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Syndromic Surveillance Practice in the United States: Findings from a Survey of State, Territorial, and Selected Local Health Departments

Description

In 2007-2008, the authors surveyed public health officials in 59 state, territorial, and selected large local jurisdictions in the United States regarding their conduct and use of syndromic surveillance. Fifty-two (88%) responded, representing areas comprising 94% of the United States population. Forty-three (83%) of the respondents reported conducting syndromic surveillance for a median of 3 years (range = 2 months to 13 years). Emergency department visits were the most common data source, used by 84%, followed by outpatient clinic visits (49%), over-the-counter medication sales (44%), calls to poison control centers (37%), and school absenteeism (35%). Among those who provided data on staffing and contract costs, the median number of staff dedicated to alert assessment was 1.0 (range 0.05 to 4), to technical system maintenance 0.6 (range zero to 3); and, among the two-thirds who reported using external contracts to support system maintenance, median annual contract costs were $95,000 (range = %5,500 to $1 million). Respondents rated syndromic surveillance as most useful for seasonal influenza monitoring, of intermediate usefulness for jurisdiction-wide trend monitoring and ad hoc analyses, and least useful for detecting typical community outbreaks. Nearly all plan to include syndromic surveillance as part of their surveillance strategy in the event of an influenza pandemic. Two thirds are either "highly" or "somewhat" likely to expand their use of syndromic surveillance within the next 2 years. Respondents from three state health departments who reported they did not conduct syndromic surveillance noted that local health departments in their states independently conducted syndromic surveillance. Syndromic surveillance is used widely throughout the United States. Although detection of outbreaks initially motivated investments in syndromic surveillance, other applications, notably influenza surveillance, are emerging as the main utility.

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