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van der Velden K, van Summeren J, Caini S, Nair H, Dückers M, Meijer A. William John Paget PhD. J Infect Dis 2024; 229:S1-S3. [PMID: 38064690 DOI: 10.1093/infdis/jiad554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024] Open
Affiliation(s)
- Koos van der Velden
- Department of Primary and Community Care, Radboud University, Medical Centre, Nijmegen, the Netherlands
| | | | - Saverio Caini
- Nivel-Netherlands Institute for Health Services Research, Utrecht, the Netherlands
| | - Harish Nair
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Michel Dückers
- Nivel-Netherlands Institute for Health Services Research, Utrecht, the Netherlands
- Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, the Netherlands
| | - Adam Meijer
- Centre for Infectious Disease Control (CIb), National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
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Adlhoch C, Snacken R, Melidou A, Ionescu S, Penttinen P. Dominant influenza A(H3N2) and B/Yamagata virus circulation in EU/EEA, 2016/17 and 2017/18 seasons, respectively. ACTA ACUST UNITED AC 2019; 23. [PMID: 29616611 PMCID: PMC5883452 DOI: 10.2807/1560-7917.es.2018.23.13.18-00146] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We use surveillance data to describe influenza A and B virus circulation over two consecutive seasons with excess all-cause mortality in Europe, especially in people aged 60 years and older. Influenza A(H3N2) virus dominated in 2016/17 and B/Yamagata in 2017/18. The latter season was prolonged with positivity rates above 50% among sentinel detections for at least 12 weeks. With a current west–east geographical spread, high influenza activity might still be expected in eastern Europe.
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Affiliation(s)
- Cornelia Adlhoch
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - René Snacken
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Angeliki Melidou
- Microbiology Department, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Silviu Ionescu
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Pasi Penttinen
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
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- The members of the European Influenza Surveillance Network are listed at the end of article
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Goddard N, Rebelo-de-Andrade H, Meijer A, McCauley J, Daniels R, Zambon M. Future directions for the European influenza reference laboratory network in influenza surveillance. ACTA ACUST UNITED AC 2015; 20. [PMID: 26250071 DOI: 10.2807/1560-7917.es2015.20.30.21195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
By defining strategic objectives for the network of influenza laboratories that have national influenza centre status or national function within European Union Member States, Iceland and Norway, it is possible to align their priorities in undertaking virological surveillance of influenza. This will help maintain and develop the network to meet and adapt to new challenges over the next 3-5 years and underpin a longer-term strategy over 5-10 years. We analysed the key activities undertaken by influenza reference laboratories in Europe and categorised them into a framework of four key strategic objectives areas: enhancing laboratory capability, ensuring laboratory capacity, providing emergency response and translating laboratory data into information for public health action. We make recommendations on the priority areas for future development.
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Affiliation(s)
- N Goddard
- Public Health England (PHE), London, United Kingdom
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Lahey T, Nelson WA. A proposed nationwide reporting system to satisfy the ethical obligation to prevent drug diversion-related transmission of hepatitis C in healthcare facilities. Clin Infect Dis 2015; 60:1816-20. [PMID: 25767254 DOI: 10.1093/cid/civ203] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Accepted: 03/04/2015] [Indexed: 11/14/2022] Open
Abstract
In 2012, dozens of patients of Exeter Hospital in New Hampshire contracted new hepatitis C infections that were tracked back to a cardiac technician who ultimately confessed to drug diversion. A multistate epidemiological investigation of hepatitis C cases occurring in multiple hospitals revealed that the technician had been fired from prior institutions due to similar drug diversion activity, about which Exeter Hospital had not been notified. In this article, we highlight the institutional ethical issues raised by this outbreak, and propose a national centralized reporting system to support institutional fulfillment of the ethical obligation to protect the health of patients by preventing such nosocomial outbreaks.
