Seasonal Influenza surveillance and vaccination policies in the WHO South-East Asian Region.
The WHO South-East Asia Region (SEAR), with its high population density, is recognised by epidemiologists as a critical reservoir for the emergence and global dissemination of novel influenza strains, making it a potential epicentre for future influenza pandemics. Despite this significant risk, most SEAR countries lack comprehensive seasonal influenza vaccination policies, resulting in low vaccine uptake across the region. This review analysed the latest WHO National Influenza Programme factsheets from the 11 SEAR member states and supplemented this with extensive manual literature searches using electronic databases and government websites. As of October 2022, only three countries—India, Bhutan and Thailand—had established seasonal influenza vaccination policies. Among them, Bhutan and Thailand have policies that cover all five WHO-recommended high-risk groups. While national influenza surveillance systems are in place across SEAR, only India and the Democratic People’s Republic of Korea claim full population coverage. Influenza vaccine production capacity is limited to Bangladesh, India and Indonesia. The region’s varied climatic conditions and insufficient local data have further obscured the true burden of influenza. Thailand offers a successful model for other countries in the region, beginning with the most vulnerable groups and gradually expanding coverage. To effectively develop and implement national influenza vaccination policies, SEAR countries must close the evidence gap by strengthening surveillance systems to provide accurate, timely data and prioritise context-specific research, leverage existing vaccine infrastructure, enhance public education and finally engage with local and international stakeholders to establish strong international cooperation to support these efforts and improve pandemic preparedness. Read More
Increasing child vaccination coverage can reduce influenza cases across age groups: An agent-based modeling study.
Availability of caregiver-administered nasal spray live attenuated influenza vaccine (LAIV) raises the potential for increased influenza vaccine uptake. Direct and indirect benefits (decreased influenza cases and hospitalizations) of increased uptake among school-age children may be realized across the age spectrum. We used an agent-based model to determine the extent to which increased vaccination of children might affect overall influenza epidemiology.
The Framework for Reproducing Epidemiological Dynamics (FRED) uses a population based on the US census and accounts for individual characteristics to estimate the effect of changes in parameters including vaccine uptake, on outcomes. We modeled increases in vaccine uptake among school-age children 5-17 years old on influenza cases and hospitalizations by age group.
Increasing vaccination rates in school-aged children by 5%-15% decreased their symptomatic influenza cases by 3.2%-10.9%, and among all age groups by 3.3%-11.6%, corresponding to an estimated annual reduction in cases of 522,867-1,810,170 among school-age children and of 1,394,687-4,945,952 overall. Annual U.S. hospitalizations could decrease by as much as 49,977, with the greatest impact (23,258) in those ages 65 years and over.
The opportunity to increase vaccination coverage in school-age children using LAIV can have a positive impact across all ages. Read More
H3N2 influenza virus characteristics in China (2019–2022): Genetic, antigenic, and infection dynamics during the COVID-19 pandemic
Seasonal influenza activity significantly decreased in China during the coronavirus disease 2019 (COVID-19) pandemic, yet the H3N2 virus led to three epidemic waves. Understanding the characteristics of H3N2 epidemic viruses is essential for recognizing influenza during COVID-19 and for updating vaccines. In this study, we analyzed 579 respiratory samples from patients exhibiting influenza-like symptoms, collected between late 2019 and summer 2022, leading to the successful sequencing of 36 complete H3N2 genomes. Genomic analysis indicated that the epidemic strains from these periods belonged to different hemagglutinin (HA) clades and exhibited phylogenetic divergence from the concurrently used vaccine strains. Significant antigenic differences were identified through cross-hemagglutination inhibition (HI) and microneutralization (MN) assays. Further pathogenicity studies showed that representative strains replicated in MDCK cells, with varying abilities, and all replicated more effectively at 37 °C than 33 °C. These strains also replicated well in the respiratory tracts of mice and guinea pigs. The findings indicate a mismatch between circulating H3N2 viruses and recommended vaccine strains, highlighting the need for improved international cooperation and epidemiological surveillance of influenza viruses post-COVID-19. Prioritizing effective vaccine strain updates and developing a universal influenza vaccine are crucial for future preparedness.Read More
UAE doctors caution against flu symptoms
