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Infectious Disease Early Warning

An early detection system for infectious diseases, integrating data from outpatient clinics, hospitals, ambulance transport, pharmacies, schools, nursery schools, and elderly care facilities across Japan.

Explore the System
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Multi-Channel Data

Eight surveillance channels including outpatient, inpatient, ambulance, OTC pharmacy, nursery school, school absenteeism, elderly facilities, and laboratory testing.

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Early Detection

Syndromic surveillance identifies unusual patterns before laboratory confirmation, enabling faster public health responses to emerging outbreaks.

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Event Monitoring

Enhanced surveillance was conducted at major mass gatherings including the Hokkaido Toyako Summit 2008, APEC Yokohama 2010, and COP10 Nagoya 2010.

How Syndromic Surveillance Works

Syndromic surveillance monitors health-related data in near real-time to detect signals of infectious disease outbreaks before conventional diagnosis-based systems. By tracking symptoms and proxy indicators — such as school absenteeism, pharmacy dispensing, and ambulance transports — public health authorities can identify anomalies and respond earlier.

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Surveillance Channels

Syndromic surveillance in Japan draws on a broad range of data sources, each contributing a distinct signal for outbreak detection. These channels collectively provide a comprehensive picture of community health status, from clinical settings to everyday community indicators.

  • Outpatient (外来) — clinic visit symptom data
  • Inpatient (入院) — hospital admission surveillance
  • Ambulance Transport (救急車搬送) — emergency call patterns
  • OTC Pharmacy (OTC) — over-the-counter medication sales
  • Nursery School (保育園) — preschool absenteeism tracking
  • School Absenteeism (学校欠席) — nationwide school-based system
  • Elderly Facilities (高齢者施設) — care-home health monitoring
  • Laboratory Testing (検査) — test-ordering pattern analysis
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School Absenteeism System

As of January 2016, approximately 23,618 schools across 25 prefectures, 6 designated cities, and 2 special wards — covering about 53% of elementary, junior high, and high schools nationwide.

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Pharmacy Surveillance

Daily influenza estimates derived from anti-influenza drug dispensing data across 10,064 participating pharmacies, with prefecture-level and designated-city breakdowns from the 2009/2010 through 2014/2015 seasons.

Blog

  1. Watching the watchers: spotting vaccine safety signals through symptom clusteringAdverse reactions to vaccines are uncommon, yet the public-health systems that protect millions of Australians depend on the ability to detect even rare safety…
  2. Tracking Asthma Flares Through Pharmacy SignalsAsthma symptoms can rise across a community before emergency departments, laboratories or formal clinical reports show a clear change. During pollen season, a…
  3. Mapping febrile seizure clusters from emergency department timestampsWhen a parent rushes a toddler into an emergency department during a febrile convulsion, the clock starts ticking in ways that public health teams have only…
  4. Tracking Norovirus Readiness Through Antiemetic Pharmacy Sales in AustraliaAustralia's public-health system is famously federated, with outbreak intelligence shared across state health departments, the Commonwealth Department of…
  5. Combining clinic and school absenteeism data to spot gastro outbreaksGastroenteritis can spread quickly through schools, childcare services, households and workplaces before a laboratory result confirms the cause. Vomiting and…
  6. Detecting Meningococcal Disease In College DormitoriesA sudden high fever followed by a petechial rash is a serious public-health signal in any residential setting. In a college dormitory, students sleep in shared…
  7. Detecting tuberculosis reactivation in elderly-care facilitiesMonitoring tuberculosis reactivation using chronic cough and weight loss in elderly-care facility residents can give public-health teams an earlier warning…
  8. Turning Ambulance Allergy Signals Into Food Safety WarningsFood contamination incidents can become visible before a laboratory result, inspection report or formal notification is available. A sudden rise in ambulance…
  9. Using Oral Lesion Reports to Detect Hand-Foot-and-Mouth Disease EarlyHand-foot-and-mouth disease is usually mild, yet it can move quickly through primary schools, early learning centres and households. A child may first develop…
  10. Using pharmacy data to spot a COVID-19 resurgence earlyA rise in rapid antigen test kit sales can provide an early signal that COVID-19 transmission is increasing in the community. Pharmacies often see people…

Technical Support

For inquiries about the syndromic surveillance systems, including the school absenteeism information collection system and pharmacy surveillance:

Contact: Yasushi Ohkusa, Senior Researcher

Institution: Infectious Disease Epidemiology Center, National Institute of Infectious Diseases

FAX: 03-5285-1129

Email: ohkusa@nih.go.jp

All inquiries accepted by FAX or email only. For school absenteeism system login issues, please contact your municipal board of education or childcare division.