Revision of clinical case definitions: influenza-like illness and severe acute respiratory infection.
Identifieur interne : 000245 ( PubMed/Checkpoint ); précédent : 000244; suivant : 000246Revision of clinical case definitions: influenza-like illness and severe acute respiratory infection.
Auteurs : Julia Fitzner [Suisse] ; Saba Qasmieh [Suisse] ; Anthony Wayne Mounts [Suisse] ; Burmaa Alexander [Mongolie] ; Terry Besselaar [Suisse] ; Sylvie Briand [Suisse] ; Caroline Brown [Danemark] ; Seth Clark [Suisse] ; Erica Dueger [Philippines] ; Diane Gross [Danemark] ; Siri Hauge [Norvège] ; Siddhivinayak Hirve [Suisse] ; Pernille Jorgensen [Danemark] ; Mark A. Katz ; Ali Mafi [Égypte] ; Mamunur Malik [Égypte] ; Margaret Mccarron ; Tamara Meerhoff [Pays-Bas] ; Yuichiro Mori [Suisse] ; Joshua Mott [Kenya] ; Maria Teresa Da Costa Olivera [Brésil] ; Justin R. Ortiz [Suisse] ; Rakhee Palekar [États-Unis] ; Helena Rebelo-De-Andrade [Portugal] ; Loes Soetens [Pays-Bas] ; Ali Ahmed Yahaya ; Wenqing Zhang [Suisse] ; Katelijn Vandemaele [Suisse]Source :
- Bulletin of the World Health Organization [ 1564-0604 ] ; 2018.
Descripteurs français
- KwdFr :
- MESH :
English descriptors
- KwdEn :
- MESH :
- diagnosis : Influenza, Human, Respiratory Tract Infections.
- virology : Respiratory Tract Infections.
- Child, Child, Preschool, Cough, Hospitalization, Humans, Infant, Influenza A Virus, H1N1 Subtype.
Abstract
The formulation of accurate clinical case definitions is an integral part of an effective process of public health surveillance. Although such definitions should, ideally, be based on a standardized and fixed collection of defining criteria, they often require revision to reflect new knowledge of the condition involved and improvements in diagnostic testing. Optimal case definitions also need to have a balance of sensitivity and specificity that reflects their intended use. After the 2009-2010 H1N1 influenza pandemic, the World Health Organization (WHO) initiated a technical consultation on global influenza surveillance. This prompted improvements in the sensitivity and specificity of the case definition for influenza - i.e. a respiratory disease that lacks uniquely defining symptomology. The revision process not only modified the definition of influenza-like illness, to include a simplified list of the criteria shown to be most predictive of influenza infection, but also clarified the language used for the definition, to enhance interpretability. To capture severe cases of influenza that required hospitalization, a new case definition was also developed for severe acute respiratory infection in all age groups. The new definitions have been found to capture more cases without compromising specificity. Despite the challenge still posed in the clinical separation of influenza from other respiratory infections, the global use of the new WHO case definitions should help determine global trends in the characteristics and transmission of influenza viruses and the associated disease burden.
DOI: 10.2471/BLT.17.194514
PubMed: 29403115
Affiliations:
- Brésil, Danemark, Kenya, Mongolie, Norvège, Pays-Bas, Philippines, Portugal, Suisse, Égypte, États-Unis
- Gueldre, Hovedstaden, Minas Gerais, Washington (État), Østlandet
- Belo Horizonte, Copenhague, Nimègue, Oslo
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Katelijn" sort="Vandemaele, Katelijn" uniqKey="Vandemaele K" first="Katelijn" last="Vandemaele">Katelijn Vandemaele</name><affiliation wicri:level="1"><nlm:affiliation>Infectious Hazard Management, World Health Organization, avenue Appia 20, 1211 Geneva 27, Switzerland.</nlm:affiliation><country xml:lang="fr">Suisse</country><wicri:regionArea>Infectious Hazard Management, World Health Organization, avenue Appia 20, 1211 Geneva 27</wicri:regionArea><wicri:noRegion>1211 Geneva 27</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2018">2018</date><idno type="RBID">pubmed:29403115</idno><idno type="pmid">29403115</idno><idno type="doi">10.2471/BLT.17.194514</idno><idno type="wicri:Area/PubMed/Corpus">000327</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">000327</idno><idno type="wicri:Area/PubMed/Curation">000327</idno><idno type="wicri:explorRef" wicri:stream="PubMed" 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last="Qasmieh">Saba Qasmieh</name><affiliation wicri:level="1"><nlm:affiliation>Infectious Hazard Management, World Health Organization, avenue Appia 20, 1211 Geneva 27, Switzerland.</nlm:affiliation><country xml:lang="fr">Suisse</country><wicri:regionArea>Infectious Hazard Management, World Health Organization, avenue Appia 20, 1211 Geneva 27</wicri:regionArea><wicri:noRegion>1211 Geneva 27</wicri:noRegion></affiliation></author><author><name sortKey="Mounts, Anthony Wayne" sort="Mounts, Anthony Wayne" uniqKey="Mounts A" first="Anthony Wayne" last="Mounts">Anthony Wayne Mounts</name><affiliation wicri:level="1"><nlm:affiliation>Infectious Hazard Management, World Health Organization, avenue Appia 20, 1211 Geneva 27, Switzerland.</nlm:affiliation><country xml:lang="fr">Suisse</country><wicri:regionArea>Infectious Hazard Management, World Health Organization, avenue Appia 20, 1211 Geneva 27</wicri:regionArea><wicri:noRegion>1211 Geneva 27</wicri:noRegion></affiliation></author><author><name sortKey="Alexander, Burmaa" sort="Alexander, Burmaa" uniqKey="Alexander B" first="Burmaa" last="Alexander">Burmaa Alexander</name><affiliation wicri:level="1"><nlm:affiliation>National Centre for Communicable Diseases, Ulaanbataar, Mongolia.