Influenza Incidence Surveillance Project

Key DFM Personnel

Jonathan Temte, MD, PhD - Principal Investigator
Shari Barlow, BA - Surveillance Coordinator
Chuck Illingworth - Database Administrator

Funding

Center for Disease Control (CDC) - Council of State and Territorial Epidemiologists (CSTE)

Summary

The purpose of this study is to provide ongoing assessment of influenza activity along with other respiratory and enteric viruses across Wisconsin. The project is conducted at several DFM clinics. At each clinic, project staff recruits the 5-6 highest volume clinicians-typically physician assistants and faculty-who see more of the urgent care type visits. This will yield a pool of 20-24 clinicians for surveillance. Clinicians will be trained by Dr. Temte and/or Ms. Barlow and will then collect samples from patients meeting specified criteria. Rapid Influenza tests will be done by the labs at each clinic and a second sample will be sent to the Wisconsin State Lab of Hygiene (WSLH) for multiplex PCR testing. The lab results along with de-identified patient data (age, gender, symptoms, etc.) and clinic volume will be sent to CDC on a weekly basis. The DFM study is one of 12 sites in the United States.

Goal

To describe the incidence and presentation of influenza and other viruses associated with acute respiratory infections in representative primary care populations in Wisconsin.

Methodology

Clinical specimens are collected from patients presenting with acute respiratory infections. A "Clinical Data Form" will be used to obtain basic demographic and symptom data and accompany every specimen sent to the ambulatory laboratory. This form, on carbonless copy paper, is used as the "order" for testing. One copy is for the ambulatory lab and the second is sent with the clinical specimen to the Wisconsin State Laboratory of Hygiene. The copy of the clinical data retained by the clinical laboratory will be collected on a weekly basis by Ms. Barlow. Data will be entered into the master spreadsheet by Ms Barlow who will assure transfer of data on a weekly basis to CDC.

The WSLH will perform testing on all specimens for a panel of respiratory viruses using a multiplex PCR-based test system. Testing will include the following agents: respiratory syncytial virus (RSV) A and B; parainfluenza virus types 1, 2, 3, and 4; human metapneumovirus; human rhinoviruses; adenoviruses; and coronaviruses. In addition, WSLH proposes to perform real-time PCR testing for a panel of respiratory viruses (RVP) on respiratory specimens already received for influenza.

Aliquots of residual specimens (positive and negative) and specimen extracts will be stored at -70°C at the WSLH for possible shipment to CDC. Specimens and extracts will be submitted to CDC on dry ice, by overnight shipment, according to current practice and CDC request.

We will use the Clinical Data Warehouse to run an independent and parallel assessment of the frequency of ILI and ARI patients.