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Influenza is not a reportable disease in New Hampshire, but surveillance systems are in place to help determine the extent of illness and current circulating virus types. Data from heath care providers and laboratories, as well as data from other surveillance systems, are analyzed, and NH flu activity is reported weekly to the Centers for Disease Control and Prevention (CDC). New Hampshire participates in the US Influenza Sentinel Provider Surveillance System, a collaborative effort between the CDC, the NH Department of Health and Human Services, and health care providers throughout the State.

Influenza Sentinel Provider

An influenza sentinel provider can be a health care provider (physician, physician assistant, nurse practitioner, nurse) in any of the following specialties: family medicine, internal medicine, pediatrics, emergency medicine, student health. Health care providers working in a private practice or in a public health clinic are eligible.

Data Collection and Reporting

Influenza sentinel providers conduct surveillance for influenza-like illness (ILI) in collaboration with the CDC and the NH Department of Health and Human Services. Data provided by sentinel providers are combined with other influenza surveillance data to provide a national picture of influenza activity in the US During the 2005-06 influenza season, approximately 2300 providers in the US participated in this surveillance system.

Sentinel providers report the total number of patient visits each week and the number of patient visits for ILI by age group. ILI is defined as 1) a fever of 100° F or more and 2) cough and/or sore throat, in the absence of a known cause. These data are transmitted once a week to a central data repository at CDC via the Internet or fax.

Reporting is done during the traditional influenza season (October through mid-May), but continued reporting through the summer months is strongly encouraged. This helps determine baseline flu activity and may detect unusual influenza viruses that are circulating.

Laboratory Specimen Collection

Specimens for virus isolation are collected from a subset of patients at the beginning, middle and end of the influenza season, from unusual clinical, or unusually severe cases and from outbreak-related cases. Specimens are sent to the Public Health Laboratories, and testing is done free-of-charge for sentinel providers.

Importance of Influenza Surveillance

Influenza viruses are constantly evolving and cause substantial morbidity and mortality each year. The data from sentinel providers are critical for monitoring the impact of influenza and, when combined with other influenza surveillance data, can be used to guide prevention and control activities, vaccine strain selection, and patient care. Sentinel providers receive feedback on the data submitted, summaries of regional and national influenza data, and a free subscription to CDC's Morbidity and Mortality Weekly Report and Emerging Infectious Diseases journal. The most important consideration is the influenza sentinel provider's contribution to an important public health surveillance system.

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New Hampshire Department of Health and Human Services
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