【欧洲疾控中心】呼吸道病毒综合监测报告方案-2026.6

EpiPulseCases

Reportingprotocolforintegratedrespiratoryvirussurveillance-Version1.2

June2026

REPORTINGPROTOCOL

EpiPulseCases:ReportingProtocolforintegratedrespiratoryvirussurveillance

1

Contents

Introduction 2

Howtousethisdocument 2

Findingfurtherinformation 2

Copyright 2

ReportingtoEpiPulseCases 3

Checkingthedatacollectionschedule 3

Preparingdata 3

Usinglatestmetadata 3

CheckingyourSurveillanceSystemDescriptors 4

Uploadingyourdata 4

Finalisingyoursubmission 5

EpiPulseCasesHelpdesk 6

Annex1.Overviewofreporting 7

Subjectcodes 7

Casedefinitions 7

Deadlineforreporting 7

Datasharing 7

Annex2.Reportingquantitativedata 8

SurveillanceType 8

SYND 8

PATH 8

Denominatorsforsyndromicdata 9

Testingdenominators 9

Agegroups 10

Co-infections 10

Case-baseddata 10

Aggregatedata 10

UNKvsmissing 11

Zerovsmissing 11

EHRdiagnosticcodes 11

Annex3.Reportingqualitativeindicators 12

Integratedreportingofinfluenza,SARS-CoV-2andRSV 12

Transmissibilityforinfluenza 13

Morbidityandmortalityforinfluenza 13

Otherreportingconsiderations 13

Annex4.Reportingthresholds 14

Annex5.Metadata 15

RESPICLINPC 15

RESPIAGGR 15

RESPICLINSC 16

RESPISEVERE 22

RESPICASE 26

RESPIQUAL 33

2

Introduction

Thisreportingprotocoldescribesdatacollectionin

EpiPulseCases

forrespiratoryvirussurveillance(including

influenza-likeillness(ILI),acuterespiratoryinfection(ARI),severeacuterespiratoryinfection(SARI),Influenza,SARS-CoV-2andRSV)intheEuropeanUnion/EuropeanEconomicArea(EU/EEA)andWorldHealthOrganizationEuropeanRegion.FromJune2026,allrespiratoryvirussurveillancedataarereportedtoEpiPulseCases,withtheexceptionofviruscharacterisationdatawhichcanstillbereportedviatheTESSyrecordtypesINFLANTIVIRand,optionally,

NCOVVARIANT(see

relatedreportingprotocol

).

Reportingprotocolsaredatacollectionguidelinesforthedatamanagersofreportingcountries,andtheprotocoldesignisintendedtoimproveuser-friendlinessby:

•introducingauniformstructuretomakeiteasierfordatamanagerstofinddatacollectioninformationacrossdifferentsubjects;

•removinginformationwhichisnotrelevantfordatamanagers.

Sincethedatamanagersinreportingcountriesoftenhavemultipleroles,subject-specificmaterialisdistributedinthemultipleannexestogetherwiththereportingprotocol.

Howtousethisdocument

Thisreportingprotocolprovidesinformationforthedatamanagersofreportingcountriesinthreemainsections:

•ReportingtoEpiPulseCaseswhichcontainsguidelinesonhowtopreparedataforsubmissiontoEpiPulseCasesandlinkstofurtherinformation.

•Annex1providesanintroductionandoverviewofthesubjectcodesusedforreporting.

•Annex2outlinesconsiderationsforsubmittingquantitativedata.

•Annex3outlinesconsiderationsforsubmittingqualitativeindicators(RESPIQUAL)

•Annex4outlinesconsiderationsforsubmittingthresholds.

•Annex5providesalistofallvariables.Pleasenotethatthisisautomaticallygeneratedandidenticaltothemetadataintheexcelfile.

Findingfurtherinformation

Updatedlinkstoalltheschedules,documentationandtrainingmaterialsmentionedinthisreportingprotocolareincludedinthe

EpiPulseHelp

,including:

•EpiPulseCasesMetadata

•EpiPulseCasesMachinetoMachineTechnicalDocumentation

Copyright

©EuropeanCentreforDiseasePreventionandControl,2026.Reproductionisauthorised,providedthesourceisacknowledged.

