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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 neonatal sepsis via infant fever in EDsNeonatal sepsis remains one of the most time-critical diagnoses in paediatrics. Every hour of delay between the first sign of illness and the first antibiotic…
  2. Tracking Home Heater Carbon Monoxide Poisoning Through Ambulance CodesWinter across southern Australia brings a familiar routine. Families in Melbourne, Hobart and Canberra pull out the gas heater, the ducted system kicks on…
  3. Spotting Hepatitis A Signals In School Meal ProgramsHepatitis A can enter a school food setting quietly. A worker may feel unusually tired for several days, lose their appetite, or complain of nausea before…
  4. Detecting mumps orchitis signals in young adult urology careMumps orchitis is an important but easily missed complication of mumps infection in post-pubertal males. It can cause acute testicular pain, swelling and…
  5. Tracking Anaphylaxis Through Epinephrine Auto-Injector Pharmacy SalesAustralia has one of the highest rates of childhood food allergy globally, with Melbourne and Sydney frequently cited in research. Anaphylaxis, the severe…
  6. Detecting Alcohol Intoxication Spikes During Australian Public HolidaysEvery January, as the Harbour Bridge glows with fireworks and barbecues fire up across the country, Australian emergency departments quietly brace themselves…
  7. Detecting Influenza-Associated Pneumonia Through Chest X-Ray CountsEmergency physicians across Australia have long suspected that chest imaging volumes during colder months tell a story labs only confirm weeks later. Each…
  8. Detecting Cholera Signals in Returning TravelersCholera is uncommon in Australia, but imported infections can create an early warning problem for public-health teams. A returning traveler may first present…
  9. Detecting salmonellosis earlier with combined clinic and lab order dataAustralia records thousands of salmonellosis notifications every year, with OzFoodNet and the National Notifiable Diseases Surveillance System logging well…
  10. Mining Ambulance Narratives for Earlier Cluster Headache SignalsAmbulance services record much more than a dispatch category or final diagnostic code. Free-text notes may describe a patient pacing in agony, pressing a hand…

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.