7c - Protecting Scotland’s health: An evaluation of the Community Acute Respiratory Infection (CARI) surveillance programme

Background : Public health surveillance is crucial for timely intervention. The Community Acute Respiratory Infection (CARI) surveillance programme, launched by Public Health Scotland (PHS) in 2021, follows WHO guidelines and is key to PHS's national infectious respiratory diseases plan for monitoring acute respiratory infections (ARI) in the community.The study aimed to evaluate CARI’s performance during the 2023/24 season (2 October 2023 to 5 May 2024).

Methods : CARI recruits sentinel general practitioner (GP) practices to identify ARI patients, for testing and trend monitoring of ten respiratory pathogens. The evaluation assessed key attributes: Simplicity and flexibility via daily operations and GP survey feedback; acceptability by recruitment/withdrawal rates; representativeness by demographic and geographic characteristics and data quality; timeliness and stability via publication speed and reliability; usefulness by data dissemination and its impact on decision making. Sensitivity/predictive value positive remains uncertain due to limited knowledge of true case numbers.

Results : Across 215 GP practices, 24,512 samples were tested. The evaluation of CARI highlighted its simplicity, flexibility, and acceptability, with streamlined swab kit usage, adaptable processes, and positive GP feedback (92.3% overall satisfaction from 78 survey responses). Representativeness was generally satisfactory, although some health boards were over-/ under-represented. Data quality was high, with minimal lab rejections (8.4%). CARI mirrored European trends, detecting increased Mycoplasma pneumoniae and parainfluenza in early 2024. Timeliness was evident in weekly publications. CARI proved highly useful, disseminating information internally, externally, and contributing to alerts, and scientific papers.

Conclusions This comprehensive evaluation demonstrates the usefulness and validity of CARI, generating critical data to guide local and national evidence-based actions and strategic decisions, informing effective interventions, ultimately protecting the health of Scotland’s population.