Outbreak detection algorithms for seasonal disease data : a case study using Ross River virus disease

Pelecanos, Anita M., Ryan, Peter A., & Gatton, Michelle L. (2010) Outbreak detection algorithms for seasonal disease data : a case study using Ross River virus disease. BMC Medical Informtics Decision Making, 10(74).

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Detection of outbreaks is an important part of disease surveillance. Although many algorithms have been designed for detecting outbreaks, few have been specifically assessed against diseases that have distinct seasonal incidence patterns, such as those caused by vector-borne pathogens.


We applied five previously reported outbreak detection algorithms to Ross River virus (RRV) disease data (1991-2007) for the four local government areas (LGAs) of Brisbane, Emerald, Redland and Townsville in Queensland, Australia. The methods used were the Early Aberration Reporting System (EARS) C1, C2 and C3 methods, negative binomial cusum (NBC), historical limits method (HLM), Poisson outbreak detection (POD) method and the purely temporal SaTScan analysis. Seasonally-adjusted variants of the NBC and SaTScan methods were developed. Some of the algorithms were applied using a range of parameter values, resulting in 17 variants of the five algorithms.


The 9,188 RRV disease notifications that occurred in the four selected regions over the study period showed marked seasonality, which adversely affected the performance of some of the outbreak detection algorithms. Most of the methods examined were able to detect the same major events. The exception was the seasonally-adjusted NBC methods that detected an excess of short signals. The NBC, POD and temporal SaTScan algorithms were the only methods that consistently had high true positive rates and low false positive and false negative rates across the four study areas. The timeliness of outbreak signals generated by each method was also compared but there was no consistency across outbreaks and LGAs.


This study has highlighted several issues associated with applying outbreak detection algorithms to seasonal disease data. In lieu of a true gold standard, a quantitative comparison is difficult and caution should be taken when interpreting the true positives, false positives, sensitivity and specificity.

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7 citations in Scopus
5 citations in Web of Science®
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ID Code: 75113
Item Type: Journal Article
Refereed: Yes
Additional Information: Pelecanos, Anita M
Ryan, Peter A
Gatton, Michelle L
Research Support, Non-U.S. Gov't
BMC medical informatics and decision making
BMC Med Inform Decis Mak. 2010 Nov 24;10:74.
Additional URLs:
Keywords: Algorithms, Alphavirus Infections/diagnosis/epidemiology, Australia/epidemiology, Disease Notification, Disease Outbreaks/prevention & control, Humans, Population Surveillance/methods, Ross River virus/isolation & purification, Seasons
DOI: 10.1186/1472-6947-10-74
ISSN: 1472-6947
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > PUBLIC HEALTH AND HEALTH SERVICES (111700) > Health Information Systems (incl. Surveillance) (111711)
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Copyright Owner: Copyright 2010 Pelecanos et al; licensee BioMed Central Ltd.
Copyright Statement: This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Deposited On: 18 Aug 2014 01:24
Last Modified: 22 Jun 2017 08:01

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