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J Epidemiol . Comparison of Influenza Epidemic Trends Based on a Large-scale Claims Database and National Infectious Disease Surveillance in Japan

tetano

Editor, Senior Moderator
J Epidemiol


. 2026 Jan 24.
doi: 10.2188/jea.JE20250565. Online ahead of print.
Comparison of Influenza Epidemic Trends Based on a Large-scale Claims Database and National Infectious Disease Surveillance in Japan

Takenori Yamauchi[SUP] 1 [/SUP], Hiroki Den[SUP] 1 [/SUP], Shouhei Takeuchi[SUP] 2 [/SUP], Masaya Saito[SUP] 3 [/SUP], Mitsuo Uchida[SUP] 4 [/SUP], Akatsuki Kokaze[SUP] 1 [/SUP]


Affiliations
Free article Abstract

Background: Seasonal influenza is a recurrent respiratory infection, and timely detection is essential for public health. In Japan, surveillance is conducted through sentinel medical institutions under the National Epidemiological Surveillance of Infectious Diseases (NESID). Recently, access to large claims databases, such as the JMDC claims database (JMDCdb), has increased. While both are sample-based systems, JMDCdb covers a much larger population. We aimed to assess consistency between these sources in estimating influenza cases and the effective reproduction number (R[SUB]t[/SUB]), and to explore their utility in epidemic analysis.
Methods: We analyzed data from week 36 of 2016 to week 35 of 2019. Influenza cases were estimated from NESID (reported cases and cases per sentinel) and JMDCdb (cases with influenza-related diagnoses and antiviral prescriptions). Daily infection counts were derived to estimate R[SUB]t[/SUB].
Results: Although minor differences appeared at epidemic peaks, estimates from NESID reports aligned well with JMDCdb. Estimates based on cases per sentinel were lower. R[SUB]t[/SUB] values were consistent across data sources. R[SUB]t[/SUB] exceeded 1.0 when cases per sentinel surpassed 0.2-0.3. Using a threshold of 0.25 cases per sentinel enabled detection of epidemic onset 4-5 weeks earlier than current standards.
Conclusion: Claims data such as those from JMDCdb may be useful for retrospective examination of influenza trends. Moreover, a detailed analysis of the number of cases reported per sentinel suggested the potential to propose threshold values that enable earlier prediction of epidemics than conventional criteria.

Keywords: Epidemiology; claim database; influenza; mathematical model.

 
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