African Countries Gain Ground in Fight Against Influenza

Twenty-seven papers published in the Journal of Infectious Diseases highlight African countries’ improved abilities to detect, monitor and respond to influenza

Cover image by Dan Higgins, MAMS.

An 'Influenza in Africa ' Journal of Infectious Diseases supplement published on December 15, 2012, gives new data on the burden and epidemiology of seasonal flu in Africa and sheds light on the impact of the 2009 H1N1 pandemic, which tested many countries’ relatively new preparedness plans, laboratory networks and surveillance systems.

"These papers reflect the vast amount of work being done by African countries, in collaboration with CDC, the World Health Organization, Institut Pasteur and many other partners to better understand the impact of influenza on the continent," said Dr. Mark Katz, Medical Epidemiologist with CDC, who worked with many of the authors along the way. Katz is the former Influenza Lead for the CDC office in Kenya and is now Advisor for Surveillance and Epidemic-Prone Diseases in CDC’s Haiti office.

Highlights from the supplement include:

Groundbreaking evidence on the epidemiology of influenza disease in Ethiopia, Tanzania, Rwanda, the Democratic Republic of Congo, and Angola.
Data on the contribution of influenza to respiratory illness from population-based studies in Africa.
New information about the seasonality and genetic diversity of influenza viruses on the African continent.
Descriptions of the transmission and impact of the pandemic virus, and pandemic vaccine acceptability and use in Africa.

"The recent large-scale improvements in influenza surveillance and response systems in many African countries made it possible to generate the data described in these articles," said Dr. Marc-Alain Widdowson, Team Lead for the International Epidemiology and Research in CDC’s Influenza Division. "The findings from this supplement can be used to inform important policy decisions about seasonal and pandemic influenza prevention and control policies at the national and regional level."

As more data are collected, ministries of health will see with increasing clarity who is most impacted by flu, if a vaccine policy would be beneficial, and when during a calendar year flu vaccine should be administered to prevent as much flu-related illness and death as possible.

Especially when in-country resources are scarce, solid data on impacted populations and documented seasonality of flu viruses are pivotal to attracting donations of influenza vaccine.

The African Network for Influenza Surveillance and Epidemiology (ANISE) was founded in 2009 to help scientists share and standardize influenza surveillance methods in Africa. ANISE encourages African countries to generate and disseminate data on the burden and epidemiology of influenza. Members use the Network to coordinate with one another and provide laboratory and epidemiologic support to other members.

The 27 papers reflect the work of nearly 300 authors from more than 50 institutions, based primarily in 16 African countries. Authors were invited to participate in the supplement in January 2011, at the Second Annual Meeting for the African Network for Influenza Surveillance and Epidemiology (ANISE) in Ghana. The supplement was funded by CDC’s Influenza Division as part of the ongoing objective of supporting countries in increasing the reporting and dissemination of influenza data. The data give countries heightened ability to pursue prevention measures such as vaccination.

Prior to 2006, little was known about the epidemiology, burden, and seasonality of influenza in Africa. That year, amidst global concern about outbreaks of highly pathogenic avian influenza A (H5N1) in Asia, CDC, World Health Organization, Institut Pasteur and others joined African ministries of health to begin ramping up pandemic preparedness on the continent.

Since 2006, the Influenza Division has provided financial and technical support to African countries through various cooperative agreements that have focused on building and sustaining influenza-related epidemiologic and laboratory capacity in grantee countries. Support provided by the Influenza Division is detailed in the Influenza Division International Activities Fiscal Year 2011 Annual Report.