How Electronic Data Helps Protect the Public from Influenza

Brit Colanter

How bad is the flu season?

Were any flu-related deaths reported last week?

Did the number of flu cases go up or down? How about the percentage of people at local emergency rooms with influenza-like symptoms?

These are the main questions that Brit Colanter, an epidemiologist with Public Health Services at the County Health and Human Services Agency (HHSA), must find answers for year-round to determine how influenza is impacting residents in the region.

To do that, she turns to several County systems that collect electronic health information and lab results from the local medical community on influenza and dozens of other infectious diseases.

These systems include the communicable disease registry and other electronic health data systems. Colanter and her colleagues analyze the data on a weekly basis to determine how influenza is impacting the local community.

The analysis is turned into HHSA’s weekly Influenza Watch report, which tracks key flu indicators and summarizes influenza activity in the region. The report is issued every Wednesday from October to April primarily to the medical community, but members of the public and the media can also register to receive it.

The data crunching requires a lot of packaging that results in spreadsheets, tables and graphs that inform county doctors about influenza activity at any week during the season and what trends are being detected.

“Now we have more robust electronic records which allow us to have comparable data from season to season.”

For Colanter, the data behind the Influenza Watch report are like pieces of a puzzle that help to describe for the medical community what is happening in relationship to influenza.

“I love it,” said Colanter, who’s been with HHSA for 15 years and has a master’s degree in public health epidemiology from San Diego State University. “Public health is a great place to be. I have always been interested in infectious diseases.”

Data on Influenza Deaths

On influenza-related deaths, the County collects as much data as possible, but privacy is protected, and the information released to the public is limited.  What is reported is the date of death, the age and gender of the person who died, the type of influenza involved, as well as the region of the county where they lived and whether they had underlying medical conditions or had been vaccinated.

To get all this info, Colanter looks at electronic medical records, the San Diego Regional Immunization Registry, and death certificates that are filed with the County’s Office of Vital Records and Statistics.

The lab-confirmed influenza cases come from local hospital labs and private medical labs, as well as the County Public Health Lab and community clinics, which also serve as influenza sentinel sites. Much of the lab data is reported through electronic lab interfaces with local hospital labs.

The cases are then divided by flu strain, which this season has predominantly been influenza A Pandemic H1N1, although the region has now started to see an increase in influenza A H3N2.

Local emergency departments also report the percentage of patients reporting influenza-like illness, which Colanter compiles to provide a weekly percentage for the region.

Protecting the Public’s Health

Although only pediatric deaths and influenza outbreaks are required to be reported to local health departments in California, the County encourages voluntary reporting of all lab-confirmed influenza cases so it can provide a more detailed and accurate picture of flu activity. These reports help to identify flu outbreaks and deaths. The close connection to the local medical community allows the County to provide extensive analysis on influenza.

“We have really good relationships with our local hospitals and providers,” said Colanter, who in years past had to call emergency departments each week to collect their percentage of influenza-like illness. “Now we have more robust electronic records which allow us to have comparable data from season to season.”

The County’s electronic data collection enables Colanter and other County epidemiologists to provide timely and detailed internal and external reports, not just on influenza, but on other infectious diseases that occur in the region.

Recently, Colanter prepared an extensive flu case count and influenza-like illness report for each week of the past 11 influenza seasons. Both reports were created at the request of the local daily newspaper.

“The data we provide helps inform local residents and to protect the public’s health,” Colanter said.

José A. Álvarez is a communications specialist with the County of San Diego Communications Office. Contact