BackgroundEffective influenza surveillance and communication of influenza activity are crucial for the management of influenza outbreaks. The accuracy of clinical diagnoses can be enhanced if the influenza virus is known to be circulating in the community.ObjectiveTo report on the development of a new influenza surveillance system in Germany (2001–2002) based on consultation rates and near patient test results using the Influenza A/B Rapid Test (IRT) and RealFlu™ Surveillance methodology.MethodsThis is the first internationally standardized, rapid influenza surveillance system providing harmonized influenza-specific information. RealFlu™ Surveillance is unique in its approach by generating two baselines: one with morbidity rates and one with specific influenza activity based on near patient test results. The baselines are set independently for each participating country and its constituent regions, thereby allowing monitoring of national as well as regional influenza activity. The system is highly specific and sensitive to influenza and differentiates between three levels of the RealFlu™ Surveillance influenza activity:no/sporadic activity;moderate activity; andhigh activity.Weekly activity is presented in graphs, maps, and data tables with daily updates and comments. In this report, data collected during the influenza season 2001–2002 in Germany are presented.ResultsThe RealFlu™ Surveillance system has been running for four consecutive influenza seasons since 1999. The first increase in influenza circulation was seen from week 2 (from year start) to week 4. In week 5, a steep increase in influenza positives was observed. A significant amount of excess morbidity was seen from week 7, peaking in week 11. The season started in western regions of Germany and ended in eastern regions of Germany. Regional outbreaks were detected also when the aggregated country data did not indicate any significant increase in influenza activity.ConclusionBy providing specific, real-time monitoring of regional and national influenza outbreaks, the RealFlu™ Surveillance system complements existing schemes and presents a practical surveillance methodology for countries where influenza surveillance does not exist.