title: National Influenza Surveillance in the Philippines from 2006 to 2012: seasonality and circulating strains.
abstract: The results of routine influenza surveillance in 13 regions in the Philippines from 2006 to 2012 are presented, describing the annual seasonal epidemics of confirmed influenza virus infection, seasonal and alert thresholds, epidemic curve, and circulating influenza strains.
  
  
  
  Retrospective analysis of Philippine influenza surveillance data from 2006 to 2012 was conducted to determine seasonality with the use of weekly influenza positivity rates and calculating epidemic curves and seasonal and alert thresholds using the World Health Organization (WHO) global epidemiological surveillance standards for influenza.
  
  
  
  Increased weekly influenza positive rates were observed from June to November, coinciding with the rainy season and school opening. Two or more peaks of influenza activity were observed with different dominant influenza types associated with each peak. A-H1N1, A-H3N2, and two types of B viruses circulated during the influenza season in varying proportions every year. Increased influenza activity for 2012 occurred 8 weeks late in week 29, rather than the expected week of rise of cases in week 21 as depicted in the established average epidemic curve and seasonal threshold. The intensity was severe going above the alert threshold but of short duration. Southern Hemisphere vaccine strains matched circulating influenza virus for more surveillance years than Northern Hemisphere vaccine strains.
  
  
  
  Influenza seasonality in the Philippines is from June to November. The ideal time to administer Southern Hemisphere influenza vaccine should be from April to May. With two lineages of influenza B circulating annually, quadrivalent vaccine might have more impact on influenza control than trivalent vaccine. Establishment of thresholds and average epidemic curve provide a tool for policy-makers to assess the intensity or severity of the current influenza epidemic even early in its course, to help plan more precisely resources necessary to control the outbreak. Influenza surveillance activities should be continued in the Philippines and funding for such activities should already be incorporated into the Philippine health budget.
authors.affiliation: Department of Health, Research Institute for Tropical Medicine, Filinvest Corporate City, Alabang, Muntinlupa City, Philippines. marilla.lucero@gmail.com.
authors.forename: Marilla G
authors.initials: MG
authors.lastname: Lucero
authors.affiliation: Department of Health, Research Institute for Tropical Medicine, Filinvest Corporate City, Alabang, Muntinlupa City, Philippines.
authors.forename: Marianette T
authors.initials: MT
authors.lastname: Inobaya
authors.affiliation: Department of Health, Research Institute for Tropical Medicine, Filinvest Corporate City, Alabang, Muntinlupa City, Philippines.
authors.forename: Leilani T
authors.initials: LT
authors.lastname: Nillos
authors.affiliation: Department of Health, Research Institute for Tropical Medicine, Filinvest Corporate City, Alabang, Muntinlupa City, Philippines.
authors.forename: Alvin G
authors.initials: AG
authors.lastname: Tan
authors.affiliation: Department of Health, Research Institute for Tropical Medicine, Filinvest Corporate City, Alabang, Muntinlupa City, Philippines.
authors.forename: Vina Lea F
authors.initials: VL
authors.lastname: Arguelles
authors.affiliation: Department of Health, Research Institute for Tropical Medicine, Filinvest Corporate City, Alabang, Muntinlupa City, Philippines.
authors.forename: Christine Joy C
authors.initials: CJ
authors.lastname: Dureza
authors.affiliation: Department of Health, Research Institute for Tropical Medicine, Filinvest Corporate City, Alabang, Muntinlupa City, Philippines.
authors.forename: Edelwisa S
authors.initials: ES
authors.lastname: Mercado
authors.affiliation: Department of Health, Research Institute for Tropical Medicine, Filinvest Corporate City, Alabang, Muntinlupa City, Philippines.
authors.forename: Analisa N
authors.initials: AN
authors.lastname: Bautista
authors.affiliation: Department of Health, Research Institute for Tropical Medicine, Filinvest Corporate City, Alabang, Muntinlupa City, Philippines.
authors.forename: Veronica L
authors.initials: VL
authors.lastname: Tallo
authors.affiliation: Department of Health, Research Institute for Tropical Medicine, Filinvest Corporate City, Alabang, Muntinlupa City, Philippines.
authors.forename: Agnes V
authors.initials: AV
authors.lastname: Barrientos
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: Tomas
authors.initials: T
authors.lastname: Rodriguez
authors.affiliation: Department of Health, Research Institute for Tropical Medicine, Filinvest Corporate City, Alabang, Muntinlupa City, Philippines.
authors.forename: Remigio M
authors.initials: RM
authors.lastname: Olveda
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks / Q000517:prevention & control; D058872:Epidemics; D006801:Humans; D007223:Infant; D053118:Influenza A Virus, H1N1 Subtype / Q000472:pathogenicity; D053122:Influenza A Virus, H3N2 Subtype / Q000472:pathogenicity; D007252:Influenza Vaccines / Q000008:administration & dosage / Q000627:therapeutic use; D007251:Influenza, Human / Q000453:epidemiology* / Q000517:prevention & control / Q000821:virology*; D008875:Middle Aged; D010679:Philippines / Q000453:epidemiology; D011159:Population Surveillance / Q000379:methods; D012189:Retrospective Studies; D012574:Schools; D012621:Seasons; D013997:Time Factors; D055815:Young Adult
chemical_list: D007252:Influenza Vaccines
keywords: Alert threshold; Average epidemic curve; Circulating influenza strains; Influenza seasonality; Influenza vaccine strains; Seasonal threshold