</nlm:affiliation><country xml:lang="fr">Mongolie</country><wicri:regionArea>National Centre for Communicable Diseases, Ulaanbataar</wicri:regionArea><wicri:noRegion>Ulaanbataar</wicri:noRegion></affiliation></author><author><name sortKey="Besselaar, Terry" sort="Besselaar, Terry" uniqKey="Besselaar T" first="Terry" last="Besselaar">Terry Besselaar</name><affiliation wicri:level="1"><nlm:affiliation>Infectious Hazard Management, World Health Organization, avenue Appia 20, 1211 Geneva 27, Switzerland.</nlm:affiliation><country xml:lang="fr">Suisse</country><wicri:regionArea>Infectious Hazard Management, World Health Organization, avenue Appia 20, 1211 Geneva 27</wicri:regionArea><wicri:noRegion>1211 Geneva 27</wicri:noRegion></affiliation></author><author><name sortKey="Briand, Sylvie" sort="Briand, Sylvie" uniqKey="Briand S" first="Sylvie" last="Briand">Sylvie Briand</name><affiliation wicri:level="1"><nlm:affiliation>Infectious Hazard Management, World Health Organization, avenue Appia 20, 1211 Geneva 27, Switzerland.</nlm:affiliation><country xml:lang="fr">Suisse</country><wicri:regionArea>Infectious Hazard Management, World Health Organization, avenue Appia 20, 1211 Geneva 27</wicri:regionArea><wicri:noRegion>1211 Geneva 27</wicri:noRegion></affiliation></author><author><name sortKey="Brown, Caroline" sort="Brown, Caroline" uniqKey="Brown C" first="Caroline" last="Brown">Caroline Brown</name><affiliation wicri:level="3"><nlm:affiliation>Regional Office for Europe, World Health Organization, Copenhagen, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Regional Office for Europe, World Health Organization, Copenhagen</wicri:regionArea><placeName><settlement type="city">Copenhague</settlement><region type="région" nuts="2">Hovedstaden</region></placeName></affiliation></author><author><name sortKey="Clark, Seth" sort="Clark, Seth" uniqKey="Clark S" first="Seth" last="Clark">Seth Clark</name><affiliation wicri:level="1"><nlm:affiliation>Infectious Hazard Management, World Health Organization, avenue Appia 20, 1211 Geneva 27, Switzerland.</nlm:affiliation><country xml:lang="fr">Suisse</country><wicri:regionArea>Infectious Hazard Management, World Health Organization, avenue Appia 20, 1211 Geneva 27</wicri:regionArea><wicri:noRegion>1211 Geneva 27</wicri:noRegion></affiliation></author><author><name sortKey="Dueger, Erica" sort="Dueger, Erica" uniqKey="Dueger E" first="Erica" last="Dueger">Erica Dueger</name><affiliation wicri:level="1"><nlm:affiliation>Western Pacific Regional Office, World Health Organization, Manila, Philippines.</nlm:affiliation><country xml:lang="fr">Philippines</country><wicri:regionArea>Western Pacific Regional Office, World Health Organization, Manila</wicri:regionArea><wicri:noRegion>Manila</wicri:noRegion></affiliation></author><author><name sortKey="Gross, Diane" sort="Gross, Diane" uniqKey="Gross D" first="Diane" last="Gross">Diane Gross</name><affiliation wicri:level="3"><nlm:affiliation>Regional Office for Europe, World Health Organization, Copenhagen, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Regional Office for Europe, World Health Organization, Copenhagen</wicri:regionArea><placeName><settlement type="city">Copenhague</settlement><region type="région" nuts="2">Hovedstaden</region></placeName></affiliation></author><author><name sortKey="Hauge, Siri" sort="Hauge, Siri" uniqKey="Hauge S" first="Siri" last="Hauge">Siri Hauge</name><affiliation wicri:level="3"><nlm:affiliation>Department of Infectious Disease Epidemiology, Norwegian Institute of Public Health, Oslo, Norway.</nlm:affiliation><country xml:lang="fr">Norvège</country><wicri:regionArea>Department of Infectious Disease Epidemiology, Norwegian Institute of Public Health, Oslo</wicri:regionArea><placeName><settlement type="city">Oslo</settlement><region nuts="2">Østlandet</region></placeName></affiliation></author><author><name sortKey="Hirve, Siddhivinayak" sort="Hirve, Siddhivinayak" uniqKey="Hirve S" first="Siddhivinayak" last="Hirve">Siddhivinayak Hirve</name><affiliation wicri:level="1"><nlm:affiliation>Infectious Hazard Management, World Health Organization, avenue Appia 20, 1211 Geneva 27, Switzerland.</nlm:affiliation><country xml:lang="fr">Suisse</country><wicri:regionArea>Infectious Hazard Management, World Health Organization, avenue Appia 20, 1211 Geneva 27</wicri:regionArea><wicri:noRegion>1211 Geneva 27</wicri:noRegion></affiliation></author><author><name sortKey="Jorgensen, Pernille" sort="Jorgensen, Pernille" uniqKey="Jorgensen P" first="Pernille" last="Jorgensen">Pernille Jorgensen</name><affiliation wicri:level="3"><nlm:affiliation>Regional Office for Europe, World Health Organization, Copenhagen, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Regional Office for Europe, World Health Organization, Copenhagen</wicri:regionArea><placeName><settlement type="city">Copenhague</settlement><region type="région" nuts="2">Hovedstaden</region></placeName></affiliation></author><author><name sortKey="Katz, Mark A" sort="Katz, Mark A" uniqKey="Katz M" first="Mark A" last="Katz">Mark A. Katz</name><affiliation><nlm:affiliation>Centers for Disease Control and Prevention, Atlanta, United States of America (USA).</nlm:affiliation><wicri:noCountry code="subField">United States of America (USA)</wicri:noCountry></affiliation></author><author><name sortKey="Mafi, Ali" sort="Mafi, Ali" uniqKey="Mafi A" first="Ali" last="Mafi">Ali Mafi</name><affiliation wicri:level="1"><nlm:affiliation>Eastern Mediterranean Regional Office, World Health Organization, Cairo, Egypt.