Trends for syndromic surveillance of norovirus in emergency department data based on chief complaints

Abstract

Background: This study compared the trends in norovirus cases to determine whether chief complaint-based emergency department (ED) visits data could reflect trends of norovirus in Korea.

Methods: The ED visits from the National Emergency Department Information System (NEDIS) database and the weekly reported number of noroviruses from the sentinel surveillance system were collected between August 2017 and December 2020. The correlation between weekly norovirus cases and weekly ED visits considering the chief complaint and discharge diagnosis code was estimated using a three-week moving average.

Results: In total, 6,399,774 patients with chief complaints of digestive system disease visited ED. A higher correlation between reported norovirus cases and ED visit with chief complaint of vomiting and discharge diagnosis code of gastroenteritis and colitis of unspecified origin or other and unspecified gastroenteritis and colitis of infectious origin was observed (R=0.88, p<.0001). The correlation was highest for the 0-4-years age group (R=0.89, p<.0001). However, no correlation was observed between the reported norovirus cases and the number of emergency department visits with norovirus identified as a discharge diagnosis code.

Conclusions: ED visit data considering a combination of chief complaints and discharged diagnosis code would be available for early detection of infectious disease trends.

Keywords: Emergency department; Gastroenteritis; Norovirus; Signs and Symptoms; Syndromic Surveillance; Vomiting.