Estimating influenza incidence and rates of influenza-like illness in the outpatient setting
Version of Record online: 18 SEP 2012
© 2012 John Wiley & Sons Ltd
Influenza and Other Respiratory Viruses
Volume 7, Issue 5, pages 694–700, September 2013
How to Cite
Fowlkes, A., Dasgupta, S., Chao, E., Lemmings, J., Goodin, K., Harris, M., Martin, K., Feist, M., Wu, W., Boulton, R., Temte, J., Brammer, L. and Finelli, L. (2013), Estimating influenza incidence and rates of influenza-like illness in the outpatient setting. Influenza and Other Respiratory Viruses, 7: 694–700. doi: 10.1111/irv.12014
- Issue online: 21 AUG 2013
- Version of Record online: 18 SEP 2012
- Accepted 24 July 2012. Published Online 17 September 2012.
Please cite this paper as: Fowlkes et al. (2012) Estimating influenza incidence and rates of influenza-like illness in the outpatient setting. Influenza and Other Respiratory Viruses DOI: 10.1111/irv.12014.
Background: Estimating influenza incidence in outpatient settings is challenging. We used outpatient healthcare practice populations as a proxy to estimate community incidence of influenza-like illness (ILI) and laboratory-confirmed influenza-associated ILI.
Methods: From October 2009 to July 2010, 38 outpatient practices in seven jurisdictions conducted surveillance for ILI (fever with cough or sore throat for patients ≥2 years; fever with ≥1 respiratory symptom for patients <2 years). From a sample of patients with ILI, respiratory specimens were tested for influenza.
Results: During the week of peak influenza activity (October 24, 2009), 13% of outpatient visits were for ILI and influenza was detected in 72% of specimens. For the 10-month surveillance period, ILI and influenza-associated ILI incidence were 20·0 (95% CI: 19·7, 20·4) and 8·7/1000 (95% CI: 8·2, 9·2) persons, respectively. Influenza-associated ILI incidence was highest among children aged 2–17 years. Observed trends were highly correlated with national ILI and virologic surveillance.
Conclusions: This is the first multistate surveillance system demonstrating the feasibility of using outpatient practices to estimate the incidence of medically attended influenza at the community level. Surveillance demonstrated the substantial burden of pandemic influenza in outpatient settings and especially in children aged 2–17 years. Observed trends were consistent with established syndromic and virologic systems.