Enhanced Surveillance for Severe Acute Respiratory Infections in Arizona

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 >100°F 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.