Redefining syndromic surveillance

Abstract

With growing concerns about international spread of disease and expanding use of early disease detection surveillance methods, the field of syndromic surveillance has received increased attention over the last decade. The purpose of this article is to clarify the various meanings that have been assigned to the term syndromic surveillance and to propose a refined categorization of the characteristics of these systems. Existing literature and conference proceedings were examined on syndromic surveillance from 1998 to 2010, focusing on low- and middle-income settings. Based on the 36 unique definitions of syndromic surveillance found in the literature, five commonly accepted principles of syndromic surveillance systems were identified, as well as two fundamental categories: specific and non-specific disease detection. Ultimately, the proposed categorization of syndromic surveillance distinguishes between systems that focus on detecting defined syndromes or outcomes of interest and those that aim to uncover non-specific trends that suggest an outbreak may be occurring. By providing an accurate and comprehensive picture of this field's capabilities, and differentiating among system types, a unified understanding of the syndromic surveillance field can be developed, encouraging the adoption, investment in, and implementation of these systems in settings that need bolstered surveillance capacity, particularly low- and middle-income countries.

Keywords: AIDS; Biosurveillance; CDC; Centers for Disease Control and Prevention; DOD-GEIS; Department of Defense Global Emerging Infections Surveillance and Response System; Disease outbreaks; EWORS; Early Warning Outbreak Recognition System; Epidemiology; ICD; IHR; ILI; ISDS; IT; International Classification of Diseases; International Health Regulations; International Society for Disease Surveillance; JHU/APL; Johns Hopkins University/Applied Physics Laboratory; Population surveillance; Regional Office for South-East Asia; SARS; SBS; SEARO; SNS; STD; Syndrome; Syndromic surveillance; US; USAID; United States; United States Agency for International Development; WHO; World Health Organization; acquired immune deficiency syndrome; influenza-like illness; information technology; severe acute respiratory syndrome; sexually transmitted disease; syndromic-based surveillance; syndromic-non-specific surveillance.