Drociuk Daniel

The South Carolina (SC) Department of Health and Environmental Control uses multiple surveillance systems to monitor influenza activity from October to May of each year, including participating in the U.S. Influenza Sentinel Providers Surveillance Network. A percentage of influenza-like-illness surpassing the national 2.5% baseline is considered evidence of increased influenza activity by the CDC; this baseline is historical and does not change throughout the influenza season. Though not a part of the national influenza surveillance, SC also requires health care providers in the state to report positive rapid influenza tests, by number, on a weekly basis. Currently, only a trend analysis is used on weekly reports of positive rapid influenza test data for SC. A more robust method for determining statistically significant increases in activity for these two influenza surveillance systems is needed, and would provide a more accurate assessment of the status of seasonal influenza activity in SC.

Objective

Use the Early Aberration Reporting System (EARS) to analyze influenza sentinel provider surveillance data and positive rapid influenza test reports to identify weeks where influenza activity was significantly increased in South Carolina. Demonstrate the utility of using EARS to detect increases in influenza activity using existing surveillance systems.

Syndromic surveillance has traditionally been used by public health in disease epidemiology. Partnerships between hospital-based and public health systems can improve efforts to monitor for disease clusters. Greenville Hospital System operates a syndromic surveillance system, which uses EARS-X to monitor chief complaint, lab, and radiological data for the four emergency departments within the hospital system. Combined, the emergency departments have approximately 145,000 visits per year. During March 2007 an increase in invasive group A Streptococcus (GAS) disease in the community lead to the use of syndromic surveillance to determine if there was a concomitant increase in Scarlet Fever within the community.

Objective

 Demonstrate the utility of collaboration between hospital-based and public health syndromic surveillance systems in disease investigation. Demonstrate the ability of syndromic surveillance in identification and evaluation of process improvements.

Syndromic surveillance has traditionally been used by public health to supplement mandatory disease reporting. The use of chief complaints as a data source is common for early event detection. Though some public health syndromic surveillance systems allow individual hospitals to view their own data through a web interface, many ICPs have the experience and knowledge-base to conduct their own surveillance and analysis internally. Additionally, they often have interests specific to their hospital which may motivate them to conduct additional syndromic surveillance projects themselves. Lastly, in many cases, ICPs are better able to investigate problems with chief complaint syndrome categorization and aberrations within their own facility before notification of public health staff. A good understanding of the foundation of syndromic surveillance by hospital ICPs can be extremely beneficial when paired with public health to investigate possible cases and outbreaks. ICPs at Greenville Hospital System (GHS), composed of 1110 beds, a level I trauma center with an average of 85,000 visits per year plus three smaller outlying emergency rooms, has had interest in syndromic surveillance for many years and collected data manually for trend analysis using Microsoft Excel to monitor chief complaint data since August 2003.

Objective

Demonstrate the use and benefit to hospital-based infection control practitioners (ICP) of chief complaint data for syndromic surveillance in partnership with public health to assist with traditional public health disease investigations.