title: High added value of a population-based participatory surveillance system for community acute gastrointestinal, respiratory and influenza-like illnesses in Sweden, 2013-2014 using the web.
abstract: In 2013-2014, the Public Health Agency of Sweden developed a web-based participatory surveillance system, Hӓlsorapport, based on a random sample of individuals reporting symptoms weekly online, to estimate the community incidence of self-reported acute gastrointestinal (AGI), acute respiratory (ARI) and influenza-like (ILI) illnesses and their severity. We evaluated Hӓlsorapport's acceptability, completeness, representativeness and its data correlation with other surveillance data. We calculated response proportions and Spearman correlation coefficients (r) between (i) incidence of illnesses in Hӓlsorapport and (ii) proportions of specific search terms to medical-advice website and reasons for calling a medical advice hotline. Of 34 748 invitees, 3245 (9·3%) joined the cohort. Participants answered 81% (139 013) of the weekly questionnaires and 90% (16 351) of follow-up questionnaires. AGI incidence correlated with searches on winter-vomiting disease [r = 0·81, 95% confidence interval (CI) 0·69-0·89], and ARI incidence correlated with searches on cough (r = 0·77, 95% CI 0·62-0·86). ILI incidence correlated with the web query-based estimated incidence of ILI patients consulting physicians (r = 0·63, 95% CI 0·42-0·77). The high response to different questionnaires and the correlation with other syndromic surveillance systems suggest that Hӓlsorapport offers a reasonable representation of AGI, ARI and ILI patterns in the community and can complement traditional and syndromic surveillance systems to estimate their burden in the community.
authors.affiliation: The Public Health Agency of Sweden,Stockholm,Sweden.
authors.forename: A
authors.initials: A
authors.lastname: Pini
authors.affiliation: The Public Health Agency of Sweden,Stockholm,Sweden.
authors.forename: H
authors.initials: H
authors.lastname: Merk
authors.affiliation: The Public Health Agency of Sweden,Stockholm,Sweden.
authors.forename: A
authors.initials: A
authors.lastname: Carnahan
authors.affiliation: The Public Health Agency of Sweden,Stockholm,Sweden.
authors.forename: I
authors.initials: I
authors.lastname: Galanis
authors.affiliation: The Public Health Agency of Sweden,Stockholm,Sweden.
authors.forename: E
authors.initials: E
authors.lastname: VAN Straten
authors.affiliation: European Programme for Intervention Epidemiology Training (EPIET),European Centre for Disease Prevention and Control (ECDC),Stockholm,Sweden.
authors.forename: K
authors.initials: K
authors.lastname: Danis
authors.affiliation: The Public Health Agency of Sweden,Stockholm,Sweden.
authors.forename: M
authors.initials: M
authors.lastname: Edelstein
authors.affiliation: The Public Health Agency of Sweden,Stockholm,Sweden.
authors.forename: A
authors.initials: A
authors.lastname: Wallensten
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003256:Community Participation; D062665:Epidemiological Monitoring; D005260:Female; D005759:Gastroenteritis / Q000453:epidemiology*; D006302:Health Services Research; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D020407:Internet; D008297:Male; D008875:Middle Aged; D012141:Respiratory Tract Infections / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult
keywords: Acute gastrointestinal illness; acute respiratory illness; influenza-like illness; population-based study; surveillance system