How a community-based assessment can show physicians the ways in which the flu spreads.
Understanding the community-based pathology of influenza (flu) may help the responders and resources often most burdened in flu care: hospitalists, pediatricians, and even schools. The Seattle Flu Study, presented at IDWeek 2019 in Washington, DC, set a blueprint for major cities.
In an interview with MD Magazine®, study author Helen Chu, MD, MPH, an assistant professor at the University of Washington, explained the study’s intent, and what could be replicated by other investigators and public health experts.
MD Mag: What is the objective of the Seattle Flu Study?
Chu: So, the impetus for the Seattle flu study was to develop a system to understand how flu would enter and spread in a city. Traditionally, we rely on the hospital to give us answers for when the flu season starts, and often, the people who go to the hospital, or people who are elderly who are very young.
And they're not often the first people who get sick. So, we think that the people who actually get sick first and probably spread it within the community are not in the hospital, and if we did community-wide surveillance, we might be able to understand how flu enters the city and spreads before it hits the hospital system.
MD Mag: How could a similar model benefit physicians?
Chu: I think one of the key benefits is to be able to prepare for the flu season. When flu season starts, it often overwhelms the hospital infrastructure and often overwhelms pediatricians offices. Everybody shows up at the same time, and you suddenly need to have a lot of doses of antivirals ready to give.
And this would provide a system where we would know early. We would give you about 2-3 weeks notice ahead of time, that something was happening, in order to prepare for it.
MD Mag: What is the feasibility of implementing a community-based system like this?
Chu: So the Seattle flu study was designed to really understand how flu entered and spread in any metropolitan area. And the goal was that this would be able to be extrapolated to any city around the world, for flu surveillance.
I think what it requires is strong partnerships in the community. We worked very closely with groups, including the airport, workplaces, childcare centers, and homeless shelters in Seattle, and we implemented community surveillance systems at all of these sites.
And I think that requires a lot of communication and education, and a lot of time spent answering questions of the community—to make sure that what we're doing is appropriate and acceptable to those out there, who are actually going to be seen during the first cases of flu.