Original Article

FluSTAR, A Novel Influenza Surveillance System: Outcomes from the 2005–2006 Flu Season

Authors: Larry Aull, PharmD, William A. Blumentals, PhD, Dominick A. Iacuzio, PhD, Steve Cheng, PhD

Abstract

Background: The FluSTAR Surveillance System covers most of the United States, providing local and national information on influenza and influenza-like illness that is updated twice weekly.


Methods: Descriptive statistical analyses were performed to explore demographic characteristics, symptoms, vaccination status, and treatment of patients tested for influenza, using a rapid test kit, in the FluSTAR program during the 2005 to 2006 influenza season (October 1, 2005–April 11, 2006).


Results: Of 17,247 patients tested, the most common age groups were 35 to 49 (20%) or 19 to 34 years (18%). Overall, 22% of tests were positive. Patients testing positive were more likely to report influenza-associated symptoms such as cough and fever than those testing negative. Most patients testing positive were prescribed antiviral agents.


Conclusions: Surveillance systems such as FluSTAR can provide timely data on the circulation of influenza and influenza-like illness. This information could assist with accurate diagnosis and aid treatment decisions.


Key Points


* The FluSTAR Surveillance System covers approximately 80% of the United States population and provides local and national information on influenza and influenza-like illness in the community that is updated twice weekly.


* FluSTAR tracks influenza and influenza-like illness with the objective of raising patient and physician awareness of impending influenza epidemics and hence assisting physicians in diagnosing influenza.


* During the 2005–2006 influenza season, 17,247 patients were tested for influenza in the FluSTAR program.


* The most commonly tested age groups comprised adults of working age.


* When stratified by age, significant relationships were found between a positive influenza test result and increased risk of cough, fatigue, fever, myalgia, and runny nose in most age groups.


* Following diagnosis, most patients were prescribed antiviral drugs.

This content is limited to qualifying members.

Existing members, please login first

If you have an existing account please login now to access this article or view purchase options.

Purchase only this article ($25)

Create a free account, then purchase this article to download or access it online for 24 hours.

Purchase an SMJ online subscription ($75)

Create a free account, then purchase a subscription to get complete access to all articles for a full year.

Purchase a membership plan (fees vary)

Premium members can access all articles plus recieve many more benefits. View all membership plans and benefit packages.

References

1. World Health Organization. Global influenza surveillance network. 2006. Available at: http://www.who.int/csr/disease/influenza/surveillance/en/index.html. Accessed on December 1, 2006.
 
2. Centers for Disease Control and Prevention. Fact sheet: Overview of influenza surveillance in the United States. June 26, 2006. Available at: http://www.cdc.gov/flu/weekly/pdf/flu-surveillance-overview.pdf. Accessed on November 30, 2006.
 
3. Centers for Disease Control and Prevention. Flu activity reports and surveillance methods in the United States. Available at: http://www.cdc.gov/flu/weekly/fluactivity.htm. Accessed on December 1, 2006.
 
4. World Health Organization. Position paper on influenza vaccines. Weekly Epidemiological Record 2005;80:279–287.
 
5. Cox NJ, Fukuda K. Influenza. Infect Dis Clin North Am 1998;12:27–38.
 
6. Call SA, Vollenweider MA, Hornung CA, et al. Does this patient have influenza? JAMA 2005;293:987–997.
 
7. Boivin G, Hardy I, Tellier G, et al. Predicting influenza infections during epidemics with use of a clinical case definition. Clin Infect Dis 2000;31:1166–1169.
 
8. Monto AS, Gravenstein S, Elliott M, et al. Clinical signs and symptoms predicting influenza infection. Arch Intern Med 2000;160:3243–3247.
 
9. Smith NM, Bresee JS, Shay DK, et al. Prevention and control of influenza. Recommendations of the Advisory Committee on Immunization Practices (ACIP). Centers for Disease Control and Prevention.Available at: http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5510a1.htm. Accessed on November 30, 2006.
 
10. American Academy of Pediatrics: 2005–2006 Influenza Guidance. Available at: http://www.cispimmunize.org/pro/pro_main.html?http&&&www.cispimmunize.org/pro/influenzaguidance.html. Accessed on November 28, 2006.
 
11. Treanor J. Influenza vaccine: outmaneuvering antigenic shift and drift. N Engl J Med 2004;350:218–220.
 
12. Nicholson KG, Aoki FY, Osterhaus AD, et al. Efficacy and safety of oseltamivir in treatment of acute influenza: a randomised controlled trial: Neuraminidase Inhibitor Flu Treatment Investigator Group. Lancet 2000;355:1845–1850.
 
13. Treanor JJ, Hayden FG, Vrooman PS, et al. Efficacy and safety of the oral neuraminidase inhibitor oseltamivir in treating acute influenza: a randomized controlled trial: US Oral Neuraminidase Study Group. JAMA 2000;283:1016–1024.
 
14. Whitley RJ, Hayden FG, Reisinger KS, et al. Oral oseltamivir treatment of influenza in children. Pediatr Infect Dis J 2001;20:127–133.
 
