Infectious Disease
Evaluating the Moving Epidemic Method for establishing seasonal and alert thresholds for influenza-like illness at a single-site university health center setting Carman North* Carman North North University of Tennessee, Knoxville
Infectious diseases like influenza like illness (ILI) spread rapidly at institutes of higher education (IHE) thanks to congregate housing, a high level of social interaction in the campus community, and poor uptake of preventive measures like vaccination. Syndromic surveillance may provide an early indicator to student health services at IHEs that ILI season has arrived, allowing IHEs to more effectively deploy influenza intervention strategies and thereby reduce the burden of influenza on all members of the campus community; however, no gold standard for health surveillance currently exists for IHEs. The Moving Epidemic Method (MEM) is a statistical tool that identifies periodicity and intensity of the ILI season, widely used globally for its simplicity and use of standardized data.
In this study, we evaluated the performance of the MEM as a surveillance standard at a single site campus health center. We utilized anonymized electronic health data from a student health center at a large R-1 university in the southeast encompassing ten influenza seasons between 2012 and 2025. Using R, we determined epidemic period, pre- and post-epidemic ILI thresholds, and intensity thresholds based on population-adjusted case counts for each historical season analyzed and calculated standard model performance indicators.
Results showed that seven of ten seasons were classified as medium, two as high, and none as very high. The resulting model demonstrated high specificity (96.01%) and moderate sensitivity (66.08%) in identifying epidemic periods. The findings suggest that MEM is an acceptable surveillance method for ILI at a campus health clinic; however, future research should integrate the use of additional indicators of campus and community impact to improve sensitivity and campus wide response.
This study highlights the potential for MEM to serve as a standardized tool for syndromic surveillance in IHEs, providing actionable insights to reduce the burden of influenza on campus.