Utilizing spatiotemporal analysis of influenza-like illness and rapid tests to focus swine-origin influenza virus intervention

In the spring of 2009, a novel strain of H1N1 swine-origin influenza A virus (S-OIV) emerged in Mexico and the United States, and soon after was declared a pandemic by the World Health Organization. This work examined the ability of real-time reports of influenza-like illness (ILI) symptoms and rapid influenza diagnostic tests (RIDTs) to approximate the spatiotemporal distribution of PCR-confirmed S-OIV cases for the purposes of focusing local intervention efforts. Cluster and age adjusted relative risk patterns of ILI, RIDT, and S-OIV were assessed at a fine spatial scale at different time and space extents within Cameron County, Texas on the US-Mexico border. Space-time patterns of ILI and RIDT were found to effectively characterize the areas with highest geographical risk of S-OIV within the first two weeks of the outbreak. Based on these results, ILI and/or RIDT may prove to be acceptable indicators of the location of S-OIV hotspots. Given that S-OIV data is often difficult to obtain real-time during an outbreak; these findings may be of use to public health officials targeting prevention and response efforts during future flu outbreaks. (C) 2010 Elsevier Ltd. All rights reserved.