Implementing the Health Early Warning System based on syndromic and event-based surveillance at the 2019 Hajj.

Bieh, Kingsley Lezor; Khan, Anas; Yezli, Saber; El-Ganainy, Ahmed; Asiri, Sari; Alotaibi, Badriah; Ghallab, Sujoud; Elkholy, Amgad; Abubakar, Abdinasir; Jokhdar, Hani

Background During the 2019 Hajj, the Ministry of Health in Saudi Arabia implemented for the first time a health early warning system for rapid detection and response to health threats. Aims This study aimed to describe the early warning findings at the Hajj to highlight the pattern of health risks and the potential benefits of the disease surveillance system. Methods Using syndromic surveillance and event-based surveillance data, the health early warning system generated automated alarms for public health events, triggered alerts for rapid epidemiological investigations and facilitated the monitoring of health events. Results During the deployment period (4 July-31 August 2019), a total of 121 automated alarms were generated, of which 2 events (heat-related illnesses and injuries/trauma) were confirmed by the response teams. Conclusion The surveillance system potentially improved the timeliness and situational awareness for health events, including non-infectious threats. In the context of the current COVID-19 pandemic, a health early warning system could enhance case detection and facilitate monitoring of the disease geographical spread and the effectiveness of control measures.