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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

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  3. Detecting varicella outbreaks from daycare absenteeismChickenpox, or varicella, often begins quietly in early-childhood settings. One child stays home with a fever, another is collected after developing an itchy…
  4. Detecting Carbon Monoxide Exposure After CyclonesWhen a cyclone cuts electricity, portable generators can keep refrigerators, medical devices, pumps and communication equipment operating. They can also create…
  5. Turning ambulance signals into an early warning for hospital demandEmergency ambulance activity can reveal pressure on the health system before hospital admission data, laboratory results or formal outbreak notifications…
  6. Using clinic diarrhoea data to detect campylobacteriosis earlierCampylobacteriosis is one of Australia’s most frequently notified bacterial gastrointestinal infections. It commonly causes diarrhoea, abdominal pain, fever…
  7. School Health Records As An Early Signal For ConjunctivitisA child with red, itchy or watery eyes may be the first visible sign of a wider outbreak. In a busy school, several students can develop similar symptoms…
  8. Detecting Falls Among Older People Through Syndromic SurveillanceFalls are a major cause of injury, hospitalisation and loss of independence for older Australians. A person who trips in a bathroom in Adelaide, slips on a wet…
  9. Detecting dehydration early in Australian aged careHeat can turn a familiar clinical problem into a rapidly developing emergency in residential aged care. Older people may lose fluid through sweating, fever,…
  10. Using pharmacy antifungal sales to spot school tinea outbreaksTinea is a common fungal skin infection that can spread through close contact, shared equipment and damp communal spaces. In schools, clusters may appear among…

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.