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Continuous Morbidity Registration at Dutch Sentinel General Practice Network 2009.

Donker, G.A. Continuous Morbidity Registration at Dutch Sentinel General Practice Network 2009. Utrecht: NIVEL, 2011.
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The Mexican flu pandemic was limited to a mild pandemic, although the flu incidence rate was higher than in the previous three seasons. At the peak of the epidemic 189 per 100.000 registered patients consulted their general practitioner (GP). The sentinel GP’s of NIVEL registered the number of new flu cases weekly all year round. The usual seasonal flu did not occur.

By the epidemic of Mexican flu in the autumn of 2009 a usual seasonal flu epidemic in the spring of 2010 did not occur. The Mexican flu epidemic started in week 41 of 2009 and remained above epidemic threshold levels during ten weeks. The peak of 189 per 100.000 registered patients consulting the GP took place in week 46. In week 51 the flu fell below epidemic threshold level and a second peak did not occur. In almost all nose and throat swabs the pandemic influenzavirus A(H1N1)2009 was identified. The virus was in almost all cases sensitive to oseltamivir. The flu occurred especially in children 0-14 years of age while the elderly were in general protected from contracting the disease. The GP’s of the Dutch Sentinel General Practice Network reported weekly about the flu nationally and to ECDC and WHO. The World Health Organisation declared the end of the pandemic in July 2010.

Size of the epidemic
The sentinel GP’s reported data about numbers of new flu cases also weekly to RIVM which was coordinating care and prevention concerning the pandemic. The flu surveillance was temporarily extended with 12 practices from the National Information Network GP Care (LINH). The pandemic flu virus is incorporated in the influenza vaccine for the flu season 2010-2011.

CMR Sentinel General Practice Network
The Continuous Morbidity Registration (CMR) Sentinel General Practice Network is based on a network of 59 GP’s in 42 practices covering a patient population of 0.8% of the Dutch population. The network is nationally representative by age and gender, regional distribution and population density. The sentinel GP’s report weekly (showing trends vastly) or annually about the incidence of diseases, events and interventions not included and difficult to incorporate in routine registrations. The CMR Sentinel GP Network exists since 1970.
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