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McGuinness Don

Description

In 2003, with the advent of SARS, the Ontario Ministry of Health and Long-Term Care (MOHLTC) released a document mandating the use of a clinical screening tool to detect patients at high risk for having a febrile respiratory illness (FRI), defined as a temperature of > 38ºC and a new or worsening cough or shortness of breath (1). The FRI screening tool is available in all Ontario Emergency Departments (ED), and is utilized in 86% of them (2). Any patient who meets all of the criteria is designated FRI positive, treated with droplet precautions and is instructed to wear a mask and undergo frequent hand-washing (1). The FRI screening tool was created as a response to the SARS outbreaks, and while it is used to identify any FRI, its sensitivity has not been documented. We attempt to determine the utility of FRI as a defining element of clinical influenza.

Objective

 (1) To determine if patients who are found to be positive for influenza or parainfluenza by culture or antigen detection are all detected by the Ontario Ministry of Health and Long-Term Care's Febrile Respiratory Illness (FRI) screening tool, and thereby treated with appropriate respiratory precautions to prevent spread. (2) To determine if syndromic surveillance or another clinical predictor would be a more effective screening tool than FRI.

Submitted by elamb on
Description

In September 2004, Kingston, Frontenac and Lennox and Addington Public Health began a 2-year pilot project to develop and evaluate an Emergency Department Chief Complaint Syndromic Surveillance System in collaboration with the Ontario Ministry of Health and Long Term Care – Public Health Branch, Queen’s University, Public Health Agency of Canada, Kingston General Hospital and Hotel Dieu Hospital. At this time, the University of Pittsburgh’s Real-time Outbreak and Disease Surveillance (RODS, Version 3.0) was chosen as the surveillance tool best suited for the project and modifications were made to meet Canadian syndromic surveillance requirements. To evaluate the design and implementation of the system, a multi-sectored approach to evaluation was taken. Individual evaluations of the process, technical aspects and of cost/benefit were conducted to demonstrate proof of concept and the associated costs. An overall outcome or effectiveness evaluation will take place in spring 2006.

 

Objective

This paper outlines the approach used to evaluate an emergency department syndromic surveillance system on the following areas: process and outcome, cost/benefit and technical.

Submitted by elamb on
Description

This paper outlines the integration of hospital admission, Febrile Respiratory Illness (FRI) screening and Canadian Triage and Acuity Score (CTAS) data streams within an Emergency Department Syndromic Surveillance system. These data elements allow better characterization of outbreak severity and enable more effective resource allocation within acute care settings.

Submitted by elamb on
Description

In September 2004, Kingston, Frontenac and Lennox and Addington Public Health began a 2-year pilot project to develop and evaluate an Emergency Department Chief Complaint Syndromic Surveillance System in collaboration with the Ontario Ministry of Health and Long Term Care – Public Health Branch, Queen’s University, Public Health Agency of Canada, Kingston General Hospital and Hotel Dieu Hospital. At this time, the University of Pittsburgh’s Real-time Outbreak and Disease Surveillance (RODS, Version 3.0) was chosen as the surveillance tool best suited for the project and modifications were made to meet Canadian syndromic surveillance requirements.

 

Objective

This poster provides an overview of a RODS-based syndromic surveillance system as adapted for use at a Public Health unit in Kingston, Ontario Canada. The poster will provide a complete overview of the technical specifications, the capture, classification and management of the data streams, and the response protocols developed to respond to system alerts. It is hoped that the modifications described here, including the addition of unique data streams, will provide a benchmark for Canadian syndromic surveillance systems of the future.

Submitted by elamb on
Description

Syndromic surveillance has been used been used as method of surveillance for various events in recent years. For example, post September 11th, 2001 anthrax attacks in New York City, World Youth Day in Toronto 2002, Salt Lake City 2002 Olympics, Democratic National Convention Boston 2004, and the G8 Summit in Scotland 2005.

 

Objective

Historical Emergency Department (ED) visits were examined to characterize ED utilization for the weeks before, during and after Queen’s University Homecoming weekend in Kingston, Ontario, Canada. This information was used to prospectively monitor the 2006 Homecoming period and inform key stakeholders.

Submitted by elamb on
Description

A syndromic surveillance system has been implemented at Kingston, Frontenac and Lennox & Addington Public Health in Kingston Ontario as part of a pilot project funded by the Ontario Ministry of Health and Long-Term Care – Public Health Division. The information captured by the Real-time Outbreak and Disease Surveillance-based syndromic surveillance system includes Febrile Respiratory Illness screening results (implemented since SARS) for Emergency Department (ED) visits and information detailing hospital admissions.

 

Objective

To use an electronic real-time ED monitoring tool to involve public health, acute care and laboratory stakeholders in an integrated alerting and response process for community-wide influenza.

Submitted by elamb on
Description

A retrospective chart review was performed to examine chief complaint, syndrome classification and discharge diagnoses of laboratory confirmed Salmonella Enteritidis phage type (PT) 13 cases who visited the Emergency Departments (ED) of two local hospitals during a province-wide outbreak in Ontario in the fall of 2005. This assessment was used to assess the sensitivity of the ED syn-dromic surveillance system to detect a local foodborne outbreak, and to modify syndrome classification.

Submitted by elamb on
Description

The prompt detection of disease outbreaks is a major concern to public health as it has the potential to reduce morbidity and mortality (1). Real-time syndromic surveillance uses existing non-traditional data for timely analysis and feedback to those responsible for investigations and follow-up of potential outbreaks (2). Recent studies have suggested that integrating multiple data sources can significantly improve detection accuracy of syndromic surveillance systems, but more work is needed to explore the most effective means of said integration and what types of data streams give the greatest benefit (3;4).

Objective:

This paper will examine the temporal relationship between Ontarioís emergency department (ED) visits and telephone health line (Telehealth Ontario) call volume for respiratory illnesses, in an effort to test the feasibility of using Telehealth Ontarioís system for real-time surveillance.

Submitted by elamb on
Description

Influenza epidemics occur seasonally, impose a high economic burden on the health care system, and are responsible for substantial morbidity and mortality (1). The past century has seen three influenza A pandemics with variable severity. The recent outbreaks of avian influenza involving different virus strains in Asia, North America and the Netherlands, indicates the increasing potential of a new influenza pandemic (2). Public and political awareness needs to be strengthened while public health surveillance strategies need significant improvements if we are to mitigate such a potentially devastating worldwide pandemic, and provide the healthcare system with as much early warning as possible to enhance preparedness. Telehealth Ontario is a provincial telephone helpline for health information staffed by nurses that, if monitored on a real-time basis, has the potential to identify increases in seasonal respiratory infection rates. A recent study suggested that Telehealth Ontario respiratory calls reflect the seasonality of diagnosed respiratory illnesses in emergency departments (van Dijk et al., unpublished data), but an estimation of how respiratory pathogens contribute to Telehealth Ontario’s respiratory complaint calls has not been studied.

Objective:

This paper will explore the possibility and utility of monitoring Telehealth Ontario respiratory calls as an efficient public health influenza strategy for early warning by comparing this data source to provincial viral lab data.

Submitted by elamb on