3

ReportingtoEpiPulseCases

EpiPulseCaseswasbuiltasareplacementforTESSy,withtheaimofimprovingtheprocessofreporting,reviewing,

andupdatingsurveillancedata.ThissectionprovidesbothanoverviewoftheEpiPulseCasesreportingprocessandtipsonwhereyoucanfindusefulinformation.

Theoverallprocessisasfollows:

•Familiariseyourselfwiththedatacollectiondeadlines.

•Prepare(exportandtransform)yourdata.

•CheckthatyourdatacomplieswiththeEpiPulseCasesmetadata–see

EpiPulseHelp

.

•Checkthatyourdatasourcesareuptodate.

•Submityourfile(s)toEpiPulseCases.

•Finaliseandapproveyoursubmission.

Checkingthedatacollectionschedule

Alinktothecurrentdatacollectionsschedulecanbefoundthe

EpiPulseHelp

section.

Preparingdata

Afteryouhaveexportedthedatafromyournationaldatabase,youneedtoensurethatthedataareinaformatthatEpiPulseCasescanaccept.EpiPulseCasesacceptsonlyCSVandXMLfiles,optionallyZIP-compressed.TheEpiPulseCasesmetadatahasbeendevelopedfromtheTESSyMetadata,withtheaimtomakeonlytheminimalnumberofchangesnecessary,andtohopefullyprovideabetterexperiencewhenreportingyourdatasetstoECDC.

AfileconvertertoolisalsoavailableinEpiPulseCasestosupportusersinthetransitionperiodwiththeconversionoffilesinTESSyformattoaformatthatwouldbecompatibletoEpiPulseCases,seeSection18intheEpiPulseCasesGuide–see

EpiPulseHelp

.

SpecificguidelinesfordatacollectionandpreparationforEpiPulseCasesareprovidedintheannexes.

Usinglatestmetadata

ThemetadatadefinesthefieldsanddataformatsthatarevalidasinputtoEpiPulseCasesforagivensubject.TheEpiPulseCasesmetadataincludesasectionthatcomparesandhighlightsthechangesbetweenTESSyandEpiPulseCases,tofacilitatethetransition.

AstherequirementsfordatatobesharedamongECDCstakeholderscanchange,thedataformatchangesneededtosupportthenewrequirementsareidentifiedandagreeduponbetweentheNationalSurveillanceContactPoints,theNetworkCoordinationGroupsandECDC’sdiseaseexperts.ThesechangesarethenimplementedtotheEpiPulseCasesmetadata.

ThemetadataforthesubjectofthisreportingprotocolaredescribedinAnnex2.

Itisespeciallyimportanttofocuson:

•Fieldformats

Manyfieldsrequirethedatatobeformattedinaspecificway.Forexample,datesmustbeintheYYYY-MM-DDformat;datesintheDD/MM/YYYYformatwillberejected.

•ReferenceValues(theequivalentofTESSyCodedValues)

Somefieldsonlypermittheuseofspecificvalues(referencevalues).Forexample,M,ForOTHarethecodedvaluesfor‘Sex’andanyothervalueina‘Sex’fieldwillberejected.PleasenotethatUNKisnolongeravalidcode,youmayleavethefieldemptyinstead.

TheEpiPulseCasesmetadataExcelfilecontainsallthedefinitionsandrulesnecessarytoformatdatacorrectly.TheREADMEsheetoftheExceldocumentexplainshowtoworkwiththemetadata.Itcanbedownloadedfromthe

EpiPulseHelp

.

Filteringthefieldsinthefilebysubjectwillenableyoutoseethefieldsrequiredforyoursubjectandtherulesthatapplytothesefields.

EpiPulseCases:ReportingProtocolforintegratedrespiratoryvirussurveillance

4

Checkingyoursurveillancesystemdescriptors

Beforesubmittingfile(s),pleasereviewyourdatasource(s)inEpiPulse(inthemenu,goto‘Report’->

‘Surveillance

systemsdescriptors’

)andupdatetheinformationasnecessary.

Completeandup-to-datedatasourceinformationforeachsubjectisimportantforimprovingtheinterpretationofdata–eachsurveillancesystemhasdifferentfeaturesthatneedtobeconsideredwhencomparingdataatEuropeanlevel.Ifyourdatasourceinformationisout-of-dateandyoudonothaveaccessrightstoupdateit,pleaseaskyourNationalFocalPointforSurveillanceorNationalCoordinatortodoso.

