title: Emergency department syndromic surveillance providing early warning of seasonal respiratory activity in England.
abstract: Seasonal respiratory infections place an increased burden on health services annually. We used a sentinel emergency department syndromic surveillance system to understand the factors driving respiratory attendances at emergency departments (EDs) in England. Trends in different respiratory indicators were observed to peak at different points during winter, with further variation observed in the distribution of attendances by age. Multiple linear regression analysis revealed acute respiratory infection and bronchitis/bronchiolitis ED attendances in patients aged 1-4 years were particularly sensitive indicators for increasing respiratory syncytial virus activity. Using near real-time surveillance of respiratory ED attendances may provide early warning of increased winter pressures in EDs, particularly driven by seasonal pathogens. This surveillance may provide additional intelligence about different categories of attendance, highlighting pressures in particular age groups, thereby aiding planning and preparation to respond to acute changes in EDs, and thus the health service in general.
authors.affiliation: Real-time Syndromic Surveillance Team,Public Health England,Birmingham,UK.
authors.forename: H E
authors.initials: HE
authors.lastname: Hughes
authors.affiliation: Real-time Syndromic Surveillance Team,Public Health England,Birmingham,UK.
authors.forename: R
authors.initials: R
authors.lastname: Morbey
authors.affiliation: John Radcliffe Hospital,Oxford,UK.
authors.forename: T C
authors.initials: TC
authors.lastname: Hughes
authors.affiliation: The Royal College of Emergency Medicine,London,UK.
authors.forename: T E
authors.initials: TE
authors.lastname: Locker
authors.affiliation: Respiratory Diseases Department,Public Health England,London,UK.
authors.forename: R
authors.initials: R
authors.lastname: Pebody
authors.affiliation: Respiratory Diseases Department,Public Health England,London,UK.
authors.forename: H K
authors.initials: HK
authors.lastname: Green
authors.affiliation: Virus Reference Department,Public Health England,London,UK.
authors.forename: J
authors.initials: J
authors.lastname: Ellis
authors.affiliation: Real-time Syndromic Surveillance Team,Public Health England,Birmingham,UK.
authors.forename: G E
authors.initials: GE
authors.lastname: Smith
authors.affiliation: Real-time Syndromic Surveillance Team,Public Health England,Birmingham,UK.
authors.forename: A J
authors.initials: AJ
authors.lastname: Elliot
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001988:Bronchiolitis / Q000453:epidemiology / Q000821:virology; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D062486:Public Health Surveillance; D012044:Regression Analysis; D018357:Respiratory Syncytial Virus Infections / Q000453:epidemiology* / Q000821:virology; D012136:Respiratory Syncytial Viruses / Q000302:isolation & purification*; D012141:Respiratory Tract Infections / Q000453:epidemiology* / Q000821:virology; D055815:Young Adult
keywords: Emergency department; influenza-like illness; respiratory infections; respiratory syncytial virus; syndromic surveillance