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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. School-Based Syndromic Surveillance for Faster Outbreak ResponseSchools are among the earliest places where infectious disease activity becomes visible. A sudden rise in absences, clusters of fever, or repeated reports of…
  2. Using Pharmacy Sales To Track Seasonal FluSeasonal influenza often spreads for days or weeks before health authorities receive enough laboratory results to describe its scale with confidence. People…
  3. Detecting Foodborne Illness Signals in Emergency DepartmentsSyndromic surveillance for foodborne illness signals in emergency departments can reveal unusual disease activity before laboratory confirmation is available.…
  4. Detecting norovirus outbreaks through absenteeism and pharmacy dataNorovirus can spread rapidly through schools, households, care facilities, workplaces, restaurants, and healthcare settings. Its short incubation period and…
  5. Why Nurse Hotline Calls Matter for Outbreak DetectionWhen people develop fever, breathing problems, vomiting, or other acute symptoms, many seek advice before visiting a clinic. A nurse hotline can capture those…
  6. Syndromic Surveillance Lessons From Tokyo 2020Mass gatherings create a distinctive public-health environment. Large numbers of people move through transport hubs, venues, hotels, restaurants, schools,…
  7. Building A Multi-Channel Early Warning System For Infectious DiseasesAn infectious disease outbreak rarely begins with a laboratory result. Patients may first visit a clinic, call an ambulance, miss school, seek medicine from a…
  8. How Syndromic Surveillance Complements Laboratory ReportingLaboratory reporting remains a foundation of infectious disease control. It identifies the pathogen, confirms diagnoses, supports case definitions, and…
  9. Turning Frontline Health Data Into Earlier Outbreak WarningsAn infectious disease outbreak rarely begins with a confirmed laboratory result. It often starts with a patient describing fever and fatigue, a clinician…
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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.