Rosenthal Mariana, Anderson Katey, Tengelsen Leslie, Carter Kris, Hahn Christine, Ball Christopher
Centers for Disease Control and Prevention, Idaho Department of Health and Welfare, Boise, ID, United States.
Idaho Bureau of Laboratories, Idaho Department of Health and Welfare, Boise, ID, United States.
JMIR Public Health Surveill. 2017 Aug 24;3(3):e57. doi: 10.2196/publichealth.6648.
The Right Size Roadmap was developed by the Association of Public Health Laboratories and the Centers for Disease Control and Prevention to improve influenza virologic surveillance efficiency. Guidelines were provided to state health departments regarding representativeness and statistical estimates of specimen numbers needed for seasonal influenza situational awareness, rare or novel influenza virus detection, and rare or novel influenza virus investigation.
The aim of this study was to compare Roadmap sampling recommendations with Idaho's influenza virologic surveillance to determine implementation feasibility.
We calculated the proportion of medically attended influenza-like illness (MA-ILI) from Idaho's influenza-like illness surveillance among outpatients during October 2008 to May 2014, applied data to Roadmap-provided sample size calculators, and compared calculations with actual numbers of specimens tested for influenza by the Idaho Bureau of Laboratories (IBL). We assessed representativeness among patients' tested specimens to census estimates by age, sex, and health district residence.
Among outpatients surveilled, Idaho's mean annual proportion of MA-ILI was 2.30% (20,834/905,818) during a 5-year period. Thus, according to Roadmap recommendations, Idaho needs to collect 128 specimens from MA-ILI patients/week for situational awareness, 1496 influenza-positive specimens/week for detection of a rare or novel influenza virus at 0.2% prevalence, and after detection, 478 specimens/week to confirm true prevalence is ≤2% of influenza-positive samples. The mean number of respiratory specimens Idaho tested for influenza/week, excluding the 2009-2010 influenza season, ranged from 6 to 24. Various influenza virus types and subtypes were collected and specimen submission sources were representative in terms of geographic distribution, patient age range and sex, and disease severity.
Insufficient numbers of respiratory specimens are submitted to IBL for influenza laboratory testing. Increased specimen submission would facilitate meeting Roadmap sample size recommendations.
“合适规模路线图”由公共卫生实验室协会和疾病控制与预防中心制定，旨在提高流感病毒学监测效率。向各州卫生部门提供了有关季节性流感态势感知、罕见或新型流感病毒检测以及罕见或新型流感病毒调查所需标本数量的代表性和统计估计的指南。
本研究的目的是比较路线图抽样建议与爱达荷州的流感病毒学监测，以确定实施的可行性。
我们计算了2008年10月至2014年5月期间爱达荷州门诊患者流感样疾病监测中就诊的流感样疾病（MA - ILI）比例，将数据应用于路线图提供的样本量计算器，并将计算结果与爱达荷州实验室局（IBL）实际检测的流感标本数量进行比较。我们根据年龄、性别和健康区居住地评估了检测标本患者与人口普查估计数之间的代表性。
在接受监测的门诊患者中，爱达荷州5年期间MA - ILI的年均比例为2.30%（20,834/905,818）。因此，根据路线图建议，爱达荷州需要每周从MA - ILI患者中收集128份标本用于态势感知，每周收集1496份流感阳性标本用于检测患病率为0.2%的罕见或新型流感病毒，检测后每周收集478份标本以确认真正患病率≤流感阳性样本的2%。除2009 - 2010年流感季节外，爱达荷州每周检测的流感呼吸道标本平均数在6至24份之间。收集了各种流感病毒类型和亚型，标本提交来源在地理分布、患者年龄范围和性别以及疾病严重程度方面具有代表性。
提交给IBL进行流感实验室检测的呼吸道标本数量不足。增加标本提交将有助于满足路线图样本量建议。
