The moving epidemic method applied to influenza surveillance in Guangdong, China

Objectives: The moving epidemic method (MEM) has been well used for assessing seasonal influenza epidemics in temperate regions. This study used the MEM to establish epidemic threshold for influenza in Guangdong, a subtropical province in China. Methods: Influenza virology surveillance data from 2011/2012 to 2017/2018 seasons in Guangdong were used with the MEM to calculate the epidemic thresholds and timeously detect the 2018/2019 influenza season epidemic. The weekly positive proportion of influenza A(H1N1)pdm09, A(H3N2), B/Victoria-lineage and B/Yamagata-lineage were separately adapted to calculate the subtype-specific epidemic thresholds. The performance of MEM was evaluated using a cross-validation procedure. Results: For the 2018/2019 influenza season, the epidemic threshold of a weekly positive proportion was 15.08%. Epidemic detection for the 2018/2019 season was 1 week in advance. Influenza A(H1N1)pdm09, B/Yamagata-lineage and B/Victoria-lineage prevailed during winter and spring and their epidemic thresholds were 5.12%, 4.53% and 4.38%, respectively. Influenza A(H3N2) was active in the summer, with an epidemic threshold of 11.99%. Conclusions: Using influenza virology surveillance data stratified by types of influenza virus, the MEM was effectively used in Guangdong, China. This study provided a practical way for subtropical regions to establish local influenza epidemic thresholds. (c) 2021 The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Automated summary

The moving epidemic method (MEM) was used to establish epidemic thresholds for influenza in Guangdong, a subtropical province in China, with virology surveillance data from multiple seasons. The study successfully predicted the epidemic for the 2018/2019 season by adapting subtype-specific thresholds. The MEM proved effective in detecting and monitoring influenza epidemics based on different strains of the virus.