title: Hospital surveillance of influenza strains: a concordant image of viruses identified by the Swiss Sentinel system?
abstract: The Swiss Sentinel system for influenza virus surveillance reports influenza-like illness in the community through a network of primary care practitioners, but the epidemiologic, demographic, and virological characterization may differ from that observed in hospitalized patients with influenza.
  
  
  
  To compare demographic and virological data from hospital influenza cases with Sentinel system data during the 2014-2015 season.
  
  
  
  We included 2623 in- and outpatients with a screening request for influenza A/B in a university teaching hospital in Geneva, Switzerland, and 933 participants from the Swiss Sentinel surveillance system and compared the demographic and virological data of the two populations, including the respective distribution of influenza subtypes, and conducted a phylogenetic comparison at the HA1 level of influenza viruses recovered in community and hospital cases.
  
  
  
  There were similar proportions of influenza strains recovered in the hospital and in the community (H3N2, 57.1% and 56.9%; H1N1pdm09, 15.5% and 14.2%; B, 27.4% and 28.8%, respectively). HA1 sequence analysis confirmed that all three strains were genetically similar between the two populations. During this particular season, influenza cases were detected earlier in the hospital than in the Sentinel system.
  
  
  
  Although an influenza surveillance system based on the community can predict the type of influenza strains that will be associated with hospitalizations, it fails to estimate the potential virulence of circulating strains. Further, the population characteristics in the community differ from those in hospitalized patients. This suggests that any national influenza surveillance system should include both community- and hospital-based surveys.
authors.affiliation: Swiss National Reference Centre for Influenza, Geneva University Hospitals, Geneva, Switzerland.|Laboratory of Virology, Geneva University Hospitals, Geneva, Switzerland.|University of Geneva Medical School, Geneva, Switzerland.
authors.forename: Ana Rita
authors.initials: AR
authors.lastname: Gonçalves
authors.affiliation: University of Geneva Medical School, Geneva, Switzerland.|Infection Control Program and WHO Collaborating Centre on Patient Safety, Geneva University Hospitals, Geneva, Switzerland.
authors.forename: Anne
authors.initials: A
authors.lastname: Iten
authors.affiliation: Swiss National Reference Centre for Influenza, Geneva University Hospitals, Geneva, Switzerland.|Laboratory of Virology, Geneva University Hospitals, Geneva, Switzerland.|University of Geneva Medical School, Geneva, Switzerland.
authors.forename: Patricia
authors.initials: P
authors.lastname: Suter-Boquete
authors.affiliation: Laboratory of Virology, Geneva University Hospitals, Geneva, Switzerland.|University of Geneva Medical School, Geneva, Switzerland.
authors.forename: Manuel
authors.initials: M
authors.lastname: Schibler
authors.affiliation: Swiss National Reference Centre for Influenza, Geneva University Hospitals, Geneva, Switzerland.|Laboratory of Virology, Geneva University Hospitals, Geneva, Switzerland.|University of Geneva Medical School, Geneva, Switzerland.
authors.forename: Laurent
authors.initials: L
authors.lastname: Kaiser
authors.affiliation: Swiss National Reference Centre for Influenza, Geneva University Hospitals, Geneva, Switzerland.|Laboratory of Virology, Geneva University Hospitals, Geneva, Switzerland.|University of Geneva Medical School, Geneva, Switzerland.
authors.forename: Samuel
authors.initials: S
authors.lastname: Cordey
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003153:Community Health Services; D005260:Female; D019267:Hemagglutinin Glycoproteins, Influenza Virus / Q000235:genetics; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D053118:Influenza A Virus, H1N1 Subtype / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D053122:Influenza A Virus, H3N2 Subtype / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D009981:Influenza B virus / Q000235:genetics / Q000302:isolation & purification; D007251:Influenza, Human / Q000453:epidemiology* / Q000821:virology*; D008297:Male; D008875:Middle Aged; D010802:Phylogeny; D012621:Seasons; D018571:Sentinel Surveillance; D013557:Switzerland / Q000453:epidemiology; D055815:Young Adult
chemical_list: D019267:Hemagglutinin Glycoproteins, Influenza Virus
keywords: Switzerland; community; hospital; influenza; surveillance