SiVIRA, the key surveillance system for Covid, influenza and RSV

Winter is the peak travel season respiratory tract infections, The main ones that stand out are influenzahe respiratory syncytial virus (VRS), and now Coronavirus disease Caused by SARS-CoV-2. Its spread poses a challenge to health systems, which are experiencing increased demand for primary care and inpatient care.

To control these conditions, Epidemiological surveillance system. Owned by the National Center for Epidemiology (CNE) of the Carlos III Health Institute (ISCIII) National Epidemiological Surveillance Network (RENAVE) Responsible for infectious disease surveillance. Different systems have been created to monitor different pathologies, the Spanish Influenza Surveillance System (SVGE) being an example.

The emergence of Covid-19 has led to the adaptation of SVGE to this pathogen as well as other respiratory pathogens such as RSV, all of which have high transmissibility. In this way, according to the recommendations of the World Health Organization (WHO) and the European Center for Disease Prevention and Control (ECDC), Surveillance System for Acute Respiratory Infections (SiVIRA).

SiVIRA started operations in October 2020 based on recommendations from WHO and ECDC

The system is essentially a sentinel system and includes monitoring Mild acute respiratory infection (ARI) in primary care, and Severe acute respiratory infection (SARI) in hospital. It began operating at national and regional level in October 2020 and responds to a series of protocols that allow it to control respiratory infections that occur in Spain and that may occur in the future.

Notification and Investigation

2022, SiVIRA sentinel monitoring protocol. There are two documents in total, one for each of the two respiratory infections controlled by this system, with the main objective not only to monitor Covid-19, influenza and any other respiratory viruses, but also to help assess. control and preventive measures. effectiveness.

In the specific case of HAIs, the protocol stipulates the need to estimate incidence rates at national and regional levels by sex and age group; to know the percentage of respiratory samples positive for SARS-CoV-2, influenza and RSV at national level and in each autonomous region; to describe three Spatial and temporal evolution of infection; objectives such as determining the epidemiological and clinical characteristics of cases or assessing the effectiveness of preventive measures.

These protocols allow us to understand the evolution of incidence rates, epidemiology, presenting symptoms and risk factors that may affect patients or variant types.

In order to achieve these goals, Monitor weekly incidence of ARI Sentinel components were collected by sex and age group as well as percent case positivity as well as epidemiological, clinical, virological characteristics and vaccination status. Depending on the protocol, a wealth of information can be obtained to understand the incidence, epidemiological evolution, presenting symptoms and risk factors that may affect patients or the types of variants or subtypes of the virus present. Developing more effective prevention tools.

Surveillance of severe respiratory infections provides similar information, i.e. the evolution of incidence, epidemiological characteristics, effectiveness of preventive measures… However, in this case the data provided are the weekly number of hospitalizations. Admission lists and electronic medical records. Samples must also be collected from these patients and virus variants identified.

Through these protocols and the work of SiVIRA, the CNE publishes a weekly report on the respiratory tract infection situation. Information used to monitor outbreaks of these diseases so that public health measures can be implemented if necessary. The data show that in November, which coincides with the coronavirus and influenza vaccination campaigns, global rates of mild and severe infections are currently stable and hospital admissions are particularly low, mainly due to preventive immunization measures.

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