Skip to main content
×
×
Home

Harmonizing influenza primary-care surveillance in the United Kingdom: piloting two methods to assess the timing and intensity of the seasonal epidemic across several general practice-based surveillance schemes

  • H. K. GREEN (a1), A. CHARLETT (a1), J. MORAN-GILAD (a1), D. FLEMING (a2), H. DURNALL (a2), D. Rh. THOMAS (a3), S. COTTRELL (a3), B. SMYTH (a4), C. KEARNS (a4), A. J. REYNOLDS (a5), G. E. SMITH (a6), A. J. ELLIOT (a6), J. ELLIS (a7), M. ZAMBON (a7), J. M. WATSON (a1), J. McMENAMIN (a5) and R. G. PEBODY (a1)...
Summary

General Practitioner consultation rates for influenza-like illness (ILI) are monitored through several geographically distinct schemes in the UK, providing early warning to government and health services of community circulation and intensity of activity each winter. Following on from the 2009 pandemic, there has been a harmonization initiative to allow comparison across the distinct existing surveillance schemes each season. The moving epidemic method (MEM), proposed by the European Centre for Disease Prevention and Control for standardizing reporting of ILI rates, was piloted in 2011/12 and 2012/13 along with the previously proposed UK method of empirical percentiles. The MEM resulted in thresholds that were lower than traditional thresholds but more appropriate as indicators of the start of influenza virus circulation. The intensity of the influenza season assessed with the MEM was similar to that reported through the percentile approach. The MEM pre-epidemic threshold has now been adopted for reporting by each country of the UK. Further work will continue to assess intensity of activity and apply standardized methods to other influenza-related data sources.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Harmonizing influenza primary-care surveillance in the United Kingdom: piloting two methods to assess the timing and intensity of the seasonal epidemic across several general practice-based surveillance schemes
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Harmonizing influenza primary-care surveillance in the United Kingdom: piloting two methods to assess the timing and intensity of the seasonal epidemic across several general practice-based surveillance schemes
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Harmonizing influenza primary-care surveillance in the United Kingdom: piloting two methods to assess the timing and intensity of the seasonal epidemic across several general practice-based surveillance schemes
      Available formats
      ×
Copyright
Corresponding author
* Author for correspondence: Dr R. G. Pebody, Respiratory Diseases Department, Centre for Infectious Disease Surveillance and Control, Public Health England, 61 Colindale Avenue, London NW9 5EQ, UK. (Email: richard.pebody@phe.gov.uk)
References
Hide All
1. Public Health England. Real-time Syndromic Surveillance (http://www.hpa.org.uk/Topics/InfectiousDiseases/InfectionsAZ/RealtimeSyndromicSurveillance/). Accessed 4 March 2014.
2. Health Protection Agency. HPA Weekly National Influenza Report (h http://www.hpa.org.uk/Topics/InfectiousDiseases/InfectionsAZ/SeasonalInfluenza/EpidemiologicalData/03influsweeklyreportpdfonly/). Accessed 4 March 2014.
3. Department of Health. Seasonal flu plan: Winter 2011/12 (http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_127088.pdf). Accessed 4 March 2014.
4. National Institute for Health and Clinical Excellence. Oseltamivir, amantadine (review) and zanamivir for the prophylaxis of influenza (http://publications.nice.org.uk/oseltamivir-amantadine-review-and-zanamivir-for-the-prophylaxis-of-influenza-ta158). Accessed 4 March 2014.
5. Fleming, DM, et al. The duration and magnitude of influenza epidemics: a study of surveillance data from sentinel general practices in England, Wales and the Netherlands. European Journal of Epidemiology 1999; 15: 467473.
6. Goddard, NL, Kyncl, J, Watson, JM. Appropriateness of thresholds currently used to describe influenza activity in England. Communicable Disease and Public Health 2003; 6: 238245.
7. Hine, D. The 2009 Influenza Pandemic: an independent review of the UK response to the 2009 influenza pandemic (http://www.cabinetoffice.gov.uk/sites/default/files/resources/the2009influenzapandemic-review.pdf). Accessed 4 March 2014.
8. Department of Health. Pandemic influenza preparedness programme: Statistical Legacy Group – a report for the Chief Medical Officer (http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/@ps/documents/digitalasset/dh_122754.pdf). Accessed 4 March 2014.