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Affiliation(s)
- Tim Lahey
- Geisel School of Medicine at Dartmouth Medical School, Hanover Dartmouth-Hitchcock Medical Center, Lebanon
| | - William A Nelson
- Geisel School of Medicine at Dartmouth Medical School, Hanover The Dartmouth Institute for Health Policy and Clinical Practice, Hanover, New Hampshire
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Adlhoch C, Broberg E, Beauté J, Snacken R, Bancroft E, Zucs P, Penttinen P. Influenza season 2013/14 has started in Europe with influenza A(H1)pdm09 virus being the most prevalent subtype. ACTA ACUST UNITED AC 2014; 19. [PMID: 24507465 DOI: 10.2807/1560-7917.es2014.19.4.20686] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The 2013/14 influenza season has started in Europe. Four countries have reported medium intensity influenza activity, with children under 15 years being the most affected age group. A growing number of countries see increasing rates of influenza-like illness or acute respiratory infection and increasing proportions of specimens positive for influenza A(H1)pdm09 virus. In previous seasons, this subtype was associated with higher reported numbers of severe and fatal cases. Clinicians should offer influenza vaccination to unvaccinated persons belonging to risk groups.
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Affiliation(s)
- C Adlhoch
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
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Thompson CI, Lackenby A, Daniels RS, McCauley JW, Pereyaslov D, Broberg EK, Meijer A, Zambon MC. Evaluation of influenza virus antiviral susceptibility testing in Europe: results from the first external quality assessment exercise. J Clin Virol 2013; 56:212-8. [PMID: 23201459 DOI: 10.1016/j.jcv.2012.11.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2012] [Accepted: 11/01/2012] [Indexed: 11/27/2022]
Abstract
BACKGROUND The first antiviral susceptibility testing external quality assessment (EQA) was held for European influenza reference laboratories during winter 2010/11. OBJECTIVES To assess European network influenza antiviral susceptibility testing capability and provide participants with an independent performance evaluation. STUDY DESIGN The EQA panel contained ten coded specimens of inactivated human influenza A and B viruses with reduced susceptibility to neuraminidase inhibitors (NAI), or adamantanes. Twenty-four laboratories from 19 member states of the WHO European region analysed the panel using phenotypic (determination of 50% inhibitory concentration (IC(50)) values by neuraminidase (NA) enzyme inhibition assay) and/or genotypic methods. RESULTS All 24 laboratories returned genotypic data for A(H1N1)pdm09 influenza virus, 18 (75%) for former seasonal A(H1N1), 16 (67%) for A(H3N2) and 15 (63%) for influenza B virus, correctly identifying NAI or adamantane reduced susceptibility-associated substitutions in the NA (mean 84%; range 52-100%) or M2 (mean 85%; range 73-94%), respectively. Thirteen laboratories (54%) returned phenotypic NAI susceptibility data. Despite inter-laboratory and inter-assay IC(50) value variation, all 13 laboratories correctly identified oseltamivir reduced susceptibility/resistance in pure preparations of A(H1N1) oseltamivir-resistant viruses. However, only 11 (85%) identified oseltamivir reduced susceptibility/resistance in a mixture of A(H1N1)pdm09 oseltamivir-sensitive/-resistant viruses. Furthermore, 3 laboratories (23%) considered oseltamivir-sensitive influenza B virus reduced susceptible/resistant. CONCLUSIONS Detection of NA-H275Y in A(H1N1) viruses was achieved by most laboratories. IC(50) values and interpretation thereof varied for a sensitive/resistant virus mixture and for influenza B virus. The results of this exercise will assist harmonisation of antiviral susceptibility testing, interpretation and reporting within the European network through targeted training.
