Pandemic Influenza Surveillance, Capacity and Capability Model

Background:  Maricopa County Department of Public Health (MCDPH) conducts infectious disease surveillance through the BioSense Surveillance System (BioSense) and many other sources. However, the coordination of multiple complex data sources necessary for prolonged pandemic influenza surveillance and monitoring required a new methodology.   

Setting:  Maricopa County, Arizona.  It comprises 32 cities, 15 unincorporated communities and 5 Tribal Nations 

Population: The third largest public health jurisdiction in the nation with a population of 4 million

Project Description:  An interactive model (MCDPH Pandemic Influenza Surveillance, Capacity and Capability Model) developed and implemented to track the progression of 2009 H1N1 influenza and determine if the County possessed the capacity and capability to care for ill persons.  BioSense data from 28.5% of local hospital beds were supplemented with a survey of participating hospitals containing the baseline number of available beds, doctors, nurses, and laboratory technicians.   

Results/Lessons Learned: Results: 

1. Daily pandemic influenza data are compared to CDC models (FluSurge, FluAid) based on selected attack rates (15, 25, or 35%)
2. The number of required vs. available resources based on current disease projections are tracked
3. The Local Health Officer has access to an electronic dashboard indicating the epidemiology of  the pandemic and the availability of local resources on which to base policy decisions 

Lessons Learned:

1. Local health organizations require a tool which tracks influenza surveillance data and puts it into the context of available critical resources to make evidence-based policy decisions.
2. Health care facilities rely on public health for central resource coordination.
3. Available resources are often dispersed across public and private entities located miles apart.  Locating and distributing these resources requires a robust electronic system.
4. Pediatric beds, ventilators, and trained medical staff are the limiting factor in responding to a severe influenza pandemic in Maricopa County.