title: Estimating the undetected burden of influenza hospitalizations in children.
abstract: During the 2004-2005 influenza season two independent influenza surveillance systems operated simultaneously in three United States counties. The New Vaccine Surveillance Network (NVSN) prospectively enrolled children hospitalized for respiratory symptoms/fever and tested them using culture and RT-PCR. The Emerging Infections Program (EIP) and a similar clinical-laboratory surveillance system identified hospitalized children who had positive influenza tests obtained as part of their usual medical care. Using data from these systems, we applied capture-recapture analyses to estimate the burden of influenza related-hospitalizations in children aged<5 years. During the 2004-2005 influenza season the influenza-related hospitalization rate estimated by capture-recapture analysis was 8.6/10,000 children aged<5 years. When compared to this estimate, the sensitivity of the prospective surveillance system was 69% and the sensitivity of the clinical-laboratory based system was 39%. In the face of limited resources and an increasing need for influenza surveillance, capture-recapture analysis provides better estimates than either system alone.
authors.affiliation: Department of Preventive Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232-2637, and Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, OH, USA.
authors.forename: C G
authors.initials: CG
authors.lastname: Grijalva
authors.forename: G A
authors.initials: GA
authors.lastname: Weinberg
authors.forename: N M
authors.initials: NM
authors.lastname: Bennett
authors.forename: M A
authors.initials: MA
authors.lastname: Staat
authors.forename: A S
authors.initials: AS
authors.lastname: Craig
authors.forename: W D
authors.initials: WD
authors.lastname: Dupont
authors.forename: M K
authors.initials: MK
authors.lastname: Iwane
authors.forename: A S
authors.initials: AS
authors.lastname: Postema
authors.forename: W
authors.initials: W
authors.lastname: Schaffner
authors.forename: K M
authors.initials: KM
authors.lastname: Edwards
authors.forename: M R
authors.initials: MR
authors.lastname: Griffin
mesh_terms: D002675:Child, Preschool; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007251:Influenza, Human / Q000453:epidemiology*; D011159:Population Surveillance / Q000379:methods*; D014481:United States / Q000453:epidemiology