title: Influenza surveillance and incidence in a rural area in China during the 2009/2010 influenza pandemic.
abstract: BACKGROUND
  Most influenza surveillance is based on data from urban sentinel hospitals; little is known about influenza activity in rural communities. We conducted influenza surveillance in a rural region of China with the aim of detecting influenza activity in the 2009/2010 influenza season.
  
  
  METHODS
  The study was conducted from October 2009 to March 2010. Real-time polymerase chain reaction was used to confirm influenza cases. Over-the-counter (OTC) drug sales were daily collected in drugstores and hospitals/clinics. Space-time scan statistics were used to identify clusters of ILI in community. The incidence rate of ILI/influenza was estimated on the basis of the number of ILI/influenza cases detected by the hospitals/clinics.
  
  
  RESULTS
  A total of 434 ILI cases (3.88% of all consultations) were reported; 64.71% of these cases were influenza A (H1N1) pdm09. The estimated incidence rate of ILI and influenza were 5.19/100 and 0.40/100, respectively. The numbers of ILI cases and OTC drug purchases in the previous 7 days were strongly correlated (Spearman rank correlation coefficient [r] = 0.620, P = 0.001). Four ILI outbreaks were detected by space-time permutation analysis.
  
  
  CONCLUSIONS
  This rural community surveillance detected influenza A (H1N1) pdm09 activity and outbreaks in the 2009/2010 influenza season and enabled estimation of the incidence rate of influenza. It also provides a scientific data for public health measures.
authors.affiliation: Department of Infectious Disease, Tianjin Centers for Disease Control and Prevention, Tianjin, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Infectious Disease, Tianjin Centers for Disease Control and Prevention, Tianjin, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Li
authors.affiliation: Department of Infectious Disease, Tianjin Centers for Disease Control and Prevention, Tianjin, China.
authors.forename: Xiaochun
authors.initials: X
authors.lastname: Dong
authors.affiliation: Institute of Pathogenic Microbiology, Tianjin Centers for Disease Control and Prevention, Tianjin, China.
authors.forename: Mei
authors.initials: M
authors.lastname: Kong
authors.affiliation: Department of Infectious Disease, Tianjin Centers for Disease Control and Prevention, Tianjin, China.
authors.forename: Lu
authors.initials: L
authors.lastname: Gao
authors.affiliation: Hangu Centers for Disease Control and Prevention, Binhai New Area, Tianjin, China.
authors.forename: Xiaojing
authors.initials: X
authors.lastname: Dong
authors.affiliation: Department of Infectious Disease, Tianjin Centers for Disease Control and Prevention, Tianjin, China.
authors.forename: Wenti
authors.initials: W
authors.lastname: Xu
mesh_terms: D002681:China / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D053118:Influenza A Virus, H1N1 Subtype / Q000145:classification / Q000235:genetics*; D007251:Influenza, Human / Q000453:epidemiology* / Q000235:genetics; D004366:Nonprescription Drugs; D058873:Pandemics; D012423:Rural Health; D012424:Rural Population; D018571:Sentinel Surveillance
chemical_list: D004366:Nonprescription Drugs