Early warning signs of unusual influenza activity in an area can direct physician attention toward a potential outbreak and greater investigation. 9 Physician awareness of an outbreak in an area will increase the likelihood of ordering laboratory resting and engaging in a more thorough investigation. Confirmation is typically obtained through laboratory testing. This issue is more probably with Influenza Like Illness (ILI) as it shares similar signs and symptoms with other diseases, especially during the early stages of the infection. 10–12Īnother limitation of the system is that some physicians may miss cases. The time taken for analysis at the central registry and the time needed for the public health registry to communicate the findings with the applicable hospital(s) authority and treating physician(s) and the issuing of a warning signal can be somewhat substantial. 6–9 This system could result in longer outbreak detection time since there are additional steps needed prior to the data being entered into the reporting system. Although this type of system can improve the accuracy of the reported data by allowing physicians to assess the case and confirm the diagnosis, it has the disadvantage of longer reporting time as well as the possibility of missing false-negative cases. Some systems require laboratory confirmation of diagnosis. This information occurs prior to diagnosis, something which often requires laboratory results to be obtained. It is an early stage of detection that uses information to estimate the probability of a case or outbreak and then may ask for a further public health response. 5 This type of system often uses data prior to confirmation of diagnosis. Syndromic surveillance methods involve “relying on detection of clinical case features that are discernible before confirmed diagnoses are made”. 5 Generally, systems can be in one or two categories: data collected before visiting a healthcare facility and data collected after visiting a healthcare facility. Each system has its own strengths and weaknesses that can be identified based on the data being collected. There are various surveillance systems that can be used at different phases of the disease lifecycle. The lifecycle begins with initial exposure and then progresses to incubation, symptoms, a visit to a healthcare facility, and confirmation of diagnosis. The lifecycle of an influenza outbreak has several phases and the detection in each phase requires different information. The assessment of case eligibility for reporting requires data from multiple sources including physical examination, collection of signs and symptoms, and laboratory results. The determination of data included in this report is determined by the surveillance system. 4 Different surveillance systems may have different criteria and reporting eligibilities. Surveillance systems for influenza often rely on hospital-based clinical data to monitor the virus’ activities and allow public health officials to take necessary actions. 1 In temperate climates, seasonal epidemics occur primarily during the winter, but in tropical regions, influenza may occur throughout the year, something that causes irregular and hard to predict outbreaks. The virus is able to assume epidemic proportion in a short time frame. There are various forms of seasonal influenza and it spreads easily and rapidly in communities throughout the world. Seasonal influenza is an acute respiratory infection caused by the influenza virus.
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