Influenza-like illness volunteer surveillance program

The Massachusetts Department of Public Health (MDPH) Bureau of Infectious Disease and Laboratory Sciences Division of Epidemiology is recruiting outpatient medical practices to participate in ILINet, a national surveillance system for influenza-like illness (ILI).*

This volunteer program is a critical component of influenza surveillance, allowing real-time tracking of the ever-changing epidemiology of influenza. We cannot conduct this important surveillance without your help.

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*For reporting purposes, ILI is defined as an illness consisting of a fever (≥ 100°F [37.8°C], oral or equivalent) AND a cough or sore throat.

ILINet participation has two components:

  1. Submission of specimens (usually nasopharyngeal (NP) swabs) to the Massachusetts State Public Health Laboratory (MA SPHL) for influenza surveillance testing. Results are provided to the submitting provider/practice. If negative for influenza and SARS-CoV-2, our BioFire FilmArray** will test for several other respiratory viruses and bacterial organisms.
    • **BioFire FilmArray includes testing for Influenza, Adenovirus, Coronavirus, Human Metapneumovirus, Human Rhinovirus/Enterovirus, Parainfluenza, RSV, Bordetella pertussis, Chlamydophila pneumoniae, and Mycoplasma pneumoniae. The kits and the testing, as well as the transportation of specimens to MA SPHL, are provided at no cost to the provider.
  2. Weekly data collection and reporting, of patient visits due to influenza-like illness in five age groups, and the total number of patients seen in all age groups for any reason during the week. Most ILINet participants find that this takes less than an hour each week. Reporting is done electronically. Your reports are summarized weekly, both nationally from the Centers for Disease Control and Prevention and at the Massachusetts Respiratory Illness Dashboard.


The goals of national influenza surveillance are two-fold:

  • ILINet provides useful real-time epidemiologic information about both novel (or variant) influenza and seasonal influenza and allows for the rapid detection of changes in severity and/or age-distribution of affected individuals as measured by reports of influenza-like illness (ILI).
  • It also enables states and the CDC to monitor antigenic changes in circulating viruses in order to provide information for the formulation of vaccine for the subsequent season. In addition, influenza surveillance within the Commonwealth can help to rapidly detect outbreaks and assist disease control through timely preventive action.

What we are asking of you

  1. Specimen collection for influenza testing

    Collect and submit specimens for laboratory isolation of influenza virus (NP swabs preferred –   although other specimen sources are acceptable); we are encouraging sites to submit specimens every week for influenza testing so that we can detect increases in influenza activity and identify which strains of influenza are circulating.

    MDPH will supply the flu kits free of charge and will ensure the kits are returned to MA SPHL in a timely manner at no cost to your facility. We use UPS for this purpose, and occasionally use a private courier service. Should you need additional flu kits during the season, please contact an Epidemiologist at (617) 983-6800.
  2. Reporting ILI every week

    In addition to submitting specimens, we ask that you also report your ILI data online directly to the CDC U.S. Outpatient ILI Surveillance Network each week. The weekly data transmission consists of the following two items:
    1. The number of patients seen for ILI during a given week in each of the following five age categories:
      a) 0 through 4 years
      b) 5 through 24 years
      c) 25 through 49 years
      d) 50 through 64 years
      e) >64 years
    2. and the total number of patients seen for any reason at your health care setting during the course of a given week.

Weekly reports should be submitted even if you have had no patient visits for ILI during that week. We need to know when you are NOT seeing influenza, too. This is especially significant during the early and late parts of the surveillance period.

Benefits for sentinel sites

Each site is provided with respiratory kits to test patients throughout the season. Test results are returned through electronic reporting or fax, to the submitting facility.  Testing is primarily for surveillance purposes. Beyond influenza results, it may be useful to learn which other respiratory pathogens are circulating in your community as flu and SARS-CoV-2-negative specimens (NP swabs only) will be tested using the BioFire FilmArray respiratory panel.

You will receive regular e-mails and reports from MDPH during the influenza season showing the latest flu activity in the state and your region, as well as important announcements related to influenza and the vaccine. Each participating site is also offered one free registration to our annual adult and pediatric immunization conferences.  Lastly, all actively participating sites will receive a certificate of appreciation from the Centers for Disease Control and Prevention.

