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An evaluation model for syndromic surveillance: assessing the performance of a temporal algorithm.
David L Buckeridge1, P Switzer, D Owens
1Palo Alto Veterans Health Care, Palo Alto, California, USA. david.buckeridge@stanford.edu
MMWR Supplements
|September 24, 2005
Summary
Syndromic surveillance can detect inhalational anthrax attacks within 3-4 days if over 10,000 people are infected. Detection sensitivity and timeliness decrease with fewer infected individuals, impacting public health response effectiveness.
Area of Science:
- Public Health
- Epidemiology
- Biosecurity
Background:
- Syndromic surveillance systems are crucial for early detection of bioterrorism-related outbreaks.
- Limited evidence exists on the actual performance of these systems in outbreak detection scenarios.
Purpose of the Study:
- To model inhalational anthrax case simulations following an aerosol release.
- To evaluate the effectiveness of syndromic surveillance in detecting such an outbreak.
Main Methods:
- Simulated disease progression and healthcare-seeking behavior for anthrax-infected individuals.
- Integrated simulated cases with real surveillance data to create test datasets.
- Applied a temporal outbreak detection algorithm to assess sensitivity and timeliness.
Main Results:
- Earliest detection occurred within 2 days post-release, correlating with higher infection numbers.
- Detection performance declined with a lower proportion of individuals seeking care during the prodromal phase.
- Shorter incubation periods (≤5 days) enabled detection as early as 1 day post-release.
Conclusions:
- Syndromic surveillance detected simulated anthrax attacks within 3-4 days when over 10,000 individuals were infected.
- Detection timeliness and sensitivity were inversely related to the number of infected persons, highlighting system limitations for smaller-scale events.
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