Query purpose:
Created by the CDC National Syndromic Surveillance Program (NSSP) for use with emergency department data to develop queries for all National Notifiable Diseases defined by the National Notifiable Diseases Surveillance System (NNDSS). Please note that while the disease queries are developed using the NNDSS case definition as the basis for identifying patient visits of interest, the queried patient visits themselves may or may not represent a case patient in NNDSS and further public health investigation will most often be required. This query is intended to be a version 1 and may be further improved upon by the NSSP community of practice in the future. This query is intended to be narrow and capture visits with specific terms to support greater monitoring and actionable public health data. More complex and/or broader queries may exist that more broadly capture symptoms or travel-based terms.
How it was developed:
- The CDC team used the NNDSS case definition of “Animal Rabies” to identify diagnostic codes (International Classification of Diseases, 9th & 10th Revision (ICD-9-CM, ICD-10-CM), SNOMED Clinical Terms (CT)) and chief complaint free-text for syndrome development.
- The codes and free text were then categorized as inclusion or exclusion terms. These terms were formatted for querying in ESSENCE
- Text analysis was conducted on the initial query to find additional inclusion or exclusion terms.
- The query was cross-checked internally as NSSP and by CDC subject matter experts as needed.
How it works:
The Chief Complaint Discharge Diagnosis (CCDD) parsed field is used to query both the discharge diagnosis codes and chief complaint free text.
- Inclusion based on Rabies related chief complaint free text terms:
- The visit is included if it contains:
- Chief complaints related to the disease name – (“rabid”, “rabie”, “rabbie”, “rabes”) OR
- The visit is included if it contains:
- Inclusion based on ICD-10 discharge diagnosis codes related to Rabies:
- The visit is included if it contains:
- A discharge diagnosis code of Rabies (A82) OR
- A discharge diagnosis code of Contact with and (suspected) exposure to rabies (Z20.3) OR
- A discharge diagnosis code of Encounter for prophylactic rabies immune globin (Z29.14) OR
- The visit is included if it contains:
- Inclusion based on ICD-9 discharge diagnosis codes related to Rabies:
- The visit is included if it contains:
- A discharge diagnosis code of Rabies (071) OR
- A discharge diagnosis code of Contact with or exposure to rabies (V01.5) OR
- A discharge diagnosis code of Need for prophylactic vaccination and inoculation against rabies (V04.5) OR
- The visit is included if it contains:
- Inclusion based on SNOMED discharge diagnosis codes related to Rabies:
- The visit is included if it contains:
- A discharge diagnosis code of Exposure to Rabies virus (444459008) OR
- A discharge diagnosis code of Administration of vaccine product containing only Rabies lyssavirus antigen (34631000) ANDNOT
- The visit is included if it contains:
- Inclusion based on animal exposures chief complaint free text terms:
- The visit is included if it contains:
- Chief complaint free text of animal exposures nested together – (“bit”, “scratch”, “exposure”) AND (“bat”, “raccoon”, “racoon”, “fox”, “skunk”, “otter”, “mongoose”, “coyote”) ANDNOT
- The visit is included if it contains:
- All of the above must exclude:
