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This supplement to IORV, dedicated to the Global Influenza Initiative (GII) and associated research, covers many of the key challenges involved in influenza disease prevention, management, and treatment. This supplement shares the latest data and current thinking on a range of issues including epidemiology and burden of disease, case definitions, vaccination of pregnant women, and the potential public health impact of quadrivalent influenza vaccines (QIV) versus trivalent influenza vaccines (TIV). The studies reported within this supplement have been conducted by members of the GII, and the GII members have utilized the group’s global reach to report on both expert experience and the latest data from around the world. In a report based on global surveillance data, Caini et al. describe the epidemiologic characteristics of influenza A and B epidemics. In this study, the authors obtained data from the Northern and Southern hemispheres, including data from tropical and subtropical regions. The authors also examine the frequency of influenza B, the age distribution of influenza B versus influenza A, the epidemiologic impact of influenza B versus influenza A, and vaccine mismatches over the past decade. Cheng et al. present an important study on the burden of influenza-associated deaths between 2002 and 2008 in the Americas. This research examines whether influenza remains an important cause of mortality in the Pan American Health Organization region, and the outcome is clear. As the detection and diagnosis of influenza is paramount, Falsey et al. reviewed the currently used clinical case definitions in the elderly population and report here their findings regarding the different definitions and their respective sensitivity and specificity. The authors also suggest what the case definition should include, and what the optimal fever threshold should be to characterize influenza in the elderly. Vaccination of pregnant women continues to be the subject of interest and debate, and additional data have become available in recent years. Macias et al. undertook a literature review, supplemented with data from GII members, and have developed recommendations for the vaccination of pregnant women against seasonal influenza. Finally, Cr epey et al. used a dynamic model to estimate the relative public health benefit of using QIV versus TIV for routine influenza vaccination in the United States. An elegant aspect of the authors’ analysis is that they have integrated the potential cross-protection against a mismatched B lineage conferred by the TIV, an important factor that potentially limits the added value of QIV over TIV.

influenza and other respiratory viruses

Preventing seasonal influenza worldwide through vaccination, education, and international cooperation: research, findings, and recommendations from the Global Influenza Initiative