The assessment of data sources for influenza virologic surveillance in New York State

Escuyer, Kay L.; Waters, Christine L.; Gowie, Donna L.; Maxted, Angie M.; Farrell, Gregory M.; Fuschino, Meghan E.; St. George, Kirsten

Clinical and commercial laboratories submit influenza-positive test results electronically to the NYSDOH via ECLRS. Each ECLRS report contains specimen-level data, including name, DOB, sex, address, home phone, county of residence, reporting laboratory, ordering physician, specimen source, testing method, results, specimen collection date, and report date. New York State Department of Health staff review the submitted data to determine whether it meets the case definition for laboratory-confirmed influenza, defined as a positive influenza laboratory test result with at least one of the following methods: culture, enzyme immunoassay (EIA), direct immunofluorescence assay (DFA), immunofluorescence assay (IFA), RT-PCR, immunohistochemistry (IHC), or influenza virus antigen detection systems (IVADs, also known as rapid influenza diagnostic tests, RIDTs). If the case definition is met, an influenza case report is created in the Communicable Disease Electronic Surveillance System (CDESS). The system automatically deletes duplicate CDESS case reports on the same patient. If the Wadsworth Center tests and does not confirm an initial positive influenza result from another laboratory, the initial F I G U R E 1 NYS map showing the 39 counties of 57 total outside of NYC that contribute to the ILINet and EIP influenza virologic surveillance networks. Counties participating in the EIP program are clustered around the cities of Albany and Rochester. The distribution of the ILINet primary care practitioners is indicated by number in each county and include the following practice types: pediatrics, family practice, internal medicine, student health, urgent care, obstetrics/gynecology, allergy and asthma, ear nose and throat, employee health, infectious disease, and pulmonology. Gray counties do not have providers enrolled in either the ILINet or EIP. The NYS map also depicts the 11 NREVSS laboratories and the 11 WHO collaborating laboratories, which include the NYS PHL in Albany and the three regional PHLs in Erie and Westchester Counties and NYC test is considered a false-positive result and the original influenza case report is revoked. Communicable Disease Electronic Surveillance System allocates ECLRS positive influenza laboratory results to disease classification codes for influenza type A or B, influenza type not specified, A/H1pdm09 subtype (since 2009), and H7N9 (since 2013).