- Chief complaint free text and discharge diagnosis codes nested together:
- Chief complaint free text indicating subsequent visit - (“2”, “3”, “4”, “5”) ANDNOT “Z20 3” OR (“second”, “third”, “fourth”, “fifth”, “final”, “last”, “repeat”, “return”, “recheck”, “revisit”, “subsequent” AND
- Chief complaint free text indicating shot or visit – (“dose”, “immun”, “inj”, “round”, “series”, “set”, “shot”, “vac”, “vax”, “visit”) OR
- ICD-10 discharge diagnosis code of Encounter for Immunization (Z23) AND
- Chief complaint free text indicating rabies – (“rabid”, “rabie”, “rabbie”, “rabes”) OR
- ICD-10 discharge diagnosis code of Rabies (A82) OR
- ICD-10 discharge diagnosis code of Contact with and (suspected) exposure to rabies (Z20.3) OR
- ICD-10 discharge diagnosis code of Encounter for prophylactic rabies immune globin (Z29.14) OR
- ICD-9 discharge diagnosis code of Rabies (071) OR
- ICD-9 discharge diagnosis code of Contact with or exposure to rabies (V01.5) OR
- ICD-9 discharge diagnosis code of Need for prophylactic vaccination and inoculation against rabies (V04.5) OR
- SNOMED discharge diagnosis code of Exposure to Rabies virus (444459008) OR
- SNOMED discharge diagnosis code of Administration of vaccine product containing only Rabies lyssavirus antigen (34631000) OR
- Chief complaint free text related to subsequent visits for rabies – (“second rabid”, “second rabie”, “second rabbie”, “second rabes”, “third rabid”, “third rabie”, “third rabbie”, “third rabes”, “fourth rabid”, “fourth rabie”, “fourth rabbie”, “fourth rabes”, “fifth rabid”, “fifth rabie”, “fifth rabbie”, “fifth rabes”, “last rabid”, “last rabie”, “last rabbie”, “last rabes”, “follow up”, “followup”, “next rabid”, “next rabie”, “repeat rabies”, “repeat rabid”, “return for rabie”, “return for rabie”, “return for rabbie”, return for rabes”, “return rabid”, “return rabie”, “return rabbie”, “return rabes”, “recheck”) OR
- SNOMED discharge diagnosis codes related to adverse effects of Rabies vaccination:
- A discharge diagnosis code of Adverse reaction to component of vaccine product containing Rabies lyssavirus antigen (293118001) OR
- A discharge diagnosis code of Post rabies vaccination encephalitis (192714000)
- Chief complaint free text and discharge diagnosis codes nested together:
(,^rabi[de]^,OR,^rabbie^,OR,^rabes^,OR,^;A82^,OR,^;Z203^,OR,^;Z2914^,OR,^;071;^,OR,^;V0[14]5^,OR,^;444459008;^,OR,^;34631000;^,OR,(,^bit^,OR,^scratch^,OR,^exposure^,),AND,(,!bat!,OR,^raccoon^,OR,^racoon^,OR,^fox^,OR,^skunk^,OR,^otter^,OR,^mongoose^,OR,^coyote^,),),ANDNOT,(,(,(,![2345]!,ANDNOT,^Z20 3^,OR,^second^,OR,^third^,OR,^fourth^,OR,^fifth^,OR,^final^,OR,^last^,OR,^repeat^,OR,^return^,OR,^recheck^,OR,^revisit^,OR,^subsequent^,),AND,(,^dose^,OR,^immun^,OR,^inj^,OR,^round^,OR,^series^,OR,^set^,OR,^shot^,OR,^va[cx]^,OR,^visit^,OR,^;Z23^,),AND,(,^rabi[de]^,OR,^rabbie^,OR,^rabes^,OR,^;A82^,OR,^;Z203^,OR,^;Z2914^,OR,^;071;^,OR,^;V015^,OR,^;444459008;^,OR,^;34631000;^,),),OR,^second rabi[de]^,OR,^second rabbie^,OR,^second rabes^,OR,^third rabi[de]^,OR,^third rabbies^,OR,^third rabes^,OR,^fourth rabi[de]^,OR,^fourth rabbie^,OR,^fourth rabes^,OR,^last rabi[de]^,OR,^last rabbie^,OR,^last rabes^,OR,^follow up^,OR,^followup^,OR,^next rabi[de]^,OR,^repeat rabi[de]^,OR,^return for rabi[de]^,OR,^return for rabbie^,OR,^return for rabes^,OR,^return rabi[de]^,OR,^return rabbie^,OR,^return rabes^,OR,^recheck^,OR,^;293118001;^,OR,^;192714000;^,)