TY - JOUR AU - Levin-Rector, Alison AU - Wilson, Elisha AU - Fine, Annie AU - Greene, Sharon T1 - Refining Historical Limits Method to Improve Disease Cluster Detection, New York City, New York, USA T2 - Emerging Infectious Disease journal PY - 2015 VL - 21 IS - 2 SP - 265 SN - 1080-6059 AB - Since the early 2000s, the Bureau of Communicable Disease of the New York City Department of Health and Mental Hygiene has analyzed reportable infectious disease data weekly by using the historical limits method to detect unusual clusters that could represent outbreaks. This method typically produced too many signals for each to be investigated with available resources while possibly failing to signal during true disease outbreaks. We made method refinements that improved the consistency of case inclusion criteria and accounted for data lags and trends and aberrations in historical data. During a 12-week period in 2013, we prospectively assessed these refinements using actual surveillance data. The refined method yielded 74 signals, a 45% decrease from what the original method would have produced. Fewer and less biased signals included a true citywide increase in legionellosis and a localized campylobacteriosis cluster subsequently linked to live-poultry markets. Future evaluations using simulated data could complement this descriptive assessment. KW - communicable disease KW - historical limits method KW - disease cluster detection KW - New York City KW - surveillance KW - New York KW - USA DO - 10.3201/eid2102.140098 UR - https://wwwnc.cdc.gov/eid/article/21/2/14-0098_article ER - End of Reference