Syndromic Surveillance

Epidemiological surveillance is used to monitor time trends in diseases and the distribution of the diseases in the population. To streamline the process of identifying outbreaks, and notification of disease, syndromic surveillance has emerged as a method to report and analyze health data. Rather than report data by disease status (ie disease/no disease), clinical symptoms are used to detect outbreaks as early as possible. 

Currently, only data collected via active surveillance (notifiable disease investigations) are usable for identifying communities that require attention. Therefore, any interventions performed using said data is reactive in nature. Syndromic surveillance systems must be disaggregated to enable proactive health promotion, and responses.

Furthermore, a common method must be established to assess the overall impact of syndromes. Diseases are not equal; some have a greater impact on health, and life. To address this issue, the World Health Organization (WHO) has created disability weights to be used in calculating disability adjusted life years (DALY). DALYs are effective in calculating the overall impact of disease in a community. DALYs estimate the burden of disease, not syndromes; therefore, it is reactive tool. To create a more effective syndromic surveillance system, syndromes must be associated with an overall impact weight.

Objective

The justification for address based syndromic surveillance systems, and building syndrome weighting mechanisms.

Syndromic surveillance is the real-time collection and interpretation of data to allow the early identification of public health threats and their impact, enabling public health action. Statistical methods are used in syndromic surveillance to identify when the activity of indicator ‘signals’ have significantly increased. A wide range of techniques have been applied to syndromic data internationally. As part of the preparation for the 2012 Olympics Public Health England expanded its syndromic surveillance service. As new syndromic systems were introduced, statistical methods were developed and applied for each system, tailored to the particular system challenges at the time, e.g. a lack of historical data, and regular changes to geographical coverage.

Objective

This paper describes the design and application of a new statistical method for real-time syndromic surveillance, used by Public Health England.

Decreasing contact between infectious and susceptible people in community settings may reduce influenza transmission. Examining the temporal relationship between the winter holiday break and seasonal influenza activity can provide insight of alternative contact patterns on influenza spread.

Objective

To explore the relationship between influenza-like illness observed by influenza out-patient network and winter holiday breaks in US.

Spurred by recent advances in PH informatics, the implementation of the Medicare and Medicaid Electronic Health Records Incentive Programs (Meaningful Use), and the opportunities provided by the availability of the redesigned BioSense program, SyS has become an increasingly important component of the biosurveillance enterprise. Knowing how and when jurisdictions use SyS, as well as challenges faced, allows ISDS, ASTHO, CDC, and other partners to provide relevant CBA – information transfer, training, and technical assistance – to further biosurveillance practice.

Objective

To present the results of a nationwide survey designed to assess the syndromic surveillance (SyS) practices and capacity-building assistance (CBA) needs of U.S. state public health authorities (PHAs).

Within the UK, previous syndromic surveillance studies have used statistical estimation to describe the activity of respiratory pathogens. The Emergency Department Syndromic Surveillance System (EDSSS) was initially developed in preparation of the London 2012 Olympic and Paralympic Games and has continued as a standard surveillance system, with expanding coverage across England and Northern Ireland. All reporting to this system is completely passive, with no extra work required within the ED. The data collection includes the diagnosis for each attendance, where available, using the coding system in use locally. The coding varies by ED with ICD- 10, Snomed-CT and the less detailed NHS Accident and Emergency Diagnosis Tables all in use. The use of diagnosis coding systems with differing levels of detail creates the need to have a variety of syndromic indicators to make best use of the data received.

We aim to describe the trends in respiratory attendances, and their comparison to the known circulating pathogens identified though laboratory surveillance to establish if any single syndromic indicator may be attributed to any one pathogen in particular. We also aim to describe the flexibility in the development of EDSSS syndromic indicators to best fit the data received.

Objective

Can syndromic surveillance using standard emergency department data collected using automated daily extraction be used to describe and alert the onset of the seasonal activity of named respiratory pathogens within the community?

Motor vehicle crashes (MVC) are a significant public health problem in Nebraska. These events cost Nebraska $1.6 billion a year, are the leading cause of injury death, and the fourth leading cause of injury hospital treatment in the state. Speeding, driving under the influence, distracted driving, and adverse weather are the main causes of MVC in Nebraska. Effective prevention efforts to reduce MVC related deaths and injuries depend greatly on a surveillance system that monitors the frequency of these events so stakeholders may ascertain the MVC related causes and impact on the state. Currently, the Nebraska Department of Health and Human Services (NDHHS) Crash Outcome Data Evaluation System (CODES) monitors MVC related death and injuries by linking the following databases statewide crash data, hospital discharge data (HDD), trauma registry, emergency medical system (EMS) data and death certificate data. Although this system has been effective in identifying the causes of MVC-ralated injuries and supporting community based highway safety programs, it is limited by the lack of immediate availability of data. ‘An ED based SS system could potentially be used to enhance MVC injury surveillance by allowing the timely detection of clusters, anomalies and trends. Therefore, and ED SS system could be incorporated to support an efficient and rapid prevention response to MVC-related injuries.

Objective

The objective of this pilot study is to demonstrate the value of emergency department (ED) syndromic surveillance (SS) data to aid the surveillance of motor vehicle crash (MVC) related injuries in Nebraska.

On a day to day basis, farmers and their veterinarians deal with many diseases without the benefit of surveillance for early outbreak detection, or coordinated outbreak responses. Without this support, highly contagious pathogens such as Porcine Epidemic Diarrhea Virus (PEDv) can spread quickly and potentially cause significant harm. The purpose of this project was to develop a surveillance system to help Canadian swine farmers and veterinarians to deal more effectively with diseases

Objective

To improve swine farmers and veterinarians ability to manage disease

Meat inspection data are routinely collected over several years providing the possibility to use historical data for constructing a baseline model defining the expected normal behaviour of the indicator monitored. In countries in which the reporting of data is compulsory (e.g. in the EU), coverage of the majority of the slaughtered population is ensured.

Objective

We evaluate the performance of the improved Farrington algorithm for the detection of simulated outbreaks in meat inspection data.

 

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.