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ISDS 2012 Conference Abstracts

ILI and SARI Surveillance along the California & Arizona
Borders with Mexico, 2011-12
Pete Kammerer*, Gary Brice, Anthony Hawksworth and Chris Myers

Operational Infectious Diseases, NHRC, San Diego, CA, USA

Objective
To identify the pathogens responsible for influenza-like illness

(ILI) and severe acute respiratory illness (SARI) along the U.S.-Mex-
ico border region in San Diego and Imperial Counties, CA and Pima
County, AZ.

Introduction
National borders do not prevent the transmission of pathogens and

associated vectors among border populations. The Naval Health Re-
search Center (NHRC) has collaborated with the Mexican Secretariat
of Health, the U. S. Department of State’s Biosecurity Engagement
Program (BEP) and the U. S. Centers for Disease Control and Pre-
vention (CDC) in concert with local health officials to conduct ILI
surveillance (since 2004) and SARI surveillance (since 2009) in the
border region.

Methods
Respiratory swabs were collected from patients with ILI (fever !

100F, and sore throat or cough) or SARI (! 5 y.o.: ILI with hospital
admission; < 5 y.o.: clinical suspicion of pneumonia with hospital ad-
mission) and stored at -70C. Specimens were tested with molecular
techniques, viral and bacterial culture.

Results
NHRC received and tested 295 ILI specimens collected from four

surveillance sites in 2011-12. Demographics: 53% female, 47% male;
36% 0-4 yrs old, 50% 5-24 yrs old, 8% 25-49 yrs old, 4% 50-64 yrs
old, 2% >64 yrs old. Pathogens identified included influenza A

(15%); rhinovirus (8%); respiratory syncytial virus (RSV) (7%); ade-
novirus (6%); influenza B (4%) and parainfluenza virus (PIV) 1;
(4%). 335 SARI specimens were collected from 6 sites. Demo-
graphics: 52% female, 48% male; 41% 0-4 yrs old; 9% 5-24 yrs old,
12% 25-49 yrs old, 11% 50-64 yrs old, 28% >64 yrs old. Pathogens
identified included RSV (17%); rhinovirus (10%); influenza A (9%);
adenovirus (6%); influenza B (2%) and PIV 1 (1%).

Conclusions
In 2011-12, our surveillance identified a difference in the propor-

tion of respiratory pathogens affecting outpatients and inpatients. In-
fluenza A was isolated more frequently in outpatients, whereas RSV
was more frequent in hospitalized patients. We also noted an in-
creased proportion of specimens from the 50-64 yr old and the >64
yr old age groups in the SARI surveillance, whereas 86% of the ILI
specimens are from patients 24 yrs old or less. Additional benefits of
this collaborative surveillance have been the cooperation, joint train-
ing and communication between the participating entities. These pre-
established lines of communication are invaluable during a public
health emergency, which was demonstrated during the recent in-
fluenza pandemic.

Keywords
influenza; ILI; respiratory syncytial virus; US-Mexico border; SARI

*Pete Kammerer
E-mail: peter.kammerer@med.navy.mil

Online Journal of Public Health Informatics * ISSN 1947-2579 * http://ojphi.org * 5(1):e134, 2013