Copyright © 2009 R. S. Sparks et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Automated public health records provide the necessary data for rapid outbreak detection. An adaptive exponentially weighted moving average (EWMA) plan is developed for signalling unusually high incidence when monitoring a time series of nonhomogeneous daily disease counts. A Poisson transitional regression model is used to fit background/expected trend in counts and provides “one-day-ahead” forecasts of the next day's count. Departures of counts from their forecasts are monitored. The paper outlines an approach for improving early outbreak data signals by dynamically adjusting the exponential weights to be efficient at signalling local persistent high side changes. We emphasise outbreak signals in steady-state situations; that is, changes that occur after the EWMA statistic had run through several in-control counts.