Since 2004, the US Centers for Disease Control and Prevention (CDC) Influenza Division (ID) has supported seven countries in the Eastern Mediterranean region and the World Health Organization Regional Office for the Eastern Mediterranean to establish and strengthen influenza surveillance. The substantial growth of influenza surveillance capacities in the region demonstrates a commitment by governments to strengthen national programs and contribute to global surveillance. The full value of surveillance data is in its use to guide local public health decisions. CDC ID remains committed to supporting the region and supporting partners to translate surveillance data into policies and programs effectively.

Background: In 2020, countries implemented universal surveillance to detect and monitor severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) cases. Although crucial for early monitoring efforts, universal surveillance is resource intensive. To understand the implications of transitioning from universal to sentinel surveillance for monitoring SARS-CoV-2 transmissibility, morbidity and mortality, and disease seriousness, we compared measures of SARS-CoV-2 reported from both surveillance strategies in Argentina, Chile, and Mexico. Methods: We obtained weekly case counts in Argentina, Chile, and Mexico, in periods when both universal and sentinel surveillance were ongoing. To assess the countries' surveillance strategies, we measured the proportion of total sites that were included in sentinel surveillance. We compared 8 measures of SARS-CoV-2 transmissibility, morbidity and mortality, and disease seriousness between sentinel and universal surveillance and assessed the correlation between the 2 strategies for the 8 measures. Pearson and Spearman correlation was classified as very strong (rs = 0.8–1.0), strong (rs = 0.60–0.79), moderate (rs = 0.50–0.59), or poor (r < 0.50). Results: The proportion of total sites included in sentinel surveillance was 5.8% for Argentina, 1.1% for Chile, and 7.6% for Mexico. A total of 21 measures were calculated (8 for Mexico, 8 for Chile, and 5 for Argentina). Of these, 17 showed consistency between the 2 surveillance strategies, with strong or very strong correlations (r = 0.66–0.99): all 8 measures for Mexico, 6 of 8 measures for Chile, and 3 of 5 measures for Argentina. Each country had ≥1 measure reflecting transmissibility and ≥1 reflecting morbidity and mortality for which the correlation was strong or very strong. Chile and Mexico also had ≥1 measure of disease seriousness for which the correlation was strong. Conclusions: Our findings suggest that the integration of SARS-CoV-2 into national sentinel surveillance can yield information comparable to that provided by nationwide universal surveillance for measures related to SARS-CoV-2 transmissibility, morbidity and mortality, and seriousness of disease.

Introduction: Influenza sentinel surveillance has been ongoing in Tunisia since 1999. We describe the epidemiology of respiratory viruses during 2022–2023, the first season to include testing for other respiratory viruses, such as respiratory syncytial virus (RSV). Methods: We analyzed weekly surveillance data from severe acute respiratory infection (SARI) inpatients and influenza‐like illness outpatients from 11 hospitals and 85 clinics in Tunisia. Nasopharyngeal specimens and demographic, clinical, and vaccination data were collected. Specimens were tested by rRT‐PCR for influenza, SARS‐CoV‐2, RSV, and 18 other respiratory viruses. Descriptive statistics were used to summarize case characteristics; group differences were assessed using chi‐squared or Fisher's exact tests. Results: 2038 specimens were collected from unique patients; 1231 (60.4%) were positive for ≥ 1 respiratory virus and 200 (16.2%) were positive for ≥ 2 viruses. Influenza was the most detected ( n = 445; 21.8%), followed by rhinovirus ( n = 301, 14.8%), RSV ( n = 255, 12.5%), and SARS‐CoV‐2 ( n = 125, 6.1%). Among SARI cases, infections with influenza and SARS‐CoV‐2 were more common in adults ≥ 50 years (61.8% and 71.4%, respectively), while children < 2 years had higher RSV prevalence (83.0%, adjusted p ‐value = 0.004). 4.9% of patients received a recent influenza vaccine. Conclusion: The burden of respiratory viruses varied by age, with RSV being more prevalent among younger children and SARS‐CoV‐2 and influenza being more prevalent among older adults. Ongoing sentinel surveillance is essential to monitor priority respiratory pathogens, particularly those with available public health interventions, such as vaccination, to enable timely action and reduce disease burden.

Since 2004, the U.S. Centers for Disease Control and Prevention (CDC) Influenza Division (ID) has supported seven countries in the Eastern Mediterranean region and the World Health Organization Regional Office for the Eastern Mediterranean to establish and strengthen influenza surveillance. There has been substantial growth in influenza surveillance capacities in the region over two decades that demonstrates commitment by national governments to strengthen national programs and contribute to global influenza surveillance. CDC ID remains committed to continuing support to the region and supporting partners to translate surveillance data into policies and programs effectively.

Background: COVID-19 vaccine hesitancy remains a public health issue despite the fact that vaccines are readily available and recommended for all persons aged 5 years or older in the United States. We aimed to describe parental plan to vaccinate their children in two different populations: families in a prospective, longitudinal cohort study and families experiencing homelessness enrolled in cross-sectional surveillance for acute respiratory infections. Methods: Participants were parents/guardians of children aged <18 years, recruited either from a serial cross-sectional homeless study in Seattle-King County, Washington or from a household cohort study in the Seattle Metropolitan area. Participants were surveyed during October 2020-May 2021 about their plans to vaccinate their child against COVID-19. Vaccine plans were described by study population as well as by sociodemographic features and over time. Results: Among parents of 640 children enrolled in the household study surveyed in October 2021, 66% reported planning to vaccinate their child vaccinated against COVID-19 once vaccines became available. This proportion increased slightly over the study period, to 75% in May 2021. In the homeless study, 1284 surveys were collected from parents of 338 children. The proportion of parents of families experiencing homelessness who planned to have their child vaccinated against COVID-19 ranged from 52% in November 2020 to 16% in March 2021. Conclusion: COVID-19 vaccine plan among parents of children experiencing homelessness in Seattle-King County decreased over time, with the majority of parents reporting that they did not plan or were undecided about COVID-19 vaccination for their children by May 2021. Further investigations are needed among families experiencing homelessness to assess vaccine attitudes and perceived barriers to getting their children vaccinated against COVID-19.