InformationondatasourcesisavailableintheEpiPulseCasesGuide–see

EpiPulseHelp

.

Uploadingyourdata

Dataissubmittedthroughthe

EpiPulsewebinterface

(inthemenu,gotoCases->EpiPulseCases).

ThevisualinterfaceforreportingnewdataandeditingexistingrecordshasremainedverysimilartothatofTESSy.SimilartoTESSy,youcanAdd/UpdateorReplacedatawithnewuploads,usingeitherCSVorXMLfiles.Youcanalsomanuallycreaterecordsforsomediseases,andreportzerocaseswhereappropriate.

Thefunctionalityformanuallyeditingexistingrecordsisalsoafamiliarexperience.Searchfortherecordyouwishtoeditandmodifytheexistinginformationasneeded.

EpiPulseCases:ReportingProtocolforintegratedrespiratoryvirussurveillance

5

Finalisingyoursubmission

Thecomplianceofyourdatawiththevalidationrulesinthemetadataischeckedautomaticallyduringthedatauploadprocess.InEpiPulseCasesthisprocessiscalled“TechnicalValidation”,anditistheonlystepwhereyouruploadcanberejectedbythesystem,forseveredataqualityissues,suchasthefileformatnotbeingreadablebythesystem,or(oneofthefew)technicallyrequiredvariableshavingmissingvalues.

Ifyourfilehasbeenrejected,therewillbeamessageexplainingeachinstanceofnon-compliancewiththemetadatathatneedscorrecting.

ThesignificantnewfeatureinEpiPulseCasesistheDataValidationReport,whichputsyourdatainthecontextofthealreadyexistinginformationforthesamedisease.Itprovidesyouadetailedoverviewofthenewdatainthefileyouhavejustuploaded,aswellasanoverallepidemiologicalsituationshowedwiththeexisting(past)datatogetherwiththenewlyuploadedfile(s).Thismeansmuchmoretimelyfeedbackonyouruploads,includingdetailsondataquality,aswellasoutputs(graphs,charts,andtables)onsomeofepidemiologicalindicators.TheDataValidationreportswillevolveandgrowbasedonyourfeedbackincollaborationwithourDiseaseExperts.ThesereportswillprovideanewandbetterwayofunderstandingandupdatingtheinformationcollectedatEuropeanlevelandwillhopefullyincreasethequalityandtimelinessofthedata,whilereducingworkloads.

BelowyoucanfindafewscreenshotsoftheDataValidationReport.

1.Beginbyopeningthereport:

2.Viewthereportinawindow,downloadthelistofeventualvalidationmessages,ordownloadthereport

6

3.Thedownloadedreportcanbeopenedfullscreenforeasierviewingandnavigation.

4.AfterreviewingtheinformationintheDataValidationReportyoucanchoosetoapproveorrejectit.YoucandownloadtheDataValidationReportfileandemailittoanyonewhoneedstocheckitbeforeapproval.

Ifyouchoosetorejectit,nodatawillbesavedintheEpiPulseCasessystem,butyourfilewillremainvisibleshouldyouwishtore-downloaditorresubmititforanewdatavalidationatalaterdateorafterfurtherchecks.Pleasecheckthe

DataValidationReportcarefully,theremightbewarningsandremarksrelatingtopossibledataqualityissuesorpotentialoverwritingofexistingrecordsthatyoushouldconsider.

Whenyourfilehasbeenvalidatedandyouaresatisfiedthatallcorrectionshavebeenmade,pleaseensurepromptapprovalorrejection.Unapproveduploadswillblocktheapprovalofotherrelateduploadsforthesamedisease.

EpiPulseCasesHelpdesk

Email:

EpiPulseCases@ecdc.europa.eu

Telephonenumber:+46-(0)8-58601601

Availability:9:00–16:00Stockholmtime,MondaytoFriday(exceptECDCholidays).

7

Annex1.Overviewofreporting

Dataforroutinerespiratorysurveillanceiscollectedinsevenintegratedsubjectcodes.Theseareoutlinedbelowtogetherwithinformationoncasedefinitions,reportingdeadlineanddatasharing.

Subjectcodes

ThefollowingsubjectcodesexistinEpiPulseCases:

1.RESPICLINPCforreportingweeklyage-disaggregatedprimarycaresyndromicdata(ILI/ARI).

