Oda Gina

Bordetella pertussis infection (whooping cough) has been on the rise and the most cases in the US since 1955 were reported in 2012 (48,277 or 15.4 per 100,000). Pertussis is highly infectious and can cause serious illness in infants and children as well as adults, and in general is preventable by vaccination. Since 2005, it has been recommended that anyone 19-64 years old should have a onetime booster of the pertussis vaccine (Tdap). In 2010, that recommendation was broadened stating people 65 years old and older should also obtain a booster of Tdap. Given the increased number of pertussis cases in the Western US, and that approximately 20% of these cases occurred in patients >20 years of age, we performed pertussis surveillance in Veterans in care at VA medical facilities.

Objective

To perform pertussis surveillance in VA facilities in the Western US.

The National Strategy for Biosurveillance promotes a national effort to improve early detection and enable ongoing situational awareness of all-hazards threats. Implicit in the Strategy’s implementation plan is the need to upgrade capabilities and integrate multiple disparate data sources, including more complete electronic health record (EHR) data into future biosurveillance capabilities. Thus, new biosurveillance applications are clearly needed. Praedico™ is a next generation biosurveillance application that incorporates cloud computing technology, a Big Data platform utilizing MongoDB as a data management system, machine-learning algorithms, geospatial and advanced graphical tools, multiple EHR domains, and customizable social media streaming from public health-related sources, all within a user friendly interface.

Objective

The purpose of our study was to conduct an initial assessment of the biosurveillance capabilities of a new software application called Praedico™ and compare results obtained from previous queries with the Electronic Surveillance System for the Early Notification of Community-Based Epidemics (ESSENCE).

 

VA began using ESSENCE as a public health surveillance tool in 2005. The system offered alerting capability for pre-defined syndromes and querying capability for outpatient ICD-9 diagnosis codes. Herein, we highlight examples of how we have invested in upgrades to analytic capabilities and expanded data sources available to ESSENCE in order to augment the overall utility of this system within VA.

Objective

To describe VA’s experience developing innovative and alternative uses of a surveillance system and improve the overall value proposition of this tool for the agency.

DENV, CHIKV and ZIKV are all transmitted by mosquitoes and have occurred in outbreaks in the Caribbean. Common symptoms (which can be severe and disabling) are similar among the 3 viruses and include fever, joint pain/swelling, headache, muscle pain and rash. In December 2015, the first endemic case of ZIKV infection was reported by VACHS. Since that time, an increasing number of ZIKV infections have been reported in Puerto Rico. Due to the growing ZIKV outbreak, we performed ongoing testing and surveillance.

Objective

We describe surveillance for Dengue virus (DENV), Chikungunya virus (CHIKV) and Zika virus (ZIKV) in VA Caribbean Healthcare System (VACHS) from the start of ZIKV transmission in Puerto Rico.

Many methods to detect outbreaks currently exist, although most are ineffective in the face of real data, resulting in high false positivity. More complicated methods have better precision, but can be difficult to interpret and justify. Praedico™ is a next generation biosurveillance application built on top of a Hadoop High Performance Cluster that incorporates multiple syndromic surveillance methods of alerting, and a machine-learning (ML) model using a decision tree classifier  evaluating over 100 different signals simultaneously, within a user friendly interface.

Objective

To compare syndromic surveillance alerting in VA using Praedico™ and ESSENCE.

It is estimated that in the United States (US), unintentional non-fire related CO poisoning causes an average of 439 deaths annually, and in 2007 confirmed CO poisoning cases resulted in 21,304 ED visits and 2,302 hospitalizations (71 per million and 8 per million population, respectively)1 . Despite the significant risk of morbidity and mortality associated with CO poisoning, existing surveillance systems in the United States are limited. This study is the first to focus specifically on CO poisoning trends within the VHA population.

Objective

To describe characteristics of Veterans Health Administration (VHA) patients with ICD 9/10 CM inpatient discharge and/or emergency department (ED)/urgent care outpatient encounter codes for carbon monoxide (CO) poisoning.

Firearm violence is an issue of public health concern leading to more than 30,000 deaths and 80,000 nonfatal injuries in the United States annually. To date, firearm-related studies among Veterans have focused primarily on suicide and attempted suicide. Herein, we examine firearm violence among VHA enrollees for all manners/ intents, including assault, unintentional, self-inflicted, undetermined and other firearm-related injury encounters in both the inpatient and outpatient settings.