</nlm:affiliation><country xml:lang="fr">Égypte</country><wicri:regionArea>Eastern Mediterranean Regional Office, World Health Organization, Cairo</wicri:regionArea><wicri:noRegion>Cairo</wicri:noRegion></affiliation></author><author><name sortKey="Malik, Mamunur" sort="Malik, Mamunur" uniqKey="Malik M" first="Mamunur" last="Malik">Mamunur Malik</name><affiliation wicri:level="1"><nlm:affiliation>Eastern Mediterranean Regional Office, World Health Organization, Cairo, Egypt.</nlm:affiliation><country xml:lang="fr">Égypte</country><wicri:regionArea>Eastern Mediterranean Regional Office, World Health Organization, Cairo</wicri:regionArea><wicri:noRegion>Cairo</wicri:noRegion></affiliation></author><author><name sortKey="Mccarron, Margaret" sort="Mccarron, Margaret" uniqKey="Mccarron M" first="Margaret" last="Mccarron">Margaret Mccarron</name><affiliation><nlm:affiliation>Centers for Disease Control and Prevention, Atlanta, United States of America (USA).</nlm:affiliation><wicri:noCountry code="subField">United States of America (USA)</wicri:noCountry></affiliation></author><author><name sortKey="Meerhoff, Tamara" sort="Meerhoff, Tamara" uniqKey="Meerhoff T" first="Tamara" last="Meerhoff">Tamara Meerhoff</name><affiliation wicri:level="3"><nlm:affiliation>Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, Netherlands.</nlm:affiliation><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Primary and Community Care, Radboud University Medical Center, Nijmegen</wicri:regionArea><placeName><settlement type="city">Nimègue</settlement><region type="province" nuts="2">Gueldre</region></placeName></affiliation></author><author><name sortKey="Mori, Yuichiro" sort="Mori, Yuichiro" uniqKey="Mori Y" first="Yuichiro" last="Mori">Yuichiro Mori</name><affiliation wicri:level="1"><nlm:affiliation>Infectious Hazard Management, World Health Organization, avenue Appia 20, 1211 Geneva 27, Switzerland.</nlm:affiliation><country xml:lang="fr">Suisse</country><wicri:regionArea>Infectious Hazard Management, World Health Organization, avenue Appia 20, 1211 Geneva 27</wicri:regionArea><wicri:noRegion>1211 Geneva 27</wicri:noRegion></affiliation></author><author><name sortKey="Mott, Joshua" sort="Mott, Joshua" uniqKey="Mott J" first="Joshua" last="Mott">Joshua Mott</name><affiliation wicri:level="1"><nlm:affiliation>United States Centers for Disease Control and Prevention Kenya Office, Nairobi, Kenya.</nlm:affiliation><country xml:lang="fr">Kenya</country><wicri:regionArea>United States Centers for Disease Control and Prevention Kenya Office, Nairobi</wicri:regionArea><wicri:noRegion>Nairobi</wicri:noRegion></affiliation></author><author><name sortKey="Olivera, Maria Teresa Da Costa" sort="Olivera, Maria Teresa Da Costa" uniqKey="Olivera M" first="Maria Teresa Da Costa" last="Olivera">Maria Teresa Da Costa Olivera</name><affiliation wicri:level="3"><nlm:affiliation>Municipal Health Secretariat, Belo Horizonte, Brazil.</nlm:affiliation><country xml:lang="fr">Brésil</country><wicri:regionArea>Municipal Health Secretariat, Belo Horizonte</wicri:regionArea><placeName><settlement type="city">Belo Horizonte</settlement><region type="state">Minas Gerais</region></placeName></affiliation></author><author><name sortKey="Ortiz, Justin R" sort="Ortiz, Justin R" uniqKey="Ortiz J" first="Justin R" last="Ortiz">Justin R. Ortiz</name><affiliation wicri:level="1"><nlm:affiliation>Infectious Hazard Management, World Health Organization, avenue Appia 20, 1211 Geneva 27, Switzerland.</nlm:affiliation><country xml:lang="fr">Suisse</country><wicri:regionArea>Infectious Hazard Management, World Health Organization, avenue Appia 20, 1211 Geneva 27</wicri:regionArea><wicri:noRegion>1211 Geneva 27</wicri:noRegion></affiliation></author><author><name sortKey="Palekar, Rakhee" sort="Palekar, Rakhee" uniqKey="Palekar R" first="Rakhee" last="Palekar">Rakhee Palekar</name><affiliation wicri:level="2"><nlm:affiliation>Pan American Health Organization, World Health Organization, Washington, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Pan American Health Organization, World Health Organization, Washington</wicri:regionArea><placeName><region type="state">Washington (État)</region></placeName></affiliation></author><author><name sortKey="Rebelo De Andrade, Helena" sort="Rebelo De Andrade, Helena" uniqKey="Rebelo De Andrade H" first="Helena" last="Rebelo-De-Andrade">Helena Rebelo-De-Andrade</name><affiliation wicri:level="1"><nlm:affiliation>Department of Infectious Diseases, National Institute of Health, Lisbon, Portugal.</nlm:affiliation><country xml:lang="fr">Portugal</country><wicri:regionArea>Department of Infectious Diseases, National Institute of Health, Lisbon</wicri:regionArea><wicri:noRegion>Lisbon</wicri:noRegion></affiliation></author><author><name sortKey="Soetens, Loes" sort="Soetens, Loes" uniqKey="Soetens L" first="Loes" last="Soetens">Loes Soetens</name><affiliation wicri:level="1"><nlm:affiliation>Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, Netherlands.</nlm:affiliation><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven</wicri:regionArea><wicri:noRegion>Bilthoven</wicri:noRegion></affiliation></author><author><name sortKey="Yahaya, Ali Ahmed" sort="Yahaya, Ali Ahmed" uniqKey="Yahaya A" first="Ali Ahmed" last="Yahaya">Ali Ahmed Yahaya</name><affiliation><nlm:affiliation>Regional Office for Africa, World Health Organization, Brazzaville, Congo.</nlm:affiliation><wicri:noCountry code="subField">Congo</wicri:noCountry></affiliation></author><author><name sortKey="Zhang, Wenqing" sort="Zhang, Wenqing" uniqKey="Zhang W" first="Wenqing" last="Zhang">Wenqing Zhang</name><affiliation wicri:level="1"><nlm:affiliation>Infectious Hazard Management, World Health Organization, avenue Appia 20, 1211 Geneva 27, Switzerland.