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• W2141569126 abstract "Background: The arrival of the influenza pandemic (pH1N1) highlights gaps in surveillance. This pilot project leverages EMR to rapidly detect changes in the severity of influenza-like-illness (ILI) and associated risk factors to support public health actions. Methods: The sentinel primary care clinics use their EMR with minimal operational disruption to transmit de-identified surveillance information daily to the secure Canadian Network for Public Health Intelligence (CNPHI) server at the Public Health Agency of Canada. The Canadian FluWatch ILI case definition is used:-fever (T > 38 0C) and-cough and-myalgia or arthralgia or sore throat or fatigue. Chi-Square, Fisher Exact and Mann-Whitney tests, with p < 0.05 (2-sided) denoting statistical significance are used. Results: During the initial phase of the 12 month study (Oct 4-Nov 19, 2009), 237 medicallyattended ILI (MA-ILI) cases arising from 12,581 patient visits were reported from participating Canadian sentinel sites. Children under 10 years accounted for 33.8% of these cases. Pneumonia was reported in 8.4% of the MA-ILI cases, increasing from none in early October to 22.2% in the second week of November. Comparing ILI cases with pneumonia to those without, the median age was 30 years vs 21 years (p = 0.5); 50.0% vs 64.5% were females (p = 0.2); 0% vs 0.9% were health care workers (p = 1.0); median time from symptom onset to primary care visit was 5 days vs 2 days (p = 0.02); 0% vs 2.3% received the current season's influenza vaccine (p = 1.0), 5.0% vs 0.5% received the pH1N1 influenza vaccine (p = 0.2), 45.0% vs 39.4% received a pneumococcal vaccine (p = 0.2); 0% vs 3.3% had diabetes (p = 1.0) and 20.0% vs 23.4% had asthma (p = 1.0). Conclusion: Children under 10 years were disproportionately affected but most cases were not life threatening. EMR was able to rapidly detect the shifts in the pandemic severity in real time. The proportion of ILI cases with pneumonia was escalating during the initial phase of this study. Pneumonia was associated with a longer time from symptom onset to primary care visit. With increasing sample size in this ongoing study, statistical power to assess vaccine effectiveness and severity risk factors is anticipated to increase greatly. Abstracts for SupplementInternational Journal of Infectious DiseasesVol. 14Preview Full-Text PDF Open Archive" @default.
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• W2141569126 date "2010-03-01" @default.
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• W2141569126 title "Rapid real time surveillance and monitoring of pandemic influenza associated pneumonia & risk factors using primary care electronic medical records (EMR)" @default.
• W2141569126 doi "https://doi.org/10.1016/j.ijid.2010.02.2209" @default.
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