title: Surveillance for severe acute respiratory infections in Southern Arizona, 2010-2014.
abstract: BACKGROUND
  The Binational Border Infectious Disease Surveillance program began surveillance for severe acute respiratory infections (SARI) on the US-Mexico border in 2009. Here, we describe patients in Southern Arizona.
  
  
  METHODS
  Patients admitted to five acute care hospitals that met the SARI case definition (temperature ≥37·8°C or reported fever or chills with history of cough, sore throat, or shortness of breath in a hospitalized person) were enrolled. Staff completed a standard form and collected a nasopharyngeal swab which was tested for selected respiratory viruses by reverse transcription polymerase chain reaction.
  
  
  RESULTS
  From October 2010-September 2014, we enrolled 332 SARI patients. Fifty-two percent were male and 48% were white non-Hispanic. The median age was 63 years (47% ≥65 years and 5·2% <5 years). During hospitalization, 51 of 230 (22%) patients required intubation, 120 of 297 (40%) were admitted to intensive care unit, and 28 of 278 (10%) died. Influenza vaccination was 56%. Of 309 cases tested, 49 (16%) were positive for influenza viruses, 25 (8·1%) for human metapneumovirus, 20 (6·5%) for parainfluenza viruses, 16 (5·2%) for coronavirus, 11 (3·6%) for respiratory syncytial virus, 10 (3·2%) for rhinovirus, 4 (1·3%) for rhinovirus/enterovirus, 3 (1·0%) for enteroviruses, and 3 (1·0%) for adenovirus. Among the 49 influenza-positive specimens, 76% were influenza A (19 H3N2, 17 H1N1pdm09, and 1 not subtyped), and 24% were influenza B.
  
  
  CONCLUSIONS
  Influenza viruses were a frequent cause of SARI in hospitalized patients in Southern Arizona. Monitoring respiratory illness in border populations will help better understand the etiologies. Improving influenza vaccination coverage may help prevent some SARI cases.
authors.affiliation: Arizona Department of Health Services, Office of Border Health, Tucson, AZ, USA.
authors.forename: Zimy
authors.initials: Z
authors.lastname: Wansaula
authors.affiliation: Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: Sonja J
authors.initials: SJ
authors.lastname: Olsen
authors.affiliation: Arizona Department of Health Services, Office of Border Health, Tucson, AZ, USA.
authors.forename: Mariana G
authors.initials: MG
authors.lastname: Casal
authors.affiliation: Arizona Department of Health Services, Office of Infectious Disease Services, Phoenix, AZ, USA.
authors.forename: Catherine
authors.initials: C
authors.lastname: Golenko
authors.affiliation: Arizona Department of Health Services, Office of Infectious Disease Services, Phoenix, AZ, USA.
authors.forename: Laura M
authors.initials: LM
authors.lastname: Erhart
authors.affiliation: Naval Health Research Center, San Diego, CA, USA.
authors.forename: Peter
authors.initials: P
authors.lastname: Kammerer
authors.affiliation: Clinical and Molecular Microbiology, University of Arizona, Tucson, AZ, USA.
authors.forename: Natalie
authors.initials: N
authors.lastname: Whitfield
authors.affiliation: Arizona Department of Health Services, Office of Border Health, Tucson, AZ, USA.|Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: Orion Z
authors.initials: OZ
authors.lastname: McCotter
mesh_terms: D000257:Adenoviridae Infections / Q000453:epidemiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001130:Arizona / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D062665:Epidemiological Monitoring; D005260:Female; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D009980:Influenza A virus / Q000145:classification / Q000302:isolation & purification; D009981:Influenza B virus / Q000145:classification / Q000302:isolation & purification; D007252:Influenza Vaccines; D007251:Influenza, Human / Q000453:epidemiology* / Q000821:virology; D008297:Male; D029121:Metapneumovirus / Q000235:genetics / Q000302:isolation & purification; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D009305:Nasopharynx / Q000821:virology*; D018184:Paramyxoviridae Infections / Q000453:epidemiology / Q000821:virology; D010850:Picornaviridae Infections / Q000453:epidemiology / Q000821:virology; D012136:Respiratory Syncytial Viruses / Q000235:genetics / Q000302:isolation & purification; D012141:Respiratory Tract Infections / Q000453:epidemiology* / Q000821:virology*; D012229:Rhinovirus / Q000235:genetics / Q000302:isolation & purification; D055815:Young Adult
chemical_list: D007252:Influenza Vaccines
keywords: Arizona; influenza; respiratory tract diseases; surveillance