Assessment of 12 influenza-like illness case definitions using Department of Defense Global, Laboratory-based Influenza Surveillance Program data, 2011-2014

Despite the growth in influenza surveillance programs, standardization of a globally accepted influenza-like illness (ILI) case definition remains difficult. With 2011-2014 Department of Defense Global, Laboratory-based Influenza Surveillance Program (DISP) data, 12 case definitions were evaluated u...

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Bibliographic Details
Published in:MSMR (U.S. Army Center for Health Promotion and Preventive Medicine, Executive Communications Division) Executive Communications Division), 2018-01, Vol.25 (1), p.10-15
Main Authors: DeMarcus, Laurie S, Soderlund, Laurel V, Voss, Jameson D
Format: Article
Language:English
Subjects:
Age Factors
Female
Humans
Incidence
Influenza, Human - classification
Influenza, Human - diagnosis
Influenza, Human - epidemiology
Influenza, Human - physiopathology
Male
Military Family - statistics & numerical data
Military Personnel - statistics & numerical data
Odds Ratio
Physical Examination
Population Surveillance
Predictive Value of Tests
Real-Time Polymerase Chain Reaction
Respiratory Tract Infections - classification
Respiratory Tract Infections - diagnosis
Respiratory Tract Infections - epidemiology
Respiratory Tract Infections - physiopathology
ROC Curve
United States - epidemiology
United States Department of Defense
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Summary:Despite the growth in influenza surveillance programs, standardization of a globally accepted influenza-like illness (ILI) case definition remains difficult. With 2011-2014 Department of Defense Global, Laboratory-based Influenza Surveillance Program (DISP) data, 12 case definitions were evaluated using a combination of ILI case definitions from the Centers for Disease Control and Prevention, World Health Organization, and the DISP. The sensitivity, specificity, positive and negative predictive values, and odds ratios for each case definition were calculated. Additionally, area under the curve (AUC) was calculated for a receiver operating characteristic (ROC) curve to compare the case definitions. Between 2 October 2011 and 27 September 2014, 52.3% (5,575 of 10,662) of respiratory specimens submitted met the inclusion criteria. The case definition for the DISP had a sensitivity of 54.6% and specificity of 63.7%. Case definitions should be selected according to the objectives of the surveillance system and resources available. Sensitive case definitions capture a larger proportion of cases but at the cost of testing more specimens. Definitions with higher specificity result in fewer false positives but may miss more cases.
ISSN:2152-8217