title: Identifying pneumonia outbreaks of public health importance: can emergency department data assist in earlier identification?
abstract: OBJECTIVE
  To retrospectively review the performance of a near real-time Emergency Department (ED) Syndromic Surveillance System operating in New South Wales for identifying pneumonia outbreaks of public health importance.
  
  
  METHODS
  Retrospective data was obtained from the NSW Emergency Department data collection for a rural hospital that has experienced a cluster of pneumonia diagnoses among teenage males in August 2006. ED standard reports were examined for signals in the overall count for each respiratory syndrome, and for elevated counts in individual subgroups including; age, sex and admission to hospital status.
  
  
  RESULTS
  Using the current thresholds, the ED syndromic surveillance system would have trigged a signal for pneumonia syndrome in children aged 5-16 years four days earlier than the notification by a paediatrician and this signal was maintained for 14 days.
  
  
  CONCLUSIONS
  If the ED syndromic surveillance system had been operating it could have identified the outbreak earlier than the paediatrician's notification. This may have permitted an earlier public health response.
  
  
  CONCLUSIONS
  By understanding the behaviour of syndromes during outbreaks of public health importance, response protocols could be developed to facilitate earlier implementation of control measures.
authors.affiliation: Newcastle Institute of Public Health, New South Wales. kirsty.hope@hnehealth.nsw.gov.au
authors.forename: Kirsty
authors.initials: K
authors.lastname: Hope
authors.forename: David N
authors.initials: DN
authors.lastname: Durrheim
authors.forename: David
authors.initials: D
authors.lastname: Muscatello
authors.forename: Tony
authors.initials: T
authors.lastname: Merritt
authors.forename: Wei
authors.initials: W
authors.lastname: Zheng
authors.forename: Peter
authors.initials: P
authors.lastname: Massey
authors.forename: Patrick
authors.initials: P
authors.lastname: Cashman
authors.forename: Keith
authors.initials: K
authors.lastname: Eastwood
mesh_terms: D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks / Q000706:statistics & numerical data*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006780:Hospitals, Rural / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D009517:New South Wales / Q000453:epidemiology; D011014:Pneumonia / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D011159:Population Surveillance; D011634:Public Health; D015980:Public Health Practice; D012189:Retrospective Studies; D013997:Time Factors