A continuous viral respiratory surveillance program was established throughout the U.S. Department of Defense beneficiary population living in Europe with a few specimens coming from the Middle East. This program provided influenza rapid antigen test kits, specimen collection kits, detailed instructions, and a questionnaire. Training on specimen collection and testing was provided to health care providers and lab staff. We received 1875 patient specimens (39% active duty, 13% adult beneficiary, and 48% pediatric beneficiary) collected from 36 medical treatment facilities in 10 European and Middle Eastern countries over a 52-week period. Nine hundred and twenty-two questionnaires were received. The greatest activity of viral respiratory infections occurred between weeks 7 to 13. We found the sensitivity of rapid antigen testing compared poorly to both viral culture and PCR; however, the information provided by the rapid testing was utilized locally for guiding patient treatment. Additionally, although 91% of the active duty population received the influenza vaccine, we calculated the vaccine efficacy to be 52%.