Lewis Paul

The DoD and VDH both maintain local ESSENCE installations to monitor the health status of their military and civilian populations, respectively, and submit syndromic surveillance data to the NSSP ESSENCE to foster data sharing and collaborative initiatives among public health entities. Military Treatment Facilities (MTFs), housed on DoD installations, provide healthcare to all service members and their beneficiaries stationed in the area. Service members and their beneficiaries represent a substantial portion of the local community and interact with the civilian population throughout daily activities. Sharing syndromic surveillance data between DoD and public health jurisdictions can provide public health situational awareness among both civilian and military populations to support disease surveillance. DoD and VDH engaged in a pilot project to develop processes and procedures for data sharing, data access, and communication with the aim they can serve as best practices for other jurisdictions seeking to share syndromic surveillance data with DoD.

Objective: This panel will focus on the experiences from the Department of Defense (DoD) and Virginia Department of Health (VDH) data sharing project using the National Syndromic Surveillance Program (NSSP) ESSENCE and will discuss lessons learned, challenges, and recommendations within the following areas: 1) data sharing authority, 2) coordination and implementation of data sharing with a focus on personnel, training, and managing access and 3) communication between local, state, and federal agencies.

Timely influenza data can help public health decision-makers identify influenza outbreaks and respond with preventative measures. DoD ESSENCE has the unique advantage of ingesting multiple data sources from the Military Health System (MHS), including outpatient, inpatient, and emergency department (ED) medical encounter diagnosis codes and laboratory-confirmed influenza data, to aid in influenza outbreak monitoring. The Influenza-like Illness (ILI) syndrome definition includes ICD-9 or ICD-10 codes that may increase the number of false positive alerts. Laboratory-confirmed influenza data provides an increased positive predictive value (PPV). The gold standard for influenza testing is molecular assays or viral culture. However, the tests may take 3-10 days to result. Rapid influenza diagnostic tests (RIDTs) have a lower sensitivity, but the timeliness of receiving a result improves to within <15 minutes. We evaluate the utility of RIDTs for routine ILI surveillance.

Objective: To describe influenza laboratory testing and results in the Military Health System and how influenza laboratory results may be used in DoD Electronic Surveillance System for Early Notification of Community-based Epidemics (ESSENCE)

Although effective preventive measures for heat-related illness have been recommended and mandated for military personnel, there continues to be incident cases. In 2016, there were 401 incident cases of heat stroke and 2,135 incident cases of “other heat illness” among all active component service members. Current military guidelines utilize the wet bulb globe temperature (WBGT) index to measure heat risk, guiding work/rest and hydration practices. The WBGT requires calibrated instrumentation and is based on fixed cutoff values. We propose using readily available meteorological data inputs and EHI cases to identify and validate an EHI risk prediction model. Prior studies have found that combinations of WBGT and the previous day’s WBGT and relative humidity and temperature have predictive value for EHI. We build upon prior work by using generalized additive models (GAMs).

Objective:

To identify predictors of the risk of developing exertional heat illness (EHI) among basic training populations in the Department of Defense.