title: Case study of early detection and intervention of infectious disease outbreaks in an institution using Nursery School Absenteeism Surveillance Systems (NSASSy) of the Public Health Center.
abstract: Objectives Detecting outbreaks early and then activating countermeasures based on such information is extremely important for infection control at childcare facilities. The Sumida ward began operating the Nursery School Absenteeism Surveillance System (NSASSy) in August 2013, and has since conducted real-time monitoring at nursery schools. The Public Health Center can detect outbreaks early and support appropriate intervention. This paper describes the experiences of Sumida Public Health Center related to early detection and intervention since the initiation of the system.Methods In this study, we investigated infectious disease outbreaks detected at 62 nursery schools in the Sumida ward, which were equipped with NSASSy from early November 2013 through late March 2015. We classified the information sources of the detected outbreak and responses of the public health center. The sources were (1) direct contact from some nursery schools, (2) messages from public officers with jurisdiction over nursery schools, (3) automatic detection by NSASSy, and (4) manual detection by public health center officers using NSASSy. The responses made by the health center were described and classified into 11 categories including verification of outbreak and advice for caregivers.Results The number of outbreaks detected by the aforementioned four information sources was zero, 25, 15, and 7 events, respectively, during the first 5 months after beginning NSASSy. These numbers became 5, 7, 53, and 25 events, respectively, during the subsequent 12 months. The number of outbreaks detected increased by 47% during the first 5 months, and by 87% in the following 12 months. The responses were primarily confirming the situation and offering advice to caregivers.Conclusion The Sumida Public Health Center ward could achieve early detection with automatic or manual detection of NSASSy. This system recently has become an important detection resource, and has contributed greatly to early detection. Because the Public Health Center can use it to achieve real-time monitoring, they can recognize emergent situations and intervene earlier, and thereby give feedback to the nursery schools. The system can contribute to providing effective countermeasures in these settings.
authors.affiliation: Public Health Center, Sumida Ward.
authors.forename: Kayo
authors.initials: K
authors.lastname: Matsumoto
authors.forename: Chifumi
authors.initials: C
authors.lastname: Hirayama
authors.forename: Yoko
authors.initials: Y
authors.lastname: Sakuma
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Itoi
authors.forename: Asami
authors.initials: A
authors.lastname: Sunadori
authors.forename: Junko
authors.initials: J
authors.lastname: Kitamura
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nakahashi
authors.forename: Tamie
authors.initials: T
authors.lastname: Sugawara
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Ohkusa
mesh_terms: D000041:Absenteeism; D004196:Disease Outbreaks; D042241:Early Diagnosis; D061345:Early Medical Intervention; D006801:Humans; D011634:Public Health; D012578:Schools, Nursery