Hospital Instructions for Influenza Surveillance and Reporting, 2020-2021 Season  

Influenza-associated hospitalizations and influenza-associated deaths are reportable to the Connecticut Department of Public Health (DPH). These events will continue to be reportable throughout the dual influenza season/COVID-19 pandemic. This information is shared with relevant local health departments through the Connecticut Electronic Disease Surveillance System (CTEDSS).

The Emerging Infections Program (EIP) at the Yale School of Public Health conducts enhanced surveillance activities for residents of Middlesex and New Haven Counties on behalf of the DPH. These data contribute to FluSurv-NET, CDC’s Influenza Hospitalization Surveillance Network, which covers over 70 counties in 14 states. FluSurv-NET data are used to estimate age-specific hospitalization rates and describe characteristics of persons hospitalized with severe influenza illness. Staff of the DPH or Yale EIP may request supplemental information from healthcare providers. Providers can contact Alan Siniscalchi (DPH: 860-509-7994) or Kim Yousey-Hindes (Yale: 203-764-5942) with any questions.

Reporting should be done through the web-based CTEDSS, the preferred method of reporting. This option will help with prompt dissemination of information. For information about how hospital staff can acquire access to CTEDSS, contact the CTEDSS team at dph.ctedss@ct.gov.   

Influenza-associated Hospitalizations Influenza-associated hospitalizations must be reported within 12 hours on the day of recognition or strong suspicion (i.e. patients with compatible illness regardless of the results of the initial rapid antigen and/or DFA test). Respiratory specimens from all flu-associated hospitalizations should be submitted to the CT DPH State Public Health Laboratory (SPHL) for PCR testing.

Testing and treatment of influenza when SARS-CoV-2 and influenza viruses are co-circulating

Influenza-associated Deaths

All possible influenza-associated deaths must be reported to the DPH within 12 hours, even if influenza was not the primary cause of death. Save respiratory specimens and submit them to the SPHL for post-mortem PCR testing. Reporting is conducted by entry into CTEDSS. Provide both date and causes of death. For after hours or holiday reporting, report on the next normal business day.

Criteria for Submission of Specimens to the SPHL for Influenza/COVID-19 PCR Testing

To monitor circulating influenza strains throughout the dual influenza season/COVID-19 pandemic, rapidly identify novel strains, and determine the effectiveness of this season’s vaccines, the SPHL provides testing of specimens obtained from select patients. During the ongoing COVID-19 pandemic, most patients presenting with respiratory symptoms had been tested for the SARS-CoV-2 virus prior to any testing for influenza or other respiratory viruses.

For the 2020-2021 influenza season, laboratories are asked to submit respiratory specimens obtained from patients with a positive or unknown influenza test result AND a negative COVID test result* in the following categories (1-4) who present with influenza-like illness (ILI= fever ≥100°F [37.8°C] AND cough and/or sore throat).  Respiratory specimens may also be accepted from patients with a positive influenza test result AND a positive COVID test result* who present with ILI in the following categories:

  1. All hospitalized patients with ILI or confirmed influenza
  2. Selected non-hospitalized patients with ILI including: a) patients of ILI network (ILINet) providers, b) patients associated with outbreaks in long-term care, schools, or other facilities, and c) in children, severe respiratory illness with or without fever. Please contact the DPH EEIP at 860-509-7994 to discuss testing of 2a-c, including possible respiratory viral panel (RVP) testing for enterovirus and other respiratory viruses.
  3. All patients with ILI and recent close exposure to swine, sick poultry at farms and agricultural settings, or migratory birds (exposure history should be provided);
  4. All patients with pneumonia and/or Acute Respiratory Distress Syndrome (ARDS) developing within 17 days of travel to Southeast Asia or within 14 days of travel in or near the Arabian Peninsula, contact the DPH EEIP at 860-509-7994 to discuss possible avian flu or Middle East Respiratory Syndrome Coronavirus [MERS-CoV] testing. Travel history should be provided.

*During the dual 2020-2021 influenza season/COVID-19 pandemic, SPHL will also consider accepting specimens from patients who may not yet have been tested for SARS-CoV-2 or who have tested positive for both influenza and SARS-CoV-2 to evaluate for combined influenza/COVID-19 infections. The SPHL will utilize the CDC Influenza SARS-CoV-2 (Flu SC2) Multiplex Assay for their primary evaluation of specimens from patients presenting with ILI. Since the SPHL has limited resources for testing using this assay, requests for multiplex testing beyond typical seasonal influenza surveillance testing must be approved by DPH EEIP at 860-509-7994 prior to specimen submission.

Healthcare providers must follow the testing instructions and complete the Laboratory Clinical Test Requisition form (OL-9B) to submit specimens for PCR testing. There is no charge for this service.

 

 Flowchart summary of hospital influenza reporting.

 

 

 

This page last updated 11/27/2020.