Europe: The 1981-1982 European influenza season, which began
with
isolations of influenza B and influenza A(H1N1) and (H3N2) viruses
in
a few countries in November-December, 1981 (1,2), continued through
the spring of 1982, with isolations of influenza B viruses in
Belgium,
Czechoslovakia, Hungary, and West Germany; isolations of influenza
A(H1N1) viruses throughout eastern Europe (Czechoslovakia, East
Germany, Hungary, and Rumania), as well as Scandinavia (Finland,
Norway, and Sweden); and isolations of influenza A(H3N2) strains in
Bulgaria, East Germany, and the Netherlands. In East Germany,
morbidity associated with A(H3N2) activity approached epidemic
levels
in some districts; in the United Kingdom, influenza B activity
increased considerably from what were originally low levels (2),
and
in several countries, local outbreaks of influenza A(H1N1) or
influenza B were reported. Overall, however, the European
influenza
season had remarkably little activity.
Central and South America: In addition to the previously
reported
outbreak of influenza A(H3N2) in Trinidad from October to December
1981 (2), sporadic influenza B activity has occured in July and
August, 1982, in Trinidad. Laboratory confirmation of influenza
activity by virus isolations has also been obtained in the past
year
from Brazil, Colombia, and Peru. Influenza A(H1N1) strains were
isolated in Lima, Peru, beginning in October 1981, and in Belem,
Rio
de Janeiro, and Sao Paulo, Brazil, from February to April 1982.
These
represent the minority of reported isolations. In Brazil,
influenza B
and influenza A(H3N2) viruses were recovered in approximately
equivalent total numbers from March to June, with influenza B virus
isolated more frequently in Rio de Janerio and influenza A(H3N2)
virus
isolated more frequently in Sao Paulo. During April 1982,
influenza
A(H3N2) strains were isolated in Bogota, Colombia. Despite active
surveillance, no influenza viruses were recovered in Chile during
the
winter.
Asia, the Pacific, and Africa: Influenza A(H1N1) virus was
isolated in Indonesia from December 1981 to February 1982 and in
Qingdao, People's Republic of China (PRC) in February 1982. Virus
of
this subtype has not recently been isolated. In contrast,
influenza B
virus has been circulating throughout the past year. In Taiwan
(Republic of China), influenza B viruses were isolated beginning in
December 1981, increased to cause outbreaks peaking in March, and
declined in activity in April and May, paralleling activity
reported
previously from Japan (1,3). Influenza B viruses were also
isolated
in Beijing and Fuxin city, Liaoning Province, PRC, in February and
March 1982; in Hong Kong in March 1982; in Singapore in April and
May;
and in Indonesia from April to July. In Fiji, influenza B virus
circulated from April to June and, in May, caused an outbreak among
university students. The first sporadic isolate of influenza B
virus
in Australia during the season was reported in April, and by July
and
August, influenza B virus represented about one-half of isolates
being
recovered from epidemics. By the end of July, only sporadic
isolations of influenza B virus had been reported from South
Africa.
Circulation of influenza A(H3N2) viruses throughout the past
year
has been confirmed by virus isolation in the cities of Qingdao and
Shanghai, PRC, in February and March 1982. In June, this virus was
detected for the first time this year in Australia where
approximately
one-half of influenza isolates during epidemics in July and August
have been influenza A(H3N2) strains. Influenza A(H3N2) viruses
have
been isolated in the Philippines and Singapore in July and
predominanted in Jakarta, Indonesia, during July and August.
Antigenic analysis of the first isolates in Australia and
Indonesia received from outbreaks during June and July has not
indicated that new variants are associated with recent influenza
activity. Preliminary findings show that strains appear similar to
those that circulated in the United States during the past two
winters.
Reported by WHO National Influenza Centers, Australia, Brazil,
Chile,
Colombia, Czechoslovakia, People's Republic of China, Peru, Sweden,
Singapore, Caribbean Epidemiology Centre, Trinidad, USAF Diagnostic
Virology Section, USAF School of Aerospace Medicine, San Antonio,
Texas; NAMRU-2, Jakarta, Indonesia; National Institute of Health
and
Veterans Administration Hospital, Taipei, Taiwan, ROC; Virus
Diseases
Unit, WHO, Geneva; WHO Collaborating Center for Influenza,
Influenza
Br, Div of Viral Diseases, Center for Infectious Diseases, CDC.
Editorial Note
Editorial Note: International surveillance of influenza during the
past year has confirmed the continued circulation of influenza
A(H3N2)
strains, although they were rarely seen in the United States last
winter. Influenza B viruses, which caused a major epidemic in the
United States in 1979-1980 and low-level morbidity last winter,
have
been detected in all regions of the world. Influenza A(H1N1)
viruses
have been isolated relatively infrequently. Viruses of this
subtype
circulated widely among children and young adults in the United
States
in early 1978 and in a major epidemic of 1978-1979. They have also
circulated during the past two winters in the United States, but to
a
much lesser extent than in 1977-1979. Results of international
surveillance during the past several years have tended to
demonstrate
that, except when a major new strain appears, considerable
differences
exist between regions in patterns of virus prevalence within any
one
year, although over a several-year period, the combined experiences
are similar. Thus, as one example, in 1980-1981, when influenza
A(H3N2) viruses caused a major epidemic in the United States, many
other countries had relatively low influenza activity. Because of
the
great disparity in influenza activity between different countries
and
the continued circulation of influenza A(H1N1), (H3N2) and
influenza B
strains during the past year, neither the likelihood of an epidemic
in
the United States next winter, nor the predominant influenza strain
or
strains, can be reliably predicted. This underscores the
desirability
of immunizing the high-risk population before winter with current
vaccines (4) containing antigens representing all three influenza
strains that have been prevalent worldwide. Although this year's
vaccine composition is similar to last year's, revaccination of
persons who received vaccine before the winter of 1981-1982 is
recommended because of the anticipated decline in antibody titers
that
will have occurred in such persons before the 1982-1983 influenza
season.
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