Validation of syndromic surveillance for respiratory pathogen activity.
Syndromic surveillance is increasingly used to signal unusual illness events. To validate data-source selection, we retrospectively investigated the extent to which 6 respiratory syndromes (based on different medical registries) reflected respiratory pathogen activity. These syndromes showed higher levels in winter, which corresponded with higher laboratory counts of Streptococcus pneumoniae, respiratory syncytial virus, and influenza virus. Multiple linear regression models indicated that most syndrome variations (up to 86%) can be explained by counts of respiratory pathogens. Absenteeism and pharmacy syndromes might reflect nonrespiratory conditions as well. We also observed systematic syndrome elevations in the fall, which were unexplained by pathogen counts but likely reflected rhinovirus activity. Earliest syndrome elevations were observed in absenteeism data, followed by hospital data (+1 week), pharmacy/general practitioner consultations (+2 weeks), and deaths/laboratory submissions (test requests) (+3 weeks). We conclude that these syndromes can be used for respiratory syndromic surveillance, since they reflect patterns in respiratory pathogen activity.
van den Wijngaard
Cees
C
National Institute for Public Health and the Environment, Bilthoven, the Netherlands. kees.van.den.wijngaard@rivm.nl
van Asten
Liselotte
L
van Pelt
Wilfrid
W
Nagelkerke
Nico J D
NJ
Verheij
Robert
R
de Neeling
Albert J
AJ
Dekkers
Arnold
A
van der Sande
Marianne A B
MA
van Vliet
Hans
H
Koopmans
Marion P G
MP
D000041:Absenteeism; D021821:Communicable Diseases, Emerging / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000821:virology; D005194:Family Practice / Q000706:statistics & numerical data; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D009426:Netherlands; D010604:Pharmacy / Q000706:statistics & numerical data; D011159:Population Surveillance / Q000379:methods*; D012042:Registries; D012141:Respiratory Tract Infections / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000821:virology; D013577:Syndrome; D014777:Virus Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000821:virology; D014780:Viruses / Q000302:isolation & purification