Doctors in the UAE have cautioned residents against lingering flu and respiratory syncytial virus (RSV) infections. Dr Rajesh Kumar Gupta, an internal medicine specialist at Burjeel Specialty Hospital in Sharjah, pointed out that this year, flu and RSV viruses have arrived earlier and are more active than in previous seasons. “This is due to significant variations in weather patterns observed globally,” Dr Gupta said. “More people are falling sick due to changes in immunity, dietary habits, lack of proper hydration, good sleep and exercise. Other reasons include allergies, stressful life, air quality and vitamin deficiencies.” “A number of cases are testing positive for both influenza A and B, along with atypical bacterial infections such as Mycoplasma pneumonia,” he said. Dr Gupta warned that these compounded infections could lead to longer recovery times – sometimes up to a month. “Nowadays, viral infections persist longer than usual – more than one to two weeks, and sometimes up to four – because of frequent exposure in social and work environments, immune status, and age, especially in those with co-morbidities,” Dr Gupta said.Dr Mohamed Rafique, consultant pulmonologist and medical director at Prime Hospital, Dubai, said, “As we enter the winter season, we’ve seen an increase in flu cases. We’re also seeing RSV infections, which are not only prevalent among children but are affecting the adult population.”Dr Rafique highlighted an uptick in cases of post-viral bronchial hyper-reactivity, a condition similar to asthma that presents with symptoms such as coughing and wheezing, which can persist for an extended period. Read More
Human Metapneumovirus (HMPV) in China: India urges calm amid flu season
A top official from India’s Directorate General of Health Services (DGHS) has urged people not to panic over the spread of Human Metapneumovirus (HMPV) in China, according to Indian media reports. Meanwhile, a joint monitoring group has stated that the situation in China is not unusual given the ongoing flu season. The group agreed that the current surge in cases in China is caused by the influenza virus, RSV, and HMPV — typical pathogens expected during this time of year, according to a government statement. Dr. Atul Goel, an official from DGHS, recommended taking general precautions against respiratory infections, NDTV reported. “Otherwise, there is nothing to be alarmed about in the present situation,” Dr. Goel said. “There has been news circulating about a Metapneumovirus outbreak in China. Let me be very clear: Metapneumovirus is like any other respiratory virus that causes the common cold. In the very old and the very young, it could cause flu-like symptoms,” Dr. Goel told reporters on Friday.
He added, “we have analysed data from respiratory outbreaks within the country. There is no substantial increase in December 2024 data and no large numbers of cases reported from any of our institutions.” Read More
Trends of acute respiratory infection, including human metapneumovirus, in the Northern Hemisphere
In many countries of the Northern Hemisphere, trends in acute respiratory infections increase at this time of year. These increases are typically caused by seasonal epidemics of respiratory pathogens such as seasonal influenza, respiratory syncytial virus (RSV), and other common respiratory viruses, including human metapneumovirus (hMPV), as well as mycoplasma pneumoniae. Many countries conduct routine surveillance for acute respiratory infections and common respiratory pathogens. Currently, in some countries in the temperate Northern hemisphere, influenza-like illness (ILI) and/or acute respiratory infection (ARI) rates have increased in recent weeks and are above baseline levels, following usual seasonal trends. Seasonal influenza activity is elevated in many countries in the Northern hemisphere. Where surveillance data is available, trends in RSV detections currently vary by region with decreases reported in most regions except in North America. Recently, there has been interest in hMPV cases in China including suggestions of hospitals being overwhelmed. hMPV is a common respiratory virus found to circulate in many countries in winter through to spring, although not all countries routinely test and publish data on trends in hMPV . While some cases can be hospitalized with bronchitis or pneumonia, most people infected with hMPV have mild upper respiratory symptoms similar to the common cold and recover after a few days. Based on data published by China, covering the period up to 29 December 2024, acute respiratory infections have increased during recent weeks and detections of seasonal influenza, rhinovirus, RSV, and hMPV, particularly in northern provinces of China have also increased. The observed increase in respiratory pathogen detections is within the range expected for this time of year during the Northern hemisphere winter. In China, influenza is the most commonly detected respiratory pathogen currently affecting people with acute respiratory infections. WHO is in contact with Chinese health officials and has not received any reports of unusual outbreak patterns. Chinese authorities report that the health care system is not overwhelmed and there have been no emergency declarations or responses triggered. WHO continues to monitor respiratory illnesses at global, regional and country levels through collaborative surveillance systems, and provides updates as needed. Read More
