Description of a school nurse visit syndromic surveillance system and comparison to emergency department visits, New York City.
OBJECTIVE
We compared school nurse visit syndromic surveillance system data to emergency department (ED) visit data for monitoring illness in New York City schoolchildren.


METHODS
School nurse visit data recorded in an electronic health record system are used to conduct daily surveillance of influenza-like illness, fever-flu, allergy, asthma, diarrhea, and vomiting syndromes. We calculated correlation coefficients to compare the percentage of syndrome visits to the school nurse and ED for children aged 5 to 14 years, from September 2006 to June 2011.


RESULTS
Trends in influenza-like illness correlated significantly (correlation coefficient = 0.89; P < .001) and 72% of school signals occurred on days that ED signaled. Trends in allergy (correlation coefficient = 0.73; P < .001) and asthma (correlation coefficient = 0.56; P < .001) also correlated and school signals overlapped with ED signals on 95% and 51% of days, respectively. Substantial daily variation in diarrhea and vomiting visits limited our ability to make comparisons.


CONCLUSIONS
Compared with ED syndromic surveillance, the school nurse system identified similar trends in influenza-like illness, allergy, and asthma syndromes. Public health practitioners without school-based surveillance may be able to use age-specific analyses of ED syndromic surveillance data to monitor illness in schoolchildren.
Elisha L. Wilson, Marc Paladini, Don Weiss, and Trang Q. Nguyen are with the Bureau of Communicable Disease, New York City Department of Health and Mental Hygiene, Queens, NY. Joseph R. Egger and Kevin J. Konty are with the Bureau of Epidemiology Services, New York City Department of Health and Mental Hygiene.
Elisha L
EL
Wilson
Joseph R
JR
Egger
Kevin J
KJ
Konty
Marc
M
Paladini
Don
D
Weiss
Trang Q
TQ
Nguyen
D001249:Asthma / Q000453:epidemiology / Q000451:nursing; D002648:Child; D003967:Diarrhea / Q000453:epidemiology / Q000451:nursing; D057286:Electronic Health Records; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D005334:Fever / Q000453:epidemiology / Q000451:nursing; D006801:Humans; D006967:Hypersensitivity / Q000453:epidemiology / Q000451:nursing; D007251:Influenza, Human / Q000453:epidemiology / Q000451:nursing; D008297:Male; D009519:New York City / Q000453:epidemiology; D024802:Nurse's Role; D011159:Population Surveillance; D012572:School Health Services / Q000458:organization & administration*; D012573:School Nursing; D013577:Syndrome; D014839:Vomiting / Q000453:epidemiology / Q000451:nursing