Global Influenza Surveillance in the U.S. Military

Given that infections caused by various emerging respiratory pathogens and known biological warfare agents often present initially as influenza-like illnesses, there is interest in a near-real-time system that can identify both covert attacks involving biological agents and emerging respiratory pathogens. This article describes an approach integrating the results from lab-based influenza surveillance with several complementary health data streams (outpatient, inpatient, immunization, etc.) to create such an enhanced surveillance system. The 1918 influenza pandemic serves as a poignant reminder of how devastating influenza can be. Its ability to generate enormous numbers of casualties, probable travel restrictions, and effects on civilian support infrastructure poses a serious threat to military operations. More recently, in 1996, a United States ship of the line was taken out of service and forced into a foreign port for 2 days while waiting for enough crew member