syndromic surveillance for local outbreaks of lower-respiratory infections would it work症状监测为当地下呼吸道感染的疫情会工作.pdfVIP

Syndromic Surveillance for Local Outbreaks of Lower- Respiratory Infections: Would It Work? 1 1 1 1 Cees C. van den Wijngaard *, Liselotte van Asten , Wilfrid van Pelt , Gerda Doornbos , Nico J. D. 2 ´ 3 1 1,4 Nagelkerke , Ge A. Donker , Wim van der Hoek , Marion P. G. Koopmans 1 Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands, 2 United Arab Emirates University, Al-Ain, United Arab Emirates, 3 Netherlands Institute of Health Services Research, Utrecht, The Netherlands, 4 Erasmus Medical Center, Rotterdam, The Netherlands Abstract Background: Although syndromic surveillance is increasingly used to detect unusual illness, there is a debate whether it is useful for detecting local outbreaks. We evaluated whether syndromic surveillance detects local outbreaks of lower- respiratory infections (LRIs) without swamping true signals by false alarms. Methods and Findings: Using retrospective hospitalization data, we simulated prospective surveillance for LRI-elevations. Between 1999–2006, a total of 290762 LRIs were included by date of hospitalization and patients place of residence (.80% coverage, 16 million population). Two large outbreaks of Legionnaires disease in the Netherlands were used as positive controls to test whether these outbreaks could have been detected as local LRI elevations. We used a space-time permutation scan statistic to detect LRI clusters. We evaluated how many LRI-clusters were detected in 1999–2006 and assessed likely causes for the cluster-signals by looking for significantly higher propo