Establishing and validating syndromic surveillance of gastrointestinal infections using routine emergency department data, Germany, 2019–2023
Abstract
Abstract Gastrointestinal infections in Germany account for 24.5 million outpatient visits annually. To enhance outbreak detection and trend monitoring, we developed and validated a syndrome definition for syndromic surveillance of gastrointestinal infections in emergency departments. We selected presenting complaints (Canadian Emergency Department Information System) and diagnoses (ICD-10) to develop the syndrome definition. Validation involved cross-correlation analysis of syndromic and laboratory-based surveillance trends (norovirus-gastroenteritis, rotavirus-gastroenteritis, campylobacteriosis and salmonellosis notifications). We included emergency departments from the German AKTIN registry with continuous data transmission (01/2019–06/2023). Our novel syndrome definition combined complaints (diarrhoea, vomiting, nausea) and diagnoses (intestinal infectious diseases). Across 864,353 visits in 7 emergency departments, 2.1% (n = 18,158) were gastrointestinal infection cases. Of those, 57% (n = 10,424) were female; 23% were aged 0–19 years (n = 4108); and 23% 20–39 years (n = 4116). Trends were similar between surveillance systems. Cross-correlation was 0.73 (95%-confidence interval 0.61–0.85; p < 0.001) at lag − 1, indicating a 1-week relative reporting delay of laboratory-based surveillance. Coherent trends and significant cross-correlation validated our syndrome definition. This novel automated syndromic surveillance complements laboratory-based surveillance while offering improved timeliness and reduced workload. Therefore, it was implemented in Germany’s national routine surveillance of emergency departments.
Article Details
Authors (64)
Jonathan Hans Josef Baum
Achim Dörre
Tamara Sonia Boender
Katharina Heldt
Hendrik Wilking
Susanne Drynda
Bernadett Erdmann
Rupert Grashey
Caroline Grupp
Kirsten Habbinga
Eckard Hamelmann
Amrei Heining
Heike Höger-Schmidt
Clemens Kill
Friedrich Reichert
Joachim Risse
Tobias Schilling
Markus Baacke
Jaqueline Bauer
Michael Bernhard
Jonas Bienzeisler
Sabine Blaschke
Jörg Brokmann
Volker Burst
Hans-Jörg Busch
Harald Dormann
Christoph Duesberg
Saskia Ehrentreich
André Gries
Thomas Händl
Eric Handmann
Felix Hans
Frank Hanses
Thomas Henke
Matthias Klein
Tobias Hofmann
Marina Karg
Jan Kleinekorth
Alexander Kombeiz
Bernhard Kumle
Philipp Kümpers
Christoph Lewejohann
Alexander Dinse-Lambracht
Benjamin Lucas
Carsten Mach
Raphael W. Majeed
Jürgen Neubauer
Ronny Otto
Thomas Peschel
Norbert Pfeufer
Rainer Röhrig
Wiebke Schirrmeister
Domagoj Schunk
Wolfgang Stahl
Hartmut Stefani
Lucas Triefenbach
Bernd Uirich
Felix Walcher
Markus Wehler
Hardy Wenderoth
Sebastian Wolfrum
Christian Wrede
Markus Zimmermann
Madlen Schranz