Influenza Monitoring by the US Military

Program Provides Important Data to Support Worldwide Health Efforts

San Diego, 7 July 2009 – The recent global swine flu outbreak has underscored the critical need for good surveillance and rapid access to epidemiological data. The US military, starting with early monitoring efforts in the 1970s, has developed a broad-based influenza monitoring system. In an article published in the September 2009 issue of the American Journal of Preventive Medicine, researchers describe this little-known national jewel that has repeatedly made notable contributions to global influenza control through close collaboration with CDC, the Food and Drug Administration (FDA), the WHO, and many other partners.

National concerns about emerging infectious diseases led to the creation of the Department of Defense Global Emerging Infections Surveillance and Response System (DoD-GEIS) in 1997. This program has 6 objectives relevant to influenza: (1) To isolate and identify circulating influenza viruses, (2) To detect new virus variants or subtypes for possible vaccine modification, (3) To identify influenza outbreaks, (4) To determine the incidence of influenza-like illness among sentinel military populations at high risk, such as basic training populations, (5) To prevent or control endemic and pandemic influenza outbreaks, and (6) To conduct global, operationally relevant, laboratory-based influenza surveillance.

According to the Institute of Medicine, “The DoD–Global Emerging Infections System, through its avian influenza/pandemic influenza activities at the [DoD] overseas laboratories and headquarters, has contributed greatly to the development of laboratory and communications infrastructures within partner countries. Beneficial effects can be seen from current DoD-GEIS efforts in 56 countries to assist its public health partners in building capacity through training and support of laboratory and communications infrastructures.”

Writing in the article, Col. James Neville, MD, MPH, of the US Air Force School of Aerospace Medicine, Brooks City-Base, Texas, and colleagues state, “During seven complete influenza seasons, the DoD Global Laboratory-Based Influenza Surveillance Program…coordinated and expanded influenza surveillance efforts among the uniformed services and with DoD partner nations overseas, and operated in concert with WHO and CDC programs. As a result, the DoD and other global communities benefited from improved surveillance and expanded influenza laboratory and epidemiologic capability. The generated data and information supported timely, informed decision making in response to threats, expanded the data set used to select the components for seasonal influenza vaccines, and provided candidate seed viruses for possible use in influenza vaccines used worldwide.”

In a commentary in the same issue, Dr. Patrick W. Kelley, MD, DrPH, of the Institute of Medicine, The National Academies, notes that, “The somewhat unexpected emergence of novel H1N1 in Mexico, rather than in the anticipated Asian setting, highlights a lesson learned about the need for comprehensive global influenza surveillance. This is a lesson that geographically diverse foreign military health systems may be well-positioned to help address.”

He continues, “The success of the US DoD system, and the particular epidemiologic characteristics of military populations and military health systems, suggest that global influenza surveillance and response could be more comprehensive and informative if other military organizations around the world took advantage of their comparative organizational advantages to emulate, extend, and institutionalize the US DoD approach.”

The article is “Department of Defense Global Laboratory-Based Influenza Surveillance: 1998-2005” by Angela B Owens, MPH; Linda C Canas, BS; Kevin L Russell, MD, MTM&H; James Neville, MD, MPH; Julie A Pavlin, MD, PhD, MPH; Victor H MacIntosh, MD, MPH; Gregory C Gray, MD, MPH; and Joel C Gaydos, MD, MPH. The commentary is “A Commentary on the Military Role in Global Influenza Surveillance” by Dr. Patrick W Kelley, MD, DrPH. Both appear in the American Journal of Preventive Medicine, Volume 37, Issue 3 (September 2009) published by Elsevier.

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Full text of the articles is available upon request; contact eAJPM@ucsd.edu to obtain a pdf. To schedule an interview with Dr. Neville, please contact Joe N. Wiggins, Director of Public Affairs, Brooks City-Base at 210 536 5140 orJoe.Wiggins@brooks.af.mil. Journalists wishing to interview Dr. Kelley, please contact Christine Stencel, IOM Senior Media Officer, at 202 334 1632 or cstencel@nas.edu.

About The American Journal of Preventive Medicine
The American Journal of Preventive Medicine is the official journal of The American College of Preventive Medicine and the Association for Prevention Teaching and Research. It publishes articles in the areas of prevention research, teaching, practice and policy. Original research is published on interventions aimed at the prevention of chronic and acute disease and the promotion of individual and community health. The journal features papers that address the primary and secondary prevention of important clinical, behavioral and public health issues such as injury and violence, infectious disease, women's health, smoking, sedentary behaviors and physical activity, nutrition, diabetes, obesity, and alcohol and drug abuse. Papers also address educational initiatives aimed at improving the ability of health professionals to provide effective clinical prevention and public health services. The journal also publishes official policy statements from the two co-sponsoring organizations, health services research pertinent to prevention and public health, review articles, media reviews, and editorials.

The American Journal of Preventive Medicine is ranked 12th out of 105 Public, Environmental & Occupational Health titles and 16th out of 107 General and Internal Medicine titles according to the 2008 Journal Citation Reports© published by Thomson Reuters.

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