Since 2009, the Cook County Department of Public Health (CCDPH) has created and disseminated weekly surveillance reports to share seasonal influenza data with the community and our healthcare partners. Surveillance data is formatted into tables and graphs using Microsoft Excel, pasted into a Word document, and shared via email listserv and our website in PDF format.
Bemis Kelley
Description
The use of social media as a syndromic sentinel for diseases is an emerging field of growing relevance as the public begins to share more online, particularly in the area of influenza. Several applications have been developed to predict or monitor influenza activity using publicly posted or self-reported online data; however, few have prioritized accuracy at the local level. In 2016, the Cook County Department of Public Health (CCDPH) collected localized Twitter information to evaluate its utility as a potential influenza sentinel data source. Tweets from MMWR week 40 through MMWR week 20 indicating influenza-like illness (ILI) in our jurisdiction were collected and analyzed for correlation with traditional surveillance indicators. Social media has the potential to join other sentinels, such as emergency room and outpatient provider data, to create a more accurate and complete picture of influenza in Cook County.
Objective:
To determine if social media data can be used as a surveillance tool for influenza at the local level.
Description
In 2005, the Cook County Department of Public Health (CCDPH) began using the Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE) as an emergency department (ED)-based local syndromic surveillance program (LSSP); 23 (100%) of 23 hospitals in suburban Cook County report to the LSSP. Data are transmitted in delimited ASCII text files (i.e., flat files) and contain a unique patient identifier, visit date and time, zip code, age, sex, and chief complaint. Discharge diagnosis and disposition are optional data elements. Prior to 2017, the Illinois Department of Public Health placed facilities participating in the Cook LSSP in a holding queue to transform their flat file submissions into a HL7 compliant message; however as of 2017, eligible hospitals must submit HL7 formatted production data to IDPH to fulfill Meaningful Use. The primary syndromic surveillance system for Illinois is the National Syndromic Surveillance Program (NSSP), which transitioned to an ESSENCE interface in 2016. As of December 2016, 20 (87%) of 23 hospitals reporting to the LSSP also reported to IDPH and the NSSP. As both syndromic surveillance systems aim to collect the same data, and now can be analyzed with the same interface, CCDPH sought to compare the LSSP and NSSP for data completeness, consistency, and other attributes.
Objective:
This analysis was undertaken to determine how the data completeness, consistency, and other attributes of our local syndromic surveillance program compared to the National Syndromic Surveillance Platform.
Presented November 21, 2017.
This presentation covers how the shiny package can complement traditional surveillance reporting through online, interactive applications. Kelley demonstrates a shiny application Cook County is currently using to share influenza data and walks through the steps she took to make the application and lessons learned. She reviews portions of the code available on Github here: https://github.com/kb230557/Flu_Shiny_App.
Description
Rabies post-exposure prophylaxis (PEP) can prevent fatal encephalitis associated with exposure to the rabies virus. However, overuse and inappropriate administration of rabies PEP are common.1 Mandatory reporting of potential rabies exposures provides opportunities for public health practitioners to monitor the appropriateness of PEP administration and offer recommendations. In Illinois, potential human exposure to rabies, including any person started on PEP and any person with contact to a bat, must be reported to the local health authority. Previous investigations into the completeness of rabies reporting have concluded that active surveillance in addition to mandatory reporting may be useful.2 As rabies PEP is often given in an emergency department setting, syndromic surveillance records may provide a basis for estimating completeness of reporting and identifying candidates for active surveillance follow up.
Objective
To determine whether unreported cases of potential human exposure to rabies can be detected using an emergency department (ED) syndromic surveillance system and to assess both reporting completeness and compliance with clinical guidelines related to rabies exposures in suburban Cook County.
Description
Most public health surveillance systems in the United States do not capture individual-level measures of socioeconomic position. Without this information, socioeconomic disparities in health outcomes can be hidden. However, US Census data can be used to describe neighborhood-level socioeconomic conditions like poverty and crowding. Place matters. Neighborhood affects health independently of personal characteristics. Thus, important trends may be elucidated by linking geocoded public health surveillance data to area-based measures of socioeconomic position, such as the percentage of residents with incomes below the federal poverty level.
Objective
The panel will describe applying the methods of Harvard’s Public Health Disparities Geocoding Project to a diverse collection of infectious disease surveillance data from 14 US states and New York City. This session will demonstrate the feasibility and utility of using US Census data to reveal sub-populations vulnerable to infectious diseases.
Description
Community health assessments are a foundation of public health practice and a prerequisite to achieving public health accreditation. Best practice dictates that CHAs must incorporate qualitative and quantitative data and utilize a number of indicators to create a detailed picture of a community’s health. Metrics may describe demographics, social and economic factors, health behaviors, health outcomes, and healthcare access and utilization. Commonly used indicators facilitate cross-jurisdiction comparisons and simplify decisionmaking. However, while many readily available indicators exist on a county level, few have been made available on the sub-county level. Syndromic surveillance messages, typically emergency room visit records, contain sub-county level data on patient residence, such as zip code or municipality. As hospitals progress towards meeting Stage 2 Meaningful Use requirements, transmission of syndromic surveillance data to public health entities will become standard. Analysis of emergency room visit data, either in aggregate or by specific syndromes, may be a valuable sub-county level indicator of community health status and access to care that can be standardized across jurisdictions.
Objective
To identify geographic clustering of elevated emergency room (ER) usage rates for incorporation into community health assessments (CHA) in suburban Cook County and to validate this metric as a potential sub-county level community health indicator.