Issue 29 - The Third Annual Syndromic Surveillance Conference

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The Third Annual Syndromic Surveillance Conference
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Boston, Massachusetts was the site of the 3rd Annual Syndromic Surveillance Conference, November 3-4th, 2004. More than 400 participants from 43 states and 12 countries (1) came to listen, present, discuss and debate all the current issues in the still evolving science of syndromic surveillance and early event detection. Reporting on the conference is Deborah Martin, CEO of ICPA, Inc.

The stated conference goal was to “provide developers and current and potential users of syndromic surveillance systems information on the state of the art and future trends in order to make informed and practical choices for implementation”. (2)

To accomplish this goal, the conference hosted 22 sessions over two days. In addition, 56 poster presentations provided information on everything from surveillance success stories in rural Kentucky, Washington D.C. and the Mall of America to evaluating alternative data sources such as over-the-counter (OTC) drug sales and medical call center data.

The program explored seven focus areas in syndromic surveillance:
1) National programs for syndromic surveillance such as Biosense
2) What level syndromic surveillance should be conducted
3) Aberration detection methods and evaluation metrics
4) How to effectively use the data to detect and respond to outbreaks
5) Overcoming obstacles in data sharing
6) International experiences
7) Challenges and future directions

We were impressed by the sheer number of syndromic surveillance systems already in place around the United States. These systems have been developed by the federal government (e.g., Essence, Biosense), by academic institutions using federal grants (e.g., RODS), and by corporations (e.g., RedBat), and some are homegrown. Some cities/states already combine and analyze syndromic surveillance data from several of these systems.

Syndromic surveillance based on emergency department surveillance is being performed by health departments at all governmental levels: small cities, large cities (e.g., NYC), counties (Montgomery Co, Maryland), regions (e.g., Gateway Health District), states (New Hampshire), and even drop-in surveillance at events (e.g., G-8 Summit). A wide variety of emergency department data is being collected, ranging from simple symptoms (e.g., New York City, Connecticut), ICD-9 discharge codes (Essence), and text mining that results in calculated syndromes scores (e.g., RedBat).

Another dominant impression from the conference is that many health departments want to be able to analyze data from disparate sources. Examples of data sets include Emergency Department text data, school absenteeism, OTC drug sales, and EMS runs. These data sources enable the health department to look at outbreaks from several different angles as well as confirm a signal from one data source by looking at another. (3)

Using these surveillance systems, many real and potential outbreaks were investigated over the last year. Example of outbreaks identified included citywide norovirus, rotavirus and influenza. NYC identified an increase in diarrheal illness after the NYC blackout and an increase in SOB and chest tightness immediately following President Clinton’s announcement of pending CABG surgery in September 2004. (4) (5)

Julie Pavlin, MD (Program Chair), Farzad Mostashari, MD (Organizing Chair), and the Tufts Health Care Institute are to be commended for an excellent and very thought provoking conference. The general consensus is that the science of syndromic surveillance is young but holds great promise. Even during their point/counterpoint debate, both Dr. Julie Pavlin and Dr. Art Reingold agreed that SS is very useful in preventing public panic because only current accurate data can provide the necessary reassurance that outbreak is not occurring. (6)

If you weren’t able to attend this year’s conference, be watching for the proceedings to be posted on www.syndromic.org. Also, pencil in the tentative date for next year’s 4th annual syndromic surveillance conference, Sept 13-15th in Seattle.

(1) Szaniszlo, Marie. Surveillance system keeps a close eye on diseases in Hub. All Editions. Boston Herald. Boston, Mass: Nov 4, 2004

(2) Conference Proceedings. 2004 Syndromic Surveillance Conference

(3) Magruder, Steven et al. Comparisons of Timeliness and Signal Strength for Multiple Syndromic Surveillance Data Types in San Diego County. Presented at the 2004 Syndromic Surveillance Conference in Boston, Mass. Nov 3-4, 2004

(4) Mostashari, Farzad. Increase in Emergency Room Visits for Chest Pain: The Clinton Effect?. Presented at the 2004 Syndromic Surveillance Conference in Boston, Mass. Nov 3-4, 2004

(5) Balter, Sharon. Three Years of Emergency Department Syndromic Surveillance in NYC: Have We Found Anything Yet? Presented at the 2004 Syndromic Surveillance Conference in Boston, Mass. Nov 3-4, 2004

(6) Pavlin, Julie and Reingold, Art. Debate: Does Syndromic Surveillance Work? Moderated by James Buehler. Presented at the 2004 Syndromic Surveillance Conference in Boston, Mass. Nov 3-4, 2004

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