</nlm:affiliation><country xml:lang="fr">Suisse</country><wicri:regionArea>Infectious Hazard Management, World Health Organization, avenue Appia 20, 1211 Geneva 27</wicri:regionArea><wicri:noRegion>1211 Geneva 27</wicri:noRegion></affiliation></author><author><name sortKey="Vandemaele, Katelijn" sort="Vandemaele, Katelijn" uniqKey="Vandemaele K" first="Katelijn" last="Vandemaele">Katelijn Vandemaele</name><affiliation wicri:level="1"><nlm:affiliation>Infectious Hazard Management, World Health Organization, avenue Appia 20, 1211 Geneva 27, Switzerland.</nlm:affiliation><country xml:lang="fr">Suisse</country><wicri:regionArea>Infectious Hazard Management, World Health Organization, avenue Appia 20, 1211 Geneva 27</wicri:regionArea><wicri:noRegion>1211 Geneva 27</wicri:noRegion></affiliation></author></analytic><series><title level="j">Bulletin of the World Health Organization</title><idno type="eISSN">1564-0604</idno><imprint><date when="2018" type="published">2018</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Child</term><term>Child, Preschool</term><term>Cough</term><term>Hospitalization</term><term>Humans</term><term>Infant</term><term>Influenza A Virus, H1N1 Subtype</term><term>Influenza, Human (diagnosis)</term><term>Respiratory Tract Infections (diagnosis)</term><term>Respiratory Tract Infections (virology)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Enfant</term><term>Enfant d'âge préscolaire</term><term>Grippe humaine (diagnostic)</term><term>Hospitalisation</term><term>Humains</term><term>Infections de l'appareil respiratoire (diagnostic)</term><term>Infections de l'appareil respiratoire (virologie)</term><term>Nourrisson</term><term>Sous-type H1N1 du virus de la grippe A</term><term>Toux</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Influenza, Human</term><term>Respiratory Tract Infections</term></keywords><keywords scheme="MESH" qualifier="diagnostic" xml:lang="fr"><term>Grippe humaine</term><term>Infections de l'appareil respiratoire</term></keywords><keywords scheme="MESH" qualifier="virologie" xml:lang="fr"><term>Infections de l'appareil respiratoire</term></keywords><keywords scheme="MESH" qualifier="virology" xml:lang="en"><term>Respiratory Tract Infections</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Child</term><term>Child, Preschool</term><term>Cough</term><term>Hospitalization</term><term>Humans</term><term>Infant</term><term>Influenza A Virus, H1N1 Subtype</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Enfant</term><term>Enfant d'âge préscolaire</term><term>Hospitalisation</term><term>Humains</term><term>Nourrisson</term><term>Sous-type H1N1 du virus de la grippe A</term><term>Toux</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The formulation of accurate clinical case definitions is an integral part of an effective process of public health surveillance. Although such definitions should, ideally, be based on a standardized and fixed collection of defining criteria, they often require revision to reflect new knowledge of the condition involved and improvements in diagnostic testing. Optimal case definitions also need to have a balance of sensitivity and specificity that reflects their intended use. After the 2009-2010 H1N1 influenza pandemic, the World Health Organization (WHO) initiated a technical consultation on global influenza surveillance. This prompted improvements in the sensitivity and specificity of the case definition for influenza - i.e. a respiratory disease that lacks uniquely defining symptomology. The revision process not only modified the definition of influenza-like illness, to include a simplified list of the criteria shown to be most predictive of influenza infection, but also clarified the language used for the definition, to enhance interpretability. To capture severe cases of influenza that required hospitalization, a new case definition was also developed for severe acute respiratory infection in all age groups. The new definitions have been found to capture more cases without compromising specificity. Despite the challenge still posed in the clinical separation of influenza from other respiratory infections, the global use of the new WHO case definitions should help determine global trends in the characteristics and transmission of influenza viruses and the associated disease burden.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" IndexingMethod="Curated" Owner="NLM"><PMID Version="1">29403115</PMID><DateCompleted><Year>2019</Year><Month>01</Month><Day>14</Day></DateCompleted><DateRevised><Year>2019</Year><Month>01</Month><Day>14</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1564-0604</ISSN><JournalIssue CitedMedium="Internet"><Volume>96</Volume><Issue>2</Issue><PubDate><Year>2018</Year><Month>Feb</Month><Day>01</Day></PubDate></JournalIssue><Title>Bulletin of the World Health Organization</Title><ISOAbbreviation>Bull. World Health Organ.</ISOAbbreviation></Journal><ArticleTitle>Revision of clinical case definitions: influenza-like illness and severe acute respiratory infection.