Enhanced Syndromic Surveillance for the Fourth Japan-China-South Korea Trilateral Summit 2011

Background: When high profile events such as mass gatherings or political events are held, syndromic surveillances are enhanced to quickly detect health emergencies. Drawing on past experiences, enhanced surveillance was conducted during the Fourth Japan-China-South Korea Trilateral Summit (May 21-22, 2011). This report describes the details and results of the enhanced syndromic surveillance. Methods: Enhanced surveillance started on May 18, and ended on June 4, two weeks after the meeting, using three existing surveillance systems that operate routinely: Official Syndromic Surveillance, Ambulance Transfer Syndromic Surveillance, and Pharmacy Surveillance. The enhanced surveillance was a joint work between the Tokyo Metropolitan Government and the National Institute of Infectious Diseases. Information from the three surveillance systems was mutually exchanged and daily risk assessment on potential health emergencies such as bioterrorism and potential epidemics of infectious diseases was performed jointly. Results: During the enhanced surveillance period, the only case that required verification was one suspected measles case from the report in the Official Syndromic Surveillance. None of the cases in the Ambulance Transfer Syndromic Surveillance or the Pharmacy Surveillance required additional investigation. All three syndromic surveillance systems that were utilized for the enhanced surveillance are run routinely, and the enhancement areas were simply conducting the daily risk assessment and reporting. Therefore, the enhanced surveillance is conducted only by agreements and arrangements among members. In spite of very short notice, we were able to initiate the enhanced surveillance because the existing surveillance required no baseline or other preparation. The burden of implementation of surveillance was significantly small in comparison with the previous enhanced surveillance. Conclusions: It is possible to activate the enhanced surveillance arrangements whenever needed. We were able to make a comprehensive assessment by utilizing three syndromic surveillance systems, which we believe are useful in detecting a possible case of bioterrorism.