Syndromic Surveillance for enhanced detection of waterborne disease outbreaks?

Syndromic surveillance has received much attention as a method for health departments to accelerate the detection of and the reaction to outbreaks. However, the ability of syndromic surveillance to enhance the detection of waterborne disease outbreaks and under what circumstances has not been demonstrated. In our current study our aims are to investigate whether monitoring of over-the-counter drug sales can be used to detect regional or local diarrhea waterborne outbreaks earlier than traditional surveillance, and if so, to determine appropriate alert levels. For the analysis we are employing time series and control chart techniques on retrospective over-the-counter drug sales data, provided by the National Retail Data Monitor, and reports of diarrhea disease cases and outbreaks to four county health departments. We will present the model development process and sensitivity, specificity and timeliness estimates for a range of models and model parameters. We will also discuss the problems and benefits in using this data or technique, and will develop recommendations on the implementation of syndromic surveillance with over-the-counter drug sales data in the early detection of waterborne disease outbreaks.