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Gunn Julia

The burden of asthma on the youngest children in Boston is largely characterized through hospitalizations and self-report surveys. Hospitalization rates are highest in Black and Hispanic populations under age five. A study of children living in Boston public housing showed significant risk factors, including obesity and pest infestation, with less than half of the study population being prescribed daily medication.

Information on asthma visits for children 5 years old or younger was requested by the Boston Public Health Commission Community Initiatives Bureau. The information is being used to establish a baseline for an integrated Healthy Homes Program that includes pest management and lead abatement. There is limited experience in using syndromic surveillance data for chronic disease program planning.

 

Objective

The objective of this study is to report on the use of syndromic surveillance data to describe seasonal patterns of asthma and health inequities among Boston residents, age five and under.

Referenced File
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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
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In 2003, the need for a system to track and manage patient status and location was identified by Boston Emergency Medical Services (Boston EMS) and the Conference of Boston Teaching Hospitals. After consultation with EMS (municipal, fire based, and private), hospital, local and state public health and emergency management stakeholders, a core group from Boston EMS and Boston Public Health Commission (BPHC) developed guidelines for a Metro Boston Patient Tracking System. The goal was to provide a system to reunite family members and serve as a tool for managing short term/high impact mass casualty incidents and protracted disease outbreaks.

Since 2004, BPHC Communicable Disease Control Division (CDC) has effectively managed several mass prophylaxis clinics in response to infectious disease outbreaks. However patient data was largely collected on paper based forms, limiting the availability of real-time clinic data to incident command. To address these challenges BPHC CDC began meeting with Boston EMS to define the business processes and information needs during public health emergencies.

 

Objective

To describe the electronic patient tracking system configured by Boston EMS and the BPHC CDC to address information needs during public health emergencies.

Referenced File
Submitted by elamb on

Abbreviation, misspellings, and site specific terminology may misclassify chief complaints syndromes. The Emergency Medical Text Processor (EMT-P) is system that cleans emergency department chief complaints and returns standard terms. However, little information is available on the implementation of EMT-P in a syndromic surveillance system.

 

Objective

To describe the implementation and baseline evaluation of EMT-P developed by the University of North Carolina.

Referenced File
Submitted by elamb on

The interpretation of aberrations detected by syndromic surveillance is critical for success, but poses challenges for local health departments who must conduct appropriate follow-up and confirm outbreaks. This paper describes the response of the Boston Public Health Commission (BPHC) to a cluster of emergency department (ED) visits in children detected by syndromic surveillance.

Referenced File
Submitted by elamb on

Syndromic surveillance systems use residential zip codes for spatial analysis to identify disease clusters. However, the use of emergency medical services can be influenced by geographic proximity, specialty services, and severity of illness. We evaluated zip codes reported to the Boston Public Health Commission’s syndromic surveillance system from 10 Boston emergency departments (EDs).

 

Objective

To examine the distribution of residential zip codes among patients in Boston EDs over a two month period to better understand how this type of spatial analysis may affect the sensitivity of syndromic surveillance.

Referenced File
Submitted by elamb on

During influenza season, the Boston Public Health Commission uses syndromic surveillance to monitor Emergency Department visits for chief complaints indicative of influenza-like illness (ILI). We created three syndrome definitions for ILI to capture variable presentations of disease, and compared the trends with Boston pneumonia and influenza mortality data, and onset dates for reported cases of influenza.

 

Objective

To evaluate the impact of different syndrome definitions for ILI by comparing weekly trends with other data sources during the 2005-2006 influenza season in Boston.

Referenced File
Submitted by elamb on

The purpose of syndromic surveillance is the early identification of disease outbreaks. Classification of chief complaints into syndromes and the type of statistics used for aberration detection can affect outbreak detection sensitivity and specificity. Few data are available on the relationship between chief complaints and demographics such as gender, age, or race. For example, myocardial infarction in women would be misclassified using definitions based solely on “male” symptoms such as chest pain because women more commonly report neck, jaw, and back pain.

 

Objective

We evaluated the sensitivity and specificity of a gastrointestinal syndrome group using the Boston Public Health Commission syndromic surveillance system.

Referenced File
Submitted by elamb on

 

Syndromic surveillance has been used to detect variation in seasonal viral illnesses such as influenza and norovirus infection (1). Limited information is available on the use of a comprehensive bio-surveillance system, including syndromic surveillance, for detection and situational awareness during a sustained outbreak.  

Objective:

To report on surveillance and response activities during the 2006-2007 norovirus season in Boston.

Referenced File
Submitted by elamb on
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