Translating physicians' intuition into quantifiable data: clinical hospital-based surveillance to complement existing methods to address gaps in current surveillance systems.

Informal clinical exchanges among pediatricians frequently provide the first indications of emerging (para-)infectious diseases. However, these observations often remain anecdotal and unstructured, leaving gaps in traditional surveillance systems. In this Perspective, we advocate for the integration of active, hospital-based clinical surveillance to bolster early detection and response. Drawing on recent pediatric examples, including multisystem inflammatory syndrome in children, acute hepatitis of unknown origin, invasive group A streptococcal disease, and Mycoplasma pneumoniae, we show how frontline clinical awareness often preceded formal recognition and informed early management. We outline a model for structured data collection within pediatric hospital networks, combining routine Internation Classification of Diseases-coded reporting with eventual natural language processing to extract key clinical features from health records. This system aims to transform clinical intuition into real-time, actionable data, enabling timely intervention and more accurate public health responses. By linking informal clinical insight with formal surveillance, we can enhance preparedness, enable earlier intervention, and ultimately improve outcomes in pediatric infectious diseases.