Department of Defense Global Laboratory-Based Influenza Surveillance: 1998-2005.

The Department of Defense (DoD) Global Laboratory-Based Influenza Surveillance Program was initiated in 1997 to formally consolidate and expand existing influenza surveillance programs within the DoD and in areas where DoD was working. Substantial changes in 2008 provided an opportunity to review the operation of the surveillance program as it existed during seven complete influenza seasons (1998-2005); the review was conducted in 2008. A unique aspect of the DoD program was the global reach for specimen collection and the ability to rapidly ship, process, and evaluate specimens from 27 countries. The resulting epidemiologic data combined with the culture results from >46,000 patients provided information that was shared with similar national and international programs, such as those of the CDC. Likewise, selected influenza isolates were molecularly characterized and shared with the CDC to be compared with other surveillance programs. Timeliness of the samples contributed to the information available for annual influenza vaccine selection.

Asthma hospitalizations among US military personnel, 1994 to 2004.

BACKGROUND: Acute asthma attacks strike unpredictably and may lead to hospitalization in otherwise healthy individuals. The burden of asthma hospitalization on the US health care system has greatly interested health care workers, many of whom see the incidence of asthma as increasing. OBJECTIVES: To examine the annual incidence of hospitalization and the frequency of subsequent hospitalization for asthma among all active-duty US military personnel between 1994 and 2004 and to determine demographic and occupational risk factors of asthma hospitalization within this generally healthy US population. METHODS: Annual demographic and occupational data were combined with electronic hospitalization records for patients with a discharge diagnosis of asthma. Using Cox proportional hazard modeling, the authors investigated demographic and occupational risk factors for asthma hospitalization. RESULTS: Women, married persons, health care workers, enlisted personnel, US Army personnel, and older persons were found to have a significantly greater risk of asthma hospitalization. Yearly rates of hospitalization declined from 22.3 per 100,000 persons to 12.6 per 100,000 persons between 1994 and 2004. CONCLUSIONS: Although these data have some limitations, they suggest that the burden of asthma hospitalizations in the large, healthy population of US military personnel has declined during the last decade. The decrease in hospitalization potentially reflects improved outpatient management strategies.

Human metapneumovirus, Peru.

We retrospectively studied 420 pharyngeal swab specimens collected from Peruvian and Argentinean patients with influenzalike illness in 2002 and 2003 for evidence of human metapneumovirus (HMPV). Twelve specimens (2.3%) were positive by multiple assays. Six specimens yielded HMPV isolates. Four of the 6 isolates were of the uncommon B1 genotype.

Innovative surveillance methods for rapid detection of disease outbreaks and bioterrorism: results of an interagency workshop on health indicator surveillance.

A system designed to rapidly identify an infectious disease outbreak or bioterrorism attack and provide important demographic and geographic information is lacking in most health departments nationwide. The Department of Defense Global Emerging Infections System sponsored a meeting and workshop in May 2000 in which participants discussed prototype systems and developed recommendations for new surveillance systems. The authors provide a summary of the group's findings, including expectations and recommendations for new surveillance systems. The consensus of the group was that a nationally led effort in developing health indicator surveillance methods is needed to promote effective, innovative systems.