1. 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, FRACGP, FAFPHM UCMC North Hill, Calgary

2. TARRANT Annual Meeting Calgary, February 24, 2005 2 TARRANT- Introduction Influenza surveillance system in Alberta A history of more than 20 years Integration of clinical and virological data 37 sentinel physicians Covering 8 of the 9 health regions in Alberta

3. TARRANT Annual Meeting Calgary, February 24, 2005 3 Information Loop of TARRANT Surveillance Data Summaries, Interpretations, Recommendations Weekly Reports TARRANT Central Office TARRANT sentinel physicians Local Health Regions Alberta Health Health Canada WHO Other data sources Provincial Lab

4. TARRANT Annual Meeting Calgary, February 24, 2005 4 Use of TARRANT Surveillance Data Measurement of influenza epidemics Identification of community virus types Guidance to planning of programs to prevent and control influenza

5. TARRANT Annual Meeting Calgary, 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

6. TARRANT Annual Meeting Calgary, February 24, 2005 6 New Recruitment Potential physicians are: Interested in public health Willing to send data consistently Potential practices are: Likely to see full range of patients Likely to see flu patients Walk-in practices

7. TARRANT Annual Meeting Calgary, February 24, 2005 7 TARRANT Sentinel Physicians Health Region#Sentinel physicians R1 Chinook R H A 3 R2 Palliser 4 R3 Calgary 11 R4 David Thompson 9 (1 practice) R5 East Central Health 1 R6 Capital Health 6 R7 Aspen R H A 2 R8 Peace Country Health 1 R9 Northern Lights 0 TOTAL37

8. TARRANT Annual Meeting Calgary, February 24, 2005 8 Sentinels’ Reporting Behavior 2003-2005 2003 2004 2005 Year-round reporting first started

9. TARRANT Annual Meeting Calgary, February 24, 2005 9 % Weeks Reported Per Sentinel Week 43, 2003 to Week 6, 2005 (68 weeks)

10. TARRANT Annual Meeting Calgary, 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

11. TARRANT Annual Meeting Calgary, February 24, 2005 11 Which Sentinels Persevere? What’s Available in the Literature 1 Factors related to long compliance Interest in epidemiology <5 or ~20 years seniority Factors related to short compliance Interest in local epidemiology surveys Experience 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

12. TARRANT Annual Meeting Calgary, February 24, 2005 12 Influenza-Like Illness and Influenza Isolates TARRANT 2004-2005

13. TARRANT Annual Meeting Calgary, February 24, 2005 13 Influenza-Like Illness TARRANT 1999-2005 #ILI cases/recorder/day