Cookson Susan

On August 29, 2005, Hurricane Katrina made landfall just east of New Orleans, LA at 6:10AM CST and again at the LA/MS border at 10:00AM CST as a Category 3 hurricane, causing mass destruction along their coastlines. The devastation in LA and MS forced many residents to evacuate. Outside of the hurricane affected areas of LA, MS, and AL, GA received the second largest number of evacuees (approximately 125,000).

Objective

To describe the victims of Hurricane Katrina who evacuated to GA and to assess their impact on emergency departments enrolled in GA’s syndromic surveillance system.

Although many syndromic surveillance (SS) systems have been developed and implemented, few have included response protocols to guide local health jurisdictions when alerts occur [1,2]. SS was first implemented in GA during the 2004 G-8 Summit. Six EDs in the Coastal Public Health District (PHD), 1 of 18 GA PHDs (Figure 1), conducted SS during that “national security special event.” Since that time, EDs in other PHDs have been actively recruited to participate in GA’s SS system. In GA, the PHD has the responsibility for monitoring SS data. Likewise, the PHD responds to alerts and initiates public health investigations and interventions; the state Division of Public Health (DPH) assists, if requested. To address these responsibilities, the Coastal PHD informally developed their own response practices.

Objective

To develop a template protocol to guide local response to syndromic surveillance alerts generated through analyses of emergency department (ED) visit data.

The Georgia Power Corporation (GPC) provides power to 155 (97.5%) of the 159 counties in Georgia (GA), and employs 9,600 people throughout the state. GPC is engaged in preparing for pandemic influenza, and committed to protecting the critical infrastructure and ensuring its continuity of operations. The GPC employee “Crisis Absence Reporting Tool” (CART) was designed to provide the Georgia Syndromic

Surveillance (GA SS) Program with employee absentee/ reason to inform Public Health and GPC leadership about health events occurring in their employees statewide.

The GA SS Program has been implemented in 13 (72%) of the 18 Health Districts. In each of these locations, data are transferred from an ED, ambulatory care center, or school district to the Georgia Division of Public Health (GDPH) for analysis and dissemination of results to all stakeholders. GDPH wanted to collaborate with a large corporation with a statewide employee base to conduct absentee and reason for absence SS to provide an additional perspective to the existing data streams used by GA SS.

In GA, the LHD are responsible for organizing pandemic planning committees comprised of community partners to discuss continuity of basic services and maintenance of the critical infrastructure at the local level during an influenza pandemic. Increasing SS capacity is an important component of Local Health District (LHD) pandemic planning strategies in GA.

Objective

To create a non-traditional partnership between the GPC and the GDPH to aid in adverse health event detection and response activities during an influenza pandemic or other health emergency. This will include augmenting CART with SS data from the GA SS Program. These data will be analyzed by GA SS and results disseminated to LHDs, who monitor and respond to SS data in their jurisdictions. Analyses will also be provided to GPC to aid in resource allocation to ensure the continuity of services in GA during emergencies.

As part of public health protection activities conducted in support of the G8 Summit in Sea Island, GA, June 2004, DPH implemented SS in the state’s coastal region using information provided from ED visits, 911 calls, and pharmacy sales. Following this high-profile event, questions arose about whether to maintain the ED system and about whether and where to extend its use in GA.  Despite the emergence of practice-based guidance for conducting SS and the growing experience of public health agencies, little guidance is available regarding strategies for identifying sites where SS should be targeted.

 

Objective

This paper describes the strategy used by the Georgia Division of Public Health (DPH) in implementing syndromic surveillance (SS), including criteria for prioritizing localities and the early results of applying these criteria in initiating new emergency department (ED)-visit based systems.

On Monday, August 29, 2005, Hurricane Katrina struck the Gulf Coast. Outside of the affected areas of TX, LA, MS, and AL, GA received the largest number of these evacuees, approximately 125,000. By August 30, 2005, GA began receiving a total of approximately 1,300 NDMS patients from flights arriving at Dobbins Air Force Base. Within days, Georgia established 13 shelters for evacuees. Crowded shelters can increase the risk for communicable diseases. In addition, many evacuees left behind needed medications, thus increasing the risk for chronic disease exacerbations.

Objective

To assess public health needs among sheltered evacuees, the GA Department of Human Resources, Division of Public Health recommended daily surveillance.

To examine data from 911/Emergency Medical Services (EMS) and determine whether these data provide a useful addition to syndromic surveillance (SS) when used with emergency department (ED) chief complaint (CC) data.