California Sentinel Provider Program

Interested in becoming a sentinel provider?

Resources for current sentinel providers

The California Sentinel Provider Influenza Surveillance Program is a partnership between clinicians, local health departments (LHDs), the California Department of Public Health (CDPH), and the Centers for Disease Control and Prevention (CDC) to conduct surveillance for influenza-like illness (ILI). Since its inception in 1998, the program has been contributing valuable information to state, national, and global influenza surveillance efforts.

The information collected by California sentinel providers is combined with other influenza surveillance data on influenza-related hospitalizations, antiviral usage, severe influenza cases and laboratory detections from collaborating hospital, academic, and public health laboratories throughout the state to monitor the timing, location, and impact of influenza viruses year-round.

Influenza-like Illness Surveillance

Sentinel Providers report the number of patients seen with ILI in five age categories (0-4 years, 5-24 years, 25-49 years, 50-64 years, >64 years) and the total number of patients seen for any reason. Reports are submitted on a weekly basis to the CDC by internet or fax.

Case definition for Influenza-like Illness

Any illness with fever (≥100°F or 37.8°C) - temperature can be from measurement in the office or at home, AND
Cough and/or sore throat (in the absence of a known cause)

Compiling and reporting data usually takes less than 30 minutes per week. Participating sentinel providers receive weekly updates on state and national influenza activity. Weekly updates of California influenza activity can also be accessed on the website for the CDPH Influenza Surveillance Program.

Virologic Testing

Nasal, throat, or nasopharyngeal swabs from selected patients are submitted to the CDPH Viral and Rickettsial Disease Laboratory (VRDL) for viral testing free of charge. Specimen collection kits will be replenished as specimens are submitted.

CDPH encourages sentinel providers to submit samples for influenza testing. It is especially important to collect and submit specimens early in the season (October-December), when influenza isolates are forwarded to the CDC to identify which strains are circulating and should be considered for inclusion in the 2013-2014 vaccine. Testing at least one specimen a week from each sentinel provider is recommended to meet the goal of testing a sampling of specimens from different areas of the state in all age groups throughout the influenza season, and to characterize circulating strains, populations affected, and whether a novel influenza virus is emerging that may herald a new pandemic strain.

Specimens will be tested for influenza A and B by PCR. Specimens that test positive by PCR for influenza A will then be sub-typed as A (seasonal H1), A (H3), or A (2009 H1N1). If you have any questions regarding submission of specimens or test results, please e-mail VRDL at flu@cdph.ca.gov or contact Katharine King at (510) 307-8585.

Specimens should be collected from patients that meet the case definition for influenza-like illness (see case definition above), especially those with any of the following:

presenting at the beginning, peak, and end of the influenza season
with severe disease
with recent overseas travel
occurring in an outbreak setting

Why volunteer for the Sentinel Provider Surveillance Program?

Influenza viruses are constantly changing which requires ongoing collection and characterization of the strains. By reporting weekly influenza-like illness data and sending respiratory specimens to the state laboratory for testing, Sentinel Providers play a critical role in state and national influenza surveillance. Your participation enables us to monitor the impact of influenza and helps to guide prevention and control policies, vaccine strain selection, and recommendations for patient care.

Who can be an Influenza Sentinel Provider?

Providers of any specialty (e.g., family practice, internal medicine, pediatrics, infectious diseases) in any type of practice (e.g., private practice, public health clinic, urgent care center, emergency room, university student health center) are eligible to be sentinel providers. In addition, sentinel providers may be physicians, nurse practitioners or physician assistants.

How do I enroll in the program?

Fill out the Sentinel Provider Enrollment Form New Window and return it to the Communicable Disease Emergency Response Branch (CDER), Sentinel Provider Program by:

fax: 510-620-5896, or
mail: 850 Marina Bay Parkway, Bldg P - Second Floor, Richmond, CA 94804

Questions?

For more information about enrolling in the Sentinel Provider Program, contact the CDER Branch at InfluenzaSurveillance@cdph.ca.gov or 510-231-6861. For questions regarding specimen submission and available testing, please contact Katharine King at 510-307-8585 or flu@cdph.ca.gov.