EuroGROG : A Pan European Perspective for the Surveillance of Influenza

Because Influenza is essentially an international disease, and because European surveillance was scattered amongst a number of national systems, the need to centralise the follow up of IA led gradually to the creation of EuroGROG by C. Hannoun in the early 90's. The main goal of this new system was to systematically gather morbidity and virological reports from a variety of institutions throughout Europe. EuroGROG is an informal system, focused on Europe. EuroGROG is an extensive system covering today 14 countries, not including the members of the sister European system EISS. The same need to improve communication between European networks gave birth to other European scheme as EuroGROG started to function. The Eurosentinel experience, which lasted from 1987 to 1991 [1] , was followed by the ENS-CARE Influenza system which operated from 1992 to 1995 [2] , under the initiative of the WHO (World Health Organisation) regional office for Europe and the help of the Directorate General (DG) XIII of the European Union. In 1995, the early warning influenza system called "European Influenza Surveillance Scheme" (EISS) [3] . was created. EISS, in operation since 1996 in its current form, is a more formal system, comprising sixteen countries which are also included in EuroGROG pan-European covering [4] . Any contributor can join EuroGROG. EISS and EuroGROG fully co-operate and convergence is a primary objective for EuroGROG.

Eighteen countries adopted the calendar week as the basic time unit and report regularly on this basis. Some other countries release summary reports at regular intervals.

Institutions throughout Europe contribute to data for influenza surveillance. It is noteworthy that each country may have a number of reporting organisations which contribute to the overall EuroGROG reports. Data is collated and then assessments are made based from an 'overall' perspective. For the or list of contributors click here.

Up until the 2000-2001 season, data was collected each week mainly by fax and e-mail. As a new era starts for EuroGROG, contributors will soon have the possibility to enter data into a formatted database. Up to now, data management was a time consuming activity of EuroGROG as data formats were extremely variable as were the collected items.

In the EuroGROG Bulletin, the situation in each country is summarised in a maximum of 2 lines. The level of influenza activity is reported and, when available or necessary, regional details are added. When possible or desirable, qualitative virological data is given, such as the first detection or isolation for each influenza type and sub-type, the nature of the main circulating virus in the case of co-circulation and the antigenic characteristics of the isolates. Up until the 2000-2001 season, the bulletin was produced in standard 'Word' then in 'Excel' format and then exported to a web page ready for the Internet.

The structure of the bulletin is made up of a header paragraph. This paragraph is a basic overview of the above mentioned data. The next table contains the 30 countries reporting information directly or indirectly. This is structured as can be seen on the current bulletin. A section entitled 'Elsewhere in the World' is a basic inclusion of influenza activity in areas outside Europe. The information is produced in a timely and easy to read format.

Once complete, the bulletin is sent out via email and a paper copy via postal mail or fax. The EuroGROG Bulletin was sent by e-mail, post and is also available on the Internet. Since the 2000-2001 season, the bulletin was only sent by e-mail before being posted on the web. From now on, the bulletin will be sent by e-mail as an 'html' attached file. Each bulletin will still be also posted on the net.