Skip to main content

Harcourt Sally

Routine primary care data provide the means to systematically monitor a variety of syndromes which could give early warning of health protection issues (microbiological and chemical). It is possible to track milder illnesses which may not present to hospitals (e.g. chicken pox, conjunctivitis) or illnesses for which laboratory specimens are not routinely taken (e.g. influenza). Real-time data are also needed to respond to major health protection incidents.

 

Objective

To describe the arrangements for Primary Care Surveillance in the UK and provide examples of the benefits of this work for Public Health.

Referenced File
Submitted by elamb on

Wetter and stormier weather is predicted in the UK as global temperatures rise. It is likely there will be increases in river and coastal flooding. The known short and medium term health effects of flooding are drowning, injury, acute asthma, skin rashes and outbreaks of gastrointestinal and respiratory disease. Longer term health effects of flooding are thought to be psychological stress and increased rates of mental illness. Reacher et al. conducted a retrospective study of illness in a population affected by flooding in Lewes, South-East England during 2000 [1]. They found a significant raised risk of earache (RR=2.2) and gastroenteritis (RR=1.7) for flooded households. More striking was the higher level of psychological distress experienced by these residents (RR=4.1), which may have also explained some of the excess physical illness.

Objective

This paper describes the results of prospective real time syndromic surveillance conducted during a national flooding incident during 2007 in the UK.

Referenced File
Submitted by elamb on

The negative effect of air pollution on human health is well documented illustrating increased risk of respiratory, cardiac and other health conditions. Currently, during air pollution episodes Public Health England (PHE) syndromic surveillance systems provide a near real-time analysis of the health impact of poor air quality. In England, syndromic surveillance has previously been used on an ad hoc basis to monitor health impact; this has usually happened during widespread national air pollution episodes where the air pollution index has reached "High"™ or "Very High"™ levels on the UK Daily Air Quality Index (DAQI). We now aim to undertake a more systematic approach to understanding the utility of syndromic surveillance for monitoring the health impact of air pollution. This would improve our understanding of the sensitivity and specificity of syndromic surveillance systems for contributing to the public health response to acute air pollution incidents; form a baseline for future interventions; assess whether syndromic surveillance systems provide a useful tool for public health alerting; enable us to explore which pollutants drive changes in health-care seeking behaviour; and add to the knowledge base.

Objective:

To explore the utility of syndromic surveillance systems for detecting and monitoring the impact of air pollution incidents on health-care seeking behaviour in England between 2012 and 2017.

Submitted by elamb on

Public Health England's syndromic surveillance service monitor presentations for gastrointestinal illness to detect increases in health care seeking behaviour driven by infectious gastrointestinal disease. We use regression models to create baselines for expected activity and then identify any periods of signficant increases. The introduction of a rotavirus vaccine in England during July 2013 (Bawa, Z. et al. 2015) led to a reduction in incidence of the disease, requiring a readjustment of baselines.

Objective:

To adjust modelled baselines used for syndromic surveillance to account for public health interventions. Specifically to account for a change in the seasonality of diarrhoea and vomiting indicators following the introduction of a rotavirus vaccine in England.

Submitted by elamb on

Syndromic surveillance involves monitoring big health datasets to provide early warning of threats to public health. Public health authorities use statistical detection algorithms to interrogate these datasets for aberrations that are indicative of emerging threats. The algorithm currently in use at Public Health England (PHE) for syndromic surveillance is the ‘rising activity, multi-level mixed effects, indicator emphasis’ (RAMMIE) method (Morbey et al, 2015), which fits a mixed model to counts of syndromes on a daily basis. This research checks whether the RAMMIE method works across a range of public health scenarios and how it compares to alternative methods.

Objective:

To investigate whether alternative statistical approaches can improve daily aberration detection using syndromic surveillance in England.

Submitted by elamb on

We assessed the impact of the London 2012 Olympic and Paralympic Games on syndromic surveillance systems including the incidence of syndromic indictors and total contacts with health care.

Introduction

Mass gatherings can impact on the health of the public including importation of infectious diseases, exposure of international visitors to endemic diseases in the host country and the increased risk of bioterrorist activity. Public health surveillance during mass gatherings therefore affords an opportunity to identify, and quantify any impact (or reassure on the absence of impact) on public health in a timely manner. In preparation for the Games, Public Health England undertook a programme of work to expand the existing suite of syndromic surveillance systems to include daily general practitioner out of hours (GPOOH) consultations and emergency department (ED) attendances at sentinel sites. These new systems complemented existing syndromic surveillance systems offering the opportunity to monitor trends in patient contacts with GPs outside of normal day time opening hours, as well as potentially the more severe end of the disease spectrum which would present at EDs. We assessed the impact of the 2012 Olympics on national surveillance systems, comparing to periods before and after the Games and in previous years and also the impact of specific events during the Games.

Submitted by aising on

Public Health England has developed a suite of syndromic surveillance systems, collecting data from a number of health care sources, and linking to public health action to try and improve the public health benefit of the surveillance.1 We aim to describe this national syndromic service, highlighting the flexibility of the systems in responding to a range of environmental incidents.

Objective

To deliver a national syndromic surveillance service, linking analytical and statistical methods with public health action to provide surveillance support for national public health programmes monitoring the spread of infectious diseases and the health impact of environmental incidents in England.

Submitted by rmathes on

Seasonal rises in respiratory illnesses are a major burden on primary care services. Public Health England (PHE), in collaboration with NHS 111, coordinate a national surveillance system based upon the daily calls received at the NHS 111 telehealth service. Daily calls are categorized according to the clinical ‘pathway’ used by the call handler to assess the presenting complaints of the caller e.g. cold/flu, diarrhoea, rash.

Objective

We compared weekly laboratory reports for a number of seasonal respiratory pathogens with telehealth calls (NHS 111) to assess the burden of seasonal pathogens on this syndromic surveillance system and investigate any potential for providing additional early warning of seasonal outbreaks.

Submitted by rmathes on

Syndromic surveillance systems are used by Public Health England (PHE) to detect changes in health care activity that are indicative of potential threats to public health. By providing early warning and situational awareness, these systems play a key role in supporting infectious disease surveillance programmes, decision making and supporting public health interventions. In order to improve the identification of unusual activity, we created new baselines to model seasonally expected activity in the absence of outbreaks or other incidents. Although historical data could be used to model seasonality, changes due to public health interventions or working practices affected comparability. Specific examples of these changes included a major change in the way telehealth services were provided in England and the rotavirus vaccination programme introduced in July 2013 that changed the seasonality of gastrointestinal consultations. Therefore, we needed to incorporate these temporal changes in our baselines.

Objective

To improve the ability of syndromic surveillance systems to detect unusual events.

Submitted by Magou on

From 1 September 2015, babies in the United Kingdom (UK) born on/after 1 July 2015 became eligible to receive the MenB vaccine, given at 2 and 4 months of age, with a booster at 12 months. Early trials found a high prevalence of fever (over 38°C) in babies given the vaccine with other routine vaccines at 2 and 4 months. We used syndromic surveillance data to assess whether there had been increased family doctor (general practitioner (GP)) consultations for fever in young infants following the introduction of the vaccine. 

Objective

To use syndromic surveillance data to assess whether there has been an increase in GP fever consultations since the inclusion of the meningococcal B (MenB) vaccine in the UK vaccination schedule. 

Submitted by Magou on
Subscribe to Harcourt Sally