2.RESPIAGGRforreportingofage-disaggregatedcountsofdetectionsandtestsfromILI/ARIsurveillanceandpathogen-specificlaboratory-basedsurveillancesystem.

3.RESPICLINSCforreportingweeklyage-disaggregatedsecondarycaresyndromicdata(SARI).Thissubjectcodecanalsobeusedforreportingweeklydenominatordataforcountriesreportingcase-basedSARIdatatoRESPICASE.

4.RESPISEVEREforreportingage-disaggregatedcountsofdetectionsandtestsfromSARIsurveillanceand

countsfrompathogen-specificlaboratory-basedsurveillanceofhospitaladmission,ICUadmissionsanddeathsduetorespiratoryillness.

5.RESPICASEforreportingcase-baseddataforseverecasescapturingbothsyndromicandvirologicaldataforasinglecase.BothSARIcasesandseverecasescapturedthroughpathogen-specificlaboratory-basedsurveillancecanbereportedtothissubjectcode.

6.RESPIQUALforreportingweeklyqualitativeindicators

7.RESPITHRESHOLDforreportingthresholddatacollectedforILI,ARIandSARI

Allsubjectcodesallowintegratedreportingofsyndrome(ILI,ARIorSARI)and/orlab-confirmedinfectionsbypathogen(s).

Furtherconsiderationsforreportingquantitativeandqualitativedataaredescribedinannex2and3respectively.

Instructionsforreportingthresholddatawillbeprovidedatalaterstageinannex4.Includedvariablesforeachsubjectcodesareoutlinedbelowintheannex5.

PleasenotethatINFLANTIVIRandNCOVVARIANTrecordtypeswillcontinuetobecollectedinTESSyuntilfurther

notice.Aseparatereportingprotocolwillremainavailable.Case-baseddataonhumaninfectionswithzoonoticinfluenzavirusesshouldbereportedtothesubjectcodeINFLZOOinEpiPulseCases.Aseparatereportingprotocolisavailable.

Casedefinitions

CasesshouldbereportedaccordingtothecurrentEUcasedefinition.Dataonprobableandpossiblecasesarenotcollected.

Deadlineforreporting

Wednesday23:59CETforallsubjectcodesexceptforRESPITHRESHOLD.

RESPITHRESHOLDsubmissiondeadlinewillbecommunicatedseparatelyviaemail.Annualupdatesareexpected.

DatathathavenotbeenuploadedandapprovedinEpiPulseCasesontimewillnotbeincludedinweeklyreports.Ifyouareunabletomeetthisdeadline,pleasecontacttheECDCRespiratoryVirusessurveillanceteam

(ecdc.influenza@ecdc.europa.eu).

Datasharing

PleaserefertotheECDC’spolicyondatagovernancetobepublishedontheECDCwebsiteforinformationondata

protectiongovernanceforEpiPulseincludingdatasharing:

DataprotectiongovernanceforEpipulse-final.pdf

.AlldatacollectedaresharedwiththeWorldHealthOrganisation–RegionalOfficeforEurope(WHO/Europe)onaweeklybasisandthereforeduplicatereportingtoWHOHQisthereforenotrequired.

8

Annex2.Reportingquantitativedata

Thisannexoutlinesconsiderationsforsubmittingdatatothefollowingsubjectcodes:RESPICLINPC,RESPIAGGR,

RESPICLINSC,RESPISEVEREorRESPICASEandisorganisedpertopic.Pleasenotethatthisisalivingdocumenttowhichadditionalconsiderationswillbeaddedovertime.ECDCisactivelyworkingtoexpandthissectionwithinthenextyear.

SurveillanceType

TheSurvTypevariable,withvaluesSYNDandPATH,isusedtodividesurveillancesystemsintotwobroadtypes,describedbelow.ExamplesareprovidedinTable1.

SYND

Insystemswheresurveillancetype=SYND,casesareidentifiedusingasyndromiccasedefinitionsuchasILI,ARI,

SARI,includingwheredataderivedfromelectronichealthrecords(EHR)areusedtotrytoreplicatethetraditionalcasedefinition.

WhenreportingaggregatedatatoEpiPulseCases,thesyndromiccomponentshouldbereportedtoRESPICLINPC(ILI/ARI)orRESPICLINSC(SARI)andvirologicaldatareportedtoRESPIAGGR(ILI/ARI),orRESPISEVERE(SARI).Alternatively,case-basedsyndromicandvirologicalSARIdatacanbereportedtoRESPICASE.

