Background: Syndromic surveillance for real-time disease monitoring during mass gathering events is rapidly evolving due to availability of data and new analytical tools. We established an enhanced surveillance system during the 2018 Commonwealth Games, including the introduction of the Emergency Department Syndromic Surveillance System (EDSSS) and an SMS electronic questionnaire.
Aim: To examine the role of the EDSSS and questionnaire in identifying potential gastrointestinal (GI) outbreaks during the enhanced surveillance period, 20 March–18 April 2018.
Methods: Selected and validated ICD-10 diagnosis codes were used to classify the GI syndrome. A dashboard that provided real-time data on these GI presentations was monitored daily. The questionnaire requesting food and water exposure information prior to symptom onset was sent upon ED discharge. Alert thresholds were based on historical ED GI presentation data. EDSSS and questionnaire data were extracted and analysed using Epi InfoTM software.
Results: 338 people with GI were identified through EDSSS; daily presentations exceeded the alert threshold on one occasion. There were 307 (90.8%) SMS messages were sent and 88 (28.6%) questionnaires completed. Ten signals identified through the questionnaires based on common exposures were further investigated; none were established true outbreaks.
Conclusion: EDSSS and electronic questionnaire for GI surveillance was beneficial in monitoring outbreaks with little demand on staff time. Much of this work is ongoing post Games as a direct legacy. A key recommendation for mass gathering events is to have these surveillance systems to allow early identification of the presence or absence of outbreaks.