Influenza Syndromic Surveillance

The Real-time Syndromic Surveillance Team monitor data on a range of clinical and syndromic indicators that are indicative of influenza activity.

 

Data from the syndromic surveillance systems are included within the weekly HPA National Influenza Report.

 

These indicators play a key role in determining when antiviral drugs are triggered for use in primary care at the start of the influenza season.

 

NHS Direct calls for cold/flu (all ages) and fever (5-14 years) have been shown to be sensitive to influenza and provide an excellent early warning system using thresholds based on previous historical activity. PubMed [external link]

The RCGP Weekly Returns Service (WRS) clinical influenza-like illness (ILI) rates have been at the forefront of influenza surveillance for over 40 years. In collaboration with the HPA, the RCGP also coordinates a swabbing programme where patients diagnosed with ILI are swabbed for influenza and other respiratory viruses.

The HPA/QSurveillance system provides a UK picture of influenza activity using GP diagnoses of ILI. Data are routinely published in the HPA/QSurveillance bulletin on the rates of ILI at country, SHA and PCT level; data are presented in the form of graphs, tables and maps. The HPA/QSurveillance system can be switched to provide daily data in the event of an influenza pandemic.

In addition to the surveillance of influenza, the syndromic surveillance systems are able to monitor a range of other respiratory indicators including cough and difficulty breathing (NHS Direct system), upper and lower respiratory tract infections (HPA/QSurveillance system) and acute bronchitis and common cold (RCGP system). These indicators can be sensitive to influenza and a range of other common respiratory pathogens, including respiratory syncytial virus.

The new syndromic systems currently under development (including emergency department and GP out of hours) will complement the existing systems to monitor community-based influenza activity.