Validation of syndromic surveillance for respiratory pathogen activity

Cees Van Den Wijngaard, Liselotte Van Asten, Wilfrid Van Pelt, Nico J.D. Nagelkerke, Robert Verheij, Albert J. De Neeling, Arnold Dekkers, Marianne A.B. Van Der Sande, Hans Van Vliet, Marion P.G. Koopmans

Research output: Contribution to journalArticlepeer-review

38 Citations (Scopus)


Syndromic surveillance is increasingly used to signal unusual illness events. To validate data-source selection, we retrospectively investigated the extent to which 6 respiratory syndromes (based on different medical registries) reflected respiratory pathogen activity. These syndromes showed higher levels in winter, which corresponded with higher laboratory counts of Streptococcus pneumoniae, respiratory syncytial virus, and influenza virus. Multiple linear regression models indicated that most syndrome variations (up to 86%) can be explained by counts of respiratory pathogens. Absenteeism and pharmacy syndromes might reflect nonrespiratory conditions as well. We also observed systematic syndrome elevations in the fall, which were unexplained by pathogen counts but likely reflected rhinovirus activity. Earliest syndrome elevations were observed in absenteeism data, followed by hospital data (+1 week), pharmacy/ general practitioner consultations (+2 weeks), and deaths/laboratory submissions (test requests) (+3 weeks). We conclude that these syndromes can be used for respiratory syndromic surveillance, since they reflect patterns in respiratory pathogen activity.

Original languageEnglish
Pages (from-to)917-925
Number of pages9
JournalEmerging Infectious Diseases
Issue number6
Publication statusPublished - Jun 2008
Externally publishedYes

ASJC Scopus subject areas

  • Epidemiology
  • Microbiology (medical)
  • Infectious Diseases


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