Implementation of an Influenza-Like Illness Surveillance System at an American Indian Health Center and Indigenous Communities in the California-Baja California (Mexico) Border, Successes and Challenges

There are 18 Indian reservations in San Diego County, more than in any other county in the United States. As sovereign nations, American Indian/Alaska Native tribes are governed by a varying combination of tribal, federal and state laws. The San Diego American Indian Health Center (SDAIHC) provides services to all people in need who qualify for government assistance. Although the Center's emphasis is on the urban American Indian population, it is open to everyone regardless of race, ancestry and national origin. For the past four years, influenza-like illness (ILI) surveillance has been conducted in California at sentinel sites at the U.S.– Mexico border. In collaboration with the Early Warning Infectious Disease Surveillance program and the San Diego Naval Health Research Center in 2006 the SDAIHC was included as part of the U.S.– Mexico border ILI sentinel sites. The purpose of the ILI surveillance is to expand febrile respiratory and influenza surveillance, for the early detection of and response to respiratory diseases. This presentation describes the challenges, development, and implementation of ILI surveillance at a SDAIHC and the attempts to implement ILI surveillance at three American Indian and Mexican indigenous communities in California and Baja California. Some of these tribes and peoples share extensive cross-border family and cultural ties. One of the challenges for the implementation of ILI surveillance among Baja California indigenous people is their geographic isolation. A summary of the influenza surveillance system at the SDAIHC from 2006 to 2008 will be presented.