1. The Department of Defense Laboratory Based Global Influenza Surveillance Program Linda C. Canas Brooks City-Base, TX (210)536-1679

2. Population Based Surveillance Naval Health Research Center San Diego, California DoD Global Influenza Surveillance AF Institute for Operational Health Brooks City-Base San Antonio, Texas Influenza Surveillance

3. DoD GEIS Laboratory Funding & Guidance Routine & Annual Reports; End of Season business meeting Supplies and Instructions Program Guidance & routine reports Collect and ship Samples Info entered into AF database Flu Isolated Conventional Laboratory Methods Sentinel Sites Notification CDC Vaccine Decisions Selected Samples DoD Global Influenza Surveillance.................IN ACTION.................IN ACTION Epi Services Branch

4. 2003-2004 Influenza Sentinel Sites

5. S ENTINEL S ITES RAF Lakenheath, U.K. Ramstein AB, Germany Sheppard AFB, TX Travis AFB, CA Yokota AB, Japan Deployed Al-Udeid AB, Qatar Ganci AB, Kyrgyzstan Overseas Research Sites Armed Forces Research Institute of Medical Sciences (AFRIMS), THAILAND, NEPAL, MALDIVES Naval Medical Research Institute Detachment (NAMRID) PERU, ECUADOR, BOLIVIA, ARGENTINA, NICARAGUA Walter Reed Army Institute of Research (WRAIR), UGANDA Army (1) Tripler AMC, HI Navy/Coast Guard (6) NAB Little Creek, VA NH Yokosuka, Japan NMC San Diego NH Pearl Harbor, HI NH Bremerton CGS Ketchikan Air Force (18) Andersen AFB, Guam Air Force Academy, CO Andrews AFB, MD Aviano AB, Italy Elmendorf AFB, AK Hickam AFB, HI Incirlik AB, Turkey Kadena AB, Japan Kunsan AB, R.O.K. Maxwell AFB, AL McGuire AFB, NJ Misawa AB, Japan Osan AB, R.O.K.

6. N=2946 Pos=1310 Flu A=941

7. Asia/Pacific: Isolates N=319 Pos=128 Flu A = 91

8. North America: Isolates N=2178 Pos=1036 Flu A=739

9. South America: Isolates N=217 Pos=61 Flu A=26

10. Europe: Isolates N=174 Pos=74 FluA=64

11. Deployed: Qatar and Afghanistan N=58 Pos=21 Flu A=21

12. Percent Positive Isolates by Type

13. Percent of Positive Isolates

15. Summary 2003-2004 Overall this has been an exceptional year Monotype season more so than past 5 years A/H3N2 in most locations Few Influenza B and A/H1N1. No H5/H7 at this point. Molecular Analysis H3N2 viruses: nearly 100% variant from vaccine strain