JMIR Public Health Surveill. 2017 Sep 19;3(3):e66. doi: 10.2196/publichealth.7429.
Influenzanet: Citizens Among 10 Countries Collaborating to Monitor Influenza in Europe.
JMIR public health and surveillance
Carl E Koppeschaar, Vittoria Colizza, Caroline Guerrisi, Clément Turbelin, Jim Duggan, W John Edmunds, Charlotte Kjelsø, Ricardo Mexia, Yamir Moreno, Sandro Meloni, Daniela Paolotti, Daniela Perrotta, Edward van Straten, Ana O Franco
Affiliations
Affiliations
- De Grote Griepmeting, Science in Action BV, Amsterdam, Netherlands.
- UPMC Univ Paris 06, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Sorbonne Universités, Paris, France.
- School of Engineering and Informatics, National University of Ireland, Galway, Ireland.
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom.
- Statens Serum Institute, København, Denmark.
- Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisbon, Portugal.
- Institute for Biocomputation and Physics of Complex Systems, Department of Theoretical Physics, University of Zaragoza, Zaragoza, Spain.
- Institute for Scientific Interchange Foundation, Torino, Italy.
- Public Health Agency of Sweden, Solna, Sweden.
- Instituto Gulbenkian de Ciência, Oeiras, Portugal.
PMID: 28928112
PMCID: PMC5627046 DOI: 10.2196/publichealth.7429
Abstract
BACKGROUND: The wide availability of the Internet and the growth of digital communication technologies have become an important tool for epidemiological studies and health surveillance. Influenzanet is a participatory surveillance system monitoring the incidence of influenza-like illness (ILI) in Europe since 2003. It is based on data provided by volunteers who self-report their symptoms via the Internet throughout the influenza season and currently involves 10 countries.
OBJECTIVE: In this paper, we describe the Influenzanet system and provide an overview of results from several analyses that have been performed with the collected data, which include participant representativeness analyses, data validation (comparing ILI incidence rates between Influenzanet and sentinel medical practice networks), identification of ILI risk factors, and influenza vaccine effectiveness (VE) studies previously published. Additionally, we present new VE analyses for the Netherlands, stratified by age and chronic illness and offer suggestions for further work and considerations on the continuity and sustainability of the participatory system.
METHODS: Influenzanet comprises country-specific websites where residents can register to become volunteers to support influenza surveillance and have access to influenza-related information. Participants are recruited through different communication channels. Following registration, volunteers submit an intake questionnaire with their postal code and sociodemographic and medical characteristics, after which they are invited to report their symptoms via a weekly electronic newsletter reminder. Several thousands of participants have been engaged yearly in Influenzanet, with over 36,000 volunteers in the 2015-16 season alone.
RESULTS: In summary, for some traits and in some countries (eg, influenza vaccination rates in the Netherlands), Influenzanet participants were representative of the general population. However, for other traits, they were not (eg, participants underrepresent the youngest and oldest age groups in 7 countries). The incidence of ILI in Influenzanet was found to be closely correlated although quantitatively higher than that obtained by the sentinel medical practice networks. Various risk factors for acquiring an ILI infection were identified. The VE studies performed with Influenzanet data suggest that this surveillance system could develop into a complementary tool to measure the effectiveness of the influenza vaccine, eventually in real time.
CONCLUSIONS: Results from these analyses illustrate that Influenzanet has developed into a fast and flexible monitoring system that can complement the traditional influenza surveillance performed by sentinel medical practices. The uniformity of Influenzanet allows for direct comparison of ILI rates between countries. It also has the important advantage of yielding individual data, which can be used to identify risk factors. The way in which the Influenzanet system is constructed allows the collection of data that could be extended beyond those of ILI cases to monitor pandemic influenza and other common or emerging diseases.
©Carl E Koppeschaar, Vittoria Colizza, Caroline Guerrisi, Clément Turbelin, Jim Duggan, W John Edmunds, Charlotte Kjelsø, Ricardo Mexia, Yamir Moreno, Sandro Meloni, Daniela Paolotti, Daniela Perrotta, Edward van Straten, Ana O Franco. Originally published in JMIR Public Health and Surveillance (http://publichealth.jmir.org), 19.09.2017.
Keywords: Europe; Internet; influenza; surveillance; vaccination
References
- J Med Internet Res. 2014 Mar 10;16(3):e78 - PubMed
- J Infect Dis. 2009 Jan 15;199(2):159-67 - PubMed
- Epidemics. 2015 Dec;13:28-36 - PubMed
- Am J Public Health. 2015 Aug;105(8):e90-7 - PubMed
- BMC Public Health. 2006 Oct 04;6:242 - PubMed
- BMC Infect Dis. 2017 Mar 31;17 (1):238 - PubMed
- J Infect Dis. 2016 Dec 1;214(suppl_4):S386-S392 - PubMed
- PLoS One. 2013 Sep 11;8(9):e73675 - PubMed
- Vaccine. 2009 Oct 23;27(45):6353-7 - PubMed
- PLoS One. 2013 May 17;8(5):e64156 - PubMed
- Cell Host Microbe. 2015 Mar 11;17(3):275-8 - PubMed
- PLoS One. 2014 Dec 09;9(12):e114925 - PubMed
- Vaccine. 2015 Nov 27;33(48):6537-44 - PubMed
- BMC Public Health. 2010 Oct 27;10 :650 - PubMed
- Clin Interv Aging. 2012;7:55-64 - PubMed
- J Pathol. 2007 Jan;211(2):144-56 - PubMed
- BMJ. 2013 Aug 23;347:f5061 - PubMed
- Euro Surveill. 2016;21(7):pii=30139 - PubMed
- Emerg Themes Epidemiol. 2014 Jun 20;11:7 - PubMed
- Epidemiol Infect. 2012 Jul;140(7):1309-15 - PubMed
- PLoS Comput Biol. 2012;8(3):e1002425 - PubMed
- Vaccine. 2016 Jul 25;34(34):3961-6 - PubMed
- Euro Surveill. 2007 Jul 01;12(7):E5-6 - PubMed
- Expert Rev Vaccines. 2012 Sep;11(9):1027-9 - PubMed
- Hum Vaccin Immunother. 2014;10(3):536-43 - PubMed
- BMC Public Health. 2014 Sep 20;14:984 - PubMed
- Clin Microbiol Infect. 2014 Jan;20(1):17-21 - PubMed
- Commun Dis Intell Q Rep. 2009 Sep;33(3):316-22 - PubMed
- Cochrane Database Syst Rev. 2010 Jul 07;(7):CD001269 - PubMed
- J Prev Med Hyg. 2016;57(1):E13-8 - PubMed
- PLoS Negl Trop Dis. 2016 Jun 13;10 (6):e0004795 - PubMed
- BMC Public Health. 2007 Nov 23;7:339 - PubMed
- BMC Infect Dis. 2015 Nov 14;15:522 - PubMed
- Infect Dis (Lond). 2016 Apr;48(4):322-327 - PubMed
- Epidemiol Infect. 2008 Feb;136(2):222-4 - PubMed
- Euro Surveill. 2015 Mar 19;20(11):null - PubMed
- Cochrane Database Syst Rev. 2012 Aug 15;(8):CD004879 - PubMed
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