Using public health scenarios to predict the utility of a national syndromic surveillance programme during the 2012 London Olympic and Paralympic Games

Abstract

During 2012 real-time syndromic surveillance formed a key part of the daily public health surveillance for the London Olympic and Paralympic Games. It was vital that these systems were evaluated prior to the Games; in particular what types and scales of incidents could and could not be detected. Different public health scenarios were created covering a range of potential incidents that the Health Protection Agency would require syndromic surveillance to rapidly detect and monitor. For the scenarios considered it is now possible to determine what is likely to be detectable and how incidents are likely to present using the different syndromic systems. Small localized incidents involving food poisoning are most likely to be detected the next day via emergency department surveillance, while a new strain of influenza is more likely to be detected via GP or telephone helpline surveillance, several weeks after the first seed case is introduced.

A methodological framework for the evaluation of syndromic surveillance systems: a case study of England

“…To fully assess the detection capabilities of syndromic surveillance systems in England an evaluation framework was developed. This framework builds upon the studies conducted by Morbey et al [ 13 ], Bolt et al [ 7 ], and Jackson et al [ 12 ].…”

“…Cases from the outbreak simulations were converted into the numbers of people estimated to consult healthcare systems and hence be captured by one of the four PHE syndromic surveillance data streams. This was achieved by multiplying the compartmental model output by the 10 th , 50 th , and 90 th percentiles of the range of values of the proportion of the population estimated to consult different forms of healthcare (Table 2 ) [ 35 , 36 ]. Not all healthcare providers report syndromic surveillance data to the ReSST, and so simulated data were also multiplied by the estimated coverage of each syndromic system (Table 2 ).…”

“…The estimates for the proportion of the population seeking medical advice for the selected conditions are not well known. Therefore, here they were estimated based on previous studies [ 35 , 36 ] and expert knowledge.…”

“…Research evaluating the performance of syndromic surveillance systems is scarce and has typically used a single disease type [ 6 , 7 ], and one or two syndromic data sources [ 8 – 11 ]. This knowledge gap is important to address because different diseases and data streams are likely to exhibit different behaviours (see for example [ 12 , 13 ]). In some studies, single day outbreak data were used to evaluate the detection performance of aberration detection methods [ 14 , 15 ] which conflicts with the real behaviour of epidemics [ 8 ].…”

Evaluation of the surveillance system for undiagnosed serious infectious illness (USII) in intensive care units, England, 2011 to 2013

“…For instance, the HPA and European Centre for Disease Prevention and Control (ECDC) worked jointly to identify and risk assess infectious disease hazards occurring outside the UK which may have had an impact on the Olympic and Paralympic Games [14,20]. In addition, syndromic surveillance was expanded to detect signals of uncommon illnesses [13,21]. However, the USII system was unique in having the capability to collect case-level information on potential cases of new and emerging infections.…”