Influenza viruses are tricky creatures. From year to year, they never stop changing. Scientists are constantly trying to prepare for what the viruses will do next. Several researchers supported by the Canadian Institutes of Health Research are changing the way we track the flu.

Dr. Danuta Skowronski, an epidemiologist at the British Columbia Centre for Disease Control (BCCDC), has developed a team approach to identifing new viral strains and assessing the effectiveness of influenza vaccines. Her team is monitoring genetic changes in viruses to see if these mutations result in newer strains that can evade immune protection. Genetic screening works faster than the traditional method of identifying viruses, allowing researchers to knock months off of the time it takes to spot a new influenza strain.

"We're looking at genetic and protein changes in the influenza virus, and assessing how meaningful these are in terms of how well vaccines work," says Skowronski. "We want to know how changes on the molecular level - virus mutations - influence individual protection and population impact. It is really a unique project that spans the spectrum from the molecular to the macro level."

This monitoring program has also helped improve communication between the many people who help fight influenza. Doctors on the front line collect virus samples and vaccination info from patients that may have the flu, labs analyze the samples, and epidemiologists interpret the results and look for patterns. Before Skowronski and her colleagues began their program, this type of linked and strategic monitoring didn't happen in Canada.

"This partnership between physicians, labs and epidemiologists is so critical to rehearse in advance of a pandemic," explains Skowronski. "And once it is established, this infrastructure can help us deal with other infectious diseases, not just pandemic influenza."

Other researchers, such as Dr. Gunther Eysenbach at the Centre for Global eHealth Innovation of the University Health Network in Toronto, are looking to everyday technology for answers.

"In this day and age, many consumers go to the Internet before they go to their doctor. So you should be able to detect patterns in people's Internet searches and possibly make predictions about what's going to happen in doctors' offices and what's going to happen in terms of public health," he points out.

During a recent flu season, Eysenbach bought an ad on the Google search engine that would appear whenever Canadian internet users typed in the keywords "flu" or "flu symptoms". The advertisement, which cost less than $400, read "Do you have the flu?" and linked to an educational site. As an advertiser, he was able to monitor the number of people who clicked on his ad.

When he compared his findings to flu data for the same season collected by the Public Health Agency of Canada, Eysenbach found that his system not only gave an accurate picture of how many Canadians suffered from the flu that year, it also detected outbreaks faster than traditional monitoring methods.

While tracking internet searches isn't likely to replace more direct monitoring practices anytime soon, it could help public health officials keep an eye on where the flu is making people sick.

"Any kind of information technology that interacts with a user could potentially be used for public health monitoring," says Eysenbach.