</ArticleTitle><Pagination><MedlinePgn>122-128</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.2471/BLT.17.194514</ELocationID><Abstract><AbstractText>The formulation of accurate clinical case definitions is an integral part of an effective process of public health surveillance. Although such definitions should, ideally, be based on a standardized and fixed collection of defining criteria, they often require revision to reflect new knowledge of the condition involved and improvements in diagnostic testing. Optimal case definitions also need to have a balance of sensitivity and specificity that reflects their intended use. After the 2009-2010 H1N1 influenza pandemic, the World Health Organization (WHO) initiated a technical consultation on global influenza surveillance. This prompted improvements in the sensitivity and specificity of the case definition for influenza - i.e. a respiratory disease that lacks uniquely defining symptomology. The revision process not only modified the definition of influenza-like illness, to include a simplified list of the criteria shown to be most predictive of influenza infection, but also clarified the language used for the definition, to enhance interpretability. To capture severe cases of influenza that required hospitalization, a new case definition was also developed for severe acute respiratory infection in all age groups. The new definitions have been found to capture more cases without compromising specificity. Despite the challenge still posed in the clinical separation of influenza from other respiratory infections, the global use of the new WHO case definitions should help determine global trends in the characteristics and transmission of influenza viruses and the associated disease burden.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Fitzner</LastName><ForeName>Julia</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Infectious Hazard Management, World Health Organization, avenue Appia 20, 1211 Geneva 27, Switzerland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Qasmieh</LastName><ForeName>Saba</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Infectious Hazard Management, World Health Organization, avenue Appia 20, 1211 Geneva 27, Switzerland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Mounts</LastName><ForeName>Anthony Wayne</ForeName><Initials>AW</Initials><AffiliationInfo><Affiliation>Infectious Hazard Management, World Health Organization, avenue Appia 20, 1211 Geneva 27, Switzerland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Alexander</LastName><ForeName>Burmaa</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>National Centre for Communicable Diseases, Ulaanbataar, Mongolia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Besselaar</LastName><ForeName>Terry</ForeName><Initials>T</Initials><AffiliationInfo><Affiliation>Infectious Hazard Management, World Health Organization, avenue Appia 20, 1211 Geneva 27, Switzerland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Briand</LastName><ForeName>Sylvie</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Infectious Hazard Management, World Health Organization, avenue Appia 20, 1211 Geneva 27, Switzerland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Brown</LastName><ForeName>Caroline</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Regional Office for Europe, World Health Organization, Copenhagen, Denmark.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Clark</LastName><ForeName>Seth</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Infectious Hazard Management, World Health Organization, avenue Appia 20, 1211 Geneva 27, Switzerland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Dueger</LastName><ForeName>Erica</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>Western Pacific Regional Office, World Health Organization, Manila, Philippines.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Gross</LastName><ForeName>Diane</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>Regional Office for Europe, World Health Organization, Copenhagen, Denmark.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Hauge</LastName><ForeName>Siri</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Department of Infectious Disease Epidemiology, Norwegian Institute of Public Health, Oslo, Norway.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Hirve</LastName><ForeName>Siddhivinayak</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Infectious Hazard Management, World Health Organization, avenue Appia 20, 1211 Geneva 27, Switzerland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Jorgensen</LastName><ForeName>Pernille</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Regional Office for Europe, World Health Organization, Copenhagen, Denmark.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Katz</LastName><ForeName>Mark A</ForeName><Initials>MA</Initials><AffiliationInfo><Affiliation>Centers for Disease Control and Prevention, Atlanta, United States of America (USA).</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Mafi</LastName><ForeName>Ali</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Eastern Mediterranean Regional Office, World Health Organization, Cairo, Egypt.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Malik</LastName><ForeName>Mamunur</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Eastern Mediterranean Regional Office, World Health Organization, Cairo, Egypt.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>McCarron</LastName><ForeName>Margaret</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Centers for Disease Control and Prevention, Atlanta, United States of America (USA).</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Meerhoff</LastName><ForeName>Tamara</ForeName><Initials>T</Initials><AffiliationInfo><Affiliation>Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, Netherlands.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Mori</LastName><ForeName>Yuichiro</ForeName><Initials>Y</Initials><AffiliationInfo><Affiliation>Infectious Hazard Management, World Health Organization, avenue Appia 20, 1211 Geneva 27, Switzerland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Mott</LastName><ForeName>Joshua</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>United States Centers for Disease Control and Prevention Kenya Office, Nairobi, Kenya.