ArticleBMC public health2022
National influenza surveillance systems in five European countries: a qualitative comparative framework based on WHO guidance.
Article in BMC public health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.
- Mortality Risk Among Patients With Influenza Illness Admitted to the ICU: A Systematic Review and Meta-Analysis.Influenza and other respiratory viruses · 2025Pooled it
- A Cross-Country Evaluation of Respiratory Syncytial Virus and Human Metapneumovirus Surveillance Systems: Identifying Gaps and Best Practices for Improved Disease Monitoring.Reviews in medical virology · 2026Review
- Health Care Providers' Perspectives on Early Warning Systems for Acute Respiratory Infections in Canada: Qualitative Study.JMIR public health and surveillance · 2026Article
- Balancing Human Mobility and Health Care Coverage in Sentinel Surveillance of Brazilian Indigenous Areas: Mathematical Optimization Approach.JMIR public health and surveillance · 2025Article
- Monitoring Public Health Through a Comprehensive Primary Care Database in the Netherlands: Overview of the Nivel Syndromic Surveillance System.JMIR public health and surveillance · 2025Article
- Public health and economic benefits of seasonal influenza vaccination in risk groups in France, Italy, Spain and the UK: state of play and perspectives.BMC public health · 2024Article
- Postpandemic Sentinel Surveillance of Respiratory Diseases in the Context of the World Health Organization Mosaic Framework: Protocol for a Development and Evaluation Study Involving the English Primary Care Network 2023-2024.JMIR public health and surveillance · 2024Article
- A comparative study of influenza surveillance systems and administrative data in England during the 2022-2023 season.PLOS global public health · 2024Article
- Protocol for establishing a model for integrated influenza surveillance in Tamil Nadu, India.Frontiers in public health · 2023Article
- Detecting early signals of COVID-19 outbreaks in 2020 in small areas by monitoring healthcare utilisation databases: first lessons learned from the Italian Alert_CoV project.Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2023Article
- Comparison of influenza surveillance systems in Australia, China, Malaysia and expert recommendations for influenza control.BMC public health · 2021Article
Corrections and comments
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Authors and funding
21 authors at 14 institutions in 7 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundInfluenza surveillance systems vary widely between countries and there is no framework to evaluate national surveillance systems in terms of data generation and dissemination. This study aimed to develop and test a comparative framework for European influenza surveillance.
methodsSurveillance systems were evaluated qualitatively in five European countries (France, Germany, Italy, Spain, and the United Kingdom) by a panel of influenza experts and researchers from each country. Seven surveillance sub-systems were defined: non-medically attended community surveillance, virological surveillance, community surveillance, outbreak surveillance, primary care surveillance, hospital surveillance, mortality surveillance). These covered a total of 19 comparable outcomes of increasing severity, ranging from non-medically attended cases to deaths, which were evaluated using 5 comparison criteria based on WHO guidance (granularity, timing, representativeness, sampling strategy, communication) to produce a framework to compare the five countries.
resultsFrance and the United Kingdom showed the widest range of surveillance sub-systems, particularly for hospital surveillance, followed by Germany, Spain, and Italy. In all countries, virological, primary care and hospital surveillance were well developed, but non-medically attended events, influenza cases in the community, outbreaks in closed settings and mortality estimates were not consistently reported or published. The framework also allowed the comparison of variations in data granularity, timing, representativeness, sampling strategy, and communication between countries. For data granularity, breakdown per risk condition were available in France and Spain, but not in the United Kingdom, Germany and Italy. For data communication, there were disparities in the timeliness and accessibility of surveillance data.
conclusionsThis new framework can be used to compare influenza surveillance systems qualitatively between countries to allow the identification of structural differences as well as to evaluate adherence to WHO guidance. The framework may be adapted for other infectious respiratory diseases.
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