15. Hayden FG, Osterhaus AD, Treanor JJ, et al. Efficacy and safety of the neuraminidase inhibitor zanamivir in the treatment of influenza virus infections: GG167 Influenza Study Group. N Engl J Med 1997;337:874–880.
 
16. Randomised trial of efficacy and safety of inhaled zanamivir in treatment of influenza A and B virus infections: the MIST (Management of Influenza in the Southern Hemisphere Trialists) Study Group. Lancet 1998;352:1877–1881.
 
17. Hedrick JA, Barzilai A, Behre U, et al. Zanamivir for treatment of symptomatic influenza A and B infection in children five to twelve years of age: a randomized controlled trial. Pediatr Infect Dis J 2000;19:410–417.
 
18. Centers for Disease Control and Prevention: Antiviral Medications for Influenza. November 16, 2006. Available at: http://www.cdc.gov/flu/professionals/treatment/. Accessed on November 28, 2006.
 
19. Committee on Infectious Diseases. American Academy of Pediatrics. Reduction of the influenza burden in children: policy Statement. Pediatrics 2002;110:1246–1252.
 
20. Rothberg MB, Fisher D, Kelly B, et al. Management of influenza symptoms in healthy children: cost-effectiveness of rapid testing and antiviral therapy. Arch Pediatr Adolesc Med 2005;159:1055–1062.
 
21. Aoki FY, Macleod MD, Paggiaro P, et al. Early administration of oral oseltamivir increases the benefits of influenza treatment. J Antimicrob Chemother 2003;51:123–129.
 
22. FluSTAR system for tracking and reporting flu. Available at: http://www.FluSTAR.com. Accessed on November 28, 2006.
 
23. Iacuzio DA, Blumentals WA, Curry AD. Changes in demographic and symptom characteristics of female patients identified in the FluSTAR surveillance system, 2003/2004 and 2004/2004 flu seasons [abstract]. J Womens Health 2006;15:470. doi: 10.1089/jwh.2006.15.463.
 
24. Iacuzio DA, Blumentals WA, Curry AD. Descriptive characteristics of patients identified in the FluSTAR surveillance system, 2004/2005 and 2005/2006 flu seasons [abstract]. IDSA Annual Meeting Final Program and Abstracts Book 2006; 182: Abstract 814. Available at: http://www.idsociety.org/Template.cfm?Section=Program3&CONTENTID=17277&TEMPLATE=/ContentManagement/ContentDisplay.cfm. Accessed on March 14, 2007.
 
25. Montalto NJ. An office-based approach to influenza: clinical diagnosis and laboratory testing. Am Fam Physician 2003;67:111–118.
 
26. Heckler R, Klepp J, Steinbiss J. A new rapid diagnostic test for influenza [abstract]. J Antimicrob Chemother 1999;44(Suppl A):3–184.
 
27. Wunderli W, Thomas Y, Muller DA, et al. Rapid antigen testing for the surveillance of influenza epidemics. Clin Microbiol Infect 2003;9:295–300.
 
28. Lange W, Schottler M. Real-time influenza surveillance in Germany: results of a pilot project. Med Microbiol Immunol (Berl) 2002;191:139–144.
 
29. Nicholson KG, Kent J, Hammersley V, et al. Acute viral infections of upper respiratory tract in elderly people living in the community: comparative, prospective, population based study of disease burden. BMJ 1997;315:1060–1064.
 
30. Effler PV, Ieong MC, Tom T, Nakata M. Enhancing public health surveillance for influenza virus by incorporating newly available rapid diagnostic tests. Emerg Infect Dis 2002;8:23–28.
 
31. Poehling KA, Zhu Y, Tang YW, et al. Accuracy and impact of a point-of-care rapid influenza test in young children with respiratory illnesses. Arch Pediatr Adolesc Med 2006;160:713–718.
 
32. Hulson TD, Mold JW, Scheid D, et al. Diagnosing influenza: the value of clinical clues and laboratory tests. J Fam Pract 2001;50:1051–1056.
 
33. Denny F. The clinical impact of human respiratory virus infections. Am J Respir Crit Care Med 1995;152:S4–S12.
 
34. Centers for Disease Control and Prevention. 2005–06 US influenza season summary. Available at: http://www.cdc.gov/flu/weekly/weeklyarchives2005-2006/05-06summary.htm. Accessed on March 14, 2007.
 
35. Chan KH, Maldeis N, Pope W, et al. Evaluation of the Directigen FluA+B test for rapid diagnosis of influenza virus type A and B infections. J Clin Microbiol 2002;40:1675–1680.
 
36. Ohmit SE, Monto AS. Symptomatic predictors of influenza virus positivity in children during the influenza season. Clin Infect Dis 2006;43:564–568.
 
37. Public Health Agency of Canada. FluWatch. Available at: http://www.phac-aspc.gc.ca/fluwatch/index.html. Accessed on November 30, 2006.
 
38. European influenza surveillance scheme (EISS). Available at: http://www.eiss.org/index.cgi. Accessed on November 30, 2006.