Assessment of Influenza Severity in Bhutan by Using WHO Framework Pandemic Influenza Severity Assessment (PISA): An
Tshering Dorji1, Kunzang Dorji1, Vishal Chettri2
1National Influenza Centre (NIC), Royal Centre for Disease Control, Thimphu, Bhutan.
Insights
Bhutan established influenza severity thresholds using the WHO PISA framework. This allows for better preparedness against seasonal and pandemic influenza, especially for young children.
Area of Science:
- Public Health
- Epidemiology
- Virology
Background:
- Influenza poses a significant global health threat, causing millions of severe illnesses and hundreds of thousands of deaths annually.
- Bhutan experiences high rates of influenza-associated hospitalizations, particularly in children under five, highlighting the need for enhanced surveillance and preparedness.
Purpose of the Study:
- To assess influenza severity in Bhutan utilizing the World Health Organization's (WHO) Pandemic Influenza Severity Assessment (PISA) framework.
- To establish national baseline and threshold values for influenza activity by integrating syndromic and influenza-specific data.
Main Methods:
- The WHO Average Curve Method was used to determine seasonal and intensity thresholds for influenza.
- Historical data from 2016-2019 and 2023 were analyzed to categorize influenza severity.
Main Results:
- Influenza activity in Bhutan is nearly continuous, with two distinct annual peaks.
- Thresholds for epidemic, moderate, high, and extraordinary levels of transmissibility and morbidity were defined.
- The 2019 season showed the highest transmissibility and morbidity, with notable seasonal intensity variations.
Conclusions:
- The PISA framework effectively assesses influenza severity in Bhutan, providing crucial data for public health decisions.
- Established thresholds enhance preparedness for seasonal and pandemic influenza events.
- Continuous adaptation of surveillance systems is vital for monitoring year-round influenza activity.
Background:
Influenza presents a significant global health challenge, with seasonal epidemics causing 3 to 5 million cases of severe illness and 290,000 to 650,000 respiratory deaths annually. In Bhutan, the highest rates of influenza-associated hospitalizations were observed among children under 5 years of age emphasizing the need for robust surveillance and preparedness.
Objective:
This study aims to assess influenza severity in Bhutan using the World Health Organization's (WHO) Pandemic Influenza Severity Assessment (PISA) framework. By integrating syndromic and influenza-specific data, we establish national-level baseline and threshold values for influenza activity.
Methods:
The WHO Average Curve Method was employed to establish seasonal and intensity thresholds, categorizing influenza severity based on historical data from 2016 to 2019 and 2023.
Results:
Analysis of influenza activity revealed near-continuous activity with two annual peaks. Thresholds for epidemic, moderate, high, and extraordinary levels of transmissibility and morbidity were determined. The 2019 season exhibited the highest transmissibility and morbidity, with significant variability in intensity across different seasons.
Conclusion:
The study demonstrates the effectiveness of the PISA framework in assessing influenza severity in Bhutan. The established thresholds provide a valuable tool for public health decision-making, enhancing the country's preparedness for both seasonal and pandemic influenza. These findings underscore the importance of maintaining and adapting surveillance systems to monitor influenza activity year-round.
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