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Paget WJ, Balderston C, Casas I, Donker G, Edelman L, Fleming D, Larrauri A, Meijer A, Puzelli S, Rizzo C, Simonsen L. Assessing the burden of paediatric influenza in Europe: the European Paediatric Influenza Analysis (EPIA) project. Eur J Pediatr 2010; 169:997-1008. [PMID: 20229049 PMCID: PMC2890072 DOI: 10.1007/s00431-010-1164-0] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2009] [Accepted: 02/04/2010] [Indexed: 11/29/2022]
Abstract
The European Paediatric Influenza Analysis (EPIA) project is a multi-country project that was created to collect, analyse and present data regarding the paediatric influenza burden in European countries, with the purpose of providing the necessary information to make evidence-based decisions regarding influenza immunisation recommendations for children. The initial approach taken is based on existing weekly virological and age-specific influenza-like illness (ILI) data from surveillance networks across Europe. We use a multiple regression model guided by longitudinal weekly patterns of influenza virus to attribute the weekly ILI consultation incidence pattern to each influenza (sub)type, while controlling for the effect of respiratory syncytial virus (RSV) epidemics. Modelling the ILI consultation incidence during 2002/2003-2008 revealed that influenza infections that presented for medical attention as ILI affected between 0.3% and 9.8% of children aged 0-4 and 5-14 years in England, Italy, the Netherlands and Spain in an average season. With the exception of Spain, these rates were always higher in children aged 0-4 years. Across the six seasons analysed (five seasons were analysed from the Italian data), the model attributed 47-83% of the ILI burden in primary care to influenza virus infection in the various countries, with the A(H3N2) virus playing the most important role, followed by influenza viruses B and A(H1N1). National season averages from the four countries studied indicated that between 0.4% and 18% of children consulted a physician for ILI, with the percentage depending on the country and health care system. Influenza virus infections explained the majority of paediatric ILI consultations in all countries. The next step will be to apply the EPIA modelling approach to severe outcomes indicators (i.e. hospitalisations and mortality data) to generate a complete range of mild and severe influenza burden estimates needed for decision making concerning paediatric influenza vaccination.
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Affiliation(s)
- W. John Paget
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
| | | | - Inmaculada Casas
- National Center for Microbiology, Instituto de Salud Carlos III, Madrid, Spain
| | - Gé Donker
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
| | | | | | - Amparo Larrauri
- National Center for Epidemiology, Instituto de Salud Carlos III, Madrid, Spain
| | - Adam Meijer
- Centre for Infectious Disease Control, National Institute of Public Health and the Environment, Bilthoven, The Netherlands
| | - Simona Puzelli
- Department of Infectious, Parasitic and Immune-mediated Diseases, Istituto Superiore di Sanita, Rome, Italy
| | - Caterina Rizzo
- National Center for Epidemiology, Surveillance and Health Promotion, Istituto Superore di Sanità, Rome, Italy
| | - Lone Simonsen
- SDI, Plymouth Meeting, PA USA
- School of Public Health and Health Services, George Washington University, Washington, DC USA
| | - and all EPIA collaborators
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
- SDI, Plymouth Meeting, PA USA
- National Center for Microbiology, Instituto de Salud Carlos III, Madrid, Spain
- RCGP Research and Surveillance Centre, Birmingham, UK
- National Center for Epidemiology, Instituto de Salud Carlos III, Madrid, Spain
- Centre for Infectious Disease Control, National Institute of Public Health and the Environment, Bilthoven, The Netherlands
- Department of Infectious, Parasitic and Immune-mediated Diseases, Istituto Superiore di Sanita, Rome, Italy
- National Center for Epidemiology, Surveillance and Health Promotion, Istituto Superore di Sanità, Rome, Italy
- School of Public Health and Health Services, George Washington University, Washington, DC USA
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Meijer A, Lackenby A, Hungnes O, Lina B, van-der-Werf S, Schweiger B, Opp M, Paget J, van-de-Kassteele J, Hay A, Zambon M. Oseltamivir-resistant influenza virus A (H1N1), Europe, 2007-08 season. Emerg Infect Dis 2009. [PMID: 19331731 PMCID: PMC2671453 DOI: 10.3201/eid1504.081280] [Citation(s) in RCA: 81] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
In Europe, the 2007-08 winter season was dominated by influenza virus A (H1N1) circulation through week 7, followed by influenza B virus from week 8 onward. Oseltamivir-resistant influenza viruses A (H1N1) (ORVs) with H275Y mutation in the neuraminidase emerged independently of drug use. By country, the proportion of ORVs ranged from 0% to 68%, with the highest proportion in Norway. The average weighted prevalence of ORVs across Europe increased gradually over time, from near 0 in week 40 of 2007 to 56% in week 19 of 2008 (mean 20%). Neuraminidase genes of ORVs possessing the H275Y substitution formed a homogeneous subgroup closely related to, but distinguishable from, those of oseltamivir-sensitive influenza viruses A (H1N1). Minor variants of ORVs emerged independently, indicating multiclonal ORVs. Overall, the clinical effect of ORVs in Europe, measured by influenza-like illness or acute respiratory infection, was unremarkable and consistent with normal seasonal activity.
