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Updated: Jul 17, 2026
High-throughput Detection Method for Influenza Virus
Published on: February 4, 2012
Estimating the undetected burden of influenza hospitalizations in children
C G Grijalva1, G A Weinberg, N M Bennett
1Department of Preventive Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232-2637, and Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, OH, USA.
Insights
Capture-recapture analysis improved influenza hospitalization estimates in children under 5. This method offers a more accurate picture of pediatric influenza burden than individual surveillance systems alone.
Area of Science:
- Epidemiology
- Infectious Diseases
- Public Health Surveillance
Background:
- Two independent influenza surveillance systems, the New Vaccine Surveillance Network (NVSN) and the Emerging Infections Program (EIP), operated concurrently during the 2004-2005 influenza season.
- NVSN prospectively enrolled children hospitalized with respiratory symptoms, utilizing culture and RT-PCR for influenza testing.
- EIP identified hospitalized children with positive influenza tests from routine medical care, representing a clinical-laboratory based system.
Purpose of the Study:
- To estimate the burden of influenza-related hospitalizations in children younger than 5 years.
- To compare the sensitivity of two distinct influenza surveillance systems.
- To evaluate the utility of capture-recapture analysis for improving influenza burden estimation.
Main Methods:
- Capture-recapture analysis was applied using data from the NVSN and EIP surveillance systems.
- The study focused on children aged less than 5 years hospitalized with influenza during the 2004-2005 season.
- Sensitivity of each surveillance system was calculated against the capture-recapture estimate.
Main Results:
- The estimated influenza-related hospitalization rate in children under 5 years was 8.6 per 10,000.
- The prospective surveillance system (NVSN) demonstrated a sensitivity of 69%.
- The clinical-laboratory based system (EIP) showed a sensitivity of 39%.
Conclusions:
- Capture-recapture analysis provides more accurate estimates of influenza-related hospitalizations compared to individual surveillance systems.
- Integrating data from multiple surveillance systems enhances the precision of public health estimates.
- This approach is valuable for optimizing resource allocation in influenza surveillance, especially given limited resources.
Abstract:
During the 2004-2005 influenza season two independent influenza surveillance systems operated simultaneously in three United States counties. The New Vaccine Surveillance Network (NVSN) prospectively enrolled children hospitalized for respiratory symptoms/fever and tested them using culture and RT-PCR. The Emerging Infections Program (EIP) and a similar clinical-laboratory surveillance system identified hospitalized children who had positive influenza tests obtained as part of their usual medical care. Using data from these systems, we applied capture-recapture analyses to estimate the burden of influenza related-hospitalizations in children aged<5 years. During the 2004-2005 influenza season the influenza-related hospitalization rate estimated by capture-recapture analysis was 8.6/10,000 children aged<5 years. When compared to this estimate, the sensitivity of the prospective surveillance system was 69% and the sensitivity of the clinical-laboratory based system was 39%. In the face of limited resources and an increasing need for influenza surveillance, capture-recapture analysis provides better estimates than either system alone.
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