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Epidemiology & Infection Epidemiology & Infection

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Can syndromic surveillance data detect local outbreaks of communicable disease? A model using a historical cryptosporidiosis outbreak

Published online by Cambridge University Press:  22 July 2005

D. L. COOPER ,
N. Q. VERLANDER ,
G. E. SMITH ,
A. CHARLETT ,
E. GERARD ,
L. WILLOCKS  and
S. O'BRIEN
D. L. COOPER*
Affiliation:
Regional Surveillance Unit, Health Protection Agency West Midlands, Birmingham, UK
N. Q. VERLANDER
Affiliation:
Statistics Unit, Centre for Infections, Health Protection Agency, London, UK
G. E. SMITH
Affiliation:
Regional Surveillance Unit, Health Protection Agency West Midlands, Birmingham, UK
A. CHARLETT
Affiliation:
Statistics Unit, Centre for Infections, Health Protection Agency, London, UK
E. GERARD
Affiliation:
NHS Direct Hampshire and the Isle of Wight, Southampton, UK
L. WILLOCKS
Affiliation:
Health Protection, NHS Lothian, Edinburgh, Scotland, UK
S. O'BRIEN
Affiliation:
Division of Medicine and Neurosciences, University of Manchester, Manchester, UK
*
*Author for correspondence: D. L. Cooper, Regional Surveillance Unit, Health Protection Agency West Midlands, Floor 2, Lincoln House, Heartlands Hospital, Bordesley Green East, BirminghamB9 5SS, UK. (Email: duncan.cooper@hpa.org.uk)
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Summary

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A national UK surveillance system currently uses data from a health helpline (NHS Direct) in an attempt to provide early warning of a bio-terrorist attack, or an outbreak caused by a more common infection. To test this syndromic surveillance system we superimposed data from a historical outbreak of cryptosporidiosis onto a statistical model of NHS Direct call data. We modelled whether calls about diarrhoea (a proxy for cryptosporidiosis) exceeded a statistical threshold, thus alerting the surveillance team to the outbreak. On the date that the public health team were first notified of the outbreak our model predicted a 4% chance of detection when we assumed that one-twentieth of cryptosporidiosis cases telephoned the helpline. This rose to a 72% chance when we assumed nine-tenths of cases telephoned. The NHS Direct surveillance system is currently unlikely to detect an event similar to the cryptosporidiosis outbreak used here and may be most suited to detecting more widespread rises in syndromes in the community, as previously demonstrated. However, the expected rise in NHS Direct call rates, should improve early warning of outbreaks using call data.

Type
Research Article
Information
Epidemiology & Infection , Volume 134 , Issue 1 , February 2006 , pp. 13 - 20
Copyright
Copyright © Cambridge University Press 2005

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