Emerging and re-emerging disease threats in the Middle East and North Africa region—One Health approaches and potential strategies
Emerging and re-emerging infectious diseases have no boundaries, and the Middle East and North Africa (MENA) region is no exception (For this discussion the authors define the Middle East and North Africa region as comprised of the following: countries: Afghanistan, Algeria, Bahrain, Djibouti, Egypt, Iran, Iraq, Israel, Jordan, Kuwait, Lebanon, Libya, Morocco, Oman, Pakistan, Palestine, Qatar, Saudi Arabia, Somalia, South Sudan, Sudan, Syria, Tunisia, Türkiye, United Arab Emirates, and Yemen.). Given the intricate mesh of commerce and livestock trade, mass gathering events, international travel, and population movement throughout the region, emerging health security threats in MENA can have global implications, The emergence of Middle East Respiratory Syndrome coronavirus (MERS-CoV) in Jordan and Saudi Arabia in 2012 elevated MENA as a disease emergence hotspot. The region has seen multiple pathogen emergence events during recent decades. Vector-borne diseases (VBD) in the region range from parasitic diseases such as malaria and leishmaniasis to arboviruses including flaviviruses (e.g. West Nile, dengue, Alkhurma hemorrhagic fever), the phlebovirus Rift Valley Fever (RVF), and the alphavirus chikungunya . A geographically diverse region, MENA countries have many arthropod disease vectors, including multiple species of mosquitoes and sandflies, and while they may be highly focal, increasing rainfall and water ponding can increase their distribution. Aedes aegypti and Aedes albopictus mosquitoes (vectors of dengue, Zika, chikungunya, and yellow fever viruses) have been detected in several countries. Of particular concern is the establishment of the invasive mosquito Anopheles stephensi in the Horn of Africa and Yemen, threatening regional progress toward malaria elimination .
In animal health, Foot and Mouth Disease, Peste des Petits Ruminants, and RVF have all re-emerged in MENA. Highly Pathogenic Avian Influenza (H5N1), first reported in Egypt in 2006 and Low Pathogenic Avian Influenza (H9N2) in Morocco in 2016, have been confirmed in wild and farmed birds in multiple countries and with associated zoonotic transmission. Rabies, bovine tuberculosis, leptospirosis, brucellosis, and parasitic zoonoses occur broadly across the region. Read More
$16.85 Bn Influenza Vaccines Market Research 2025-2033: Expansion of Production Capacity, Strategic Partnerships and Collaborations, Advancements in Development
The “Influenza Vaccines Market Opportunities and Strategies to 2033” report is out. This report describes and explains the influenza vaccines market and covers 2018-2023, termed the historic period, and 2023-2028, 2033F termed the forecast period. The report evaluates the market across each region and for the major economies within each region. The global influenza vaccines market reached a value of nearly $7.93 billion in 2023, having grown at a compound annual growth rate (CAGR) of 6.30% since 2018. The market is expected to grow from $7.93 billion in 2023 to $11.41 billion in 2028 at a rate of 7.54%. The market is then expected to grow at a CAGR of 8.11% from 2028 and reach $16.85 billion in 2033.
Growth in the historic period resulted from the increasing healthcare expenditure, expansion of vaccination programs, expansion of healthcare infrastructure and rise in disposable income. Factors that negatively affected growth in the historic period were high cost of vaccine.
Going forward, the increasing geriatric population, favorable governments initiatives, rising incidence of respiratory diseases and strong economic growth in emerging markets will drive the growth. Factor that could hinder the growth of the influenza vaccines market in the future include public perception and vaccine hesitancy.
The influenza vaccines market is segmented by vaccine type into inactivated and live attenuated. The inactivated market was the largest segment of the influenza vaccines market segmented by vaccine type, accounting for 88.44% or $7.01 billion of the total in 2023. Going forward, the recombinant segment is expected to be the fastest growing segment in the influenza vaccines market segmented by vaccine type, at a CAGR of 7.67% during 2023-2028. The influenza vaccines market is segmented by valency into quadrivalent and trivalent. The quadrivalent market was the largest segment of the influenza vaccines market segmented by valency, accounting for 77.04% or $6.11 billion of the total in 2023. Going forward, the quadrivalent segment is expected to be the fastest growing segment in the influenza vaccines market segmented by valency, at a CAGR of 7.83% during 2023-2028. The influenza vaccines market is segmented by route of administration into injection and nasal spray. The injection market was the largest segment of the influenza vaccines market segmented by route of administration, accounting for 93.02% or $7.38 billion of the total in 2023. Going forward, the nasal spray segment is expected to be the fastest growing segment in the influenza vaccines market segmented by route of administration, at a CAGR of 7.63% during 2023-2028.