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Olivera</LastName><ForeName>Maria Teresa da Costa</ForeName><Initials>MTDC</Initials><AffiliationInfo><Affiliation>Municipal Health Secretariat, Belo Horizonte, Brazil.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ortiz</LastName><ForeName>Justin R</ForeName><Initials>JR</Initials><AffiliationInfo><Affiliation>Infectious Hazard Management, World Health Organization, avenue Appia 20, 1211 Geneva 27, Switzerland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Palekar</LastName><ForeName>Rakhee</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Pan American Health Organization, World Health Organization, Washington, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Rebelo-de-Andrade</LastName><ForeName>Helena</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>Department of Infectious Diseases, National Institute of Health, Lisbon, Portugal.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Soetens</LastName><ForeName>Loes</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, Netherlands.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Yahaya</LastName><ForeName>Ali Ahmed</ForeName><Initials>AA</Initials><AffiliationInfo><Affiliation>Regional Office for Africa, World Health Organization, Brazzaville, Congo.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Zhang</LastName><ForeName>Wenqing</ForeName><Initials>W</Initials><AffiliationInfo><Affiliation>Infectious Hazard Management, World Health Organization, avenue Appia 20, 1211 Geneva 27, Switzerland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Vandemaele</LastName><ForeName>Katelijn</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>Infectious Hazard Management, World Health Organization, avenue Appia 20, 1211 Geneva 27, Switzerland.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><GrantList CompleteYN="Y"><Grant><GrantID>001</GrantID><Agency>World Health Organization</Agency><Country>International</Country></Grant></GrantList><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2017</Year><Month>11</Month><Day>27</Day></ArticleDate></Article><MedlineJournalInfo><Country>Switzerland</Country><MedlineTA>Bull World Health Organ</MedlineTA><NlmUniqueID>7507052</NlmUniqueID><ISSNLinking>0042-9686</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D002648" MajorTopicYN="N">Child</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D002675" MajorTopicYN="N">Child, Preschool</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D003371" MajorTopicYN="N">Cough</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006760" MajorTopicYN="N">Hospitalization</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007223" MajorTopicYN="N">Infant</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D053118" MajorTopicYN="N">Influenza A Virus, H1N1 Subtype</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007251" MajorTopicYN="N">Influenza, Human</DescriptorName><QualifierName UI="Q000175" MajorTopicYN="Y">diagnosis</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012141" MajorTopicYN="N">Respiratory Tract Infections</DescriptorName><QualifierName UI="Q000175" MajorTopicYN="Y">diagnosis</QualifierName><QualifierName UI="Q000821" MajorTopicYN="N">virology</QualifierName></MeshHeading></MeshHeadingList><OtherAbstract Type="Publisher" Language="fre"><AbstractText>La formulation de définitions précises de cas cliniques fait partie intégrante d'un processus efficace de surveillance de la santé publique. Alors que ces définitions devraient, dans l'idéal, s'appuyer sur un ensemble standardisé et fixe de critères de définition, elles nécessitent souvent une révision pour tenir compte des nouvelles connaissances relatives à la maladie concernée et des améliorations apportées aux tests diagnostiques. Pour être optimales, les définitions de cas doivent aussi établir un équilibre entre sensibilité et spécificité qui reflète leur utilisation aux fins prévues. À la suite de la pandémie de grippe H1N1 de 2009-2010, l'Organisation mondiale de la Santé (OMS) a lancé une consultation technique sur la surveillance mondiale de la grippe. Cela a conduit à des améliorations concernant la sensibilité et la spécificité de la définition de cas pour la grippe – c'est-à-dire une maladie respiratoire dont seule la symptomatologie reste à définir. Le processus de révision n'a pas seulement modifié la définition du syndrome de type grippal pour inclure une liste simplifiée des critères le mieux à même de prédire une infection grippale, il a également permis de clarifier le langage utilisé dans la définition pour en améliorer l'interprétation. Par ailleurs, afin de tenir compte des cas sévères de grippe qui nécessitaient une hospitalisation, une nouvelle définition de cas a été introduite concernant l'infection aigüe sévère des voies respiratoires dans tous les groupes d'âge. Il a été constaté que les nouvelles définitions reflétaient davantage de cas, sans pour autant compromettre la spécificité. S'il est vrai que la distinction clinique de la grippe des autres infections respiratoires continue de poser problème, l'utilisation mondiale des nouvelles définitions de cas de l'OMS devrait permettre de dégager des tendances mondiales concernant les caractéristiques et la transmission des virus grippaux ainsi que la charge de morbidité qui leur est associée.