Thesedatawerepreviouslyreportedas‘sentinel’(STL)inTESSy.

PATH

Insystemswheresurveillancetype=PATH,caseidentificationoccursonthebasisofapositivetestforapathogen(influenza,RSV,SARS-CoV-2),orEHR-baseddiagnosticcodesthatreflectpathogen-specificdiagnoses.

Whenitisclearlyknownthatalaboratory-confirmeddetectionofinfluenza,RSVorSARS-CoV-2originatesfromapatientadmittedtohospital/ICUorwhohasdied,thesedatashouldbereportedtoRESPISEVERE(aggregate)orRESPICASE(case-based).

Wherepatientsaretestedoutsideofhospitalsettings,wherethesettingfortestingisnotknownorifthedataincludeamixofhospitalandnon-hospitalsettings,onlyaggregatedatashouldbereported,usingRESPIAGGR.

Thesedatawerepreviouslyreportedas‘non-sentinel’(NONSTL)inTESSy.

9

Table1.Examplesofdifferentsurveillancesystemswithineachofthesurveillancetypesandthelinkedreportingofsyndromicandvirologicaldata

Carelevel

Surveillancetype

Examplesofsystems

Datatype

Syndromicdata

Virologicaldata

Primarycare

SYND

a.SentinelILI/ARIsurveillancenetworkofGPpractices

fromwhichasubsetofcasesistested.

b.EHR-basedARI/ILI

surveillancecoveringmostGPpracticesinthecountrypairedwithasentinelGPnetwork

thattestsARI/ILIcases

Aggregate

RESPICLINPC

RESPIAGGR

Primarycareor

unknown

PATH

a.Laboratory-based

surveillanceofallSARS-CoV-

2,influenza,RSVdetectionsand(tests)

Aggregate

NA

RESPIAGGR

Secondarycare

SYND

a.Questionnaire-basedSARIsystem

b.SARIsystemthatappliesanEHR-basedcasedefinition

forSARIusingICDcodes.

Case-

based

RESPICASE

(numerator)

and

RESPICLINSC

(denominator)

RESPICASE

Aggregate

RESPICLINSC

RESPISEVERE

Secondarycare

PATH

a.Hospitallaboratory

surveillanceofSARS-CoV-2positives.

b.ICUsurveillanceofallpatientspositiveforinfluenza,RSVorSARS-CoV-2

c.EHR-baseddataindicatingdetectionofaspecific

pathogenforpatientsnotincludedwithinaSARIcasedefinition.

Case-

based

NA

RESPICASE

Aggregate

NA

RESPISEVERE

Mortality

PATH

a.Deathsoccurringamong

patientswhorecentlytestedpositiveforinfluenza,RSVorSARS-CoV-2andwhoare

notcapturedthroughSARIsurveillance

b.Cause-specificdeathregistrydata.

Aggregate

NA

RESPISEVERE

Denominatorsforsyndromicdata

Insystemswheresurveillancetype=SYND,twodifferentdenominatorscanbereported.

ForprimarycareILI/ARI-basedsystems(RESPICLINPC),all-causeconsultationsarereportedusingIndicator=DENOMCONSULTandthecatchmentpopulationisreportedusingIndicator=DENOMPOP.

ForsecondarycareSARIsystems(RESPICLINSC),all-causeadmissionsarereportedusingIndicator=DENOMADMITandthecatchmentpopulationisreportedusingIndicator=DENOMPOP.

Oneorbothdenominatorscanbereporteddependingondataavailabilityandsystemdesign.Wherepossible,catchmentpopulationsarepreferablesincetheyallowincidenceofILI/ARI/SARItobeestimated.

Insystemswheresurveillancetype=PATH,theabovedenominatorscannotbereported.

Testingdenominators

TestingdenominatorscanbereportedirrespectiveofSurvType.Theycanbeusedtocalculatetestpositivity.For

ERVISS,ininstanceswherecountriesreportmoredetectionsthantests,dataforthatweekareexcluded,testpositivityisnotcalculated,andcountrydataareexcludedfromaggregations.

