On March 15, 2018, the DHSS syndromic surveillance system changed to a new version of the ESSENCE software.

A User’s Guide and Frequently Asked Questions document are available in the new version of ESSENCE under the "More" tab on the ESSENCE – Missouri home page. In addition, other ESSENCE online training materials are available through the links listed under "Training & Technical Support" on this website.

Please contact us at if you have questions.


Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE) software is a system that inputs electronic emergency department (ED) data for the purpose of syndromic surveillance.

Syndromic Surveillance Background

Syndromic surveillance is the use of non-traditional data sources in order to detect public health events earlier than possible with other methods (laboratory confirmed diagnosis, physician diagnosis). Examples of syndromic surveillance data include over-the-counter drug sales, laboratory report orders, and absenteeism rates.

Missouri conducts syndromic surveillance using electronic hospital emergency department visits. DHSS receives data from hospitals meeting certain criteria under 19 CSR 10-33.040 specifically for syndromic surveillance.

ESSENCE groups chief complaints from electronic ED data into ‘syndrome’ categories. This information is used to determine if the number of visits is greater than expected for that facility based on historical data and statistical analyses to conduct early event detection. Syndrome groups used are: botulism-like, exposure, fever, gastrointestinal, hemorrhagic illness, influenza-like illness, injury, neurological, rash, records of interest, respiratory, and shock/coma.

ESSENCE can also be used for situational awareness during known health events by querying all ED visits for a particular syndrome or by keyword (such as carbon monoxide, animal bite, injury, etc.).

Missouri ESSENCE Access

Only authorized users who have been issued a username and password may access Missouri ESSENCE. It is important for DHSS to grant access to relevant partners to fulfill the project’s mission, which is to help state and local partners respond to adverse public health events by providing information and tools for early event detection and situational awareness.

DHSS may grant Missouri ESSENCE access to:

  • Public health authorities including those employed at DHSS or local public health agencies so they can view statewide data. (See instructions for public health professionals to register for Missouri ESSENCE access.)
  • Staff from hospitals or hospital groups that send electronic ED data under 19 CSR 10-33.040 so they can view their own data. (See instructions for hospital staff to register for Missouri ESSENCE access.)

ESSENCE Facilities Map