Southern Hemisphere Influenza and Vaccine Effectiveness Research and Surveillance

Huang, Qiu Sue; Turner, Nikki; Baker, Michael G; Williamson, Deborah A; Wong, Conroy; Webby, Richard; Widdowson, Marc-Alain

Since its conception in 2006, SARI surveillance has become a recognized international standard for monitoring hospitalized severe respiratory disease related to influenza and other pathogens. 61 occurred over this time. [65] [66] [67] It was designed to monitor trends in severe influenza disease and to best capture the majority of influenza respiratory disease to estimate the burden of influenza-associated respiratory hospitalizations, and risk factors for severe disease. 63 The initial SARI case definition included the symptom onset of acute respiratory illness within 7 days. 61 The SHIVERS results in 2012 showed that a small proportion (7%) of influenza cases had specimens collected 8-9 days after the symptom onset. These specimens only consisted of a small proportion (9%) of total specimens; thus, the cost of testing was minimal (manuscript in preparation). This result was shared with the WHO global influenza programme. It contributed to a change in the final WHO SARI case definition, with onset shifting from 'within 7 days' to 'within 10 days'. 63 Burden and epidemiology SHIVERS allows the estimation of influenza disease burden and risk factors at various levels of severity.