Abstract
During the 2009 influenza A(H1N1) pandemic, a new laboratory-based virological sentinel surveillance system, the Respiratory DataMart System (RDMS), was established in a network of 14 Health Protection Agency (now Public Health England (PHE)) and National Health Service (NHS) laboratories in England. Laboratory results (both positive and negative) were systematically collected from all routinely tested clinical respiratory samples for a range of respiratory viruses including influenza, respiratory syncytial virus (RSV), rhinovirus, parainfluenza virus, adenovirus and human metapneumovirus (hMPV). The RDMS also monitored the occurrence of antiviral resistance of influenza viruses. Data from the RDMS for the 2009–2012 period showed that the 2009 pandemic influenza virus caused three waves of activity with different intensities during the pandemic and post pandemic periods. Peaks in influenza A(H1N1)pdm09 positivity (defined as number of positive samples per total number of samples tested) were seen in summer and autumn in 2009, with slightly higher peak positivity observed in the first post-pandemic season in 2010/2011. The influenza A(H1N1)pdm09 virus strain almost completely disappeared in the second postpandemic season in 2011/2012. The RDMS findings are consistent with other existing community-based virological and clinical surveillance systems. With a large sample size, this new system provides a robust supplementary mechanism, through the collection of routinely available laboratory data at minimum extra cost, to monitor influenza as well as other respiratory virus activity. A near real-time, daily reporting mechanism in the RDMS was established during the London 2012 Olympic and Paralympic Games. Furthermore, this system can be quickly adapted and used to monitor future influenza pandemics and other major outbreaks of respiratory infectious disease, including novel pathogens.
Highlights
The long-standing national laboratory surveillance system in England known as LabBase [1] collects positive reports of detections of a wide range of infectious pathogens, but does not collect negative results
The sample source data from two regional laboratories indicates that the biggest proportion of Respiratory DataMart System (RDMS) samples (68.3%) were from patients admitted into secondary care settings, with 3.0% from primary care settings and the rest (28.7%) from other sources
The reporting delay time from sampling date to the date of the results reported to the RDMS was examined and showed that 63.6% of sample results were reported to the system within a week of sampling, 95.8% within two weeks and 98.1% within three weeks
Summary
The long-standing national laboratory surveillance system in England known as LabBase [1] collects positive reports of detections of a wide range of infectious pathogens, but does not collect negative results. As part of strengthening respiratory virus surveillance in response to the 2009 influenza A(H1N1) pandemic [7,8,9,10], a new laboratory-based respiratory virus surveillance system, the Respiratory DataMart System (RDMS), was developed in England in 2009 This laboratory surveillance system was initially established to collect both positive and negative results for the specific detection and confirmation of infection with influenza A(H1N1)pdm virus from a network of laboratories in England using a newly implemented PCR assay [11]. The RDMS operates all year round collecting results of all routinely tested respiratory clinical samples from participating laboratories These samples have been taken from both primary and secondary healthcare settings. This paper describes this new RDMS system and results from data collected during the pandemic and post-pandemic periods between 2009 and 2012. It provides a preliminary evaluation of this new system in comparison with other existing surveillance systems
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