171662 Disease respects no borders: Conducting binational surveillance for influenza-like illness in the California-Baja California border region

Tuesday, October 28, 2008: 12:50 PM

Paula Kriner, MPH , Imperial County Public Health Department, El Centro, CA
Karla Lopez, MD , Imperial County Public Health Department, El Centro, CA
Alba E. Phippard, MPH , Border Infectious Disease Surveillance Program, San Diego County Health and Human Services Agency, Office of Border Health, MS P575, San Diego, CA
Angélica Pon Méndez, MD , Epidemiology Department, State of Baja California Department of Public Health, Mexicali, Baja California, Mexico
Marta Lorena Nava, MD , Jurisdicción de Servicios de Salud No. 1, Mexicali, Baja California, Mexico
Peter Kammerer, MD, MPH , Naval Health Research Center, San Diego, CA
Martha Vázquez-Erlbeck, MD, MPH , California Office of Binational Border Health, California Department of Public Health, San Diego, CA
Sonia Montiel, QFB , Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, San Diego, AZ
Maureen Fonseca-Ford, MPH , Div. Global Migration and Quarantine, BIDS, Centers for Disease Control and Prevention, San Diego, CA
Carlos Moya Rabelly, MD , Comisión de Salud Fronteriza México-Estados Unidos, Tijuana, Baja California, Mexico
María-Teresa Bonafonte, PhD, MPH, MS , California Office of Binational Border Health, California Department of Public Health, San Diego, CA
Background: The rapid spread of infectious diseases and threat of avian or pandemic influenza highlight the importance of global early warning, detection, and rapid response. The California-Baja California border region is particularly vulnerable due to a highly mobile population, as well as health and economic disparities between the neighboring countries. A binational surveillance system would improve detection of infectious diseases.

Methods: Since 2004-2005, active surveillance for influenza-like illness (ILI) has been conducted in two clinics in Imperial and San Diego counties on the U.S.-Mexico border. In November 2007, active ILI surveillance began in a Baja California clinic using the same protocol and case criteria as the California sites. Patients who meet the criteria receive a rapid influenza test. Nose and throat swabs are forwarded to the U.S. Naval Health Research Center Laboratory for virologic and bacteriologic testing. Borderwide surveillance data and laboratory results are distributed bimonthly among participating sites and stakeholders.

Results: For the first time, binational surveillance is conducted to monitor the frequency and distribution of ILI, characterize viral strains, and detect outbreaks in the California-Baja California border community. Between mid-November 2007-January 2008, 163 ILI cases were identified out of 16,314 patients (1.0%). Twenty-two were rapid-test positive for influenza A, one for influenza B, and one for influenza A&B. Testing confirmed 24 positive cases of influenza A, five adenovirus, and 15 Streptococcus.

Conclusions: Methodological and logistical challenges were surmounted due to past collaborations between California-Baja California. This project provides a foundation for bolstering overall disease surveillance in the region.

Learning Objectives:
1. Name three reasons why conducting influenza-like illness surveillance is important for a border region. 2. Discuss ways that binational influenza data can be used to improve overall disease surveillance along the U.S.-Mexico border. 3. Discuss the challenges of conducting binational influenza surveillance.

Keywords: Infectious Diseases, Surveillance

See more of: Public Health Without Borders (2008 Meeting Theme)
See more of: Epidemiology