10

Incase-baseddata(RESPICASE),thevariablesTestRSV,TestInfluenzaandTestSARSCOV2areusedtoreport

individualswhoaretested.Thisallowsforreportingofpatientswhoaretested,irrespectiveoftheresult.Wheretest-negativepatientsarereportedaswellaspatientswithapositivedetection,thesumoftestsreportedperpathogenisthetestingdenominatortouseforcalculatingtestpositivity.

Inaggregatesubjectcodes(RESPISEVERE,RESPIAGGR),thetestingdenominator(totalnumberoftestsperformedperpathogen)isreporteddirectly.InRESPIAGGRusingIndicator=TESTS.InRESPISEVEREusingIndicator=

HOSAD_TESTS(hospitaladmissions)orIndicator=ICU_TESTS(amongICUadmissions).Onetestingdenominatorshouldbereported(whereavailable)foreachcountry-week-pathogen-indicatorcombination.EvenifusingmultiplexPCR,separaterowsfortestsforRSV,influenzaandSARS-CoV-2shouldbereported.ThereportingofRSVTypeorInfluenzaTypeSubtypeisnotvalidwhenIndicator=TESTS.

Agegroups

WithinRESPICLINSC,RESPIAGGR,andRESPISERVE,countriesmayreportdatausingtwoalternativesetsofagegroups.

Wherepossible,pleasereportthenarrowagegroups:00–04,05–14,15–29,30–64,65–79,and80+years.Countriesthatareunabletoreportthesecanusethebroaderagegroups:00–04,05–14,15–64,and65+years.Countriesthatcannotreportanyage-disaggregateddatamayreportalldataunderAgeUnk.Thetotalacrossallagegroups,includingAgeUnk,isusedtocalculateoveralltotalsfordisplaysinERVISS.

Pleaseensurethatthesameagegroupstructureisappliedconsistentlytonumeratoranddenominatordata.

Co-infections

Co-infectionsarereporteddifferentlyforcase-based(RESPICASE)andaggregate(RESPIAGGR,RESPISEVERE)subjectcodes.

Case-baseddata

Co-infectionsinvolvingmorethanoneofinfluenza,RSVandSARS-CoV-2,e.g.RSVandInfluenza,shouldbereportedusingTestRSV=1,TestInfluenza=1,DetectionRSV=1,DetectionInfluenza=1.

Co-infectionswithtwotypesorsubtypesofthesamepathogenmakesuseofInfluenzaTypeSubtypeandRSVTypebeingrepeatableinRESPICASE.e.g.,InfluenzaA(H1N1)pdm09andinfluenzaB/Vic,wouldbereportedusing

TestInfluenza=1,DetectionInfluenza=1,InfluenzaTypeSubtype=AH1N1pdm09,InfluenzaTypeSubtype=BVic.

Co-infectionsbetweeninfluenza,RSV,SARS-CoV-2andotherrespiratorypathogenscanbereportedusingtherelevantTestandDetectionvariablesforthepathogen,togetherwithPathogenOthertoreportthedetectionoftheother

respiratorypathogen.PathogenOtherisrepeatableforRESPICASE,soco-infectionsinvolvingtwootherrespiratorypathogenscanbereportedinasimilarway.

Aggregatedata

Co-infectionsarereportedacrossmultiplerows,e.g.apatientaged66yearsco-infectedwithRSV-AandInfluenzaA(H1N1)pdm09shouldbereportedtoRESPIAGGRas:

•Pathogen=RSV,Indicator=DETECTIONS,RSVType=RSV_A,Age65_79=1

•Pathogen=RSV,Indicator=TESTS,Age65_79=1

•Pathogen=INFL,Indicator=DETECTIONS,InfluenzaTypeSubtype=AH1N1pdm09,Age65_79=1

•Pathogen=INFL,Indicator=TESTS,Age65_79=1

Co-infectionswithtwotypesorsubtypesofthesamepathogencanbereportedasaboveusingmultiplerows,e.g.apatientaged66yearsco-infectedwithInfluenzaB/VicandInfluenzaA(H1N1)pdm09shouldbereportedtoRESPIAGGRas:

•Pathogen=INFL,Indicator=DETECTIONS,InfluenzaTypeSubtype=BVic,Age65_79=1

•Pathogen=INFL,Indicator=DETECTIONS,InfluenzaTypeSubtype=AH1N1pdm09,Age65_79=1

•Pathogen=INFL,Indicator=TESTS,Age65_79=2

Theresultingdouble-countingoftestsforpatientswiththesecoinfectionsisnecessarytoavoidpotentialexclusionfromERVISS(recordsareexcludedwheredetections>tests)andwedonotexpectthistosignificantlyimpactinterpretationoftrends.

