1 TARRANT ( T he A lberta R ecording and R ese A rch N e T work) T ARRANT Annual Meeting, Calgary, February 24, 2005 Dr Jim Dickinson MBBS, CCFP, PhD,

1

TARRANT (The Alberta Recording and ReseArch NeTwork)TARRANT Annual Meeting, Calgary, February 24, 2005

Dr Jim Dickinson

MBBS, CCFP, PhD, FRACGP, FAFPHM

UCMC North Hill, Calgary

TARRANT Annual MeetingCalgary, February 24, 2005 2

TARRANT- Introduction

Influenza surveillance system in AlbertaA history of more than 20 yearsIntegration of clinical and virological data37 sentinel physicians Covering 8 of the 9 health regions in

Alberta

TARRANT Annual MeetingCalgary, February 24, 2005 3

Information Loop of TARRANT Surveillance Data

Summaries,Interpretations,

Recommendations

Weekly ReportsTARRANT Central Office

TARRANT sentinel physicians

Local Health Regions

Alberta Health

Health Canada

WHO

Other data sources

Provincial Lab

TARRANT Annual MeetingCalgary, February 24, 2005 4

Use of TARRANT Surveillance Data

Measurement of influenza epidemicsIdentification of community virus typesGuidance to planning of programs to

prevent and control influenza

TARRANT Annual MeetingCalgary, February 24, 2005 5

What TARRANT Doctors Do?

Send in clinical data (Influenza-Like Illness and Lower Respiratory Tract Infection) each week

Either By completing the weekly incident report forms

Or Through automatic computer-based information

transfer

Submit two swabs each week to the provincial lab

TARRANT Annual MeetingCalgary, February 24, 2005 6

New Recruitment

Potential physicians are: Interested in public healthWilling to send data consistently

Potential practices are: Likely to see full range of patientsLikely to see flu patientsWalk-in practices

TARRANT Annual MeetingCalgary, February 24, 2005 7

TARRANT Sentinel Physicians

Health Region #Sentinel physiciansR1 Chinook R H A 3R2 Palliser 4R3 Calgary 11R4 David Thompson 9 (1 practice)R5 East Central Health 1R6 Capital Health 6R7 Aspen R H A 2 R8 Peace Country Health 1R9 Northern Lights 0

TOTAL 37

TARRANT Annual MeetingCalgary, February 24, 2005 8

Sentinels’ Reporting Behavior 2003-2005

0

2

4

6

8

10

12

14

16

18

20w

k46

wk5

0w

k2w

k6w

k10

wk1

4w

k18

wk2

2w

k26

wk3

0w

k34

wk3

8w

k42

wk4

6w

k50

wk2

wk6

Total # recorders2003 2004 2005

Year-round reporting first started

TARRANT Annual MeetingCalgary, February 24, 2005 9

% Weeks Reported Per SentinelWeek 43, 2003 to Week 6, 2005 (68 weeks)

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

% of weeks

TARRANT Annual MeetingCalgary, February 24, 2005 10

Challenges

Only about 10 sentinels send data year-round consistently

Very low reporting rates during the summer

Interpretation of the computerized data from one practice

TARRANT Annual MeetingCalgary, February 24, 2005 11

Which Sentinels Persevere?What’s Available in the Literature1

Factors related to long compliance Interest in epidemiology<5 or ~20 years seniority

Factors related to short compliance Interest in local epidemiology surveysExperience with other surveillance networks

1. Chauvin P, Valleron AJ. Monitoring the compliance of sentinel general parctitioners in public health surveillance: which GPs persevere? International Journal of Epidemiology. 1997; 26:166-172

TARRANT Annual MeetingCalgary, February 24, 2005 12

Influenza-Like Illness and Influenza IsolatesTARRANT 2004-2005

0

5

10

15

20

25

30

35

40

45

50

Aug 3

0 (2

004)

6-Sep

13-S

ep

20-S

ep

27-S

ep4-

Oct

11-O

ct

18-O

ct

25-O

ct

1-Nov

8-Nov

15-N

ov

22-N

ov

29-N

ov

6-Dec

13-D

ec

20-D

ec

27-D

ec

Jan 3

(200

5)

10-J

an

17-J

an

24-J

an

31-J

an

Week beginning

# I

LI

pa

tie

nts

0

2

4

6

8

10

#IL

I ca

se

s/1

00

pa

tie

nts

se

en

Samples Submitted Positive Influenza

ILI(Influenza Like Illness) #ILI/100 cases seen

TARRANT Annual MeetingCalgary, February 24, 2005 13

Influenza-Like Illness

TARRANT 1999-2005

00.20.40.60.8

11.21.41.61.8

01-Oct

15-Oct

29-Oct

12-Nov

26-Nov

10-Dec

24-Dec

07-Jan

21-Jan

04-Feb

18-Feb

04-Mar

18-Mar

01-Apr

15-Apr

29-Apr

13-May

27-May

'04-05

'03-04

'02-03

'01-02

00-01

99-00

Week beginning...

'04-05 '03-04 '02-03 '01-02 00-01 99-00

#IL

I c

as

es

/rec

ord

er/d

ay