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Purpose-To demonstrate the utility of Emergency Department syndromic surveillance in the setting of a novel and unexpected H1N1 influenza outbreak.Basic procedures-Data collection from emergency department electronic medical records was used to track initial Chief Complaint (CC) and discharge ICD-9 codes related to Influenza Like Illness (ILI). An alert threshold was generated using cumulative sum sequential analysis technique. The data was retrospectively analyzed to identify alerts that correlated with Novel Influenza H1N1 illness.Main Findings-Our system alerted for ILI earlier than both the official national CDC press release for novel H1N1 and the first laboratory confirmed case in our county.Principal conclusions-Emergency Department syndromic surveillance can be used to detect novel and unexpected ILI before laboratory confirmation and serve as an adjunct to traditional laboratory guided public health alerts. Early identification of increased ILI activity may allow emergency department health care providers the ability to perform more efficient and effective targeted laboratory testing and deploy isolation measures more quickly.

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