Center for Primary Care and Public Health (Unisanté), Lausanne, Department of Family Medicine, University of Lausanne, Lausanne, Switzerland.
Laboratory of Virology, Division of Infectious Diseases, National Reference Centre of Influenza, Geneva University Hospitals, Geneva, Switzerland.
JMIR Public Health Surveill. 2020 Sep 10;6(3):e17242. doi: 10.2196/17242.
A better understanding of the influenza epidemiology among primary care workers could guide future recommendations to prevent transmission in primary care practices. Therefore, we designed a pilot study to assess the feasibility of using a work-based online influenza surveillance system among primary care workers. Such an approach is of particular relevance in the context of the coronavirus disease (COVID-19) pandemic, as its findings could apply to other infectious diseases with similar mechanisms of transmission.
This study aims to determine the feasibility of using a work-based online influenza surveillance system for primary care workers in Switzerland.
Physicians and staff of one walk-in clinic and two selected primary care practices were enrolled in this observational prospective pilot study during the 2017-2018 influenza season. They were invited to record symptoms of influenza-like illness in a weekly online survey sent by email and to self-collect a nasopharyngeal swab in case any symptoms were recorded. Samples were tested by real-time polymerase chain reaction for influenza A, influenza B, and a panel of respiratory pathogens.
Among 67 eligible staff members, 58% (n=39) consented to the study and 53% (n=36) provided data. From the time all participants were included, the weekly survey response rate stayed close to 100% until the end of the study. Of 79 symptomatic episodes (mean 2.2 episodes per participant), 10 episodes in 7 participants fitted the definition of an influenza-like illness case (attack rate: 7/36, 19%). One swab tested positive for influenza A H1N1 (attack rate: 3%, 95% CI 0%-18%). Swabbing was considered relatively easy.
A work-based online influenza surveillance system is feasible for use among primary care workers. This promising methodology could be broadly used in future studies to improve the understanding of influenza epidemiology and other diseases such as COVID-19. This could prove to be highly useful in primary care settings and guide future recommendations to prevent transmission. A larger study will also help to assess asymptomatic infections.
更好地了解初级保健工作者中的流感流行病学情况，可以为未来在初级保健实践中预防传播提供建议。因此，我们设计了一项试点研究，以评估在初级保健工作者中使用基于工作的在线流感监测系统的可行性。在冠状病毒病（COVID-19）大流行的背景下，这种方法尤其相关，因为其发现可能适用于具有类似传播机制的其他传染病。
本研究旨在确定在瑞士使用基于工作的在线流感监测系统对初级保健工作者进行监测的可行性。
在 2017-2018 年流感季节，我们招募了一家门诊诊所和两家选定的初级保健诊所的医生和工作人员参与这项观察性前瞻性试点研究。他们被邀请通过电子邮件每周在线调查记录流感样症状，并在记录任何症状时自我采集鼻咽拭子。通过实时聚合酶链反应对流感 A、流感 B 和一组呼吸道病原体进行样本检测。
在 67 名符合条件的工作人员中，58%（n=39）同意参与研究，53%（n=36）提供了数据。从所有参与者开始参与研究时起，每周调查的回复率一直接近 100%，直到研究结束。在 79 个有症状的发作中（平均每个参与者 2.2 个发作），7 名参与者中的 10 个发作符合流感样疾病病例的定义（发病率：7/36，95%CI 0%-18%）。一个拭子检测出甲型 H1N1 流感阳性（发病率：3%，95%CI 0%-18%）。拭子采集被认为相对简单。
基于工作的在线流感监测系统在初级保健工作者中使用是可行的。这种有前途的方法可以在未来的研究中广泛使用，以提高对流感流行病学和其他疾病（如 COVID-19）的认识。这在初级保健环境中可能非常有用，并为未来预防传播的建议提供指导。更大规模的研究也将有助于评估无症状感染。
