season. In Spain, the early estimate saison. En Espagne, lestimation prliminaire de lefficacit
for influenza B virus infections was 61% (95% CI: contre le virus grippal B tait de 61% (IC 95%: 22-81%).22 Aux
2281%).22 In the USA, the interim VE estimate against tats-Unis, lestimation provisoire de lefficacit vaccinale tait
laboratory confirmed influenza B virus infection among de 45% (IC 95%: 14-65%) contre les infections confirmes en
patients with medically attended ARI was 45% (95%, CI: laboratoire par le virus B chez les patients prsentant des infec-
1465%) and 48% (95%, CI: 1688%) against infection tions respiratoires aigus ncessitant une assistance mdicale
with influenza B/Yamagata lineage viruses, specifically.31 et de 48% (IC 95%: 16-88%) contre les infections dues spci-
fiquement aux virus de la ligne B/Yamagata.31

Summary Rsum
Influenza activity in the northern hemisphere peaked Cette saison, lactivit grippale a culmin plus tt que les annes
early in North America this season compared to previ- prcdentes en Amrique du Nord. Dans les autres rgions de
ous years, and in other regions in general peaked in lhmisphre Nord, elle a gnralement atteint son pic au dbut
early 2015. Overall, influenza activity was higher this de 2015. Dans lensemble, lactivit grippale a t plus intense
season compared to last season in North America and que la saison dernire en Amrique du Nord et en Europe, mais
Europe but lower in eastern Asia, North Africa, and the plus faible en Asie orientale, en Afrique du Nord et au Moyen-
Middle East. Influenza A(H3N2) virus predominated in Orient. Le virus A(H3N2) tait prdominant dans la plupart des
most regions this season and an increasing proportion rgions cette saison, avec une augmentation de la proportion
of influenza B viruses were detected after the peak of de virus B dtects aprs le pic dactivit grippale.
influenza activity.
The predominance of influenza A(H3N2) viruses and Caractrise par la prdominance des virus A(H3N2) et un taux
increased morbidity and mortality were similar to accru de morbidit et de mortalit, cette saison avait un profil
patterns observed in previous influenza seasons with a comparable celui de certaines saisons passes pour lesquelles
predominance of influenza A(H3N2) virus associated le virus A(H3N2) prdominait, saisons qui avaient t marques
with more severe illness, especially in adults aged par une plus grande incidence des formes graves de la maladie,
65years, compared to morbidity and mortality associ- en particulier chez les adultes de 65 ans, par rapport la morbi-
ated with influenza A(H1N1)pdm09 virus. During this dit et la mortalit associes au virus grippal A(H1N1)pdm09.
season, most of the circulating influenza A(H3N2) Cette saison, la plupart des virus grippaux A(H3N2) circulants
viruses differed from the virus in vaccines used in the diffraient des virus utiliss dans la prparation des vaccins

Jimnez-Jorge, S et al. Influenza vaccine effectiveness in Spain 2013/14: subtype-


32
Jimnez-Jorge, S et al. Influenza vaccine effectiveness in Spain 2013/14: subtype-specific early
32

specific early estimates using the cycEVA study. Eurosurveillance. 2014. estimates using the cycEVA study. Eurosurveillance. 2014.
RELEVE EPIDEMIOLOGIQUE HEBDOMADAIRE, No 23, 5 JUIN 2015 295
northern hemisphere, which may have contributed to dans lhmisphre Nord, ce qui a vraisemblablement contribu
the lower vaccine effectiveness estimates this season la faiblesse de lefficacit vaccinale estime cette saison par
compared to those of previous seasons. rapport aux saisons passes.
Regarding antiviral susceptibility, very few influenza En termes de sensibilit aux antiviraux, trs peu de virus circu-
viruses circulating this season demonstrated reduced lants cette saison ont prsent une sensibilit rduite aux inhi-
sensitivity to neuraminidase inhibitors. biteurs de la neuraminidase.
Global mortality and morbidity estimates and analyses Les analyses et les estimations de la morbidit et de la morta-
remain challenging, as most of the information was lit sont difficiles tablir lchelle mondiale, la plus grande
from high income countries. partie des informations disponibles provenant des pays
revenu lev.

Acknowledgements Remerciements
a
Global Influenza Programme, Pandemic and Epidemic a
Programme mondial de lutte contre la grippe, Dpartement
Diseases Department, Health Security and Environment pidmies et pandmies, Groupe Scurit sanitaire et environ-
Cluster, World Health Organization (Corresponding nement, Organisation mondiale de la Sant (Correspondance
author: Katelijn Vandemaele, fluupdate@who.int). adresser : Katelijn Vandemaele, fluupdate@who.int).
The WHO Global Influenza Surveillance and Response Le Systme mondial OMS de surveillance de la grippe et de
System (GISRS), the Global Influenza Vaccine Effective- riposte (GISRS), le Global Influenza Vaccine Effectiveness (GIVE)
ness (GIVE) Collaboration and the WHO Regional Collaboration et les bureaux rgionaux de lOMS.
offices.

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