Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Oct 13;21(41):30368.
doi: 10.2807/1560-7917.ES.2016.21.41.30368.

The potential impact of media reporting in syndromic surveillance: an example using a possible Cryptosporidium exposure in North West England, August to September 2015

Alex J Elliot  1 , Helen E Hughes, John Astbury, Grainne Nixon, Kate Brierley, Roberto Vivancos, Thomas Inns, Valerie Decraene, Katherine Platt, Iain Lake, Sarah J O'Brien, Gillian E Smith
Affiliations

The potential impact of media reporting in syndromic surveillance: an example using a possible Cryptosporidium exposure in North West England, August to September 2015

Alex J Elliot et al. Euro Surveill. .

Abstract

During August 2015, a boil water notice (BWN) was issued across parts of North West England following the detection of Cryptosporidium oocysts in the public water supply. Using prospective syndromic surveillance, we detected statistically significant increases in the presentation of cases of gastroenteritis and diarrhoea to general practitioner services and related calls to the national health telephone advice service in those areas affected by the BWN. In the affected areas, average in-hours general practitioner consultations for gastroenteritis increased by 24.8% (from 13.49 to 16.84) during the BWN period; average diarrhoea consultations increased by 28.5% (from 8.33 to 10.71). Local public health investigations revealed no laboratory reported cases confirmed as being associated with the water supply. These findings suggest that the increases reported by syndromic surveillance of cases of gastroenteritis and diarrhoea likely resulted from changes in healthcare seeking behaviour driven by the intense local and national media coverage of the potential health risks during the event. This study has further highlighted the potential for media-driven bias in syndromic surveillance, and the challenges in disentangling true increases in community infection from those driven by media reporting.

Keywords: Cryptosporidium; bias; diarrhoea; gastroenteritis; media; syndromic surveillance.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
Location of Blackpool and Lancashire upper tier local authorities (LAs) as well as the postcode districts in these two LAs, which were affected by a boil water notice, North West England, 6 August−6 September 2015
Figure 2
Figure 2
Daily presentation (3 day moving average) of gastroenteritis consultations to general practitioner services (in-hours and out-of-hours) in North West England, 7 July−26 September 2015
Figure 3
Figure 3
Daily presentation (3 day moving average) of diarrhoea general practitioner (GP) consultations and National Health Service (NHS) 111 calls in North West England, 7 July−26 September 2015
Figure 4
Figure 4
Daily presentation (3 day moving average) of vomiting general practitioner (GP) consultations and National Health Service (NHS) 111 calls in North West England, 7 July−26 September 2015
See this image and copyright information in PMC

References

    1. Shirley DA, Moonah SN, Kotloff KL. Burden of disease from cryptosporidiosis. Curr Opin Infect Dis. 2012;25(5):555-63. 10.1097/QCO.0b013e328357e569 - DOI - PMC - PubMed
    1. Leoni F, Amar C, Nichols G, Pedraza-Díaz S, McLauchlin J. Genetic analysis of Cryptosporidium from 2414 humans with diarrhoea in England between 1985 and 2000. J Med Microbiol. 2006;55(Pt 6):703-7. 10.1099/jmm.0.46251-0 - DOI - PubMed
    1. Lima AA, Moore SR, Barboza MS, Jr, Soares AM, Schleupner MA, Newman RD, et al. Persistent diarrhea signals a critical period of increased diarrhea burdens and nutritional shortfalls: a prospective cohort study among children in northeastern Brazil. J Infect Dis. 2000;181(5):1643-51. 10.1086/315423 - DOI - PubMed
    1. Cama VA, Bern C, Roberts J, Cabrera L, Sterling CR, Ortega Y, et al. Cryptosporidium species and subtypes and clinical manifestations in children, Peru. Emerg Infect Dis. 2008;14(10):1567-74. 10.3201/eid1410.071273 - DOI - PMC - PubMed
    1. Hunter PR, Nichols G. Epidemiology and clinical features of Cryptosporidium infection in immunocompromised patients. Clin Microbiol Rev. 2002;15(1):145-54. 10.1128/CMR.15.1.145-154.2002 - DOI - PMC - PubMed