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Pharmacy-based influenza surveillance may be effective
Antiviral prescription dispensing dates may be a suitable proxy for influenza surveillance at the local health authority level, data from a retrospective study suggest.
“The potential for pharmacy-based surveillance to detect changes in community illness levels earlier than traditional laboratory-based surveillance methods is premised on the fact that the public will routinely seek over-the-counter medications to relieve or alleviate common symptoms of illness, and physicians often will prescribe medications before receiving laboratory confirmation,” researchers from the Public Health Agency of Canada wrote in Morbidity and Mortality Weekly Report.
The researchers compared the weekly number of dispensed antiviral prescriptions for oseltamivir (Tamiflu, Genentech) and zanamivir (Relenza, GlaxoSmithKline) with the numbers of confirmed laboratory reports of influenza A(H1N1) during the second wave of the outbreak in 2009. The data on prescriptions were provided by Rx Canada Inc. and included data from 75% of the pharmacies in Ontario. The laboratory reports of influenza A(H1N1) were provided by the Ministry of Health and Long-Term Care in Ontario.
From July 1 to December 2009, there were approximately 43,000 prescriptions for oseltamivir and zanamivir in Ontario, and there were approximately 7,300 confirmed cases of influenza A(H1N1). The researchers observed very little lag between the case-onset trend line and the antiviral prescription trend line.
There was a significant relationship between case counts and antiviral prescriptions.
“Although laboratory-based surveillance remains a cornerstone of influenza surveillance, the need for more timely surveillance data has never been greater,” the researchers wrote. “With routine and daily movement of persons between communities, an infectious disease can rapidly spread around the world in a matter of days. Successful results of most mitigation strategies are best achieved if implemented in the community as early as possible.”
Disclosure: The researchers report no relevant financial disclosures.
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