Influenza laboratory testing and its application in timely Department of Defense biosurveillance


Timely influenza data can help public health decision-makers identify influenza outbreaks and respond with preventative measures. DoD ESSENCE has the unique advantage of ingesting multiple data sources from the Military Health System (MHS), including outpatient, inpatient, and emergency department (ED) medical encounter diagnosis codes and laboratory-confirmed influenza data, to aid in influenza outbreak monitoring. The Influenza-like Illness (ILI) syndrome definition includes ICD-9 or ICD-10 codes that may increase the number of false positive alerts. Laboratory-confirmed influenza data provides an increased positive predictive value (PPV). The gold standard for influenza testing is molecular assays or viral culture. However, the tests may take 3-10 days to result. Rapid influenza diagnostic tests (RIDTs) have a lower sensitivity, but the timeliness of receiving a result improves to within <15 minutes. We evaluate the utility of RIDTs for routine ILI surveillance.

Objective: To describe influenza laboratory testing and results in the Military Health System and how influenza laboratory results may be used in DoD Electronic Surveillance System for Early Notification of Community-based Epidemics (ESSENCE)

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Original Publication Year: 
Event/Publication Date: 
January, 2019

June 18, 2019

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