Next steps

We want to work closely with you to facilitate your active participation in the ILINet. Please contact the Division of Epidemiology at (617) 983-6800 with further questions, or to enroll.

Download: Recruitment Letter

Frequently asked questions

What are ways to participate in ILI Net? There are 2 ways to participate. You can do one or both.

  • Influenza Surveillance Participation through Specimen Submission
  • Influenza Surveillance Participation through ILINet Tracking

How should specimens be submitted to MDPH?

NP swabs should be used for specimen submission for patients with influenza-like illness (ILI) from enrolled healthcare providers in Massachusetts.  These swabs will be tested for influenza at the Massachusetts State Public Health Laboratory (MA SPHL).  Specimens testing negative for influenza and SARS-CoV-2 will also be tested for a full panel of respiratory pathogens, including a variety of viruses and bacterial organisms.

What are the benefits of participation?

Testing is done for influenza surveillance purposes, and the results are helpful to those in clinical practice.  You may discover that your patient with respiratory illness has an illness other than flu. Flu surveillance data are critical for monitoring the course of influenza virus activity on the local, state, and national level.  Influenza viruses are constantly evolving and cause substantial morbidity and mortality every year. These data can be used to guide prevention and control activities, vaccine strain selection, and patient care. The MA SPHL will provide the testing kits for sites that agree to test and submit their specimens to MA SPHL. We will also provide couriers to pick up the specimens, if necessary. There is no charge for this service.

How many specimens would a provider’s office need to collect?

At this time there is no limit to the number of specimens you may  submit for testing.  However, this can change later in the season contingent on the number of submissions and MA SPHL testing capacity.  We generally request NP swabs for patients who present with influenza-like illness (ILI) that began <72 hours prior to being seen. ILI is defined as an illness consisting of a fever (≥ 100°F [37.8°C], oral or equivalent) AND a cough or sore throat.

PCR testing will occur at MA SPHL and results will be reported out within 3 business days after specimen receipt.  For specimens that are negative for influenza and SARS-CoV-2, the BioFire FilmArray Respiratory Panel will test for the viruses and bacterial organisms listed below:

  • Adenovirus
  • Coronavirus (HKU1, OC43, NL63, 229E)
  • Human Metapneumovirus
  • Parainfluenza (1-4)
  • Respiratory Syncytial Virus (A/B)
  • Human Rhinovirus/Enterovirus
  • Bordetella pertussis
  • Chlamydophila pneumoniae
  • Mycoplasma pneumoniae

What is an influenza ILINet provider?

An influenza ILINet provider conducts surveillance for influenza-like illness (ILI) in collaboration with the Massachusetts Department of Public Health and the Centers for Disease Control and Prevention.  Data reported by ILINet providers, in combination with other influenza surveillance data, provide a national picture of influenza virus and ILI activity in the U.S. as each season unfolds.

What data do ILINet providers collect? How and to whom are data reported?

Each week ILINet providers report the total number of patients seen for any reason and the number of patient visits for influenza-like illness (ILI) by age group (0-4 years, 5-24 years, 25-49 years, 50-64 years, >65 years). These data are transmitted once a week online directly to the CDC U.S. Outpatient ILI Surveillance Network each week.

Who can be an ILINet provider?

Providers of any specialty in any type of outpatient practice where you are likely to see cases of influenza and ILI are eligible to be ILINet providers. Examples include:

  • Emergency Medicine
  • Family Practice
  • Infectious Disease
  • Internal Medicine
  • OB/GYN
  • Pediatrics
  • Ambulatory Care
  • Urgent Care

Practice settings that are not eligible are elementary, middle, or high school health centers, inpatient settings, and institutional settings such as nursing homes or prisons. 


Massachusetts Surveillance Reports

Detailed reports about influenza activity in Massachusetts are posted weekly on the Weekly Influenza Reporting Dashboard.

Summary cumulative reports are available for the following seasons:

For seasons beginning in 2022-2023, review of weekly data can be found on the Dashboard

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