Abstract
Timely detection of an inhalational anthrax outbreak is critical for clinical and public health management. Syndromic surveillance has received considerable investment, but little is known about how it will perform relative to routine clinical case finding for detection of an inhalational anthrax outbreak. We conducted a simulation study to compare clinical case finding with syndromic surveillance for detection of an outbreak of inhalational anthrax. After simulated release of 1 kg of anthrax spores, the proportion of outbreaks detected first by syndromic surveillance was 0.59 at a specificity of 0.9 and 0.28 at a specificity of 0.975. The mean detection benefit of syndromic surveillance was 1.0 day at a specificity of 0.9 and 0.32 days at a specificity of 0.975. When syndromic surveillance was sufficiently sensitive to detect a substantial proportion of outbreaks before clinical case finding, it generated frequent false alarms.
Highlights
Detection of an inhalational anthrax outbreak is critical for clinical and public health management
When the specificity was 0.9, syndromic surveillance detected from 51% to 59% of outbreaks before clinical case finding, and the mean detection benefit was 1.0–1.1 days, but this specificity resulted in a false alarm every 10 days
When we compared the performance of clinical case finding with that of syndromic surveillance for detecting an inhalational anthrax outbreak, we found that clinical case finding detected outbreaks on average 3.7–4.6 days after release of spores
Summary
Detection of an inhalational anthrax outbreak is critical for clinical and public health management. We conducted a simulation study to compare clinical case finding with syndromic surveillance for detection of an outbreak of inhalational anthrax. Despite substantial investment in syndromic surveillance and calls for further research from groups such as the Institute of Medicine [3], little evidence exists to suggest how syndromic surveillance will perform relative to clinical case finding for detection of an inhalational anthrax outbreak [10]. The reason for this lack of evidence is that data from real outbreaks are not available to evaluate the performance of syndromic surveillance alone or in comparison to clinical case finding. Detecting an Inhalational Anthrax Outbreak model to estimate the detection benefit of syndromic surveillance compared with clinical case finding
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
