Reliable infectious disease surveillance is pivotal for early detection, control, and public health reporting of emergent viral threats, such as the subtyping of influenza A. Historical documentation depicts a marked progression in the US infectious disease reporting structure. Commencing with Michigan’s 1833 law mandating contagious disease declaration, by 1901 all 45 states of that era had similar requisite notifications in place. The escalated public concern triggered by the 1916 poliomyelitis epidemic and 1918 flu pandemic ushered an era where all states were engaged in national morbidity reporting by 1925.
Today, the mandate for consistent reporting of infectious disease data to public health authorities has expanded to all US states and territories. To ensure comprehensive coverage of contagious conditions, the Centers for Disease Control and Prevention (CDC) collaborates with state legislatures through the National Notifiable Disease Surveillance System (NNDSS). Reporting regulations and infectious diseases reporting lists vary per state and are enforced by state health departments. The voluntary submission of notifiable diseases data to the CDC by states is provisional, allowing for changes as more information becomes available.
To enable consistent and accurate reporting, the CDC liaises with state health departments, providing guidance and necessary resources. The CDC functions as the central hub in collecting data, analyzing it, and disseminating information through weekly and annual reports. This information is used to monitor disease trends, detect outbreaks, and inform public health interventions.
Ohio, for instance, applies its Infectious Disease Control Manual (IDCM) as the reference for local health departments, healthcare facilities, laboratories, and healthcare personnel, providing details about communicable diseases, reporting obligations, and infection control recommendations. The ODH segregates reportable diseases into three classes – A, B, and C, indicating the urgency of reporting. Class A reportable conditions represent diseases of significant public health concern due to their severe nature or potential for epidemic transmission. One such Class A reportable condition is Novel influenza A, a viral infection of concern due to its dissimilarity from currently circulating strains.
In addressing the barrier to novel influenza A identification, our medical center employed a multi-prong strategy involving collaboration with laboratory services and leveraging the capabilities of our infection prevention and control software, VigiLanz Infection Prevention Pro. The medical center’s Infection Prevention and Control (IPC) program developed a standard operating procedure to identify suspected novel influenza A cases swiftly, brief on specimen collection instructions, and provide patient management guidance.
To comply with the CDC’s January 2025 request to subtype influenza strains, particularly for ICU patients, Infection Preventionists review all patients admitted for influenza A without a respiratory viral panel test result. Artificial intelligence (AI) rule-based detection methods were developed to identify admitted patients with influenza, including those without test results performed at our facility. In conclusion, through a strategic, multi-faceted approach leveraging the capabilities of advanced surveillance software, and robust coordination with laboratory departments and health authorities, our medical center has developed a comprehensive and adaptable SOP to identify and manage potential novel influenza A cases.