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Disease Prevention and Control / Communicable Diseases / Influenza

Workshop on the Epidemiology and Surveillance of Influenza and Other Respiratory Diseases

(Decatur, Georgia, USA, 9–13 May 2005)

Taller Influenza, Decatur 2005

Conference Documentation
(in Spanish)

Word (66 Kb)
PDF (43 Kb)

List of Participants:
Word (119 Kb)
PDF (47 Kb)

Country Presentations
(PowerPoint PDF, in Spanish)

Bolivia (255 Kb)
Colombia (360 Kb)
Costa Rica (637 Kb)
Dominican Republic (136 Kb)
Ecuador (84 Kb)
El Salvador (166 Kb)
Guatemala (70 Kb)
Honduras (839 Kb)

Nicaragua (92 Kb)
Panama (373 Kb)
Paraguay (307 Kb)
Peru (surveillance) (163 Kb)
Peru (vaccination) (490 Kb)
Puerto Rico (782 Kb)
Venezuela (90 Kb)

Objectives   |   Executive Summary   |   Next Steps

- PAHO Influenza Page
- PAHO ARIs Page
- WHO Influenza Page
- CDC Influenza Page


  1. Discuss activities on the epidemiological and virological surveillance of influenza and analyze the subject of pandemic influenza. Present basic and advanced methods of influenza prevention and control.
  2. Find out the degree of progress made in the countries and coordinate development of National Preparedness Plans for a possible influenza pandemic. Provide tools to assist in the planning process and discuss vaccines and antivirals as prevention and control methods, with a view to a possible pandemic.

Executive Summary

The Workshop began with a welcome speech by Dr. John Ehrenberg, Unit Chief for Communicable Diseases of PAHO/WHO. It continued with an introductory speech on the workshop objectives by Dr. Ann Moen, Adjunct Chief of Influenza at CDC, and Dr. Otavio Oliva, Regional Adviser on Influenza at PAHO/WHO. The subject of the meeting was introduced with a presentation on the epidemiology of SARS and other respiratory viruses in addition to influenza. Subsequently, presentations and discussions focused on influenza were carried out by workshop instructors.

The first few days of the workshop included discussions on such subjects as the epidemiological and virological surveillance of influenza, the experience of avian influenza, and basic and advanced surveillance methods to estimate the disease burden and mortality from influenza. In addition, there were other activities and presentations on basic prevention and control of influenza.

A study was presented on the benefits of carrying out coordinated laboratory and epidemiology activities, following up on country presentations on the current situation of influenza surveillance, laboratory diagnosis, prevention, and development of preparedness plans for a possible influenza pandemic.

Support documents based on WHO criteria were provided by PAHO to help facilitate the preparation of National Influenza Pandemic Plans.

Dr. Otávio Oliva presented the results of the survey on National Preparation for an Influenza Pandemic in the Americas. The workshop ended with an open discussion on what steps to take next steps as well as recommendations.

Next Steps


  • that the participating countries are trained to carry out laboratory diagnosis for respiratory viruses;
  • that the participating countries present conditions are in a condition to implement isolation and characterization of the influenza virus;
  • the need to obtain consistent high-quality epidemiological information toguide adequate prevention and control measures;
  • the importance that surveillance and diagnostic capability represent in the development and implementation of a pandemic preparedness plan;
  • the multiple resolutions adopted by the World Health Assembly and the Pan American Sanitary Conference on influenza prevention and preparation for a pandemic;
  • The commitments made to comply with the New International Health Regulations;
  • basic skills for detection of and response to events that could constitute a public-health emergency of international importance;
  • the commitments made at meetings of the subregional surveillance networks for emerging and reemerging diseases; and
  • the knowledge and tools acquired in this workshop;

We hope that the countries can do the following:

  • Develop a complete action plan in three months, with the objective of strengthening or developing the national surveillance system for influenza and other respiratory viruses, for presentation to national authorities and donor agencies:
    • using programs already under way and/or pre-existing structures;
    • having integrated the National Preparedness Plan for the Pandemic;
  • Establish at least one Sentinel Site for surveillance of influenza and other respiratory viruses in areas with geographical and demographic representation, preferably with
    • precise populational data covering (denominator);
    • associated with other programs already developed (IMCI?);
  • Increase the number of isolations of the influenza virus in the Region:
    • Prioritize sample collection for admission versus hospitalizations;
  • Participate in the WHO FluNet network for reporting IIF results and isolations of the virus every week, as well as the epidemiological situation for influenza in the respective countries:
    • Reactivation of inactive NICs:
      • Cuba, Hondura, Ecuador, CAREC and Jamaica;
    • Designation of an NIC (National Influenza Center) in each country:
      • TOR compliance;
      • Training:
        • IF
        • Isolation
      • At least one consistently active Sentinel site:
        • >5 samples per week;
        • Report every week, 100% (Form of Surveillance);
        • Shipment of over 10 samples to the CDC in the last 6 months;
  • Double the number of samples sent to the CDC for characterization by December 2005;
  • Send these isolations to the CDC for characterization, on a timely basis at least twice a year, contributing to the formulation of the flu vaccine for a given season:
    • Use the World Courier account for global sample shipment;
  • That countries improve their surveillance by generating reliable data for the future:
    • Know the seasonality of the circulation of these viruses;
    • Know the patterns of circulation of the virus, mainly in tropical areas;
    • Conduct studies on disease burden of disease with the objective of facilitating decision-making for introducing vaccination programs;
    • Assessing the impact of vaccinating against flu;
    • Investigating respiratory disease outbreaks;
  • That countries expand vaccine utilization based on reliable information generated by national surveillance systems in accordance with recommendations made by the Technical Advisory Group (TAG);
  • That countries give the political priority and devote efforts and resources to developing and implementing up to the local levels Preparedness Plans for an influenza pandemic, all the way down to the local level.

PAHO will do the following:

  • Carry out technical consultation and will promote influenza surveillance and Pandemic Preparedness Plans.
  • Provide "limited" quantities of reagents and key input, mainly in health emergencies.
  • Facilitate bibliographic materials and other information.
  • Facilitate the translation of the necessary guides.
  • Facilitate sample shipment to the CDC.
  • Devise indicators for quality and effectiveness, as well as minimum surveillance standards to which the countries should adhere.
  • Provide the technical cooperation necessary for the success of these activities.
  • Train laboratory staff through practical training.
  • Take steps to mobilize resources to strengthen the development of national preparedness plans as well as simulations to validate the plans.

Regional Office for the Americas of the World Health Organization
525 Twenty-third Street, N.W., Washington, D.C. 20037, United States of America
Tel.: +1 (202) 974-3000 Fax: +1 (202) 974-3663

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