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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. Reading Gastroenteritis Signals Through Pharmacy SalesGastroenteritis often spreads quietly before people present to a doctor or hospital. Many people first manage vomiting, diarrhoea and dehydration at home,…
  2. Syndromic Surveillance For Measles Capture-Recapture At AirportsSyndromic surveillance for measles capture-recapture in airport clinics can give public-health teams an early estimate of infections that have not yet appeared…
  3. Using Ambulance Data To Detect Heatstroke Surges EarlyHeat can become a public-health emergency before hospitals, laboratories or general practitioners can confirm a pattern. Ambulance dispatch systems offer one…
  4. Monitoring Gastrointestinal Illness Outbreaks Through School Nurse ReportsGastrointestinal illness can move through a school community before families realise that an outbreak is developing. Vomiting, diarrhoea, abdominal pain and…
  5. Syndromic Surveillance For Influenza-Like Illness In Aged CareInfluenza-like illness can move quickly through an Australian residential aged care facility. A resident may first show fatigue, reduced appetite, confusion or…
  6. Evaluating New Data Streams for Syndromic SurveillanceSyndromic surveillance uses health-related information collected before a diagnosis is confirmed to identify unusual patterns. A rise in fever-related…
  7. Detecting Waterborne Hepatitis E Through Syndromic SurveillanceAcute hepatitis E is a viral liver infection caused by hepatitis E virus (HEV). In many settings, transmission occurs through drinking water contaminated with…
  8. Using school lunch absenteeism as an early warning for food poisoningFood poisoning can spread through a school community before public-health teams receive laboratory confirmation. Several pupils may become ill during the same…
  9. Syndromic Surveillance for Emerging Tickborne Diseases in Rural JapanRural Japan has conditions that can allow tickborne infections to remain unnoticed until patients become seriously ill. Forest work, farming, hunting, mountain…
  10. How Syndromic Signals Strengthen Japan’s Disease SurveillanceJapan’s national approach to infectious disease monitoring depends on several kinds of evidence. Laboratory results provide confirmation, while clinical…

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.