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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. Syndromic Surveillance for Cryptosporidiosis in ChildcareCryptosporidiosis can move quickly through early childhood education and care settings. The parasite Cryptosporidium spreads when microscopic traces of…
  2. Reading Influenza B Shifts Through Age-Stratified AbsenteeismInfluenza surveillance often becomes most useful before a laboratory report confirms a seasonal change. A rise in students staying home, a different pattern…
  3. Detecting Copperhead Seasonality Through Emergency DataCopperhead snakebite activity rarely follows a neat calendar, yet emergency department antivenom requests can reveal when risk is rising. In Australia, these…
  4. Syndromic Surveillance For Acute Urinary Retention In Older MenAcute urinary retention is a painful, time-sensitive problem in which a person cannot empty the bladder. In older men, benign prostatic enlargement is a…
  5. Antimalarial Sales at the Chemist Counter as an Early Outbreak Signal for Mass GatheringsWhen tens of thousands of visitors pour into a host city for a major event, public-health teams have a narrow window to catch early signs of trouble before…
  6. Plasma leakage signals for severe dengue surveillance in Australian EDsDengue has quietly become one of the more consequential travel-associated infections seen across Australian emergency departments. Each year, hundreds of…
  7. Tracking asthma spikes in Australian schools during thunderstormsMonitoring asthma exacerbation spikes during thunderstorm events using school nurse logs can give public-health teams an early signal that respiratory illness…
  8. Finding Hotel-Linked Legionella Signals in Ambulance DataLegionella outbreaks can begin with a small, easily missed pattern: several hotel guests developing severe pneumonia within days of one another. Before a…
  9. Syndromic Surveillance for Typhus Outbreaks in Homeless SheltersTyphus is a flea-, louse-, and mite-borne rickettsial illness that often begins with fever, headache, rash, and in some forms a characteristic eschar at the…
  10. Using school handwashing data for norovirus surveillance in AustraliaNorovirus is the leading cause of acute gastroenteritis outbreaks in Australian schools, where it is more commonly known simply as "gastro". Each winter,…

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.