California Sentinel Provider Program

• Interested in becoming a sentinel provider?
• Resources for current sentinel providers

The California Sentinel Provider Influenza Surveillance Program is a partnership between clinicians, local health departments (LHDs), the California Department of Public Health (CDPH), and the federal Centers for Disease Control and Prevention (CDC) to conduct surveillance for influenza-like illness (ILI).  Since its inception in 1998, the program has been contributing valuable information to state, national, and global influenza surveillance efforts.

The information collected by California sentinel providers is combined with other influenza surveillance data on influenza-related hospitalizations, antiviral usage, severe influenza cases and positive laboratory detections from collaborating hospital, academic and public health laboratories throughout the state to monitor the timing, location, and impact of influenza viruses year-round. 

Influenza-like Illness Surveillance

Sentinel Providers report the number of patients seen with ILI in five age categories (0-4 years, 5-24 years, 25-49 years, 50-64 years, >64 years) and the total number of patients seen for any reason. Reports are submitted on a weekly basis to the CDC by internet or fax.

Case definition for Influenza-like Illness

• Any illness with fever (≥100°F or 37.8°C) - temperature can be from measurement in the office or at home.
AND

• Cough and/or soure throat (in the absence of a known cause)

Compiling and reporting data usually takes less than 30 minutes per week. Participating sentinel providers receive weekly updates on state and national influenza activity. Weekly updates of California influenza activity can also be accessed on the website for the CDPH Influenza Surveillance Program.

Virologic Testing

Nasal, throat, or nasopharyngeal swabs from selected patients may be submitted to the CDPH Viral and Rickettsial Laboratory (VRDL) for virus isolation free of charge.  Specimen collection kits will be replenished as specimens are submitted. 

This season, VRDL encourages sentinel providers to submit samples for influenza testing.  It is especially important that providers collect and submit specimens early in the season (October-December), when influenza isolates are forwarded to the Centers for Disease Control and Prevention (CDC) to hlep identify what may be good candidate strains for inclusion in the 2012-2013 vaccine.  Should the number of samples submitted become overwhelming and the VRDL is unable to test due to limited resources, we may contact that provider individually to ask that they limit their submissions.  Testing at least one specimen a week from each sentinel provider helps us meet our goal of testing a sampling of specimens from different areas of the state in different age groups throughout the influenza season, and helps us characterize what influenza viruses are circulating, which populations are being affected and whether a novel influenza viurs is emerging that may herald a new pandemic strain.  

Specimens will be tested for influenza A and B by PCR.  Specimens that test positive by PCR for influenza A will then be sub-typed as A (seasonal H1), A (H3), or A (2009 H1N1). If you have any questions regarding submission of specimens or test results, please e-mail VRDL at flu@cdph.ca.gov  or contact Katharine King at (510) 307-8585.

Specimens should be collected from patients that meet the case definition for influenza-like illness (see case definition above), especially those with any of the following:

• presenting at the beginning, peak, and end of the influenza season
• with severe disease
• with recent overseas travel
• occurring in an outbreak setting

Why volunteer for the Sentinel Provider Surveillance Program?

Seasonal influenza is a significant cause of illness and death in California each year. Influenza viruses are constantly evolving and routine surveillance improves our ability to monitor the circulation of influenza virus strains in the community. Surveillance for influenza aids with the detection of new subtypes and emerging strains of influenza viruses. With the circulation of the 2009 H1N1 influenza virus, and increased activity levels of influenza-like-illness (ILI), your participation in surveillance is more important now than ever.

Who can be an Influenza Sentinel Provider?

Physicians, physician assistants, and nurse practitioners from any specialty and any practice type are invited to enroll.

How do I enroll in the program?

Fill out the Sentinel Provider Enrollment Form and return it to the Communicable Disease Emergency Response Branch (CDER), Sentinel Provider Program by:

                                              fax: 510-620-5896 or

                                              mail:  850 Marina Bay Parkway, Bldg P - Second Floor, Richmond, CA 94804

Questions?

For more information about enrolling in the Sentinel Provider Program, contact the CDER Branch at InfluenzaSurveillance@cdph.ca.gov or 510-231-6861.  For questions regarding specimen submission and available testing, please contact Katharine King at 510-307-8585 or flu@cdph.ca.gov.