Syndromic Surveillance of Respiratory Pathogens using Routine ED Data in England

Introduction Within the UK, previous syndromic surveillance studies have used statistical estimation to describe the activity of respiratory pathogens.1 The Emergency Department Syndromic Surveillance System (EDSSS) was initially developed in preparation of the London 2012 Olympic and Paralympic Games and has continued as a standard surveillance system, with expanding coverage across England and Northern Ireland.2 All reporting to this system is completely passive, with no extra work required within the ED. The data collection includes the diagnosis for each attendance, where available, using the coding system in use locally. The coding varies by ED with ICD10, Snomed-CT and the less detailed NHS Accident and Emergency Diagnosis Tables all in use. The use of diagnosis coding systems with differing levels of detail creates the need to have a variety of syndromic indicators to make best use of the data received. We aim to describe the trends in respiratory attendances, and their comparison to the known circulating pathogens identified though laboratory surveillance to establish if any single syndromic indicator may be attributed to any one pathogen in particular. We also aim to describe the flexibility in the development of EDSSS syndromic indicators to best fit the data received.