Comparison of five influenza surveillance systems during the 2009 pandemic and their association with media attention

Abstract

BackgroundDuring the 2009 influenza pandemic period, routine surveillance of influenza-like-illness (ILI) was conducted in The Netherlands by a network of sentinel general practitioners (GPs). In addition during the pandemic period, four other ILI/influenza surveillance systems existed. For pandemic preparedness, we evaluated the performance of the sentinel system and the others to assess which of the four could be useful additions in the future. We also assessed whether performance of the five systems was influenced by media reports during the pandemic period.MethodsThe trends in ILI consultation rates reported by sentinel GPs from 20 April 2009 through 3 January 2010 were compared with trends in data from the other systems: ILI cases self-reported through the web-based Great Influenza Survey (GIS); influenza-related web searches through Google Flu Trends (GFT); patients admitted to hospital with laboratory-confirmed pandemic influenza, and detections of influenza virus by laboratories. In addition, correlations were determined between ILI consultation rates of the sentinel GPs and data from the four other systems. We also compared the trends of the five surveillance systems with trends in pandemic-related newspaper and television coverage and determined correlation coefficients with and without time lags.ResultsThe four other systems showed similar trends and had strong correlations with the ILI consultation rates reported by sentinel GPs. The number of influenza virus detections was the only system to register a summer peak. Increases in the number of newspaper articles and television broadcasts did not precede increases in activity among the five surveillance systems.ConclusionsThe sentinel general practice network should remain the basis of influenza surveillance, as it integrates epidemiological and virological information and was able to maintain stability and continuity under pandemic pressure. Hospital and virological data are important during a pandemic, tracking the severity, molecular and phenotypic characterization of the viruses and confirming whether ILI incidence is truly related to influenza virus infections. GIS showed that web-based, self-reported ILI can be a useful addition, especially if virological self-sampling is added and an epidemic threshold could be determined. GFT showed negligible added value.

Characteristics of seasonal influenza A and B in Latin America: Influenza surveillance data from ten countries

“…Despite considerable progress made in recent years, influenza surveillance is, however, not uniform throughout the region, and some gaps persist that need to be addressed by national and supranational health agencies. For instance, community- and hospital-based surveillance systems of respiratory pathogens (including influenza) should ideally be both in place everywhere as they both provide valuable yet complementary information [15–16]; it appears, however, that the former is still underdeveloped in several countries in the region. Unlike influenza A, a very limited percentage of influenza B cases were characterized.…”

Surveillance for emerging respiratory viruses

“…New surveillance systems such as Infl uenzanet, Flu Near You, FluTracking, and Go Viral are a new frontier in the collection of population symptom data ( This network obtains information about ILI directly from volunteers from the diff erent countries who enter data in a web-based interphase. 44,[80][81][82] Flu Near You is a website-based survey about symptoms of ILI that can be completed by anyone older than 13 years of age. The website is administered by Healthmap of Boston Children's Hospital in partnership with the American Public Health Association and the Skoll Global Threats Fund.…”

“…Medication sales [74][75][76][77][78][79] Over-the-counter drug sales correlated with infl uenza activity Self-reporting participatory systems [81][82][83] Online-based surveillance system relying on voluntary participation Informal surveillance and epidemic intelligence [85][86][87][88][89][90][91][92][93]94 Detect relevant information from the internet, nationally and internationally The Global Public Health Intelligence Network (GPHIN) is a Canadian initiative that draws on the capacity of the internet and worldwide news coverage of health events. 93 GPHIN creates an early warning of outbreaks by monitoring internet media, including news wires and websites, to detect and report disease outbreaks.…”

The bigger picture: The history of antibiotics and antimicrobial resistance displayed by scientometric data

“…Therefore, we were unable to correlate the relative research interest of individual European countries for MRSA with the respective EARS-Net data (not shown). A Google-based algorithm, such as the Google search index for common flu reflecting regional flu activity [18,19], can probably not be used to mirror antibiotic resistance since the majority of Google users lack the expertise for an appropriate and analysable search for antibiotic resistance.…”