Local implementation of a syndromic influenza surveillance system using emergency department data in Santander, Spain

S. Schrell, A. Ziemann, L. Garcia-Castrillo Riesgo, N. Rosenkötter, J. Llorca, D. Popa, T. Krafft

Research output: Contribution to journalArticlepeer-review

9 Citations (SciVal)


BackgroundWe assessed the local implementation of syndromic surveillance (SyS) as part of the European project 'System for Information on, Detection and Analysis of Risks and Threats to Health' in Santander, Spain.MethodsWe applied a cumulative sum algorithm on emergency department (ED) chief complaints for influenza-like illness in the seasons 2010-11 and 2011-12. We fine tuned the algorithm using a receiver operating characteristic analysis to identify the optimal trade-off of sensitivity and specificity and defined alert criteria. We assessed the timeliness of the SyS system to detect the onset of the influenza season.ResultsThe ED data correlated with the sentinel data. With the best algorithm settings we achieved 70/63% sensitivity and 89/95% specificity for 2010-11/2011-12. At least 2 consecutive days of signals defined an alert. In 2010-11 the SyS system alerted 1 week before the sentinel system and in 2011-12 in the same week. The data from the ED is available on a daily basis providing an advantage in timeliness compared with the weekly sentinel data.ConclusionsED-based SyS in Santander complements sentinel influenza surveillance by providing timely information. Local fine tuning and definition of alert criteria are recommended to enhance validity.

Original languageEnglish
Pages (from-to)397-403
Number of pages7
JournalJournal of Public Health (United Kingdom)
Issue number3
Early online date25 Apr 2013
Publication statusPublished - 1 Sept 2013

Bibliographical note

Funding Information:
This work was supported by the European Union, in the frame-work of the Public Health Programme (grant number 2007208).


  • communicable diseases
  • emergency care
  • epidemiology

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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