Code-based Syndromic Surveillance for Influenzalike Illness by International Classification of Diseases, Ninth Revision

With the spread of avian influenza, use of automated data streams to rapidly detect and track human influenza cases has increased. We performed correlation analyses to determine whether International Classification of Diseases, Ninth Revision (ICD-9), groupings used to detect influenzalike illness (ILI) within an automated syndromic system correlate with respiratory virus laboratory test results in the same population (r = 0.71 or 0.86, depending on group). We used temporal and signal-to-noise analysis to identify 2 subsets of ICD-9 codes that most accurately represent ILI trends, compared nationwide sentinel ILI surveillance data from the Centers for Disease Control and Prevention with the automated data (r = 0.97), and found the most sensitive set of ICD-9 codes for respiratory illness surveillance. Our results demonstrate a method for selecting the best group of ICD-9 codes to assist system developers and health officials who are interpreting similar data for daily public health activities.