The surveillance response was overseen by the Communicable Disease Network Australia (CDNA). The CDNA discussed changes to testing protocols, case definitions and reporting requirements. It met frequently, particularly in the early stages when there was a need for daily reporting of suspected cases.
The draft surveillance annex guided implementation of surveillance activities, with new surveillance approaches devised during the response as required.
Existing sentinel and syndromic surveillance systems were used to monitor trends in influenza-like illness in Australia. Influenza cases were reported nationally through NetEpi or the NNDSS. Laboratory data were collected from sentinel laboratories and the WHO Collaborating Centre for Reference and Research on Influenza (WHO CC) in Melbourne, which also provided valuable information on the subtypes of the virus. Additional laboratory capacity to test and report on patients presenting to GPs with ILI was implemented to help understand the burden of disease in the community. Laboratory-confirmed case data were used to inform phase changes.
Case data and data on hospitalisations, ICU admissions and deaths were collected throughout the early months of the pandemic by state and territory health departments. Most were initially reported nationally in NetEpi. New sources of data were also used, including ICU admission data from the Australian and New Zealand Intensive Care Society (ANZICS), hospitalisation data from the Queensland EpiLog system, and limited hospitalisation data from newly implemented sentinel system FluCAN (Influenza Complications Alert Network).
The NetEpi outbreak management system enabled the effective collection and analysis of more than 37,000 cases nationally, providing a comprehensive enhanced data set for public health considerations. Progressive implementation of an interface between NetEpi and jurisdictional systems occurred at different stages throughout the pandemic to overcome labour-intensive double data entry.
Critical information was also provided by networks of clinicians. This was initially an informal process, but these networks helped to develop collection systems quickly. It was through these systems that the unforeseen demand for extra-corporeal membrane oxygenation (ECMO) was identified.
A national serosurveillance study was commenced in October 2009 (see Chapter 9: Vaccination).
The global pandemic situation was monitored through official health websites as well as through media reporting and other websites. Situation reports, which included the latest surveillance data from Australia and other countries, were issued up to three times per day from 29 April 2009 until the end of June 2009, then once daily until 31 October 2009. Weekly Australian Influenza Surveillance Reports, which provided detailed analysis of the Australian situation, were issued once per week from 29 May 2009. Under the International Health Regulations 2005 (IHR) guidelines, regular reporting of data to WHO was required throughout the pandemic. In order to manage competing demands on limited resources, the weekly epidemiology report was provided to WHO.
Additional staff, including epidemiologists from the Australian Government Department of Agriculture, Fisheries and Forestry (DAFF) and from the Australian National University’s Master of Applied Epidemiology program, assisted the DoHA to meet the surge capacity in all areas of public health surveillance, analysis and reporting.
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