All Animal Bites v1

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: 

1. 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.
2. The codes and free text were then categorized as inclusion or exclusion terms. These terms were formatted for querying in ESSENCE.
3. Text analysis was conducted on the initial query to find additional inclusion or exclusion terms.
4. 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, and exclusions are incorporated as necessary.

• Inclusion based on animal bite chief complaint free text terms:
  • The visit is included if it contains:
    1. A chief complaint term related to bites – (“bite” or “bit ” or “bitt”) AND
    2. A chief complaint term related to mammals – (“animal” or “bat” or “beaver” or “badger” or “bunny” or “canine” or “cat” or “chipmunk” or “coyote” or “cow” or “deer” or “dog” or “donkey” or “ferret” or “fisher” or “fox” or “german shephard” or “german shepherd” or “goat” or “groundhog” or “ground hog” or “horse” or “K9” or “kitten” or “mammal” or “monkey” or “mongoose” or “mouse” or “otter” or “pig” or “pitbull” or “pit bull” or “porcupine” or “possum” or “puppy” or “rabbit” or “raccoon” or “racoon” or “ringtail” or “rodent” or “sheep” or “squirrel” or “skunk” or “weasel”) OR
• Inclusion based on ICD-10 discharge diagnosis codes related to animal bites:
  • The visit is included if it contains:
    1. A discharge diagnosis code for animal bite from rodents – (W53.01 or W53.11 or W53.21 or W53.81) OR
    2. A discharge diagnosis code for dog bite – (W54.0) OR
    3. A discharge diagnosis code for bites from cats, horses, cows, other hoof stock, pigs, raccoons, and other mammals – (W55.01 or W55.11 or W55.21 or W55.31 or W55.41 or W55.51 or W55.81) OR
• Inclusion based on ICD-9 discharge diagnosis codes related to animal bites:
  • The visit is included if it contains:
    1. A discharge diagnosis code for dog bite – (E9060) OR
    2. A discharge diagnosis code for rate bite – (E9061) OR
    3. A discharge diagnosis code for other animal bites – (E9063) OR
• Inclusion based on SNOMED discharge diagnosis codes related to animal bites:
  • The visit is included if it contains:
    1. A discharge diagnosis code for dog bite – (217697000) OR
    2. A discharge diagnosis code for cat bite – (217701002) OR
    3. A discharge diagnosis code for rat bite – (217698005) OR
    4. A discharge diagnosis code for Bite of pig (event) - (242614007)
    5. A discharge diagnosis code for Bite of mouse (event) - (242611004)
    6. A discharge diagnosis code for Bite of horse (event) - (242615008)
    7. A discharge diagnosis code for Bite of rabbit (event) - (242608000)
    8. A discharge diagnosis code for Bite of ferret (event) - (242612006)
    9. A discharge diagnosis code for Bite of rodent (event) - (242625003)
    10. A discharge diagnosis code for Bite of squirrel (event) - (770959008)
    11. A discharge diagnosis code for Bite of mammal (event) - (242606001) ANDNOT
• All the above must exclude:
  1. An ICD-10 discharge diagnosis code for Accidental bite by another person – (W50.3) OR
  2. An ICD-10 discharge diagnosis code for Bitten or stung by nonvenomous insect and other nonvenomous arthropods – (W57) OR
  3. An ICD-10 discharge diagnosis code for Bitten by nonvenomous snake – (W59.11) OR
  4. A chief complaint term related to insect and bug bites – (“insect” or “bug” or “spider” or “snake”) OR
  5. A chief complaint term related to human bites – (“human” andnot “non human”)
  6. A SNOMED CT discharge diagnosis code for Human bite (event) – (242605002) OR
  7. A SNOMED CT discharge diagnosis code for Insect bite – wound (disorder) – (276433004) OR
  8. A SNOMED CT discharge diagnosis code for Bite of spider (event) – (771257008) OR
  9. A SNOMED CT discharge diagnosis code for Bite of insect (event) – (771191003) OR
  10. A SNOMED CT discharge diagnosis code for Snake bite – wound – (283840005)