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Volume 15, Number 8—August 2009

Policy Review

Strategy to Enhance Influenza Surveillance Worldwide1

Justin R. Ortiz, Viviana Sotomayor, Osvaldo C. Uez, Otavio Oliva, Deborah Bettels, Margaret McCarron, Joseph S. Bresee, and Anthony W. MountsComments to Author 
Author affiliations: University of Washington, Seattle, Washington, USA (J.R. Ortiz); Ministerio de Salud, Santiago, Chile (V. Sotomayor); Instituto Nacional de Epidemiología, Mar del Plata, Argentina (O.C. Uez); Pan American Health Organization, Washington, DC, USA (O. Oliva); Centers for Disease Control and Prevention, Atlanta, Georgia, USA (D. Bettels, M. McCarron, J.S. Bresee, A.W. Mounts)

Main Article

Table 1

Influenza sentinel surveillance case definitions*

Case Definition criteria
Influenza-like illness
ALL OF THE FOLLOWING
• Sudden onset of fever >38°C, AND
• Cough or sore throat, AND
• Absence of other diagnoses
Severe acute respiratory infection in persons >5 years of age
ALL OF THE FOLLOWING
• Sudden onset of fever >38°C, AND
• Cough or sore throat, AND
• Shortness of breath or difficulty breathing, AND
• Requires hospitalization
Severe acute respiratory infection in persons <5 years of age EITHER
IMCI criteria for pneumonia
Any child 2 mo to 5 y of age with cough or difficult breathing and:
• breathing faster than 60 breaths/min (infants <2 mo)
• breathing faster than 50 breaths/min (2–12 mo)
• breathing faster than 40 breaths/min (1–5 y)
OR
IMCI criteria for severe pneumonia
Any child 2 mo to 5 y of age with cough or difficult breathing and any of the following general danger signs:
• unable to drink or breastfeed
• vomits everything
• convulsions
• lethargic or unconscious
• chest indrawing or stridor in a calm child
AND
Requires hospital admission

*Surveillance guidelines use the existing World Health Organization (WHO) case definition for Influenza-like Illness (19), and incorporate WHO guidance to define severe acute respiratory infection in adults and children (9,18,19). IMCI, Integrated Management of Childhood Illness.

Main Article

1A prior version of this protocol was presented in poster form at the Options for the Control of Influenza Conference in Toronto, Ontario, Canada, June 17, 2007.

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