Syndromic surveillance involves monitoring big health datasets to provide early warning of threats to public health. Public health authorities use statistical detection algorithms to interrogate these datasets for aberrations that are indicative of emerging threats. The algorithm currently in use at Public Health England (PHE) for syndromic surveillance is the ârising activity, multi-level mixed effects, indicator emphasisâ (RAMMIE) method (Morbey et al, 2015), which fits a mixed model to counts of syndromes on a daily basis.