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Syndromic Surveillance, Reports Morbidity and Mortality Weekly Report Supplement September 24, 2004 / Vol. 53 Syndromic Surveillance Reports from a National Conference, 2003 department of health and human services Centers for Disease Control and Prevention MMWR The MMWR series of publications is published by the Editorial Committee Epidemiology Program Office, Centers for Disease Richard S. Hopkins, M.D., M.S.P.H. Control and Prevention (CDC), U.S. Department of Director Health and Human Services, Atlanta, GA 30333. Division of Public Health Surveillance and Informatics, SUGGESTED CITATION Epidemiology Program Office, CDC General: Centers for Disease Control and Prevention. Syndromic Surveillance: Reports from a Farzad Mostashari, M.D., M.P.H. National Conference, 2003. MMWR Assistant Commissioner 2004:53(Suppl). Bureau of Epidemiology Services, Specific: [Author(s)]. [Title of particular article]. In: Division of Epidemiology, New York City Department Syndromic Surveillance: Reports from a of Health and Mental Hygiene National Conference, 2003. MMWR 2004;53 (Suppl):[inclusive page numbers]. Daniel Sosin, M.D., M.P.H. Associate Director for Science Office of Terrorism Preparedness and Emergency Response, Centers for Disease Control and Prevention Office of the Director, CDC Julie L. Gerberding, M.D., M.P.H. Director John W. Ward, M.D., M.P.H. Director Dixie E. Snider, Jr., M.D., M.P.H. Office of Science and Health Communications, (Acting) Deputy Director for Public Health Science Epidemiology Program Office, CDC Editor, MMWR Series Tanja Popovic, M.D., Ph.D. (Acting) Associate Director for Science Epidemiology Program Office Stephen B. Thacker, M.D., M.Sc. Director Office of Scientific and Health Communications John W. Ward, M.D. Director Editor, MMWR Series Suzanne M. Hewitt, M.P.A. Managing Editor, MMWR Series C. Kay Smith-Akin, M.Ed. Lead Technical Writer/Editor Stephanie M. Malloy Project Editor Beverly J. Holland Lead Visual Information Specialist Lynda G. Cupell Malbea A. LaPete Visual Information Specialists Kim L. Bright, M.B.A. Notice Quang M. Doan, M.B.A. This supplement is being published as a courtesy to the MMWR Erica R. Shaver readership. These papers represent the views of the authors, and their Information Technology Specialists publication does not imply endorsement by CDC. Vol. 53 / Supplement MMWR 1 CONTENTS Preface ................................................................................................................................................................................. 3 Peer Reviewers .................................................................................................................................................................... 4 Overview of Syndromic Surveillance What is Syndromic Surveillance?/Kelly J. Henning ........................................................................................................................ 7 Linking Better Surveillance to Better Outcomes/Seth L. Foldy ..................................................................................................... 12 Review of the 2003 National Syndromic Surveillance Conference — Lessons Learned and Questions To Be Answered/ James W. Buehler ..................................................................................................................................................................... 18 New York City Syndromic Surveillance Systems/Richard Heffernan, F. Mostashari, D. Das, M. Besculides, C. Rodriguez, J. Greenko, L. Steiner-Sichel, S. Balter, A. Karpati, P. Thomas, M. Phillips, J. Ackelsberg, E. Lee, J. Leng, J. Hartman, K. Metzger, R. Rosselli, D. Weiss ............................................................................................................................................... 25 Syndrome and Outbreak Detection Using Chief-Complaint Data — Experience of the Real-Time Outbreak and Disease Surveillance Project/Michael M. Wagner, J. Espino, F-C. Tsui, P. Gesteland, W. Chapman, O. Ivanov, A. Moore, W. Wong, J. Dowling, J. Hutman .............................................................................................................................................................. 28 Removing a Barrier to Computer-Based Outbreak and Disease Surveillance — The RODS Open Source Project/ Jeremy U. Espino, M. Wagner, C. Szczepaniak, F-C. Tsui, H. Su, R. Olszewski, Z. Liu, W. Chapman, X. Zeng, L. Ma, Z. Lu, J. Dara ... 32 National Retail Data Monitor for Public Health Surveillance/Michael M. Wagner, F-C. Tsui, J. Espino, W. Hogan, J. Hutman, J. Hersh, D. Neill, A. Moore, G. Parks, C. Lewis, R. Aller ........................................................................................................... 