Practitioners, midwives and nurses, who are responsible for population-based health care services in the primary health care system, became the most important human resource for surveillance during the avian influenza outbreak in Turkey. This experience clearly shows that primary health care centers should be included in the surveillance system. For a efficient surveillance system, upgrading the sentinel physician network by enlisting and retraining more participants and [16] the coordination among public health workers, clinicians and managers is most necessary. It is accepted that public health workers will play an integral role in an influenza pandemic [17] . The health managers and providers whom we interviewed believe that their experiences must be reflected in national avian influenza preparedness plans.