Abstract
During October 2011–September 2014, we screened respiratory specimens for seasonal and avian influenza A(H5N1) virus infections among outpatients with influenza-like illness and inpatients with severe acute respiratory infection (SARI) in East Jakarta, an Indonesia district with high incidence of H5N1 virus infection among poultry. In total, 31% (1,875/6,008) of influenza-like illness case-patients and 15% (571/3,811) of SARI case-patients tested positive for influenza virus. Influenza A(H1N1)pdm09, influenza A(H3N2), and influenza B virus infections were detected in all 3 years, and the epidemic season extended from November through May. Although 28% (2,810/10,135) of case-patients reported exposure to poultry, only 1 SARI case-patient with an H5N1 virus infection was detected. Therefore, targeted screening among case-patients with high-risk poultry exposures (e.g., a recent visit to a live bird market or close proximity to sick or dead poultry) may be a more efficient routine surveillance strategy for H5N1 virus in these types of settings.
Highlights
Seasonal influenza contributes substantially to acute respiratory disease in Indonesia and across the world
The rate of influenza virus–positive samples per week peaked around 72%–85% for influenza-like illness (ILI) and 38%–50% for severe acute respiratory infection (SARI). During this 3-year period of enhanced surveillance, influenza viruses were commonly detected among ILI and SARI case-patients in East Jakarta, representing 31% of ILI visits and 15% of SARI hospitalizations, many of which were chest radiograph–confirmed pneumonia
Within 7 days before illness onset, this H5N1 case-patient had visited a live bird market, a type of poultry exposure reported among other persons with H5N1 virus infection in Indonesia; this type of exposure was reported among only 4% of SARI case-patients in this surveillance
Summary
Seasonal influenza contributes substantially to acute respiratory disease in Indonesia and across the world. In. Indonesia, published data suggest that influenza virus infection has a substantial effect on population health and the healthcare system, causing both inpatient and outpatient respiratory illness [3,4,5]. Limited data from 1 district of Jakarta suggest that a longer peak in influenza activity occurs December–May, with multiple influenza viruses co-circulating [4]. In East Jakarta, 12 of 13 H5N1 cases reported in humans during 2005–2015 were fatal [9]. Multiyear data are needed to explore trends in seasonal influenza and avian H5N1 virus infections among humans. We describe the findings from a 3-year enhanced surveillance platform among inpatients and outpatients of clinics in East Jakarta for both seasonal influenza and avian influenza A(H5N1) viruses
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