11

Itisalsopossibletoreportco-infectionsbetweeninfluenza,RSVorSARS-CoV-2andotherrespiratorypathogens.Detectionsofotherrespiratorypathogensherearereportedinthesamerowasthemainpathogendetectione.g.apatientaged66yearsco-infectedwithRSV-AandHumanmetapneumovirusshouldbereportedtoRESPIAGGRas:

•Pathogen=RSV,Indicator=DETECTIONS,RSVType=RSV_A,PathogenOther=HMPV,Age65_79=1

•Pathogen=RSV,Indicator=TESTS,Age65_79=1

PathogenOtherisnotrepeatableforaggregatedata,soco-infectionsinvolvingtwootherrespiratorypathogenswillneedtobereportedasIndicator=DETECTIONSacrossmultiplerows,similartothesecondexampleabovebutusingPathogen=OTH.

UNKvsmissing

InEpiPulseCases,wherethereisnodatatoreportforavariableoritsvalueisunknown,thefieldshouldbeleftblank.UNKcannotbereportedunlessitisexplicitlyincludedinthereferencelistforavariable.Thisonlyoccurswherethe

reportingofUNKismeaningful.

WithintheRESPIsubjectcodes,thefollowingvariablesstillincludeanUNKvalueintheirreferencelists:

•InfluenzaTypeSubtype(INFL_UNK=Influenzauntyped)

•RSVType(RSV_UNK=RSVuntyped)

Zerovsmissing

InERVISS,noassumptionsaremadeaboutmissingdata.Thismeansthatzerosmustbeexplicitlyreportedsince

missingvaluesarenotrecodedtozero.Forexample,inweekswheretestingwasperformedforapathogenbutall

werenegative,pleaseensurethatavalueof0isreportedforIndicator=DETECTIONStoensurethatthisisincludedinERVISSand0%positivityiscalculated.ThisrequiressubmittinganadditionalrowofdatainRESPIAGGRand

RESPISEVEREtocapturethezerodetections.

EHRdiagnosticcodes

EHRdiagnosticcodescanbereportedtoRESPICASEinthevariableEHRDiagnosticCodes.Thesecanbereportedto

indicatewhichcodesapplytoeachpatient,includingthosethatareusedtodefinetherespiratorydiagnosistomeetacasedefinitionorthatrelatetounderlyinghealthconditions,usingtheformatdescribedbelow.Thevariableisfree

text,buttoallowvalidationofthesubmittedcodespleasesubmitcodesusingthefollowingformat:CodeSystem:CodeSystemVersion:Code:Primary(P)/Secondary(S).Forexample,“ICD10:2019:J12.1:P”.

Onlyonecodeshouldbeprimary,capturingtheprincipalmedicalconditionthatpromptedtheadmission.Allothersshouldbemarkedassecondary.

IfCodeSystemVersionisnotapplicable,pleaseleavethisblank:e.g.SNOMEDCT::86406008:S.Formultiplecodes,pleaseensureeachcodeadherestothisformattingandseparatecodeswithasemi-colon“;”withinthesamecharacterstring.

Currently,codesfromthefollowingsystemswillbeaccepted:ICD9,ICD10,ICD11,SNOMED_CT,LOINCandICPC.

EpiPulseCases:ReportingProtocolforintegratedrespiratoryvirussurveillance

12

Annex3.Reportingqualitativeindicators

Qualitativeindicators(QI)provideanoverviewofthetransmissibility,severityandimpactofrespiratoryillness,

assessedusingthresholdsthatallowforthequalitativecategorisationofintensitylevels.ReportingofQItoRESPIQUALisbasedonthe

WHOPandemicInfluenzaSeverityAssessment(PISA)guide(2025)

withsomeadaptationstoallowforreportingofRSVandSARS-CoV-2.ThePISAframeworkincludesfourindicators:transmissibility,morbidityand

mortality,seriousnessofdiseaseandimpactonhealthcarecapacity.

WeprioritisethecollectionofasetofsixcoreQIforusein