The DoD Worldwide Influenza Surveillance Program
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Brooks City-Base Texas
United States Air Force School of Aerospace Medicine (USAFSAM)
(formerly Air Force Institute for Operational Health (AFIOH)
Epidemiology Services Branch
(Air Force Hub for the DoD-GEIS)
https://gumbo2.brooks.af.mil/pestilence/Influenza/
(available to .mil and .gov users only)
Contact: influenza@brooks.af.mil
The DoD Influenza Surveillance Program is a laboratory based influenza
surveillance program that was begun in 1976 as Project Gargle under
the direction of the Air Force (AF) Surgeon General.
The goals of the program are threefold: (1) detect local respiratory
outbreaks; (2) provide isolates to the World Health Association
(WHO); (3) detect emerging strains. The season officially begins
on 1 Oct. of each year and continues until 31 Mar. Sentinel sites
are selected annually according to base location or mission.
There are 19 AF sentinel bases (9 stateside, 3 Europe, 7 Asia)
and additional sites that have been established in cooperation with
the Army and the Navy. These include sites located at a travel clinic
in Nepal, the Kwai River Christian Hospital on the Thai-Burmese
border, and at Lima, Peru.
The sites represent an effective interservice cooperative effort
providing surveillance from areas not otherwise covered. All active
duty military personnel are required to be vaccinated, so the program
serves to track vaccine efficacy and determine when coverage is
waning.
Each site collects specimens from both active duty and dependents
and ships them to the Brooks virology lab for culture. Most results
are available in 48 hours, but cultures are held up to 10 days to
detect any virus that may be present. Those reported include: influenza
A and B, parainfluenza 1,2, or 3, adenovirus, enterovirus, and herpes
simplex virus.
Selected isolates are forwarded to The Centers for Disease Control
and Prevention (CDC) for further subtyping. These submissions are
compared with others for vaccine component determinations. The goals
of the program have been consistently met, and there have been numerous
successes. For example, the surveillance provided the only specimens
CDC received from Japan in 1995 after an earthquake interrupted
that country's surveillance infrastructure. Early in the 1995-96
season isolates from Guam verified the travel of a variant strain
seen in China. Based on this information, it was decided to include
the Wuhan strain in the vaccine for the 1996-97 season. This was
the prevailing flu A strain seen that year. In 1999, the lab isolated
a strain of Influenza type-A that was incorporated in the Southern
Hemisphere vaccine.
The DoD Influenza Surveillance program is a flexible system that
provides valuable public health information as well as worldwide
surveillance of an important and continually re-emerging pathogen.
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