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Affiliation(s)
- Adam Meijer
- Netherlands Institute for Health Services Research, Utrecht, the Netherlands
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Meijer A, Lackenby A, Hungnes O, Lina B, van-der-Werf S, Schweiger B, Opp M, Paget J, van-de-Kassteele J, Hay A, Zambon M. Oseltamivir-resistant influenza virus A (H1N1), Europe, 2007-08 season. Emerg Infect Dis 2009; 15:552-60. [PMID: 19331731 DOI: 10.3201/eid1504.181280] [Citation(s) in RCA: 262] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
In Europe, the 2007-08 winter season was dominated by influenza virus A (H1N1) circulation through week 7, followed by influenza B virus from week 8 onward. Oseltamivir-resistant influenza viruses A (H1N1) (ORVs) with H275Y mutation in the neuraminidase emerged independently of drug use. By country, the proportion of ORVs ranged from 0% to 68%, with the highest proportion in Norway. The average weighted prevalence of ORVs across Europe increased gradually over time, from near 0 in week 40 of 2007 to 56% in week 19 of 2008 (mean 20%). Neuraminidase genes of ORVs possessing the H275Y substitution formed a homogeneous subgroup closely related to, but distinguishable from, those of oseltamivir-sensitive influenza viruses A (H1N1). Minor variants of ORVs emerged independently, indicating multiclonal ORVs. Overall, the clinical effect of ORVs in Europe, measured by influenza-like illness or acute respiratory infection, was unremarkable and consistent with normal seasonal activity.
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Affiliation(s)
- Adam Meijer
- Netherlands Institute for Health Services Research, Utrecht, the Netherlands
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Molecular detection and typing of influenza viruses: Are we ready for an influenza pandemic? J Clin Virol 2008; 42:194-7. [DOI: 10.1016/j.jcv.2008.02.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2007] [Revised: 11/02/2007] [Accepted: 02/07/2008] [Indexed: 11/23/2022]
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Paget J, Marquet R, Meijer A, van der Velden K. Influenza activity in Europe during eight seasons (1999-2007): an evaluation of the indicators used to measure activity and an assessment of the timing, length and course of peak activity (spread) across Europe. BMC Infect Dis 2007; 7:141. [PMID: 18047685 PMCID: PMC2216029 DOI: 10.1186/1471-2334-7-141] [Citation(s) in RCA: 82] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2007] [Accepted: 11/30/2007] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The European Influenza Surveillance Scheme (EISS) has collected clinical and virological data on influenza since 1996 in an increasing number of countries. The EISS dataset was used to characterise important epidemiological features of influenza activity in Europe during eight winters (1999-2007). The following questions were addressed: 1) are the sentinel clinical reports a good measure of influenza activity? 2) how long is a typical influenza season in Europe? 3) is there a west-east and/or south-north course of peak activity ('spread') of influenza in Europe? METHODS Influenza activity was measured by collecting data from sentinel general practitioners (GPs) and reports by national reference laboratories. The sentinel reports were first evaluated by comparing them to the laboratory reports and were then used to assess the timing and spread of influenza activity across Europe during eight seasons. RESULTS We found a good match between the clinical sentinel data and laboratory reports of influenza collected by sentinel physicians (overall match of 72% for +/- 1 week difference). We also found a moderate to good match between the clinical sentinel data and laboratory reports of influenza from non-sentinel sources (overall match of 60% for +/- 1 week). There were no statistically significant differences between countries using ILI (influenza-like illness) or ARI (acute respiratory disease) as case definition. When looking at the peak-weeks of clinical activity, the average length of an influenza season in Europe was 15.6 weeks (median 15 weeks; range 12-19 weeks). Plotting the peak weeks of clinical influenza activity reported by sentinel GPs against the longitude or latitude of each country indicated that there was a west-east spread of peak activity (spread) of influenza across Europe in four winters (2001-2002, 2002-2003, 2003-2004 and 2004-2005) and a south-north spread in three winters (2001-2002, 2004-2005 and 2006-2007). CONCLUSION We found that: 1) the clinical data reported by sentinel physicians is a valid indicator of influenza activity; 2) the length of influenza activity across the whole of Europe was surprisingly long, ranging from 12-19 weeks; 3) in 4 out of the 8 seasons, there was a west-east spread of influenza, in 3 seasons a south-north spread; not associated with type of dominant virus in those seasons.
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Affiliation(s)
- John Paget
- Netherlands Institute for Health Services Research (NIVEL). PO Box 1568, 3500BN, Utrecht, The Netherlands
- European Influenza Surveillance Scheme Coordination Centre, PO Box 1568, 3500BN, Utrecht, The Netherlands
| | - Richard Marquet
- Netherlands Institute for Health Services Research (NIVEL). PO Box 1568, 3500BN, Utrecht, The Netherlands
| | - Adam Meijer
- European Influenza Surveillance Scheme Coordination Centre, PO Box 1568, 3500BN, Utrecht, The Netherlands
| | - Koos van der Velden
- European Influenza Surveillance Scheme Coordination Centre, PO Box 1568, 3500BN, Utrecht, The Netherlands
- Department of Public Health, Radboud University Medical Centre, Geert Grooteplein 10, 6525 GA, Nijmegen, The Netherlands
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Meijer A, Brown C, Hungnes O, Schweiger B, Valette M, van der Werf S, Zambon M. Programme of the Community Network of Reference Laboratories for Human Influenza to improve Influenza Surveillance in Europe. Vaccine 2006; 24:6717-23. [PMID: 16782242 DOI: 10.1016/j.vaccine.2006.05.068] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
All laboratories participating in the Community Network of Reference Laboratories for Human Influenza in Europe (CNRL) co-ordinated by the European Influenza Surveillance Scheme (EISS) should be able to perform a range of influenza diagnostics. This includes direct detection, culture, typing, subtyping and strain characterisation of influenza viruses, diagnostic serology and the creation of archives for clinical specimens and virus isolates. To improve the capacity and quality of the laboratories of the CNRL and to increase the consistency in performance among all 25 European Union countries plus Norway, Romania, and Switzerland, five task groups were set up in February 2005. These task groups developed work programmes in the areas of virus isolation, antibodies, molecular virology, quality control assessment and antiviral susceptibility testing. This report outlines the programmes and the results achieved in the first half-year of operation of the task groups. The action plans are challenging and it is expected that these efforts will lead to considerable improvements in the performance of the laboratories and in the standardisation of methods employed in Europe with regard to routine influenza surveillance and early warning for emerging viruses.
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Affiliation(s)
- Adam Meijer
- Netherlands Institute for Health Services Research (NIVEL), European Influenza Surveillance Scheme Co-ordination Centre, Otterstraat 118-124, 3513 Utrecht, CR, The Netherlands.
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Affiliation(s)
- W John Paget
- European Influenza Surveillance Scheme ,EISS, Co-ordination Centre, Netherlands Institute for Health Services Research, NIVEL, Utrecht, The Netherlands.
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