As countries across the WHO South-East Asia Region (SEAR) continue to strengthen preparedness for influenza and other respiratory pathogen threats, institutions participating in the WHO Global Influenza Surveillance and Response System (GISRS) Unity Studies Sites Network-SEAR chapter are increasingly translating standardized investigation protocols into operational tools for outbreak response.
A recent global webinar organized by the WHO Global Influenza Programme (GIP) titled Exercising Investigation Protocols and Developing Tools in the Interpandemic Period, provided an opportunity to showcase progress from the WHO SEAR. During the webinar, Bangladesh shared its experience in adapting and applying Unity Studies investigation protocols during recent avian influenza events in the country. The webinar brought together members of the Unity Studies Network, surveillance experts, outbreak investigators, field epidemiologists and public health practitioners across the globe.
Opening the session, Dr Wenqing Zhang, Head of the Global Respiratory Threats Unit at WHO Headquarters, emphasized the importance of maintaining readiness during the interpandemic period through continued investments in surveillance and investigation systems, and in strengthening workforce capacity. She highlighted the role of the Unity Studies network in generating high-quality evidence to inform public health actions during outbreaks and future pandemics.
Moderating the session, Dr Nicki Boddington, a consultant with WHO Headquarters, provided an overview of the Unity Studies resources, including standardized investigation protocols, data collection tools, and operational guidance. She highlighted how these resources can help countries strengthen investigation systems, test readiness, and build institutional capacity for respiratory emergencies.
Bangladesh Operationalises GISRS Unity Studies Protocols during Avian and Human Influenza events
A major highlight of the webinar was the presentation by Dr Mahbubur Rahman from the Institute of Epidemiology, Disease Control and Research (IEDCR), Bangladesh’s National Influenza Centre. He shared Bangladesh’s experience in adapting and piloting the protocol for the investigation of non-seasonal influenza and other emerging acute respiratory diseases, demonstrating how standardized protocols can be translated into practical tools for outbreak investigation and response.
Building on its experience and demonstrated capacity in conducting Unity Studies during COVID-19, IEDCR formally joined the SEAR chapter of Unity Studies network in 2025. Upon joining the network, IEDCR adapted the protocol to investigate non-seasonal influenza in the national context through a multisectoral One Health process involving human and animal health stakeholders. The protocol was aligned with existing national surveillance systems, outbreak investigation guidelines and emergency response mechanisms. Following ethical approval, the protocol was piloted during avian influenza outbreaks in three sub-national settings in 2026.
The first activation of the protocol occurred in Sylhet, following reports of influenza-like illness associated with unusual poultry mortality. Investigators conducted active case finding, epidemiological assessments, poultry mapping, and specimen collection from both human and animal populations to assess zoonotic influenza transmission risks. The protocol was subsequently applied during investigations of avian and human influenza A(H5N1) infections reported through national ILI/SARI surveillance systems in Chattogram and Sylhet.
A-B. Sample collection from chickens and ducks in households surrounding the index case; C. Epidemiological data collection from the community; D: Kitchen waste disposal site behind the living room of the patient household; E: Canal behind the case household where dead bird disposal was practiced by neighbouring poultry-rearing families.
Photo Credit: Dr Md Abdullah Al Galib/IEDCR/Bangladesh
Across the three outbreak investigations, Bangladesh successfully implemented key components of the protocol, including case investigation, contact tracing, active case search, poultry mapping, anthropological assessments, specimen collection from human, animal and environmental sectors and related community engagement activities. A key success was the strong coordination achieved through a One Health approach, enabling collaboration between human and animal health sectors during investigations. Existing national surveillance platforms also played an important role in rapidly detecting events and triggering public health responses.
While several components of the protocol were successfully implemented, challenges remained in conducting sero-epidemiological investigations due to limitations in laboratory capacity for serological testing. Strengthening laboratory capabilities and data analysis capacities were identified as priorities for future implementation.
The investigations demonstrated how standardized protocols can support systematic data collection and strengthen evidence generation during outbreaks. By applying the protocol across different settings, response teams were able to test procedures, refine workflows and identify operational gaps, highlighting the value of exercising investigation tools during the interpandemic period to strengthen preparedness for future respiratory disease emergencies.
Strengthening Investigation Capacity through Go. Data
The webinar also featured a presentation by Dr Silvia Edith Morreale, an epidemiologist with the Global Outbreak Alert and Response Network (GOARN) Operational Support Team at WHO Headquarters on the application of standardized Go. Data outbreak investigation templates for human infections caused by zoonotic influenza viruses and other influenza viruses with pandemic potential.
Developed through collaboration between the WHO and the GOARN partners, the tool enables rapid deployment through pre-configured and validated data collection modules, facilitates data analysis, and generates a range of outputs to support outbreak investigations. This innovative and open-source tool supports case investigations, contact tracing, exposure assessment and follow-up activities while promoting standardized and high-quality data collection.
The presentation demonstrated how Go. Data can support countries in operationalizing Unity Studies protocols and strengthen readiness by ensuring that investigation tools are available and tested before emergencies occur.
Advancing Regional Collaboration and Learning
During the discussion session, Dr Pushpa Ranjan Wijesinghe, Programme Area Manager for Pandemic and Epidemic Management (PEM) at WHO SEARO, acknowledged the progress being made by institutions within the South-East Asia Unity Studies regional chapter. He emphasized the importance of adhering to ethical review mechanisms and governance processes to facilitate the timely implementation of investigation studies during public health emergencies. He also highlighted the need for dedicated regional sessions focused on data management, analysis and interpretation, noting that such initiatives help build the capacity of network institutions to translate investigation findings into actionable public health evidence.
The webinar reinforced the importance of maintaining preparedness during the interpandemic period by exercising investigation protocols, strengthening operational tools and sharing practical experiences across countries. Drawing on learnings from country and regional experiences, the South-East Asia Region is committed to supporting countries in strengthening evidence-based surveillance, outbreak investigation and response through early investigations and studies for influenza and other respiratory pathogens with epidemic and pandemic potential.