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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 the heart's warning signs through emergency department ECG ordersWhen influenza circulates widely each winter, hospitals brace for more than respiratory admissions. Cardiologists and emergency physicians across Melbourne,…
  2. School Cafeteria Illness Reports as an Early Warning SignalMonitoring school cafeteria worker illness reports can give public-health teams an early indication of a foodborne outbreak before laboratory results are…
  3. Tracking ICU admission shifts to gauge H3N2 severity in real timeWhen a season of influenza A(H3N2) takes a serious turn, the earliest clues rarely come from laboratory reports. They tend to surface in the rhythm of a…
  4. Detecting post-disaster tetanus through wound-related emergency visitsWhen a major flood or cyclone cuts through a town, the immediate medical priority is search and rescue, followed by the slow work of rebuilding. Hidden in that…
  5. antidiarrheal sales and school absence data for outbreak detectionSyndromic surveillance in Australia has matured into a practical early-warning system that catches outbreaks before laboratory confirmation becomes available.…
  6. Detecting Tuberculosis Signals in Residential Aged CareA persistent cough in a residential aged care facility can be easy to dismiss as a lingering cold, asthma, reflux, medication side effect or chronic lung…
  7. Tracking Athlete’s Foot in Australian School Sports TeamsAthlete’s foot, or tinea pedis, is usually treated as a minor nuisance. In a school sports team, however, a small cluster of itchy, peeling or cracked feet can…
  8. Finding Shingles Clusters Through Dermatology ReferralsShingles, or herpes zoster, is usually recognised by a painful, blistering rash following a nerve pathway. In people with weakened immune systems, however, the…
  9. Detecting Group A Streptococcal Necrotizing Fasciitis EarlierNecrotizing fasciitis caused by group A Streptococcus (GAS) is uncommon, rapidly progressive and difficult to identify from early symptoms alone. Severe pain,…
  10. Ambulance transport for syncope as a dehydration signal in older AustraliansA sudden rise in ambulance transports for fainting or near-fainting among older people can provide an early warning of dehydration before laboratory results,…

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.