The influenza vaccines market is segmented by distribution channel into hospitals and pharmacies, government and institutional supply and other distribution channels. The hospitals and pharmacies market was the largest segment of the influenza vaccines market segmented by distribution channel, accounting for 57.94% or $4.59 billion of the total in 2023. Going forward, the government and institutional supply segment is expected to be the fastest growing segment in the influenza vaccines market segmented by distribution channel, at a CAGR of 8.21% during 2023-2028. Read More
Will bird flu spark a human pandemic? Scientists say the risk is rising
Ten months on from the shocking discovery that a virus usually carried by wild birds can readily infect cows, at least 68 people in North America have become ill from the pathogen and one person has died. Although many of the infections have been mild, emerging data indicate that variants of the avian influenza virus H5N1 that are spreading in North America can cause severe disease and death, especially when passed directly to humans from birds. The virus is also adapting to new hosts — cows and other mammals — raising the risk that it could spark a human pandemic.
“The risk has increased as we’ve gone on — especially in the last couple of months, with the report of [some] severe infections,” says Seema Lakdawala, an influenza virologist at Emory University School of Medicine in Atlanta, Georgia. Last week, US President Donald Trump took office and announced that he will pull the United States — where H5N1 is circulating in dairy cows — out of the World Health Organization, the agency that coordinates the global response to health emergencies. This has sounded alarm bells among researchers worried about bird flu. Read More
Epidemiological Alert: Increased activity of seasonal influenza virus and other respiratory viruses in the northern hemisphere – 17 January 2025
In the current season of increased circulation of respiratory viruses in the northern hemisphere during the 2024 – 2025 season, several countries, mainly in the European region, are reporting an increase in care seeking and hospitalizations for respiratory infections. Given this situation and considering that similar situations may occur in the countries of the Americas Region that are in the season of increased circulation of respiratory viruses, the Pan American Health Organization / World Health Organization (PAHO/WHO) recommends adjusting preparedness plans and organization of health services for an eventual overload in the health system. It is recommended to reinforce the necessary measures for the prevention and control of respiratory virus infections, implement measures to ensure early diagnosis and adequate clinical management, especially among the population at high risk of severe disease, ensure vaccination against respiratory viruses, ensuring high vaccination coverage in high-risk groups, adequate forecasting and organization of health services, strict compliance with infection prevention control measures, adequate supply of antivirals and personal protective equipment, as well as adequate risk communication to the population and health professionals. Read More
Promoting influenza vaccination behavior among healthcare workers in the gulf cooperation council countries; Lessons from the [redacted]
Influenza poses a significant health and economic burden globally, with healthcare workers (HCWs) being particularly vulnerable. Despite their critical role in public health, influenza vaccination coverage rates (VCR) among HCWs in the Middle East remain low, with some countries reporting rates as low as 24.7 %. This study aims to identify the factors contributing to low VCR among HCWs and propose solutions to enhance vaccination uptake based on insights from the [redacted] alongside the review of literature to develop targeted interventions. Key strategies include a multifaceted approach, multi-stakeholder accountability, and robust data collection systems. The study emphasizes the need for evidence-based guidelines, streamlined education, and efficient policy frameworks to improve VCR among HCWs in the Middle East. The proposed solutions aim to bridge the gap between knowledge and practice, ensuring a resilient healthcare workforce capable of mitigating influenza outbreaks. The findings underscore the importance of stakeholder engagement and the development of a comprehensive ‘toolbox’ for early implementation in GCC countries, focusing on physicians, nurses/midwives, and pharmacists. This approach aims to foster long-term maintenance and adaptability of vaccination programs, ultimately enhancing public health protection. Read More
The mediating effect of air pollution on the association between meteorological factors and influenza-like illness in China
Although numerous studies have explored the complex relationship between air pollution, meteorological factors and respiratory infections, evidence for a mediating effect of air pollutants being involved in the association between meteorological factors and Influenza-like illness (ILI) is limited.Correlations among ILI cases, air pollutants and meteorological factors were examined with Pearson correlation analyses. Further, we formulated six candidate mediation models to explore the mediating effect of air pollutant on the association between meteorological factors and ILI infections.The meteorological factors minimum temperature/maximum humidity moderated by maximum humidity/minimum temperature and pressure directly affect ILI infections, and that some of meteorological factors can also indirectly affect them through air pollutants. Increases in maximum humidity and minimum temperature can directly reduce the numbers of ILI cases, or indirectly reduce them by reducing the concentration of air pollutants. When the haze with low temperature, low humidity is forecasted by the meteorological agency, the environmental protection departments can take effective control measures to reduce the concentration of air pollutants, and public health departments should advocate human behavioral changes in order to mitigate and control ILI prevalence. Read More