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\nThe World Health Organization (WHO) Regional Office for Europe (EURO) supports public health programs in 53 Member States in the WHO European Region. Currently, there are four bilateral influenza cooperative agreements that support influenza activity in the EURO Region. These cooperative agreements are with ministries of health or other institutions that work with the U.S. Centers for Disease Control and Prevention (CDC) to build capacity in order to routinely identify, diagnose and respond to seasonal and pandemic influenza.
\nCDC direct country support through cooperative agreements is established in the following countries:
\nIn addition, CDC supports WHO EURO via a cooperative agreement to provide technical and coordination support to Member States. This cooperative agreement also supports influenza activities in Romania and Kyrgyzstan.
\nThe core activities of these bilateral agreements are:
\nCharlene Sanders, MPH, RD (until March 2012)
Project Officer
Extramural Program
Influenza Division, NCIRD
U.S. Centers for Disease Control and Prevention
Email: csanders2@cdc.gov
Stacey Spivey-Blackford, MS (from May 2012)
Project Officer
Extramural Program
Influenza Division, NCIRD
U.S. Centers for Disease Control and Prevention
Email: ifm8@cdc.gov
Diane Gross, DVM, PhD (until June 2012)
Medical Epidemiologist
International Epidemiology and Research Team
Influenza Division, NCIRD
U.S. Centers for Disease Control and Prevention
Email: bwc3@cdc.gov
Joshua Mott, PhD (until June 2011)
Technical Officer
Influenza and Other Respiratory Pathogens
Division of Health Security, Infectious Diseases and the Environment
WHO Regional Office for Europe
Copenhagen, Denmark
Email: jmo@euro.who.int
A map of the WHO European Region (EUR) shows all 53 EUR member states/countries. The member countries, outlined with gray borders, include Albania, Andorra, Armenia, Austria, Azerbaijan, Belarus, Belgium, Bosnia and Herzegovina, Bulgaria, Croatia, Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Georgia, Germany, Greece, Hungary, Ireland, Israel, Italy, Kazakhstan, Kyrgyzstan, Latvia, Lithuania, Luxembourg, Malta, Monaco, Montenegro, Netherlands, Norway, Poland, Portugal, Republic of Moldova, Romania, Russian Federation, San Marino, Serbia, Slovakia, Slovenia, Spain, Sweden, Switzerland, Tajikistan, The Former Yugoslav Republic of Macedonia, Turkey, Turkmenistan, Ukraine, United Kingdom of Great Britain and Northern Ireland, and Uzbekistan.
\nCountries with yellow shading indicate that the Influenza Division provides project funding and technical assistance through Capacity Building Cooperative Agreements. Armenia, Georgia, Moldova, and Ukraine are shaded yellow on the map. The Russian Federation is shaded green to indicate that they have a Sustainability Cooperative Agreement. Romania is shaded dark green to indicate that they receive indirect funding from the Influenza Division.
\nCDC Influenza Division Field Staff, indicated by a yellow dot outlined in red, are located at the WHO European Regional Office in Copenhagen, Denmark, WHO Headquarters in Geneva, Switzerland and The European Centers for Disease Control and Prevention (ECDC) in Stockholm, Sweden.
\nThe Global Disease Detection [GDD] Site, indicated by the red \u201cX\u201d, is located in Kazakhstan.
\nWHO National Influenza Centers (NICs), indicated by a purple dot, are located in Albania (Tirana), Austria (Vienna), Belarus (Minsk), Belgium (Brussels), Bulgaria (Sofia), Croatia (Zagreb), Czech Republic (Prague), Denmark (Copenhagen), Estonia (Tallinn), Finland (Helsinki), France (Lyon and Paris), Georgia (Tbilisi), Germany (Berlin), Greece (Athens and Thessaloniki), Hungary (Budapest), Iceland (Reykjavik), Ireland (Dublin), Israel (Tel Hashomer), Italy (Rome), Kazakhstan (Almaty), Kyrgyzstan (Kyrgyzstan), Latvia (Riga), Lithuania (Vilnius), Luxembourg (Luxembourg), Malta (Msida), Netherlands (Rotterdam), Norway (Oslo), Poland (Warsaw), Portugal (Lisboa), Romania (Bucharest [2] and Lasi), Russia (Moscow and St. Petersburg), Serbia (Belgrade and Novi Sad), Slovakia (Bratislava), Slovenia (Ljubljana), Spain (Barcelona, Madrid and Valladolid), Sweden (Solna), Switzerland (Geneva), Turkey (Ankara), Ukraine (Kiev), and United Kingdom (Aberdeen, London and Glasgow).
