Abstract
For the last five years, the Brussels Institute of Hygiene and Epidemiology has been involved in the surveillance of acute respiratory infections (ARI). The four indicators used (number of encounters of ARI by GP's/100 encounters, virus isolations, absenteeism and mortality) are discussed. A regression procedure is applied to the data collected by a sentinel network of general practitioners (GP's). This procedure permits the baseline to be visualized and an epidemic threshold to be determined in order to recognize early an influenza outbreak. The traditional use of flu-like illnesses as an indicator might be improved by the addition of non-specific ARI which are more precocious, especially in children. The criteria for an accurate definition of an influenza epidemic are discussed. The same mathematical model can be used for the analysis of mortality linked with an outbreak. It shows that the last epidemic in the winter 1989–1990 was responsible for about 4900 deaths directly or indirectly related to influenza.
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References
Castagliola D., Flahaut A., Galinec D., Garnerin P., Menares J. and Valleron A.J. (1991): A routine tool for detection and assessment of epidemics of influenza. like syndromes in France - Am. J. Public. Health 81 (11): 97–99.
Couch R.B., Kasel J.A., Glezen W.P., Cate T.R., Six H.R., Taber L.H., Frank A.L., Greenberg S.B., Zahradnik J.M. and Keitel W.A. (1986): Influenza: its control in persons and populations - J. Inf. Dis. 153 (3): 431–440.
Curwen M., Dunnel K. and Ashley J. (1980): Hidden influenza deaths - Br. Med. J. 300: 896.
De Loof J. (1976): Griep en Griepachtige infecties tijdens de winter 1975–76 - HANU 5(4): 102–103.
DeLoof J. (1984): Epidemiologie en bestrijding van acute luchtweginfecties. In topics nit de sociale geneeskunde / Eylenbosch W.J., Vuylsteek K., Depoorter A.M., Meheus A.Z. (eds.) - Leuven, Amersfoort: ACCO, 1984: 149–161.
Fleming D.M. and Ayres J.G. (1988): Diagnosis and patterns of incidence of influenza-like illness and the common cold in general practice - J. Roy. Coll. Gen. Pract. 38: 159–162.
Fleming D.M., Crombie D.L., Norbury C.A. and Cross K.W. (1990): Observations on the influenza epidemic of November/December 1989 - Br. J. Gen. Pract. 40: 495–497.
Fox J.P. and Kilbourne E.D. (1973): Epidemiology of influenza-Summary of Influenza workshop IV - J. Inf. Dis. 128 (3): 361–386.
Glezen W.P. and Couch R.B. (1978): Interpandemic influenza in the Houston area - N. Engl. J. Med. 298: 587–592.
Hannoun C., Dab W. and Cohen J.M. (1989): A new Influenza surveillance system in France: The Ile-de-France “GROG”. I. Principles and methodology -Eur. J. Epidemiol. 5 (3): 285–293.
Hodgkin K. (1978): Towards earlier diagnosis in primary care (4th edition) - Edinburgh, Churchill Livinstone: 297–299.
Hoekelman M.D. (1977): Infectious illness during the first year of life - Pediatrics 59 (1): 119–121.
Howie J.G., Richardson I.M. and Gill G. (1971): Respiratory illness and antibioticum in general practice - J. Roy. Coll. Gen. Pract. 21: 657–663.
Institut National de Statistiques (1986): Statistiques des causes de décès.
Jenicek M. and Cléroux R. (1984): Epidémiologie. Principes - Techniques - Applications. 3éme tirage -Edisem inc. Québec: 314–320.
Langmuir A.D. (1963): The surveillance of communicable diseases of national importance -New. Engl. J. Med. 268 (4): 182–192.
Lidwell O.M. and Sommerville T. (1951): Observations on the incidence and distribution of the common cold in a rural community during 1948 and 1949 - J. Hygiene 49: 365–381.
Lui K.J. and Kendal A.P. (1987): Impact of influenza epidemics on mortality in the United States from October 1972 to May 1985 - Amer. J. Public Health 77: 712–716.
Mandell G.L., Douglas J.E. and Bennet J.E. (1990): principles and practice of Infectious Diseases -Churchill Livingstone (3th edition7 Broadway, NY 10036: 1306–1325.
Nicholson K.G. (1990): influenza vaccination and the elderly - Br. Med. J. 301: 617–618.
Nicholson K.G. (1991): Amantadine for Influenza A -Br. Med. J. 302: 425–426.
Serfling R.E. (1963): Methods for current statistical analysis of excess pneumonia. Influenza deaths -Public Health Rep. 78: 494–506.
Sprenger M.J., vanNaelten M.A., Mulder P.G. and Masurel N. (1989): Influenza mortality and excess deaths in the elderly 1967–1982 - Epidemiology and infection 103: 633–641.
Valleron A.-J., Bouvet E., Garnerin P., Menares J., Heard I., Letrait S. and Lefaucheux J. (1986): A computer network for the surveillance of communicable diseases: the French experiment -Am. J. Publ. Health 76 (11): 1289–1292.
World Health Organization (1981): Surveillance of acute viral respiratory infections in Europe: A report of WHO symposium, Madrid June 2–6 1980. Copenhagen: WHO Regional Office for Europe.
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Snacken, R., Lion, J., Van Casteren, V. et al. Five years of sentinel surveillance of acute respiratory infections (1985–1990): The benefits of an influenza early warning system. Eur J Epidemiol 8, 485–490 (1992). https://doi.org/10.1007/BF00146364
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DOI: https://doi.org/10.1007/BF00146364