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| Influenza Hospitalization Surveillance Network | |
|---|---|
| Name | Influenza Hospitalization Surveillance Network |
| Abbreviation | FluSurv-NET |
| Formation | 2003 |
| Type | Public health surveillance network |
| Headquarters | United States Centers for Disease Control and Prevention |
| Region served | United States |
| Parent organization | Centers for Disease Control and Prevention |
Influenza Hospitalization Surveillance Network The Influenza Hospitalization Surveillance Network (FluSurv-NET) is a population-based sentinel surveillance system that monitors laboratory-confirmed influenza-associated hospitalizations across multiple sites in the United States. It provides age-stratified hospitalization rates and epidemiologic characterization used by national and state-level public health officials, clinical researchers, policy makers, and vaccine developers. The network generates near real-time estimates that inform responses coordinated with organizations such as the World Health Organization, Food and Drug Administration, National Institutes of Health, and state health departments.
FluSurv-NET conducts active, population-based surveillance for influenza-associated hospitalizations across catchment areas defined within individual counties and metropolitan areas, yielding standardized hospitalization rates comparable to data from Behavioral Risk Factor Surveillance System, National Health and Nutrition Examination Survey, and other sentinel systems. The network integrates laboratory diagnostics, clinical record abstraction, and demographic linkage to provide stratified indicators for age groups including pediatrics and older adults, supporting analyses used by stakeholders like Advisory Committee on Immunization Practices, American Academy of Pediatrics, Infectious Diseases Society of America, and academic centers such as Johns Hopkins University, Harvard University, and University of California, San Francisco.
Established in 2003, FluSurv-NET evolved from earlier influenza monitoring efforts that included collaborations with the Emerging Infections Program and site-specific projects at institutions like University of Michigan and Emory University. The network expanded following the 2009 H1N1 pandemic to include enhanced case ascertainment, molecular testing linkage with laboratories such as Public Health Laboratory Network partners, and methodological harmonization with global surveillance led by WHO Global Influenza Surveillance and Response System and national liaison through the Association of State and Territorial Health Officials. Over successive influenza seasons FluSurv-NET has refined protocols in coordination with agencies including the Department of Health and Human Services and academic consortia such as Columbia University and University of Pittsburgh.
FluSurv-NET defines a case as a resident of a surveillance catchment area hospitalized with laboratory-confirmed influenza by tests including reverse transcription polymerase chain reaction (RT-PCR), viral culture, or rapid antigen assays performed by clinical or public health laboratories. Laboratory confirmation criteria align with diagnostic standards employed by the Food and Drug Administration and recommendations from the Clinical and Laboratory Standards Institute. Case ascertainment uses active hospital surveillance, chart abstraction conducted by site teams affiliated with institutions such as Yale University and University of Colorado, and standardized variables for underlying conditions mapped to coding systems used by Centers for Medicare & Medicaid Services and electronic health record platforms from vendors like Epic Systems and Cerner Corporation.
Surveillance sites are distributed across multiple states and metropolitan areas, often linked to state health departments and academic partners including University of Minnesota, University of Iowa, and State University of New York. Data elements captured include demographics, vaccination status, clinical outcomes, intensive care unit admission, mechanical ventilation, and in-hospital death, enabling comparisons with datasets from National Inpatient Sample and pediatric surveillance networks such as New Vaccine Surveillance Network. Specimen-level data are sometimes forwarded to reference laboratories including CDC Influenza Division labs for viral characterization, sequencing, and antiviral resistance testing that complement genomic surveillance conducted by centers like Broad Institute and Scripps Research.
FluSurv-NET has produced key estimates of seasonal and pandemic influenza-associated hospitalization burden by age group, highlighting elevated risk among older adults, infants, and persons with chronic conditions tracked by specialty societies like American Heart Association and American Diabetes Association. Analyses from the network have informed vaccine effectiveness studies alongside Vaccine Safety Datalink and contributed to assessments of pandemic severity during the 2009 H1N1 pandemic, seasonal burden estimates used in annual vaccine composition deliberations by WHO and FDA, and health economic evaluations cited by agencies such as Agency for Healthcare Research and Quality.
Aggregated weekly and seasonal FluSurv-NET hospitalization rates, age-specific counts, and summary tables are reported through public dashboards and surveillance summaries coordinated by Centers for Disease Control and Prevention and state health departments including California Department of Public Health and New York State Department of Health. Data releases align with surveillance reporting frameworks used by Morbidity and Mortality Weekly Report and collaborative platforms such as HealthData.gov. Access to de-identified case-level data for research is governed by data use agreements with participating sites and institutional review boards at academic partners like University of Washington and University of Pennsylvania.
FluSurv-NET collaborates with federal agencies, state and local health departments, academic investigators, and international partners including WHO and regional public health labs, supporting vaccine policy by informing Advisory Committee on Immunization Practices recommendations, antiviral guidance from Centers for Disease Control and Prevention divisions, and preparedness planning by Federal Emergency Management Agency and state emergency planners. Outputs support peer-reviewed research published in journals associated with institutions such as The Lancet, New England Journal of Medicine, and Journal of Infectious Diseases, and feed into modeling efforts by groups at Imperial College London, London School of Hygiene & Tropical Medicine, and CDC Modeling Task Force.