Syndromic Surveillance for Detection of Influenza in Albania

Motivated by the threat of infectious diseases and bioterrorism, syndromic surveillance systems are being developed and implemented around the world. The aim of the study was to describe the early warning surveillance system in Albania for detection of pandemic influenza 2009. Syndromic surveillance is a primary health care-facility-and emergency room-based syndromic surveillance system aiming at detecting outbreaks and undertaking public health actions. Acute Respiratory Infections (ARI) consist of two syndromes: Upper and Lower respiratory infection. Weekly ARI consultation rates in 2009 were compared with the rates observed in the same period in the previous 10 years (1999-2008) of influenza season: weeks 40-20. Unlike previous years’ pattern, the rate of reported ARI increased sharply from 45th week, and peaked nationally at week 47, starting on 16 of November and representing 30% increase compared to previous week, 46. This rate was the highest observed compared to the same period of past 10 years of influenza surveillance and exceeded the 95th percentile of expected rates, thus, suggesting the circulation of a novel virus. Despite the end of the pandemic period, influenza A(H1N1)pdm09 virus continued to circulate and became the most commonly detected virus in Albania and many other countries in the winter season of 2010–2011. The system is useful for detecting and responding to natural disease outbreaks such as seasonal and pandemic flu, and thus it has the potential to significantly advance and modernize the practice of public health surveillance