Abstract
BackgroundMost influenza surveillance is based on data from urban sentinel hospitals; little is known about influenza activity in rural communities. We conducted influenza surveillance in a rural region of China with the aim of detecting influenza activity in the 2009/2010 influenza season.MethodsThe study was conducted from October 2009 to March 2010. Real-time polymerase chain reaction was used to confirm influenza cases. Over-the-counter (OTC) drug sales were daily collected in drugstores and hospitals/clinics. Space-time scan statistics were used to identify clusters of ILI in community. The incidence rate of ILI/influenza was estimated on the basis of the number of ILI/influenza cases detected by the hospitals/clinics.ResultsA total of 434 ILI cases (3.88% of all consultations) were reported; 64.71% of these cases were influenza A (H1N1) pdm09. The estimated incidence rate of ILI and influenza were 5.19/100 and 0.40/100, respectively. The numbers of ILI cases and OTC drug purchases in the previous 7 days were strongly correlated (Spearman rank correlation coefficient [r] = 0.620, P = 0.001). Four ILI outbreaks were detected by space-time permutation analysis.ConclusionsThis rural community surveillance detected influenza A (H1N1) pdm09 activity and outbreaks in the 2009/2010 influenza season and enabled estimation of the incidence rate of influenza. It also provides a scientific data for public health measures.
Highlights
In China, urban general hospitals carry out influenza-like illness (ILI) surveillance
We carried out influenza surveillance in the 2009/2010 influenza season in two primary hospitals and six village clinics that provide services only to residents living in these communities
In the influenza season extending from October 2009 to March 2010, surveillance hospitals/clinics reported detection of 434 cases of ILI during 11,198 consultations (ILI%53.88%)
Summary
In China, urban general hospitals carry out influenza-like illness (ILI) surveillance. Sentinel hospitals (secondary, tertiary, and pediatric urban hospitals) collect throat swab specimens from patients with ILI weekly to carry out laboratory surveillance This surveillance likely does not capture residents of villages and townships, who typically visit primary hospitals or village clinics when presenting with ILI [1, 2]. We conducted influenza surveillance of the whole population in primary hospitals and village clinics in a rural area of China with the aim of detecting influenza activity in the 2009–2010 season. Conclusions: This rural community surveillance detected influenza A (H1N1) pdm activity and outbreaks in the 2009/2010 influenza season and enabled estimation of the incidence rate of influenza. It provides a scientific data for public health measures
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