Novel Viral Pediatric Early Warning Sentinel Surveillance (PEWSS) System

BACKGROUND:   In response to the novel influenza H1N1 outbreak in 2009, the Southern Nevada Health District in Las Vegas, Nevada developed a medical practice based sentinel respiratory virus surveillance program to identify the occurrence of influenza. 

METHODS:   We expanded the system in 2010 from influenza to monitor ten respiratory pathogens: Influenza A (including subtypes H1N1 and H3N2) and B, adenovirus, human metapneumovirus, human parainfluenza-1, -2, and -3, and respiratory syncytial virus.  Five pediatric medical practices served as sentinel sites, which collected up to 50 nasal samples each week year-round from children who met the influenza-like illness case definition.  Samples were tested by the Southern Nevada Public Health Laboratory, and results were disseminated to the medical and general communities in weekly bulletins throughout the year.

RESULTS:   The Pediatric Early Warning Sentinel Surveillance System (PEWSS) rapidly identified these respiratory diseases for three consecutive years.  PEWSS was well-received by the stakeholders, because the information was highly specific to local residents, and timely for clinicians.  We also used results to increase public health awareness and provide information on supportive treatment and prevention measures.  Comparison between PEWSS and comparable respiratory surveillance systems by the Centers for Disease Control and Prevention (National Respiratory and Enteric Virus Surveillance System) and a local participant of the Department of Defense Global Laboratory-Based Influenza Surveillance Program showed PEWSS data were obtained earlier, had higher community-level resolution, and monitored more respiratory viruses than these two programs. 

CONCLUSIONS:   PEWSS has proven to be timely, simple to implement, relatively inexpensive, accepted by stakeholders, and valuable as an enhanced respiratory virus surveillance program.