40 National Bioterrorism Syndromic Surveillance Demonstration Program/W. Katherine Yih, B. Caldwell, R. Harmon, K. Kleinman, R. Lazarus, A. Nelson, J. Nordin, B. Rehm, B. Richter, D. Ritzwoller, E. Sherwood, R. Platt .................................... 43 Daily Emergency Department Surveillance System — Bergen County, New Jersey/Marc Paladini .............................................. 47 Hospital Admissions Syndromic Surveillance — Connecticut, September 2001–November 2003/Zygmunt F. Dembek, K. Carley, A. Siniscalchi, J. Hadler ............................................................................................................................................ 50 BioSense — A National Initiative for Early Detection and Quantification of Public Health Emergencies/John W. Loonsk............ 53 Syndromic Surveillance at Hospital Emergency Departments — Southeastern Virginia/Christine M. Yuan, S. Love, M. Wilson ....... 56 Research Methods Bivariate Method for Spatio-Temporal Syndromic Surveillance/Al Ozonoff, L. Forsberg, M. Bonetti, M. Pagano .......................... 61 Role of Data Aggregation in Biosurveillance Detection Strategies with Applications from ESSENCE/Howard S. Burkom, Y. Elbert, A. Feldman, J. Lin ...................................................................................................................................................... 67 Scan Statistics for Temporal Surveillance for Biologic Terrorism/Sylvan Wallenstein, J. Naus ....................................................... 74 Approaches to Syndromic Surveillance When Data Consist of Small Regional Counts/Peter A. Rogerson, I. Yamada ................. 79 Algorithm for Statistical Detection of Peaks — Syndromic Surveillance System for the Athens 2004 Olympic Games/ Urania G. Dafni, S. Tsiodras, D. Panagiotakos, K. Gkolfinopoulou, G. Kouvatseas, Z. Tsourti, G. Saroglou ............................... 86 Taming Variability in Free Text: Application to Health Surveillance/Alan R. Shapiro .................................................................... 95 Comparison of Two Major Emergency Department-Based Free-Text Chief-Complaint Coding Systems/Christina A. Mikosz, J. Silva, S. Black, G. Gibbs, I. Cardenas .................................................................................................................................. 101 How Many Illnesses Does One Emergency Department Visit Represent? Using a Population-Based Telephone Survey To Estimate the Syndromic Multiplier/Kristina B. Metzger, A. Hajat, M. Crawford, F. Mostashari ............................................ 106 Comparison of Office Visit and Nurse Advice Hotline Data for Syndromic Surveillance — Baltimore-Washington, D.C., Metropolitan Area, 2002/Jade Vu Henry, S. Magruder, M. Snyder ......................................................................................... 112 Progress in Understanding and Using Over-the-Counter Pharmaceuticals for Syndromic Surveillance/Steven F. Magruder, S. Happel Lewis, A. Najmi, E. Florio ....................................................................................................................................... 117 Evaluation Evaluation Challenges for Syndromic Surveillance — Making Incremental Progress/Daniel M. Sosin, J. DeThomasis ............... 125 Measuring Outbreak-Detection Performance By Using Controlled Feature Set Simulations/Kenneth D. Mandl, B. Reis, C. Cassa ................................................................................................................................................................................. 130 Evaluation of Syndromic Surveillance Systems — Design of an Epidemic Simulation Model/David L. Buckeridge, H. Burkom, A. Moore, J. Pavlin, P. Cutchis, W. Hogan ............................................................................................................. 137 Benchmark Data and Power Calculations for Evaluating Disease Outbreak Detection Methods/Martin Kulldorff, Z. Zhang, J. Hartman, R. Heffernan, L. Huang, F. Mostashari ................................................................................................. 144 2 MMWR September 24, 2004 CONTENTS (Continued) Bio-ALIRT Biosurveillance Detection Algorithm Evaluation/David Siegrist, J. Pavlin ................................................................... 152 ESSENCE II and the Framework for Evaluating Syndromic Surveillance Systems/Joseph S. Lombardo, H. Burkom, J. Pavlin ..... 159 Conducting Population Behavioral Health Surveillance by Using Automated Diagnostic and Pharmacy Data Systems/ Julie A. Pavlin, P. Murdock, E. Elbert, C. Milliken, S. Hakre, J. Mansfield, C. Hoge .................................................................. 166 Evaluation of an Electronic General-Practitioner–Based Syndromic Surveillance System — Auckland,
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