Abstract
Sentinel influenza-like illness (ILI) surveillance is an essential component of a comprehensive influenza surveillance program. Community-based ILI surveillance systems that rely solely on sentinel healthcare practices omit important segments of the population, including those who do not seek medical care. Participatory surveillance, which relies on community participation in surveillance, may address some limitations of traditional ILI systems. We aimed to evaluate FluWatchers, a crowdsourced ILI application developed to complement and complete ILI surveillance in Canada. Using established frameworks for surveillance evaluations, we assessed the acceptability, reliability, accuracy and usefulness of the FluWatchers system 2015-2016, through 2018-2019. Evaluation indicators were compared against national surveillance indicators of ILI and of laboratory confirmed respiratory virus infections. The acceptability of FluWatchers was demonstrated by growth of 50%-100% in season-over-season participation, and a consistent season-over-season retention of 80%. Reliability was greater for FluWatchers than for our traditional ILI system, although both systems had week-over-week fluctuations in the number of participants responding. FluWatchers' ILI rates had moderate correlation with weekly influenza laboratory detection rates and other winter seasonal respiratory virus detections including respiratory syncytial virus and seasonal coronaviruses. Finally, FluWatchers has demonstrated its usefulness as a source of core FluWatch surveillance information and has the potential to fill data gaps in current programs for influenza surveillance and control. FluWatchers is an example of an innovative digital participatory surveillance program that was created to address limitations of traditional ILI surveillance in Canada. It fulfills the surveillance system evaluation criteria of acceptability, reliability, accuracy and usefulness.
Highlights
FluWatch is Canada’s national seasonal influenza surveillance program and consists of a network of laboratories, hospitals, physician offices, provincial and territorial ministries of health and Canadians [1]
The acceptability of FluWatchers was demonstrated by growth of 50%–100% in season-over-season participation, and a consistent season-over-season retention of 80%
Reliability was greater for FluWatchers than for our traditional influenza-like illness (ILI) system, both systems had week-over-week fluctuations in the number of participants responding
Summary
FluWatch is Canada’s national seasonal influenza surveillance program and consists of a network of laboratories, hospitals, physician offices, provincial and territorial ministries of health and Canadians [1]. Developed in 1996, the Sentinel Practitioner ILI Reporting System (SPIR) is the primary source for ILI surveillance data for the Public Health Agency of Canada’s (PHAC) FluWatch program [1]. The SPIR consists of outpatient influenza data submitted by primary care practitioners or registered nurses. There are, three major limitations to SPIR: it is reliant on voluntary reporting from a convenience sample of volunteer sentinel physicians or registered nurses; only data from individuals who seek medical attention are captured; and data submission is highly manual and interrupts practitioner workflow. Community-based ILI surveillance systems that rely solely on sentinel healthcare practices omit important segments of the population, including those who do not seek medical care.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
