Public Health Impact of Syndromic Surveillance Data—A Literature Survey

How to Cite

Albert, S. P., & Ergas, R. (2018). Public Health Impact of Syndromic Surveillance Data—A Literature Survey. Online Journal of Public Health Informatics, 10(1).



To assess evidence for public health impact of syndromic surveillance.


Systematic syndromic surveillance is undergoing a transition. Building on traditional roots in bioterrorism and situational awareness, proponents are demonstrating the timeliness and informative power of syndromic surveillance data to supplement other surveillance data.


We used PubMed and Google Scholar to identify articles published since 2007 using key words of interest (e.g., syndromic surveillance in combinations with emergency, evaluation, quality assurance, alerting). The following guiding questions were used to abstract impact measures of syndromic surveillance: 1) what was the public health impact; what decisions or actions occurred because of use of syndromic surveillance data?, 2) were there specific interventions or performance measures for this impact?, and 3) how, and by whom, was this information used?


Thirty-five papers were included. Almost all articles (n=33) remarked on the ability of syndromic surveillance to improve public health because of timeliness and/or accuracy of data. Thirty-four articles mentioned that syndromic surveillance data was used or could be useful. However, evidence of health impact directly attributable to syndromic surveillance efforts were lacking. Two articles described how syndromic data were used for decision-making. One article measured the effect of data utilization.


Within the syndromic surveillance literature instances of a conceptual shift from detection to practical response are plentiful. As the field of syndromic surveillance continues to evolve and is used by public health institutions, further evaluation of data utility and impact is needed.


Ayala, A., Berisha, V., Goodin, K., Pogreba-Brown, K., Levy, C., McKinney, B., Koski, L., & Imholte, S. (2016). Public health surveillance strategies for mass gatherings: Super Bowl XLIX and related events, Maricopa County, Arizona, 2015. Health Security, 14(3), 173-84. doi: 10.1089/hs.2016.0029.

Bermis, K., Frias, M., Patel, M.T., & Christiansen, D. (2017). Using an Emergency Department Syndromic Surveillance System to Evaluate Reporting of Potential Rabies Exposures, Illinois, 2013-2015. Public Health Reports 132(Supplement 1) 59S-64S."

Borroto, R., Williamson, B., Pitcher, P., Ballester, L., Smith, W., Soetebier, K., & Drenzek, C. (2016). Using Syndromic Surveillance Alert Protocols for Epidemiologic Response in Georgia. Online Journal of Public Health Informatics 9(1):e123. doi:10.5210/ojphi.v9i1.7707."

Daly, E.R., Dufault, K., Swenson, D.J., Lakevicius, P., Metcalf, E., & Chan, B.P. (2017). Use of emergency department data to monitor and respond to an increase in opioid overdoses in New Hampshire 2011-2015. Public Health Reports 132(Supplement 1) 73S-79S. doi: 10.1177/0033354917707934

Deyneka, L., Hakenewerth, A., Faigen, Z., Ising, A., & Barnett, C. (2017). Using syndromic surveillance data to monitor endocarditis and sepsis among drug users. Online Journal of Public Health Informatics, (9)1. doi:

DeYoung, K., Chen, Y., Beum, R., Askenazi, M., Zimmerman, C., & Davidson, A. J. (2017). Validation of a syndromic case definition for detecting emergency department visits potentially related to marijuana. Public Health Reports, epublication.doi: 10.1177/0033354917708987"

Dinh, M.M., Kastelein, C., Bein, K.J., Bautovich, T., & Ivers, R. (2015). Use of a syndromic surveillance system to describe the trend in cycling-related presentations to emergency departments in Sydney. Emergency Medicine Australasia, 27(4), 343-7. doi: 10.1111/1742-6723.12422

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Hines, J.Z., Bancroft, J., Powell, M., & Hedberg, K. (2017). Case finding using syndromic surveillance data during an outbreak of Shiga Toxin–Producing Escherichia coli O26 infections, Oregon, 2015. Public Health Reports, epublication.

Hudson, L. T., Klekamp, B.G., & Matthews, S.D. (2017). Local Public Health Surveillance of Heroin-Related Morbidity and Mortality, Orange County, Florida, 2010-2014. Public Health Reports (132), 80S-87S

Hughes, H.E., Morbey, R., Hughes, T.C., Locker, T.E., Pebody, R., Green, H.K., Ellis, J., Smith, G.E., & Elliot, A.J. (2016). Emergency department syndromic surveillance providing early warning of seasonal respiratory activity in England. Epidemiology and Infection, 144(5), 1052-64. doi: 10.1017/S0950268815002125

Hughes, H.E., Morbey, R., Hughes, T.C., Locker, T.E., Shannon, T., Carmichael, C., Murray, V., Ibbotson, S., Catchpole, M., McCloskey, B., Smith, G., & Elliot, A.J. (2014). Using an emergency department syndromic surveillance system to investigate the impact of extreme cold weather events. Public Health, 128(7), 628-635. doi: 10.1016/j.puhe.2014.05.007

Ising, A., Proescholdbell, S., Harmon, K.J., Sachdeva, N., Marshall, S.W., & Waller, A.E. (2016). Use of syndromic surveillance data to monitor poisonings and drug overdoses in state and local public health agencies. Injury Prevention 22:i43-i49."

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Liljeqvist, H. T., Muscatello, D., Sara, G., Dinh, M., & Lawrence, G. L. (2014). Accuracy of automatic syndromic classification of coded emergency department diagnoses in identifying mental health-related presentations for public health surveillance. BMC Medical Informatics and Decision Making, 14(84).

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