Anthrax 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 anthrax to identify diagnostic codes (International Classification of Diseases, 9th & 10th Revisions (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 by 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 anthrax chief complaint free text terms:
  • The visit is included if it contains:
    1. A chief complaint related to disease name – (“anthrax” or “anthracs” or “anthraks” or “anthracks”) OR
    2. A chief complaint related to disease agent – (“anthracis” or “anthrasis”) OR
• Inclusion based on ICD-10 discharge diagnosis codes related to anthrax:
  • The visit is included if it contains:
    1. A discharge diagnosis code for Anthrax – (A22) OR
    2. Discharge diagnosis codes nested together with ANDNOT - Contact with and (suspected) exposure to anthrax – (Z20.810); Contact with and (suspected) exposure to COVID-19 – (Z20.822)
• Inclusion based on ICD-9 discharge diagnosis codes related to anthrax:
  • The visit is included if it contains:
    1. A discharge diagnosis code for Anthrax – (484.5) OR
    2. A discharge diagnosis code for a positive Anthrax test – (795.31) OR
    3. A discharge diagnosis code for exposure to Anthrax – (V01.81 or V71.82) OR
• Inclusion based on SNOMED discharge diagnosis codes related to anthrax:
  • The visit is included if it contains:
    1. A discharge diagnosis code for Anthrax – (409498004) OR
    2. A discharge diagnosis code for other forms of Anthrax – (11389007 or 84980006 or 195902009 or 111800004 or 111798006) OR
    3. A discharge diagnosis code for suspected Anthrax – (170475009 or 772151004) OR
    4. A discharge diagnosis code for conditions caused by Anthrax – (720990007 or 448482003) OR
    5. A discharge diagnosis code for the presence of Anthrax – (21927003 or 442765006) ANDNOT
• All the above must exclude:
  • An ICD-10 discharge diagnosis code for negative suspected exposure to Anthrax – (Z03.810)