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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. 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…
  2. Using bronchiolitis codes to track RSV in Australian infantsRespiratory syncytial virus (RSV) is a common cause of lower respiratory tract illness in babies, yet laboratory testing is not performed for every infant who…
  3. Using school absences to anticipate influenza activitySchool attendance can provide an early view of influenza circulation before laboratory results are available. When children stay home with fever, cough, sore…
  4. Tracking seasonal influenza peaks with clinic-based syndromic dataInfluenza surveillance usually becomes most valuable before a laboratory report confirms a clear rise. A patient arriving at a general practice with fever,…
  5. Detecting Foodborne Outbreaks at Australia's Major EventsWhen tens of thousands of people gather for a long weekend of racing, a multi-day music festival, or a regional agricultural show, the question is not whether…
  6. Rash And Fever Signals In International School CommunitiesMeasles can move through a school community before public-health teams receive a laboratory-confirmed result. Fever, cough, conjunctivitis and a spreading rash…
  7. Reading heat illness signals from ambulance dispatch dataHeatwaves can turn a familiar emergency call into an early warning of a wider public-health problem. When several people in the same suburb are reported as…
  8. Using pharmacy data to spot rotavirus outbreaks in daycaresUsing pharmacy sales of oral rehydration salts to detect early rotavirus outbreaks in daycares can give public-health teams a useful signal before laboratory…
  9. Leptospirosis in the Paddy: Syndromic Surveillance for Rice Field WorkersRice paddies and rodent urine do not mix well, and across rural Australia the consequences are showing up in clinic waiting rooms before they show up in…
  10. Tracking Iron Supplement Sales as a Window into Student FatigueFor many Australian families, a sudden rush of tiredness in a teenager is brushed off as late-night scrolling or a rough patch at school. Yet when that…

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.