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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 Influenza Signals Through Pharmacy Cold Remedy SalesInfluenza surveillance often begins before a laboratory result confirms a case. People develop symptoms, choose a treatment, and visit a pharmacy while…
  2. Syndromic surveillance for acute flaccid paralysisAcute flaccid paralysis (AFP) is a clinical syndrome involving sudden weakness and reduced muscle tone. It can arise from poliovirus infection, but also from a…
  3. Monitoring pertussis outbreaks through cough-related emergency visitsPertussis, or whooping cough, can spread before an outbreak is recognized through laboratory reporting. Early symptoms often resemble an ordinary respiratory…
  4. How Social Media Trends Strengthen Syndromic SurveillancePublic-health teams have long relied on reports from clinics, hospitals, laboratories, pharmacies, schools, and emergency services to identify unusual illness…
  5. Syndromic Surveillance for Leptospirosis After Flooding EventsFlooding can create the conditions for leptospirosis to spread quickly and quietly. Fast-moving water, saturated soil, damaged sewage systems, and displaced…
  6. How Syndromic Data Informed Japan’s 2009 H1N1 ResponseThe 2009 H1N1 pandemic tested public-health systems before many countries had reliable estimates of transmission, severity, or geographic spread. Japan’s…
  7. Syndromic Surveillance For Adverse Drug Reaction Signals In Elderly FacilitiesOlder adults often take several medicines at the same time, live with multiple chronic conditions, and may have difficulty describing new symptoms. These…
  8. Evaluating the Value of Multi-Channel Syndromic SurveillanceSyndromic surveillance uses health-related signals collected before a diagnosis is confirmed through laboratory testing. Reports of fever, respiratory…
  9. Syndromic surveillance for eye infections and conjunctivitis clustersEye infections can spread quickly through schools, workplaces, hospitals, households, and shared-care environments. A rise in red eyes, discharge, swelling, or…
  10. Turning School Nurse Visits Into Early Outbreak SignalsSchool health offices see illness before many cases reach a clinic. A student may visit with fever, vomiting, headache, a persistent cough, or unusual fatigue,…

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.