Practice of Epidemiology MoSAIC: Mobile Surveillance for Acute Respiratory Infections and Influenza-Like Illness in the Community

Surveillance for acute respiratory infection (ARI) and influenza-like illness (ILI) relies primarily on reports of med-ically attended illness. Community surveillance could mitigate delays in reporting, allow for timely collection of re-spiratory tract samples, and characterize cases of non–medically attended ILI representing substantial personal and economic burden. Text messaging could be utilized to perform longitudinal ILI surveillance in a community-based sample but has not been assessed. We recruited 161 households (789 people) in New York City for a study of mobile ARI/ILI surveillance, and selected reporters received text messages twice weekly inquiring whether anyone in the household was ill. Home visits were conducted to obtain nasal swabs from persons with ARI/ILI. Par-ticipants were primarily female, Latino, and publicly insured. During the 44-week period from December 2012 through September 2013, 11,282 text messages were sent. In responses to 8,250 (73.1%) messages, a household reported either that someonewas ill or no onewas ill; 88.9 % of responseswere received within 4 hours. Swabswere obtained for 361 of 363 reported ARI/ILI episodes. Themedian time from symptom onset to nasal swab was 2 days; 65.4 % of samples were positive for a respiratory pathogen by reverse-transcriptase polymerase chain reaction. In summary, text messaging promoted rapid ARI/ILI reporting and specimen collection and could represent a prom-ising approach to timely, community-based surveillance. acute respiratory infection; influenza; influenza-like illness; respiratory viruses; surveillance; text messagin