ACHA Pandemic Influenza Surveillance


The H1N1 flu virus was first detected in people in the United States in April 2009. This virus spread from person-to-person worldwide, probably in much the same way that regular seasonal influenza viruses spread. On June 11, 2009, the World Health Organization (WHO) signaled that a pandemic of 2009 H1N1 flu was underway. (Source: U.S. Centers for Disease Control and Prevention)

With epidemiologic data on novel H1N1 flu suggesting significant risk among those in the college setting, ACHA deemed it epidemiologically valuable to identify disease burden and population based attack rates of influenza like illnesses (ILI) [ICD-CM Diagnosis 487.1], defined by the CDC as fever (temperature of 100°F [37.8°C] or greater) and a cough and/or a sore throat without a KNOWN cause other than influenza, on college campuses. Therefore, in the summer of 2009 ACHA undertook an effort to enlist (on a voluntary basis) interested institutions of higher education to submit data on a weekly basis regarding the number of new cases of ILI. Additionally, given reports of significant variability of H1N1 vaccine availability across the nation, beginning October 30, 2009, ACHA began reporting on the availability of the H1N1 vaccine, as well as the vaccine uptake in a continuing effort to assist the CDC, public health officials, and all college health professionals in tracking national vaccine trends for the college population.


Initially, ACHA enrolled nearly 300 institutions of higher education, representing over 3 million college students, in a national weekly surveillance reporting system on pandemic influenza activity. Using CDC criteria for influenza like illness (ILI), each school reported new cases diagnosed by the campus medical service on a weekly basis. The peak level of voluntary institutional participation was 278 schools in mid-October 2009, representing over 3.3 million in population served. By project’s end, the level of IHE participation in ILI reporting fell to 170 schools representing 1.9 million in population served. The ACHA-observed peak incidence of ILI disease in colleges was 29.0 cases per 10,000 population. That level occurred during the reporting week of October 31-November 6, 2009. The lowest observed incidence was 0.8 cases per 10,000 which occurred during the final week of surveillance (April 24-30, 2010).

The H1N1 surveillance project was an important milestone for college health. Through the efforts of ACHA's national office and participating schools, the project resulted in an accurate representation of the epidemiology of the H1N1 outbreak on college campuses nationally. The data was invaluable to schools, local and state health departments, and the CDC.

ACHA remains especially grateful to all of the colleges and universities that volunteered to be a part of the surveillance project. They helped to demonstrate the importance of college health and its professionals as valuable contributors to public health of our nation.