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Benoit Stephen

Real-time emergency department (ED) data from the BioSense surveillance program for ILI visits and ILI admissions provide valuable insight into disease severity that bridges gaps in traditional influenza surveillance systems that monitor ILI in outpatient settings and laboratory-confirmed hospitalization, but do not quantify the relationship between ILI visits and hospital admissions.

Objective

The purpose of this analysis is to gain understanding of the burden of influenza in recent years through analysis of clinically rich hospital data. Patterns of visits and severity measures such as the ratio of admissions related to influenzalike illness (ILI) by age group from 2007 to 2010 are described.

Referenced File
Submitted by uysz on

During the spring of 2009, a public health emergency was declared in response to the emergence of the 2009 Influenza A (H1N1) virus. Owing to the response, timely data were needed to improve situational awareness and to inform public health officials. Traditional influenza surveillance is time-consuming and resource intensive, and electronic data sources are often more timely and resource saving. Collaboration began between the Centers for Disease Control and Prevention (CDC), the International Society for Disease Surveillance, and the Public Health Informatics Institute to expand syndromic Emergency Department (ED) surveillance through the Distribute project.

Distribute collects aggregate, daily or weekly reports of influenza-like illness (ILI) and total patient visits to EDs from participating health jurisdictions, stratified by age group and other variables. Additional variables included the three digit zip code of the patient’s residence as well as the disposition and temperature, however not all jurisdictions collect these variables. Distribute data are typically extracted from ED-based electronic health data systems. The ILI definition is determined by the participating jurisdiction that can be a city, county, or state. At the time of analysis, the network consisted of 33 jurisdictions.

Because ILI data reported to Distribute had not been systematically compared with data reported through other surveillance systems, CDC planned an evaluation of the Distribute data, which included a comparison to the Influenza-like Illness Network (ILINet). 

ILINet is a collaborative effort between the CDC, local and state health departments and primary health care providers. The network currently consists of approximately 3000 healthcare providers in all 50 states, Chicago, the District of Columbia, New York City, and the US Virgin Islands. Enrolled providers send CDC weekly reports via internet or fax that consist of the total number of patients seen for any reason and the number of those patients with ILI by age group. ILI is defined as fever (temperature of X1001F (37.8 1C)) and a cough and/or sore throat in the absence of a known cause other than influenza.

 

Objective

To compare ILI data reported to the Distribute surveillance project to data from an existing influenza surveillance system, the US Outpatient ILINet.

Referenced File
Submitted by hparton on

In May of 2001, Boston released a strategic transportation plan to improve bicycle access and safety. [1] According to the Boston Transportation Department, ridership has increased 122% between 2007 and 2009. [2] A collaborative public health and public safety task force was initiated in 2010 to foster a safe and healthy bicycling environment.

Objective

To quantify the injury burden and identify possible risk factors using bicycle related injury (BRI) visits at Boston emergency departments (ED).

Referenced File
Submitted by elamb on

Time-of-arrival (TOA) surveillance methodology consists of identifying clusters of patients arriving to a hospital emergency department (ED) with similar complaints within a short temporal interval. TOA monitoring of ED visit data is currently conducted by the Florida Department of Health at the county level for multiple subsyndromes [1]. In 2011, North Carolina's NC DETECT system and CDC's Biosense Program collaborated to enhance and adapt this capability for 10 hospital-based Public Health Epidemiologists (PHEs), an ED-based monitoring group established in 2003, for North Carolina's largest hospital systems. At the present time, PHE hospital systems include coverage for approximately 44% of the statewide general/acute care hospital beds and 32% of all emergency department visits statewide. We present findings from TOA monitoring in one hospital system.

Objective

To describe collaborations between North Carolina Division of Public Health and the Centers for Disease Control and Prevention (CDC) implementing time-of-arrival (TOA) surveillance to monitor for exposure-related visits to emergency departments (ED) in small groups of North Carolina hospitals.

Referenced File
Submitted by elamb on

The CDC's BioSense Program receives near real-time health care utilization data from a number of sources, including Department of Defense (DoD) healthcare facilities from around the globe and non-federal hospital emergency departments (EDs) in the US, to support all-hazards surveillance and situation awareness. Following the tsunami in Japan on March 11, 2011, the BioSense Program modified its surveillance protocols to monitor: 1) injuries and possible radiation-associated health effects in Japan-based DoD facilities and 2) potential adverse health effects associated with the consumption of potassium iodide (KI), a salt used to prevent injury to the thyroid gland in the event of radiation exposure, among persons attending participating EDs in the US. We present the findings from that enhanced surveillance.

Objective

To demonstrate the utility of the BioSense Program for post-disaster response surveillance.

Referenced File
Submitted by elamb on

Each year, more than two-thirds of all fireworksrelated injuries occur during June 16-July 16 [1]. During the 2006 July 4th holiday weekend, thousands of people were treated in emergency departments (EDs) for fireworks-related injuries [2]. Over 50% of these injuries were burns, most often occurring on the extremities and face. CDC’s BioSense System receives near real-time data from >11% of total U.S. ED visits. Most data is sent to BioSense by state or local systems. The system includes >540 hospital EDs; 522 facilities send patient chief complaints and 182 facilities also send physician diagnoses.  BioSense maps chief complaint and diagnosis data to 11 syndromes and 78 sub-syndromes; burns are one of 13 injury-related sub-syndromes.

Objective:

To describe burn injuries reported to the BioSense System during the 2008 Independence Day holiday.

Referenced File
Submitted by elamb on

Understanding the relationship between mental illness and medical comorbidity is an important aspect of public health surveillance. In 2004, an estimated one fourth of the US adults reported having a mental illness in the previous year (1). Studies showed that mental illness exacerbates multiple chronic diseases like cardiovascular diseases, diabetes and asthma (2). BioSense is a national electronic public health surveillance system developed by the Centers for Disease Control and Prevention (CDC) that receives, analyzes and visualizes electronic health data from civilian hospital emergency departments (EDs), outpatient and inpatient facilities, Veteran Administration (VA) and Department of Defense (DoD) healthcare facilities. Although the system is designed for early detection and rapid assessment of all-hazards health events, BioSense can also be used to examine patterns of healthcare utilization.



Objective:

The purpose of this paper was to analyze the associated burden of mental illness and medical comorbidity using BioSense data 20082011.

Submitted by Magou on
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