\nThe WHO European Regional Office (EURO), indicated by a blue star, is located in Copenhagen, Denmark. WHO Headquarters is located in Geneva, Switzerland.
\nThe five-year cooperative agreement Surveillance and Response to Pandemic and Avian Influenza by Regional Offices of the World Health Organization began in September 2006 and is in its final year. The WHO Regional Office for Europe (EURO) is located in Copenhagen, Denmark. The Office serves 53 Member States that together have a population exceeding 900 million people. Five of the 53 countries receive funding via bilateral cooperative agreements with the U.S. Centers for Disease Control and Prevention (CDC): Armenia, Georgia, Moldova, Russian Federation and Ukraine. In 2011, WHO EURO staff ran the regional surveillance platform EuroFlu (www.euroflu.org), which is organized in collaboration with the European Centre for Disease Prevention and Control (ECDC). At the annual WHO European Regional Influenza Surveillance Network Meeting, WHO EURO staff provided training and technical assistance to Member States to establish and strengthen sentinel surveillance for influenza (including SARI), supported the sharing of influenza viruses for influenza vaccine development, implemented a first survey on vaccine policies and uptake in the whole region, supported pandemic plan revisions, and developed and disseminated technical guidance.
\nIn 2011\u20132012, WHO EURO will continue the aforementioned activities and will focus on assisting countries in establishing burden estimates for influenza disease and determining risk factors for severe disease associated with influenza infection. These efforts will support the work of National Immunization Technical Advisory Groups with a view of increasing influenza vaccine uptake in priority groups. At least one NIC will be assessed for recognition by WHO and a training for laboratories from Eastern Europe will be provided to that center. To further enhance the harmonization of surveillance data in the WHO European Region, expert meetings will be held on SARI data and qualitative indicators and missions will be conducted in selected countries with established sentinel SARI surveillance. WHO EURO/ECDC/ European Commission pandemic indicators will be revised.
\nDuring the first post-pandemic season, the influenza A(H1N1)pdm09 (2009 H1N1) virus was dominant in the Region. Vigilance for disease outbreaks and potential changes to the 2009 H1N1 virus was high. Some countries experienced strains on their critical care services similar to those experienced during the pandemic and persons who developed severe disease had similar risk factors. Surveillance activities in the European Region showed the 2009 H1N1 virus to be virtually unchanged genetically or antigenically compared with strains that were circulating in 2009.
\nWHO EURO increased its activities related to seasonal influenza vaccine recommendations, policies and use in the Region.
\nForty of 53 the Member States conducting influenza surveillance currently have NICs recognized by WHO. Through the cooperative agreement, NICs receive training, support to improve laboratory quality, reagents and funds to ship viruses to WHO Collaborating Centers for Reference and Research on Influenza (WHO CC). Best practices in pandemic preparedness have been developed.
\nDuring the first post-2009 H1N1 pandemic influenza season, a number of countries experienced severe cases in the same risk groups as during the pandemic; information sharing on clinical management was arranged at the Regional level.
\nIn addition, WHO EURO\u2019s efforts focused on the evaluation report of the pandemic response in the Region and on three multi-country workshops which provided an update on countries\u2019 pandemic preparedness plans and changes made based on evaluations of the pandemic response.
\nWHO Europe conducted a separate evaluation of NIC pandemic preparedness.
\nWHO EURO, in conjunction with selected Member States, hosted the following regional and inter-country trainings in 2010\u20132011:
\nCaroline Brown, PhD
Programme Manager, Influenza and Other Respiratory Pathogens Programme
WHO Regional Office for Europe
World Health Organization
Copenhagen, Denmark
Email: cbr@euro.who.int
Pernille Jorgensen, MPH
Epidemiologist, Influenza and Other Respiratory Pathogens Programme
WHO Regional Office for Europe
World Health Organization
Copenhagen, Denmark
Email: pej@euro.who.int