Murphree Rendi

Late in September 2012, the Tennessee Department of Health (TDH) identified a cluster of fungal infections following epidural injection of methylprednisolone acetate (MPA) from a single compounding pharmacy. This presented a public health imperative to contact, educate and monitor approximately 1,100 Tennessee residents who received injections from contaminated MPA lots that were shipped to three clinics in Tennessee. There was no precedent to accomplish this rapidly and efficiently. To accomplish this goal a secure, web-based application designed by TDH for emergency patient management was deployed. 

Objective

The purpose was to facilitate real-time information sharing and data visualization for incident management during the Fungal Infections Outbreak in Tennessee.

Syndromic surveillance is the monitoring of symptom combinations (i.e., syndromes) or other indicators within a population to inform public health actions. The Tennessee Department of Health (TDH) collects emergency department (ED) data from more than 70 hospitals across Tennessee to support statewide syndromic surveillance activities. Hospitals in Tennessee typically provide data within 48 hours of a patient encounter. While syndromic surveillance often supplements disease- or condition-specific surveillance, it can also provide general situational awareness about emergency department patients during an event or response. During Hurricanes Harvey (continental US landfall on August 25, 2017) and Irma (continental US landfall on September 10, 2017), TDH supported all hazards situational awareness using the Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE) in the BioSense Platform supported by the National Syndromic Surveillance Program (NSSP). The volume of out-of-state patients in Tennessee was monitored to assess the impact on the healthcare system and any geographic- or hospital-specific clustering of out-of-state patients within Tennessee. Results were included in daily State Health Operations Center (SHOC) situation reports and shared with agency response partners such as the Tennessee Emergency Management Agency (TEMA).

Objective:

To demonstrate the use of ESSENCE in the BioSense Platform to monitor out-of-State patients seeking emergency healthcare in Tennessee during Hurricanes Harvey and Irma.