233859 Enhanced Surveillance for Severe Acute Respiratory Infections in Arizona

Tuesday, November 9, 2010

Orion McCotter, MPH , Border Health Office, Arizona Department of Health Services, Tucson, AZ
Ken Komatsu, MPH , Department of Epidemiology, Arizona Department of Health Services, Phoenix, AZ
Donna Wolk, PhD , University of Arizona, University of Arizona, Tucson, AZ
Shoana Anderson, MPH , Department of Epidemiology, Arizona Department of Health Services, Phoenix, AZ
Maureen Fonseca-Ford, MPH , Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, San Diego, CA
Laura Erhart, MPH , Arizona Department of Health Services, Phoenix, AZ
Mark Wright, MD , Department of Emergency Medicine, University of Arizona College of Medicine, Tucson, AZ
Sonia Montiel, QFB , Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, San Diego, AZ
Christine Cervantez-Young, BS , Arizona Department of Health Services, Tucson, AZ
Benjamin J. Park, MD , Mycotic Disease Branch, Center for Disease Control and Prevention, Atlanta, GA
Steven R. Machlin, MS , Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality, Rockville, MD
Selam Tecle, MPH , Office of Border Health, Arizona Department of Health Services, Tucson, AZ
Robert Guerrero, MBA , Office of Border Health, Arizona Department of Health Services, Tucson, AZ
Stephen H. Waterman, MD, MPH , Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, San Diego, CA
Background: Influenza is an acute contagious viral respiratory disease, estimated to account for over 35,000 mortalities annually in the United States alone. A new strain of influenza emerged during the recent 2009 H1N1A virus pandemic, which infected more than 61 million people in the United States. To better understand the burden of influenza in the US/Mexico border region, the Border Infectious Disease Surveillance (BIDS) project conducted syndrome-based active surveillance for Severe Acute Respiratory Infection (SARI) at sentinel hospital-sites throughout Southern Arizona. Objectives: Determine the proportion of hospitalizations and deaths associated with SARI. Isolate and antigenically characterize influenza and other etiologies of SARI. Compare epidemiologic and clinical characteristics of influenza and other SARI-associated respiratory pathogens. Methods: We utilized a broad syndromic case definition of febrile respiratory illness (Fever >100F AND Cough or Sore Throat AND Difficulty Breathing AND Hospital Admission). Specimens from patients identified at sentinel sites underwent molecular RT-PCR for identification of 18 viral respiratory pathogens, including influenza. Additionally, specimens were tested for evidence of infection with coccidioidomycosis (Valley Fever), a fungal disease that is endemic to the region and causes community-acquired pneumonia (CAP). Results: The results of surveillance were not available at time of abstract writing, but preliminary results will be available for the annual meeting. Discussion: The lessons learned from setting up a regional surveillance system that crosses an international boundary are crucial to strengthening epidemiologic and laboratory capacity. Consistent communication and education with clinicians is important to establish and maintain active infectious disease surveillance for diseases of public health importance.

Learning Areas:
Epidemiology

Learning Objectives:
1) Describe methods to enhance existing influenza surveillance activities. 2) Identify steps unique to establishing a regional surveillance system that incorporates several public health agencies.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Employed at Arizona Department of Health services, Office of Border Health, organized a special session at APHA last year
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.