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Background A country-wide lab-based surveillance system for ILI and Severe Acute Respiratory Illness (SARI) with weekly sampling and reporting was established in 2008.This system was necessary for early detection of emerging novel influenza subtypes and timely response for influenza prevention and control. Objectives To assess the trends of Influenza-like-Illness(ILI) and to monitor the predominant circulating strains of influenza viruses through Lab based sentinel surveillance. Methods A cross-sectional study was conducted based on ten years (2007-2017) influenza surveillance data obtained from National Influenza Central Laboratory Pakistan (NICLP) from January to March 2018.Study was done from the data records and samples of suspected ILI patients and SARI patients received from all seven sentinel sites. An ILI case was defined as sudden onset of fever of ≥ 38 C° and cough, with onset within last 10 days, while patients with sudden onset of fever (&amp;gt;38 °C), cough/sore throat requiring hospital admission within 7 days were termed as SARI. Samples were tested at NICLP for confirmation of virus, typing and subtyping by RT-PCR. Results A total of 15885 samples were analyzed during ten years period, out of which 3475(21.9%) were found positive for influenza virus. Among positive samples 26(0.75%) were Influenza-A (H1N1), 550(38%) were A/H3N1,550(15.9%) were A/H3N1,1587(45.7%) were A/H1N1 pdm09and 1312(37.8%) were influenza B. Males were predominant(54%).Influenza Maximum cases were reported from age group 01-&amp;gt;12 years(66%).Virus circulation was detected throughout the year along with few cases of seasonal A/H1N1 virus during late winter(January February) and spring(March). Influenza A/H3N2 virus circulation was mainly observed during summer months (August-October). Conclusions The findings of this study emphasize the need for continuous and comprehensive influenza surveillance to predict seasonal trends for vaccine development and to further fortify pandemic preparedness. Key messages The need for continuous and comprehensive influenza surveillance. Public health importance by pandemic preparedness.

Laboratory based Influenza sentinel surveillance in Pakistan At NIC, Islamabad 2007-2017