External quality assurance scheme for Haemophilus influenzae, 2011 : as part of the IBD-Labnet surveillance network

External quality assessment (EQA) is part of quality management systems (QMS) and evaluates performance of laboratories, by an outside agency, on material that is supplied specifically for the purpose. ECDC's disease-specific networks organise a series of EQAs for EU/EEA countries. In some specific networks, non-EU/EEA countries are also involved in the EQA activities organised by ECDC, although at their own costs. The aim of the EQA is to identify needs for improvement in laboratory diagnostic capacities relevant to surveillance of disease listed in Decision No 2119/98/EC and to ensure comparability of results in laboratories from all EU/EEA countries. Haemophilus influenzae is a common cause of serious disease in children worldwide. Pneumonia and meningitis are the most frequent manifestations. However, it can also be responsible for epiglottitis and infections of bones, joints, skin, soft-tissues and other body sites. Invasive bacterial diseases are an important cause of morbidity and mortality in neonates and children worldwide. Highly safe and effective protein-polysaccharide conjugate Hib vaccines have been available for almost 20 years and have completely changed the epidemiology of invasive H. influenzae infections. Nevertheless, the availability of vaccines requires a more accurate surveillance system. Completeness and accuracy become key objectives of surveillance when vaccines are introduced and the incidence of the infection approaches low levels, as it is in invasive diseases due to H. influenzae. Not only epidemiological surveillance but also laboratory data, especially serotyping are needed to ensure optimal European surveillance for H. influenzae. The European Union Invasive Bacterial Infections Surveillance Network (EU-IBIS) was a successful dedicated surveillance network for the surveillance of invasive diseases caused by Neisseria meningitidis and Haemophilus influenzae. The network had epidemiological and laboratory components. The epidemiological activities focused on the collection and analysis of data on N. meningitidis and H. influenzae cases, and the evaluation of the impact that vaccination programmes using conjugate vaccines have on the epidemiology of meningococcal disease. The laboratory activities focused on EQA and were aimed at strengthening the laboratory capacity in Member States for accurately characterising the isolates of N. meningitidis and H. influenzae. EU-IBIS was coordinated by the Health Protection Agency (HPA) in London, United Kingdom from 1999 to 2006. Since October 2007, the coordination of the activities of EU-IBIS has been integrated into the activities of ECDC and the epidemiological and the laboratory data collected by the EU-IBIS network have been transferred to ECDC. The specific objectives of this EQA exercise are: further harmonisation of molecular typing of H. influenzae; further harmonisation of methods for antimicrobial susceptibility testing of H. influenzae; training and dissemination of methods for the laboratory surveillance of invasive bacterial infections; assisting the countries in capacity building, when required; supporting ECDC in linking laboratory surveillance data and epidemiological data.