Comparison of outpatient medically attended and community‐level influenza‐like illness—New York City, 2013‐2015

Abstract

BackgroundSurveillance of influenza‐like illness (ILI) in the United States is primarily conducted through medical settings despite a significant burden of non‐medically attended ILI.ObjectivesTo assess consistency between surveillance for respiratory viruses in outpatient and community settings using ILI surveillance from the Centers for Disease Control and Prevention Influenza Incidence Surveillance Project (IISP) and the Mobile Surveillance for Acute Respiratory Infections (ARI) and Influenza‐Like Illness in the Community (MoSAIC) Study.MethodsThe Influenza Incidence Surveillance Project conducts ILI surveillance in 3 primary care clinics in New York City, and MoSAIC conducts community‐based ILI/ARI surveillance through text messaging among a cohort of New York City residents. Both systems obtain respiratory specimens from participants with ILI/ARI and test for multiple pathogens. We conducted a retrospective review of ILI cases in IISP and MoSAIC from January 2013 to May 2015 with descriptive analyses of clinical and laboratory data.ResultsFive‐hundred twelve MoSAIC and 669 IISP participants met an ILI criteria (fever with cough or sore throat) and were included. Forty percent of MoSAIC participants sought care; the majority primary care. Pathogens were detected in 63% of MoSAIC and 70% of IISP cases. The relative distribution of influenza and other respiratory viruses detected was similar; however, there were statistically significant differences in the frequency that were not explained by care seeking.ConclusionsOutpatient and community‐based surveillance in the one found similar timing and relative distribution of respiratory viruses, but community surveillance in a single neighborhood may not fully capture the variations in ILI etiology that occur more broadly.

Systematic Literature Review of Respiratory Syncytial Virus Laboratory Testing Practices and Incidence in United States Infants and Children <5 Years of Age

“…Six studies [ 39 , 42 , 56 , 62 , 69 , 70 ] reported RSV laboratory testing incidence proportions in the OP setting ( Figure 4 ; Supplementary Table 5 A ). The highest RSV laboratory testing incidence proportion was observed in 2 studies with LRTI infant populations [ 42 , 56 ].…”

Text-Based Illness Monitoring for Detection of Novel Influenza A Virus Infections During an Influenza A (H3N2)v Virus Outbreak in Michigan, 2016: Surveillance and Survey

“…In future situations, health officials could consider offering testing for novel influenza virus infections free of charge at health departments or sending clinical staff to collect specimens from ill persons in their homes as a way to address some of these barriers. The latter is a strategy that has been shown to be effective in New York City for longitudinal surveillance of influenza-like illness [16,29]. In that study, home visits were conducted to obtain specimens from persons with reports of illness.…”

Text-Based Illness Monitoring for Detection of Novel Influenza A Virus Infections During an Influenza A (H3N2)v Virus Outbreak in Michigan, 2016: Surveillance and Survey (Preprint)

“…There are several ways to address these barriers, and the mechanism depends on the resources and capabilities of the state and local health care systems. In future situations where a TIM-like platform is deployed during an outbreak, health officials could consider offering testing for novel influenza virus infections free of charge at health departments or sending surveillance staff to collect specimens from ill persons in their homes; the latter is a strategy that was been shown to be effective in New York City for longitudinal surveillance of influenza-like illness [16,22]. In addition, increased education among exposed persons about the risk of novel influenza infections and the importance of detection also may increase the likelihood of testing.…”