</AbstractText></OtherAbstract><OtherAbstract Type="Publisher" Language="spa"><AbstractText>La elaboración de definiciones precisas de los casos clínicos es una parte fundamental de un proceso efectivo de la vigilancia de la salud pública. Aunque tales definiciones deberían, idealmente, estar basadas en una recopilación estandarizada y fija de criterios de definición, a menudo necesitan una revisión para reflejar el nuevo conocimiento de la enfermedad existente y las mejoras en las pruebas de diagnóstico. Las definiciones óptimas de los casos también deben tener un equilibrio entre sensibilidad y especificidad que refleje su uso previsto. Después de la pandemia de gripe H1N1 en 2009-2010, la Organización Mundial de la Salud (OMS) inició una consulta técnica para la vigilancia mundial de la gripe. Esto dio lugar a mejoras en la sensibilidad y la especificidad de las definiciones de los casos de gripe, es decir, una enfermedad respiratoria que carece de una sintomatología definitoria singular. El proceso de revisión no solo modificó la definición de las enfermedades similares a la gripe para incluir una lista simplificada de los criterios que demostraron ser más predictivos de la infección por gripe, sino que también aclaró el lenguaje utilizado para la definición, con el fin de mejorar su interpretación. Para englobar los casos graves de gripe que requirieron hospitalización, también se desarrolló una nueva definición de los casos de la infección respiratoria aguda grave en todos los grupos de edad. Se ha descubierto que las nuevas definiciones engloban más casos sin comprometer la especificidad. A pesar del desafío que todavía plantea la separación clínica de la gripe de otras infecciones respiratorias, el uso global de las nuevas definiciones de los casos de la OMS debería ayudar a determinar las tendencias mundiales en las características y transmisión de los virus de la gripe y la carga de la enfermedad asociada.</AbstractText></OtherAbstract><OtherAbstract Type="Publisher" Language="ara"><AbstractText>إن صياغة تعريفات دقيقة للحالات من الناحية العلاجية جزء أساسي من الإجراءات الفعالة لمراقبة الصحة العامة. وبالرغم من أن مثل هذه التعريفات يجب، من الناحية النظرية، أن تقوم على مجموعة منتقاة من المعايير التعريفية الموحدة والثابتة، فغالبًا ما تحتاج تلك التعريفات إلى المراجعة لكي تعكس المعلومات التي تستجد بشأن الحالة المرتبطة بها والتطورات التي تشهدها الاختبارات التشخيصية. وتحتاج أيضًا التعريفات المثالية للحالات إلى الموازنة بين الحساسية والنوعية بما يتفق مع الاستخدام المزمع. وبعد تفشي فيروس الأنفلونزا <b>H1N1</b> في الفترة ما بين عامي 2009 و2010، بدأت منظمة الصحة العالمية في تقديم المشاورة التقنية بشأن مراقبة الأنفلونزا على المستوى العالمي. وقد شجع ذلك على تحسين الحساسية والنوعية المرتبطة بتعريف حالة الأنفلونزا - بعبارة أخرى، مرض يصيب الجهاز التنفسي يفتقر إلى مجموعة أعراض فريدة تعرّف المرض. وأدت إجراءات المراجعة إلى تعديل تعريف ذلك المرض المشابه للأنفلونزا، إذ شمل التعريف قائمة مبسطة من المعايير التي تبين أنها الأفضل للتنبؤ بعدوى الأنفلونزا، ولم تقتصر النتائج على ذلك فحسب، بل نتج أيضًا عن تلك الإجراءات استخدام لغة أكثر وضوحًا في التعريف، لتحسين القدرة على التأويل. ولتحقيق الدقة في رصد الحالات الحرجة للأنفلونزا والتي تتطلب الإقامة بالمستشفى، تم أيضًا وضع تعريف جديد لحالة العدوى التنفسية الحادة والحرجة لجميع الفئات العمرية. وتبين أن التعريفات الجديدة ترصد بدقة مزيدًا من الحالات دون الإخلال بالنوعية. وبالرغم من أن التحدي لا يزال قائمًا عند التمييز من الناحية العلاجية بين الأنفلونزا وغيرها من أنواع عدوى الجهاز التنفسي، من المفترض أن يساعد الاستخدام العالمي لما توصلت إليه منظمة الصحة العالمية من تعريفات جديدة للحالة على تحديد الاتجاهات العامة فيما يتعلق بخصائص فيروسات الأنفلونزا وطرق انتقال العدوى بها وكذلك عبء المرض المرتبط بها.</AbstractText></OtherAbstract><OtherAbstract Type="Publisher" Language="chi"><AbstractText>准确制定临床病例定义是进行有效公共卫生监督进程中的一个组成部分。虽然理论上此类定义应该以标准化和固定收集的定义标准为基础，但是这些定义通常需要进行修订，以反映所涉及的新症状知识，以及诊断测试的进展。最佳病例定义还需要达到反映其预期用途敏感性与特异性的平衡。2009–2010 年 H1N1 流感大流行之后，世界卫生组织发起了一项有关全球流感监测的技术咨询。该咨询提出改进流感定义的敏感性与特异性，即呼吸道疾病缺乏独特定义的症状。修订过程不仅修改流感样疾病定义，以纳入显示最能预测流感病毒感染的简化标准列表，同时明确了定义使用的语言，以增强解释力。为了获取需要住院治疗的严重流感病例，同时为所有年龄段的严重急性呼吸道感染制定了新的病例定义。目前已经发现新定义能够囊括更多案例，并且不会影响特异性。尽管在临床上将流感与其他呼吸道感染区分开来仍然面临挑战，但是统一使用世界卫生组织的新病例定义有助于确定全球流感病毒的特征和传播趋势以及相关的疾病负担。.</AbstractText></OtherAbstract><OtherAbstract Type="Publisher" Language="rus"><AbstractText>Формулировка точных определений клинических случаев является неотъемлемой частью эффективного эпиднадзора. Хотя в идеале такие определения должны основываться на стандартизованном и фиксированном наборе определяющих критериев, они часто требуют пересмотра с учетом новых знаний об этих состояниях и улучшениях в диагностическом тестировании. Оптимальные определения случаев также должны иметь баланс чувствительности и специфичности, который отражает их целевое назначение. После пандемии гриппа H1N1 в 2009–2010 годах Всемирная организация здравоохранения (ВОЗ) инициировала техническую консультацию по глобальному эпиднадзору за гриппом. Это привело к улучшению чувствительности и специфичности определения для гриппа, то есть респираторного заболевания, которое не имеет однозначной определяющей симптоматики. Пересмотр привел не только к изменению определения гриппоподобного заболевания, включив в него упрощенный список критериев, показавших, что гриппозная инфекция является наиболее прогностической, но и для улучшения интерпретируемости был сделан более понятным язык, используемый для этого определения. Для выявления тяжелых случаев гриппа, требующих госпитализации, было разработано новое определение для тяжелой острой респираторной инфекции во всех возрастных группах. Было обнаружено, что новые определения охватывают больше случаев без ущерба для специфичности. Несмотря на сложности, которые все еще возникают при дифференциации гриппа от других респираторных инфекций, глобальное использование новых определений ВОЗ должно помочь выявить всеобщие тенденции в характеристиках и передаче вируса гриппа, а также в связанном с ними бремени болезней.