San Diego County school health and absenteeism reporting exchange (Project SHARE): An alternative syndromic surveillance data source

Traditionally, schools have not been part of a frontline public health surveillance infrastructure used to detect large scale outbreaks or acute events. However, school attendance and health office information could potentially be of value for public health surveillance and early detection efforts. San Diego County Health & Human Services Agency established a school surveillance system called Project SHARE at selected school sites throughout the County. Over 20 districts participate with a total enrolled population representing over 90,000 students K-12. These schools report daily information about absenteeism (total enrolled students and total absences) and types of health office visits (e.g. asthma, diarrhea, fever, flu, headache, lice, rash, respiratory problems, and vomiting). The web-based system is a useful tool with easy-to-use data entry features, data displays including graphs, and data export features for data providers and researchers alike. Selected analytic results, case examples and project evaluation outcomes are highlighted. These include the most frequent reasons for health office visits, documented increases in respiratory conditions during the flu season, and the impact on school attendance during a national boycott in support of immigration reform. The simplicity of the system contributed to its successful implementation and the data are useful for public health surveillance. The system is useful to school staff as it permits easy to use documentation of health office visits and student absenteeism. The ability to perform surveillance among the school age population has potential benefits for early detection efforts.