9. United Kingdom Influenza Surveillance Harmonisation Short Life Working Group. Report 2010/11, July 2011, Health Protection Agency (internal publication).
10. Fleming, D, Slottje, P. Percentiles-based intensity levels, EISS Annual Meeting Malaga 9–11 May 2007 (https://www.euroflu.org/repository/documents/malaga_2007/1105/Epi/EISS-Malaga-2007_EPI_Pauline_Slottje_Quantified_Intensity_1_Percentiles_EpiClin.pdf). Accessed 4 March 2014.
11. European Centre for Disease Prevention and Control. Weekly influenza surveillance overview (WISO) (http://ecdc.europa.eu/en/healthtopics/seasonal_influenza/epidemiological_data/pages/weekly_influenza_surveillance_overview.aspx). Accessed 4 March 2014.
12. Vega, T, et al. Influenza surveillance in Europe: establishing epidemic thresholds by the Moving Epidemic Method. Influenza and Other Respiratory Viruses 2013; 7: 546558.
13. Vega, T, et al. Validation of the moving epidemic method for detecting influenza epidemics in Europe (http://www.euroflu.org/documents/eiss_poster_toronto_vega_lozano_et_al.pdf). Accessed 4 March 2014.
14. Vega, T, et al. Modelling influenza epidemic – can we detect the beginning and predict the intensity and duration? International Congress Series 2004; 1263: 281283.
15. Zhao, H, et al. A new laboratory-based surveillance system (Respiratory DataMart System) for influenza and other respiratory viruses in England: results and experience from 2009–2012. Eurosurveillance 2014; 19(3): pii=20680.
16. Health Protection Scotland. Reporting rates of influenza (flu) from General Practitioners in Scotland (http://www.documents.hps.scot.nhs.uk/respiratory/seasonal-influenza/expanded-technical.pdf). Accessed 4 March 2014.
17. ISO. Date and time format – ISO 8601 (http://www.iso.org/iso/iso8601). Accessed 4 March 2014.
18. Lozano Alonso, JE. Mem: Moving Epidemics Method, R Package v. 1.2, 2012 (http://www.R-project.org).
19. Mood, AM, Graybill, FA, Boes, DC. Introduction to the Theory of Statistics, 3rd edn. New York: McGraw-Hill, 1974.
20. Health Protection Agency. Surveillance of influenza and other respiratory pathogens in the UK October 2011-April 2012 (http://www.hpa.org.uk/webc/HPAwebFile/HPAweb_C/1317134705939). Accessed 4 March 2014.
21. Public Health England. Surveillance of influenza and other respiratory viruses, including novel respiratory viruses, in the United Kingdom: winter 2012/13 (http://www.hpa.org.uk/webc/HPAwebFile/HPAweb_C/1317139321787). Accessed 4 March 2014.
22. Health Protection Scotland. National influenza report (http://www.hps.scot.nhs.uk/resp/influenzareports.aspx). Accessed 4 March 2014.
23. Tay, EL, et al. Exploring a proposed WHO method to determine thresholds for seasonal influenza surveillance. PLoS ONE 2013; 8: e77244.
24. Conesa, D, et al. Bayesian hierarchical Poisson model with a hidden Markov structure for the detection of influenza epidemic outbreaks. Statistical Methods in Medical Research. Published online: 25 August 2011 . doi:10.1177/0962280211414853.
25. Steiner, SH, et al. Detecting the start of an influenza outbreak using exponentially weighted moving average charts. BMC Medical Informatics and Decision Making 2010; 10: 37.
26. Closas, P, Coma, E, Méndez, L. Sequential detection of influenza epidemics by the Kolmogorov-Smirnov test. BMC Medical Informatics and Decision Making 2012; 12: 112.
27. Tillet, HE, Spencer, IL. Influenza surveillance in England and Wales using routine statistics. Development of ‘cusum’ graphs to compare 12 previous winters and to monitor the 1980/81 winter. Journal of Hygiene (London) 1982; 88: 8394.
28. Green, HK, et al. Mortality attributable to influenza in England and Wales prior to, during and after the 2009 pandemic. PLoS ONE 2013; 8: e79360.
29. Goldstein, E, Viboud, C, Charu, V, Lipsitch, M. Improving the estimation of influenza-related mortality over a seasonal baseline. Epidemiology 2012; 23: 829838.
30. Department of Health. National immunisation programme: planned changes for 2013 to 2014 (https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/193055/130429_Rotavirus_tripartite_letter_FINAL.pdf). Accessed 4 March 2014.
31. Public Health Agency Northern Ireland. Seasonal influenza (http://www.publichealth.hscni.net/directorate-public-health/health-protection/seasonal-influenza). Accessed 10 January 2014.
32. Public Health Wales. Weekly influenza activity in Wales report (http://www.wales.nhs.uk/sites3/page.cfm?orgid=457&pid=34338). Accessed 10 January 2014.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Epidemiology & Infection
  • ISSN: 0950-2688
  • EISSN: 1469-4409
  • URL: /core/journals/epidemiology-and-infection
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords