1887
Surveillance Open Access
Like 0

Abstract

BACKGROUND

Seasonal respiratory pathogens place recurrent pressure on health services, creating a need for timely detection of seasonal onset and assessment of within-season intensity.

AIM

We aimed to evaluate the Automated and Early Detection of Seasonal Epidemic Onset and Burden Levels (AEDSEO) method, developed using Danish respiratory surveillance data, externally.

METHODS

Using 63 surveillance series of influenza, respiratory syncytial virus (RSV), acute respiratory infection (ARI) and influenza-like illness (ILI) from 21 European countries, season onset detection was compared with the Moving Epidemic Method (MEM), while intensity level categorisation was compared with MEM, the World Health Organization Average Curve Method (WHO-ACM) and the Mean Standard Deviation method (MSD).

RESULTS

The AEDSEO method signalled onset in 60 of 63 surveillance series, while MEM crossed its epidemic threshold in 55 of 63. Among 55 surveillance series in which both methods signalled onset, AEDSEO signalled earlier in 45. Median lead times were 6.5 weeks for influenza, 4.5 for RSV, 22.0 for ARI and 5.5 for ILI. Growth after the AEDSEO onset signal was usually sustained, particularly for influenza, RSV and ILI. The AEDSEO method provided more consistent within-season intensity categorisation across seasons than MEM, WHO-ACM and MSD.

CONCLUSION

Across diverse European respiratory surveillance series AEDSEO supported earlier detection of seasonal onset than MEM and more consistent within-season intensity categorisation than MEM, WHO-ACM and MSD. Its current operational use in the Danish national respiratory surveillance system further supports its practical applicability for timely situational assessment, planning, and communication of respiratory pathogen activity.

Loading

Article metrics loading...

/content/10.2807/1560-7917.ES.2026.31.30.2500896
2026-07-30
2026-08-11
/content/10.2807/1560-7917.ES.2026.31.30.2500896
Loading
Loading full text...

Full text loading...

/deliver/fulltext/eurosurveillance/31/30/eurosurv-31-30-4.html?itemId=/content/10.2807/1560-7917.ES.2026.31.30.2500896&mimeType=html&fmt=ahah

References

  1. Emborg HD, Vestergaard LS, Botnen AB, Nielsen J, Krause TG, Trebbien R. A late sharp increase in influenza detections and low interim vaccine effectiveness against the circulating A(H3N2) strain, Denmark, 2021/22 influenza season up to 25 March 2022. Euro Surveill. 2022;27(15):2200278.  https://doi.org/10.2807/1560-7917.ES.2022.27.15.2200278  PMID: 35426361 
  2. Nordholm AC, Søborg B, Jokelainen P, Lauenborg Møller K, Flink Sørensen L, Grove Krause T, et al. Mycoplasma pneumoniae epidemic in Denmark, October to December, 2023. Euro Surveill. 2024;29(2):2300707.  https://doi.org/10.2807/1560-7917.ES.2024.29.2.2300707  PMID: 38214084 
  3. Munkstrup C, Lomholt FK, Emborg HD, Møller KL, Krog JS, Trebbien R, et al. Early and intense epidemic of respiratory syncytial virus (RSV) in Denmark, August to December 2022. Euro Surveill. 2023;28(1):2200937.  https://doi.org/10.2807/1560-7917.ES.2023.28.1.2200937  PMID: 36695451 
  4. Lomholt FK, Emborg HD, Nørgaard SK, Nielsen J, Munkstrup C, Møller KL, et al. Resurgence of Respiratory Syncytial Virus in the Summer of 2021 in Denmark-a Large out-of-season Epidemic Affecting Older Children. Open Forum Infect Dis. 2024;11(3):ofae069.  https://doi.org/10.1093/ofid/ofae069  PMID: 38495773 
  5. Vega T, Lozano JE, Meerhoff T, Snacken R, Mott J, Ortiz de Lejarazu R, et al. Influenza surveillance in Europe: establishing epidemic thresholds by the moving epidemic method. Influenza Other Respir Viruses. 2013;7(4):546-58.  https://doi.org/10.1111/j.1750-2659.2012.00422.x  PMID: 22897919 
  6. Teeluck M, Samura A. Assessing the appropriateness of the Moving Epidemic Method and WHO Average Curve Method for the syndromic surveillance of acute respiratory infection in Mauritius. PLoS One. 2021;16(6):e0252703.  https://doi.org/10.1371/journal.pone.0252703  PMID: 34081752 
  7. World Health Organization (WHO). Global epidemiological surveillance standards for influenza. Geneva: WHO; 2013. Available from: https://iris.who.int/handle/10665/311268
  8. World Health Organization (WHO). Pandemic influenza severity assessment (PISA): A WHO guide to assess the severity of influenza in seasonal epidemics and pandemics, 2nd ed. Geneva: WHO; 2025. Available from: https://iris.who.int/handle/10665/376841.
  9. Sinnathamby MA, Bourouphael T, Boateng J, Collonnaz M, Quinot C, Aziz NA, et al. Setting thresholds to determine COVID-19 activity levels using the mean standard deviation (MSD) method, England, 2022-2024. Euro Surveill. 2024;29(45):2400696.  https://doi.org/10.2807/1560-7917.ES.2024.29.45.2400696  PMID: 39512168 
  10. Sinnathamby M, Meslé M, Mook P, Stolyarov K, Pebody R. Impact of the COVID-19 Pandemic on Influenza Circulation During the 2020/21 and 2021/22 Seasons, in Europe. Influenza Other Respir Viruses. 2024;18(5):e13297.  https://doi.org/10.1111/irv.13297 
  11. van Summeren J, Meijer A, Aspelund G, Casalegno JS, Erna G, Hoang U, et al. , VRS study group in Lyon. Low levels of respiratory syncytial virus activity in Europe during the 2020/21 season: what can we expect in the coming summer and autumn/winter? Euro Surveill. 2021;26(29):2100639.  https://doi.org/10.2807/1560-7917.ES.2021.26.29.2100639  PMID: 34296672 
  12. Myrup Otero S, Schou Telkamp K, Christiansen L, Statens Serum Institut. (2026). aedseo: Automated and Early Detection of Seasonal Epidemic Onset and Burden Levels. R software package version 1.1.0. Vienna: The Comprehensive R Archive Network (CRAN). Available from:
  13. Parag KV, Donnelly CA. Using information theory to optimise epidemic models for real-time prediction and estimation. PLOS Comput Biol. 2020;16(7):e1007990.  https://doi.org/10.1371/journal.pcbi.1007990  PMID: 32609732 
  14. Makowski D, Lüdecke D, Patil I, Thériault R, Ben-Shachar M, Wiernik B. (2023). Automated Results Reporting as a Practical Tool to Improve Reproducibility and Methodological Best Practices Adoption. Vienna: The Comprehensive R Archive Network (CRAN). Available from:  https://doi.org/10.32614/CRAN.package.report 
  15. Hyndman RJ, Athanasopoulos G. Forecasting: principles and practice, 3rd edition. Section 7.1 Simple exponential smoothing. OTexts: Melbourne, Australia. [Accessed: 13 Jul 2026]. Available from: https://otexts.com/fpp3/
  16. Lozano J. mem: The Moving Epidemic Method. R software package version 2.19. Vienna: The Comprehensive R Archive Network (CRAN). Available from:  https://doi.org/10.32614/CRAN.package.mem 
  17. Brown LD, Cai TT, DasGupta A. Interval Estimation for a Binomial Proportion. Stat Sci. 2001;16(2):101-17.  https://doi.org/10.1214/ss/1009213286 
  18. European Centre for Disease Prevention and Control (ECDC) and World Health Organization Regional Office for Europe. European Respiratory Virus Surveillance Summary (ERVISS). Stockholm: ECDC. [Accessed: 22 Apr 2025]. Available from: https://erviss.org/
  19. European Centre for Disease Prevention and Control (ECDC). GitHub, EU, ECDC/Respiratory_viruses_weekly_data. San Francisco: GitHub. [Accessed: 1 Sep 2025]. Available from: https://github.com/EU-ECDC/Respiratory_viruses_weekly_data
  20. The Statistical Office of the European Union (Eurostat). Population on 1 January (tps00001). Luxembourg: Eurostat. [Accessed: 7 Oct 2025]. Available from: https://ec.europa.eu/eurostat/databrowser/view/tps00001/default/table?lang=en&category=t_demo.t_demo_pop
  21. Cowling BJ, Wong IO, Ho LM, Riley S, Leung GM. Methods for monitoring influenza surveillance data. Int J Epidemiol. 2006;35(5):1314-21.  https://doi.org/10.1093/ije/dyl162  PMID: 16926216 
  22. Steiner SH, Grant K, Coory M, Kelly HA. Detecting the start of an influenza outbreak using exponentially weighted moving average charts. BMC Med Inform Decis Mak. 2010;10(1):37.  https://doi.org/10.1186/1472-6947-10-37  PMID: 20587013 
  23. García YE, Christen JA, Capistrán MA. A Bayesian Outbreak Detection Method for Influenza-Like Illness. BioMed Res Int. 2015;2015:751738.  https://doi.org/10.1155/2015/751738  PMID: 26425552 
  24. Souty C, Jreich R, LE Strat Y, Pelat C, Boëlle PY, Guerrisi C, et al. Performances of statistical methods for the detection of seasonal influenza epidemics using a consensus-based gold standard. Epidemiol Infect. 2018;146(2):168-76.  https://doi.org/10.1017/S095026881700276X  PMID: 29208062 
/content/10.2807/1560-7917.ES.2026.31.30.2500896
Loading

Data & Media loading...

Supplementary data

Submit comment
Close
Comment moderation successfully completed
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error