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Volume 14, Number 6—June 2008


Validation of Syndromic Surveillance for Respiratory Pathogen Activity

Cees van den Wijngaard*Comments to Author , Liselotte van Asten*, Wilfrid van Pelt*, Nico J.D. Nagelkerke†, Robert Verheij‡, Albert J. de Neeling*, Arnold Dekkers*, Marianne A.B. van der Sande*, Hans van Vliet*, and Marion P.G. Koopmans*
Author affiliations: *National Institute for Public Health and the Environment, Bilthoven, the Netherlands; †United Arab Emirates University, Al-Ain, United Arab Emirates; ‡Netherlands Institute of Health Services Research, Utrecht, the Netherlands;

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Table 1

Registries from which syndrome data were obtained, the Netherlands, 1999–2004*

Data type Period % Coverage† Respiratory syndrome definitions‡ Analyzed data International code system Registry
Absenteeism 2002–2003 80§ Reported sick employees; no further medical information Sick leave reports of employees Statistics Netherlands (CBS),
General practice consultations 2001–2004 1–2 Symptoms and diagnoses indicating respiratory infectious disease Symptoms and diagnoses recorded in practice or telephone consultations and in home visits ICPC Netherlands Information Network of General Practice (LINH),
Pharmacy dispensations 2001–2003 85 Prescribed medications indicative for respiratory infectious disease Prescription medications dispensed in Dutch pharmacies, coded according to the WHO ATC classification ATC Foundation for Pharmaceutical Statistics,
Hospitalization 1999–2004 99 General respiratory symptoms/diagnoses; specific respiratory biologic agent diagnoses Discharge and secondary diagnoses, date of hospitalization ICD-9-CM Dutch National Medical Register (LMR)
Laboratory submissions¶ 2001–2004 (1999–2000 excluded due to unstable coverage) 16 All submissions for microbiologic diagnostic tests on respiratory materials; all submissions for serologic testing on known specific respiratory pathogens; all submissions for Legionella or Streptococcus pneumoniae antigen tests on urine Laboratory submission requests for diagnostic testing National Infectious Diseases Information System (ISIS) (13)
Mortality 1999–2004 100 General respiratory symptoms/diagnoses; specific respiratory biologic agent diagnoses Date of death, primary cause of death, complicating factors, other additional causes of death ICD-10 CBS

*ICPC, International Classification of Primary Care; WHO, World Health Organization; ATC, Anatomic Therapeutic Chemical Classification System; ICD-9-CM, International Classification of Diseases, 9th revision, Clinical Modification; ICD-10, International Classification of Diseases, 10th revision.
†Percentage of total population, 16.3 million.
‡For detailed syndrome definitions and codes, see Technical Appendix.
§Percentage of working population, 8 million.
¶Diagnostic test requests with both negative and positive results.

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