title: Implementation of the community network of reference laboratories for human influenza in Europe.
abstract: BACKGROUND
  The increased need for accurate influenza laboratory surveillance data in the European Union required formalisation of the existing network of collaborating national influenza reference laboratories participating in the European Influenza Surveillance Scheme (EISS).
  
  
  OBJECTIVE
  To establish a Community Network of Reference Laboratories for Human Influenza in Europe (CNRL).
  
  
  METHODS
  Virologists in EISS defined the objective and tasks of the CNRL. Performance of the laboratories in the tasks was monitored by questionnaire-based inventories and quality control assessments (QCA). Subsequently, actions were defined to improve the performance of the CNRL.
  
  
  RESULTS
  The CNRL started in April 2003 and included as of May 2004 32 laboratories in 24 European countries. The objective is to provide high quality reference services for human influenza surveillance, early warning and pandemic preparedness in Europe. The defined basic tasks are direct detection, culture, typing, subtyping and strain characterisation of influenza virus, diagnostic influenza serology and storage of clinical specimens and virus isolates. The questionnaire-based inventories and QCAs revealed that the majority of CNRL laboratories perform well in most of the basic tasks, although improvements are needed in certain areas of virus testing. Therefore, task groups have been established to further improve the methods used in the network. The CNRL has proven its usefulness during the 2003-2004 season by the reporting of accurate data concerning the flu epidemic caused by A/Fujian/411/2002 (H3N2)-like viruses and by the rapid sharing of information, protocols and reagents during the A(H5N1) and A(H7N3) epizootics in Asia and Canada.
  
  
  CONCLUSIONS
  EISS has established a functioning Community Network of Reference Laboratories for Human Influenza in Europe and laid the foundation for further enhancement and collaborations. Important next steps include improving the laboratories to carry out all basic tasks and collaboration with the European Centre for Disease Prevention and Control.
authors.affiliation: European Influenza Surveillance Scheme Co-ordination Centre, Netherlands Institute for Health Services Research (NIVEL), 3500 BN Utrecht, The Netherlands. a.meijer@nivel.nl
authors.forename: Adam
authors.initials: A
authors.lastname: Meijer
authors.forename: Martine
authors.initials: M
authors.lastname: Valette
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Manuguerra
authors.forename: Pilar
authors.initials: P
authors.lastname: Pérez-Breña
authors.forename: John
authors.initials: J
authors.lastname: Paget
authors.forename: Caroline
authors.initials: C
authors.lastname: Brown
authors.forename: Koos
authors.initials: K
authors.lastname: van der Velden
mesh_terms: D019058:Community Networks / Q000458:organization & administration*; D003299:Cooperative Behavior; D018563:Disease Notification; D004196:Disease Outbreaks / Q000517:prevention & control*; D005060:Europe / Q000453:epidemiology; D005062:European Union; D006801:Humans; D009980:Influenza A virus / Q000302:isolation & purification*; D007251:Influenza, Human / Q000453:epidemiology* / Q000517:prevention & control / Q000821:virology; D007373:Interinstitutional Relations; D007753:Laboratories / Q000458:organization & administration* / Q000592:standards; D011159:Population Surveillance / Q000379:methods*; D011786:Quality Control; D011795:Surveys and Questionnaires