Public health practitioners endeavor to expand and refine their syndromic and other advanced surveillance systems that are designed to supplement their existing laboratory testing and disease surveillance toolkit. While much of the development and widespread implementation of these systems had been supported by public health preparedness funding, the reduction of these monies has greatly constrained the ability of public health agencies to staff and maintain these systems. The appearance of H3N2v and other novel influenza A viruses required agencies to carefully identify which systems provide the most cost-effective data to support their public health practice. Recent Enterovirus D68 outbreaks, along with the global emergence of influenza A (H7N9), the global emergence of influenza A (H7N9), Middle East Respiratory Syndrome Coronavirus (MERS-CoV), Ebola virus strains, and other viruses associated with high mortality, emphasize the importance of maintaining vigilance for the presence of emerging disease.
Objective
To identify and characterize challenges experienced by public health practitioners conducting surveillance for the presence of influenza, novel respiratory diseases, and globally emerging viruses in an era of limited resources.