Influenza Program

South Africa Regional Global Disease Detection Center

The Influenza Program builds Global Health Security (GHS) in South Africa by enhancing South Africa’s and the region’s capacity to detect and respond to public health threats due to novel, seasonal, pandemic, and zoonotic influenza and emerging respiratory diseases.

Program Background

The Influenza Program in South Africa started in 2007 and has both a national and regional focus. Nationally, the Influenza Program provides technical expertise and financial resources to support national respiratory surveillance, pandemic preparedness, applied research, and implementation of influenza vaccine policy in South Africa. The Influenza Program works closely with the Center for Respiratory Disease and Meningitis at the National Institute for Communicable Diseases (NICD) and the National Department of Health (NDoH) in South Africa. Regionally in Central and Southern Africa and the Indian Ocean island countries, the Influenza Program builds laboratory and epidemiological capacity for respiratory surveillance and integrates them into the World Health Organization (WHO) Global Influenza Surveillance and Response System (GISRS). The Influenza Program works bilaterally with ten countries in Central and Southern Africa and the WHO Regional Office for Africa.

Program Focus

• The objectives of the Influenza Program are to support surveillance and laboratory capacity, develop national policy to prevent and control influenza, conduct applied research projects, facilitate training, and ensure pandemic preparedness and outbreak response.
• The NICD’S Influenza Laboratory performs molecular diagnosis, typing, and isolation of influenza viruses to assess genetic drift and viral resistance and provide influenza strains for vaccine formulation.
• Examples of research activities:
  • Viral shedding and household transmission studies are underway to determine infectivity among adults with HIV that contract influenza.
  • Annual evaluation of influenza vaccine effectiveness and development of studies to estimate how well the vaccine works in high risk groups.
• Viral shedding and household transmission studies are underway to determine infectivity among adults with HIV that contract influenza.
• Annual evaluation of influenza vaccine effectiveness and development of studies to estimate how well the vaccine works in high risk groups.
• Viral shedding and household transmission studies are underway to determine infectivity among adults with HIV that contract influenza.
• Annual evaluation of influenza vaccine effectiveness and development of studies to estimate how well the vaccine works in high risk groups.

Critical Issues

• Influenza vaccine is currently underused in South Africa. The Influenza Program works closely with public and private entities to describe the burden of influenza and develop national policy on influenza vaccine use, especially in high risk groups such as those with HIV infection.
• There is limited regional capacity to identify and respond to novel influenza and respiratory illnesses. The Influenza Program continues to expand surveillance and pandemic preparedness capacity regionally through cooperative agreements (in Angola, Democratic Republic of Congo, Madagascar, Mozambique, and Zambia) and through the WHO and partners in neighboring countries (in Malawi, Republic of Congo, and Indian Ocean countries).
• Little is known about influenza in settings with high prevalence of HIV and TB. Ongoing surveillance and research studies are allowing us to learn more about this area ,and how to best prevent influenza in these high risk groups.
• Greater surveillance is needed for influenza at the animal-human interface in Southern Africa. The Influenza Program is expanding its influenza surveillance in animals and patients with exposure to animals, particularly swine and farm poultry, such as ostrich.

Recent Achievements

• Surveillance in South Africa for hospital-based severe acute respiratory illness and outpatient clinic-based influenza-like illness is expanding to improve geographic representation in all nine provinces and to test for additional diseases of high public health importance, including tuberculosis (TB), pneumocystis pneumonia, and pertussis (whooping cough).
• Newly published national estimates describe for the first time the burden of influenza in South Africa; nearly 10,000 deaths and 40,000 hospitalizations are due to influenza each year.
• Regional influenza surveillance capacity reaches more than ten countries in Southern Africa.
• The Influenza Program also assists with national inventories of capabilities for pandemic preparedness and rapid response trainings.
• The NICD Influenza Laboratory provides diagnostic testing and training to neighboring countries when assistance is required.
• Enhanced influenza surveillance in two provinces to test for other respiratory pathogens, such as TB, led to a description of the burden of TB and the association between influenza and TB in South Africa.

Opportunities for Integration and Advocacy

• Surveillance for influenza continues to serve as a platform to explore the role of other viral and bacterial respiratory pathogens that cause pneumonia in South Africa.
• Pandemic preparedness and response capacity provides a platform for improved preparedness and response to other communicable diseases of public health concern.