European Influenza Surveillance Scheme (EISS)
www.eiss.org

Purpose
The European Influenza Surveillance Scheme (EISS) collects clinical and virology data on patients with influenzalike illness from a network of sentinel physicians throughout Europe. These data are used to track the characteristics of the annual flu season and to monitor the circulating influenza viruses.

History and operational characteristics
The European Influenza Surveillance Scheme is one of 14 surveillance systems that now operate under the auspices of the European Center of Disease Control’s Surveillance and Communication Program; these databases are briefly described in Appendix 1.36 European influenza surveillance began in the 1950s. The first European surveillance network, Eurosentinel Scheme, was established in 1987 and led to the development of EISS in 1996. EISS is one of the oldest and best-funded infectious disease surveillance systems in Europe; it exemplifies many aspects of the other European disease tracking systems.

As a stipulation for membership, EISS requires participating countries to have a robust national influenza network. Each network must be comprised of sentinel sites that are nationally or regionally representative, officially recognized by the health authority in the country or region of origin, able to incorporate both clinical data and laboratory data from the same population, operational for 2 years, and able to report data on a weekly basis.37 EISS obtains its specimens for virology from a network of sentinel physicians throughout its member countries. Sentinel physicians, including general practitioners, pediatricians, and other specialists, represent 1–5% of physicians in the country or region. Physicians take nasopharyngeal or throat swabs from patients with influenzalike illness or acute respiratory syndrome and send them to a national reference laboratory for analysis. In addition to testing the samples received from the sentinel physicians, the national reference laboratories also test samples received from nonsentinel physicians. Laboratory and clinical data are entered electronically into the EISS database; EISS members can then access these data to “make detailed clinical and virology queries.”37 During influenza season, data are collected, analyzed, and reported weekly in EISS’s Weekly Electronic Bulletin. The summary includes influenza activity across Europe; during the influenza season, the EISS website receives one million visits per month.

Region/countries served
23 countries of the European Union, and Switzerland, Norway, and Romania. Countries that contribute to EISS can be found at www.eiss.org.

Funding/budget/staff
Annual budget is approximately 1,150,000 euros (U.S.$1.5 million), of which 42% is provided by the European Commission, 52% by in-kind support from national governments, and 6% from industry. The coordinating center, currently located in the Netherlands, has four full-time staff.