</AbstractText></OtherAbstract></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2017</Year><Month>03</Month><Day>28</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2017</Year><Month>10</Month><Day>30</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2017</Year><Month>10</Month><Day>30</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2018</Year><Month>2</Month><Day>7</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2018</Year><Month>2</Month><Day>7</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate 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IdType="pubmed">21054897</ArticleId></ArticleIdList></Reference></ReferenceList></PubmedData></pubmed><affiliations><list><country><li>Brésil</li><li>Danemark</li><li>Kenya</li><li>Mongolie</li><li>Norvège</li><li>Pays-Bas</li><li>Philippines</li><li>Portugal</li><li>Suisse</li><li>Égypte</li><li>États-Unis</li></country><region><li>Gueldre</li><li>Hovedstaden</li><li>Minas Gerais</li><li>Washington (État)</li><li>Østlandet</li></region><settlement><li>Belo Horizonte</li><li>Copenhague</li><li>Nimègue</li><li>Oslo</li></settlement></list><tree><noCountry><name sortKey="Katz, Mark A" sort="Katz, Mark A" uniqKey="Katz M" first="Mark A" last="Katz">Mark A. Katz</name><name sortKey="Mccarron, Margaret" sort="Mccarron, Margaret" uniqKey="Mccarron M" first="Margaret" last="Mccarron">Margaret Mccarron</name><name sortKey="Yahaya, Ali Ahmed" sort="Yahaya, Ali Ahmed" uniqKey="Yahaya A" first="Ali Ahmed" last="Yahaya">Ali Ahmed Yahaya</name></noCountry><country name="Suisse"><noRegion><name sortKey="Fitzner, Julia" sort="Fitzner, Julia" uniqKey="Fitzner J" first="Julia" last="Fitzner">Julia Fitzner</name></noRegion><name sortKey="Besselaar, Terry" sort="Besselaar, Terry" uniqKey="Besselaar T" first="Terry" last="Besselaar">Terry Besselaar</name><name sortKey="Briand, Sylvie" sort="Briand, Sylvie" uniqKey="Briand S" first="Sylvie" last="Briand">Sylvie Briand</name><name sortKey="Clark, Seth" sort="Clark, Seth" uniqKey="Clark S" first="Seth" last="Clark">Seth Clark</name><name sortKey="Hirve, Siddhivinayak" sort="Hirve, Siddhivinayak" uniqKey="Hirve S" first="Siddhivinayak" last="Hirve">Siddhivinayak Hirve</name><name sortKey="Mori, Yuichiro" sort="Mori, Yuichiro" uniqKey="Mori Y" first="Yuichiro" last="Mori">Yuichiro Mori</name><name sortKey="Mounts, Anthony Wayne" sort="Mounts, Anthony Wayne" uniqKey="Mounts A" first="Anthony Wayne" last="Mounts">Anthony Wayne Mounts</name><name sortKey="Ortiz, Justin R" sort="Ortiz, Justin R" uniqKey="Ortiz J" first="Justin R" last="Ortiz">Justin R. Ortiz</name><name sortKey="Qasmieh, Saba" sort="Qasmieh, Saba" uniqKey="Qasmieh S" first="Saba" last="Qasmieh">Saba Qasmieh</name><name sortKey="Vandemaele, Katelijn" sort="Vandemaele, Katelijn" uniqKey="Vandemaele K" first="Katelijn" last="Vandemaele">Katelijn Vandemaele</name><name sortKey="Zhang, Wenqing" sort="Zhang, Wenqing" uniqKey="Zhang W" first="Wenqing" last="Zhang">Wenqing Zhang</name></country><country name="Mongolie"><noRegion><name sortKey="Alexander, Burmaa" sort="Alexander, Burmaa" uniqKey="Alexander B" first="Burmaa" last="Alexander">Burmaa Alexander</name></noRegion></country><country name="Danemark"><region name="Hovedstaden"><name sortKey="Brown, Caroline" sort="Brown, Caroline" uniqKey="Brown C" first="Caroline" last="Brown">Caroline Brown</name></region><name sortKey="Gross, Diane" sort="Gross, Diane" uniqKey="Gross D" first="Diane" last="Gross">Diane Gross</name><name sortKey="Jorgensen, Pernille" sort="Jorgensen, Pernille" uniqKey="Jorgensen P" first="Pernille" last="Jorgensen">Pernille Jorgensen</name></country><country name="Philippines"><noRegion><name sortKey="Dueger, Erica" sort="Dueger, Erica" uniqKey="Dueger E" first="Erica" last="Dueger">Erica Dueger</name></noRegion></country><country name="Norvège"><region name="Østlandet"><name sortKey="Hauge, Siri" sort="Hauge, Siri" uniqKey="Hauge S" first="Siri" last="Hauge">Siri Hauge</name></region></country><country name="Égypte"><noRegion><name sortKey="Mafi, Ali" sort="Mafi, Ali" uniqKey="Mafi A" first="Ali" last="Mafi">Ali Mafi</name></noRegion><name sortKey="Malik, Mamunur" sort="Malik, Mamunur" uniqKey="Malik M" first="Mamunur" last="Malik">Mamunur Malik</name></country><country name="Pays-Bas"><region name="Gueldre"><name sortKey="Meerhoff, Tamara" sort="Meerhoff, Tamara" uniqKey="Meerhoff T" first="Tamara" last="Meerhoff">Tamara Meerhoff</name></region><name sortKey="Soetens, Loes" sort="Soetens, Loes" uniqKey="Soetens L" first="Loes" last="Soetens">Loes Soetens</name></country><country name="Kenya"><noRegion><name sortKey="Mott, Joshua" sort="Mott, Joshua" uniqKey="Mott J" first="Joshua" last="Mott">Joshua Mott</name></noRegion></country><country name="Brésil"><region name="Minas Gerais"><name sortKey="Olivera, Maria Teresa Da Costa" sort="Olivera, Maria Teresa Da Costa" uniqKey="Olivera M" first="Maria Teresa Da Costa" last="Olivera">Maria Teresa Da Costa Olivera</name></region></country><country name="États-Unis"><region name="Washington (État)"><name sortKey="Palekar, Rakhee" sort="Palekar, Rakhee" uniqKey="Palekar R" first="Rakhee" last="Palekar">Rakhee Palekar</name></region></country><country name="Portugal"><noRegion><name sortKey="Rebelo De Andrade, Helena" sort="Rebelo De Andrade, Helena" uniqKey="Rebelo De Andrade H" first="Helena" last="Rebelo-De-Andrade">Helena Rebelo-De-Andrade</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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