Refining historical limits method to improve disease cluster detection, New York City, New York, USA.

Of the signals detected by HLM original , 2 campylobacteriosis signals and 1 invasive Haemophilus influenzae disease signal were attributable to a bias toward signaling caused by an increasing trend in historical data.

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One signal detected by HLM refined was attributable to the adjustment of a decreasing trend in baseline disease counts of viral meningitis.

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