Abstract
BackgroundSyndromic surveillance is increasingly being evaluated for its potential for early warning of increased disease activity in the population. However, interpretation is hampered by the difficulty of attributing a causative pathogen. We described the temporal relationship between laboratory counts of influenza and respiratory syncytial virus (RSV) detection and alternative groupings of Emergency Department (ED) respiratory diagnoses.MethodsED and laboratory data were obtained for the south-eastern area of Sydney, NSW for the period 1 June 2001 - 1 December 2006. Counts of ED visits and laboratory confirmed positive RSV and influenza cases were aggregated by week. Semi-parametric generalized additive models (GAM) were used to determine the association between the incidence of RSV and influenza and the incidence of respiratory syndrome ED presentations while controlling for temporal confounders.ResultsFor every additional RSV laboratory count, ED diagnoses of bronchiolitis increased by 3.1% (95%CI: 2.7%-3.5%) in the same week. For every additional influenza laboratory count, ED diagnoses of influenza-like illness increased by 4.7% (95%CI: 4.2%-5.2%) one week earlier.ConclusionIn this study, large increases in ED diagnoses of bronchiolitis and influenza-like illness were independent and proxy indicators for RSV and influenza activity, respectively.
Highlights
Syndromic surveillance is increasingly being evaluated for its potential for early warning of increased disease activity in the population
Previous studies have found that influenza virus and respiratory syncytial virus (RSV) explain most of the variation in presentations of respiratory syndromes to Emergency Department (ED) [9,10,7], but these studies did not determine whether syndromic surveillance could distinguish between these viruses
The seasonal peaks for ED pneumonia syndrome occurred after the peaks for laboratory RSV, but shortly before the peaks for laboratory influenza
Summary
Syndromic surveillance is increasingly being evaluated for its potential for early warning of increased disease activity in the population. Syndromic surveillance is increasingly being used for monitoring disease activity because of its potential for early detection of outbreaks and epidemics [1,2,3,4,5,6], and its potentially widespread coverage of target populations. Interpretation of surveillance signals is often hampered by the difficulty of implicating a causative pathogen. RSV is the most common cause of lower respiratory tract infection in infants and children worldwide and often manifests as bronchiolitis and pneumonia [11,12]. RSV is increasingly recognized as an important cause of serious respiratory disease in the elderly and immuno-compromised individuals [11]. Otherwise healthy adults, RSV may have a clinical presentation similar to influenza [13]
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