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Influenza - The WHO Influenze programme

The WHO Influenze programme

The World Health Organization's (WHO) Influenza programme was established in 1948, three decades after influenza had caused the most deadly influenza pandemic a global epidemic - ever recorded. The threat of future pandemics similar to that in 1918-1920, when more than 20 million people died, led to the establishment in 1946 of an international mechanism to set up and finance an international centre to collect and distribute information, coordinate laboratory work on influenza and train laboratory workers.

The National Institute for Medical Research (NIMR) in London accepted to host the World Influenza programme. The programme's objective was to assist in developing plans against the possible recurrence of a pandemic and in devising control methods to limit spread, severity, and consequences of the disease. National laboratories that had the capacity to diagnose influenza, isolate the virus and were willing to share information and viral isolates with WHO, were recruited as part of the network. Early efforts of the programme were directed towards development and standardization of laboratory techniques and reagents for diagnosis of circulating influenza viruses. After four years' operation, the network already comprised 60 laboratories in 40 countries. With the rapidly increasing volume of virus isolates, a second international reference centre was established in the Strain Study Center for the Americas in New York, United States of America.

After 50 years, WHO's global surveillance of influenza now maintains 110 National Influenza Centres in 83 countries and four WHO Collaborating Centres for Virus Reference and Research in Atlanta, USA; London, UK; Melbourne, Australia; and Tokyo, Japan. The National Institute for Medical Research in London (NIMR) remains the reference centre in the United Kingdom. The Strain Study Center for the Americas was transferred to the United States public Health Services and eventually found its present location at the Centers for Disease Control and prevention in Atlanta, Georgia. A third centre was established in the early 1990s, at the former Commonwealth Serum Laboratories in Melbourne, Australia, to service laboratories in the southern hemisphere. A WHO Collaborating Centre on Influenza and Respiratory Viruses at the National Institute of Infectious Diseases (NIID) in Tokyo, Japan is also supporting the programme's activities. These four centres retain the main responsibility for strain characterization. The Collaborating Centres exchange strains, reagents and information to complete the understanding of influenza during the season. Before the expected start of influenza season, the National Influenza Centres are provided with a kit of laboratory diagnostic reagents which should enable them to determine the type and subtype of influenza viruses circulating during the season. This kit is manufactured for WHO by CDC in Atlanta, Georgia and distributed to all centres free of charge.

To improve influenza surveillance and enhance standardization of reporting, WHO in collaboration with the Institut National de la Sant et de la Recherche Mdicale, paris, France has created an electronic tool accessible through the internet for linking the global network of centres (FluNet) electronically, allowing each authorized centre to enter data remotely every week and obtain full access to real-time epidemiological and virological information. part of this information is accessible to the public (http://oms.b3e.jussieu.fr/flunet). In addition, all information from the national laboratories is analysed and published by WHO in the Weekly Epidemiological Record. A summary of country reports is also available on the Internet (http://www.who.int).

For many years, WHO has held a Consultation in mid-February to formulate a recommendation for the composition of inactivated influenza vaccines intended for the following winter (November of that year to April for the following one). As epidemics of influenza occur at different times of the year in different parts of the world, and as the influenza virus is constantly changing and the use of vaccines is increasing worldwide, the need to review the recommendation twice a year has become appropriate. A recommendation will continue to be made in February, intended for use for the following winter in the northern hemisphere (November to April). A second recommendation will be made each September for the vaccines to be used for the following winter in the southern hemisphere (May to October).

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