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Soetebier Karl

Evidence about the value of syndromic surveillance data for outbreak detection is limited. In July 2018, a salmonellosis outbreak occurred following a family reunion of 300 persons held in Camden County, Georgia, where one meal was served on 7/27/2018 and on 7/28/2018.

Objective: Describe how the Georgia Department of Public Health (DPH) used data from its State Electronic Notifiable Disease Surveillance System (SendSS) Syndromic Surveillance (SS) module for early detection of an outbreak of salmonellosis in Camden County, Georgia.

Submitted by elamb on

The Syndromic Surveillance Program (SSP) of the Acute Disease Epidemiology Section of the Georgia Division of Public Health, provides electronic influenza- like- illness (ILI) data to the Center for Disease Control and Prevention’s Influenza-like Illness Surveillance Network Program that characterizes the burden of influenza in states on a weekly basis.

ILI is defined as a fever of 1001, plus a cough or sore throat. This definition is used to classify ILI by the SSP, as well as in diagnosis at the pediatric hospital system. During the 2009 H1N1 pandemic, the SSP was provided a daily data transfer to the Center for Disease Control and Prevention to heighten situational awareness of the burden of ILI in Georgia. Throughout the peak of the pandemic, data from the pediatric hospital system identified when the percentage of daily visits for ILI had substantively increased. The data includes patient chief complaint (CC) data from emergency department visits for two facilities at Facilities A and B. The data received by SSP does not include diagnosis data.

Patient emergency department discharge data (DD) for ‘FLU’ was provided to SSP retrospectively to compare with the CC data routinely collected and analyzed. The data was derived from the pediatric health system’s month end, internal, syndromic surveillance report based upon emergency department visits, and including physician’s diagnosis at the time of patient’s discharge. The case definition of ‘FLU’ from the pediatric health system facilities is acute onset of fever, with cough and/or sore throat in the absence of a known cause other than influenza.

 

Objective

The objective of this study is to describe the difference between patient CC, ILI data provided daily to the Georgia SSP during the 2009 H1N1 pandemic, and patient DD subsequently provided for comparison with the SSP from its participating pediatric hospital system, and its two affiliated emergency rooms.

Referenced File
Submitted by hparton on

On August 29, 2005, Hurricane Katrina made landfall just east of New Orleans, LA at 6:10AM CST and again at the LA/MS border at 10:00AM CST as a Category 3 hurricane, causing mass destruction along their coastlines. The devastation in LA and MS forced many residents to evacuate. Outside of the hurricane affected areas of LA, MS, and AL, GA received the second largest number of evacuees (approximately 125,000).

 

Objective

To describe the victims of Hurricane Katrina who evacuated to GA and to assess their impact on emergency departments enrolled in GA’s syndromic surveillance system.

Referenced File
Submitted by elamb on

There are multiple sources of influenza and influenza-like illness (ILI) surveillance data within the state of Georgia. These include laboratory surveillance for influenza viruses, sentinel providers that report ILI, pneumonia and influenza mortality, influenza-associated hospitalizations, and influenza-associated pediatric deaths. The usefulness of emergency department-based (ED) syndromic surveillance (SS) data as an additional source of ILI surveillance data is currently being evaluated at national, state, and local levels.

 

Objective

To describe Georgia’s experience using ED-based SS as a source of influenza-like illness surveillance data.

Referenced File
Submitted by elamb on

As the Georgia Division of Public Health began constructing a systems interface for its syndromic surveillance program, the nature and intended use of these data inspired new approaches to interface design. With the temporal and spatial components of these data serving as fundamental determinants within common aberration detection methods (e.g., Early Aberration Reporting System, SaTScan™), it became apparent that an interface technique that could present a synthesis of the two might better facilitate the visualization, interpretation and analysis of these data.

Typical presentations of data spatially oriented at the zip code level use a color gradient applied to a zip code polygon to represent the differences in magnitude of events within a given region across a particular time span. Typical presentations of temporally oriented data use time series graphs and tabular formats. Visualizations that present both aspects of spatially and temporally rich datasets within a single visualization are noticeably absent.

 

Objective

This paper describes an approach to the visualization of disease surveillance data through the use of animation techniques applied to datasets with both temporal and geospatial components.

Referenced File
Submitted by elamb on

Although many syndromic surveillance (SS) systems have been developed and implemented, few have included response protocols to guide local health jurisdictions when alerts occur [1,2]. SS was first implemented in GA during the 2004 G-8 Summit. Six EDs in the Coastal Public Health District (PHD), 1 of 18 GA PHDs (Figure 1), conducted SS during that “national security special event.” Since that time, EDs in other PHDs have been actively recruited to participate in GA’s SS system. In GA, the PHD has the responsibility for monitoring SS data. Likewise, the PHD responds to alerts and initiates public health investigations and interventions; the state Division of Public Health (DPH) assists, if requested. To address these responsibilities, the Coastal PHD informally developed their own response practices.

Objective

To develop a template protocol to guide local response to syndromic surveillance alerts generated through analyses of emergency department (ED) visit data.

Referenced File
Submitted by elamb on

The Georgia Power Corporation (GPC) provides power to 155 (97.5%) of the 159 counties in Georgia (GA), and employs 9,600 people throughout the state. GPC is engaged in preparing for pandemic influenza, and committed to protecting the critical infrastructure and ensuring its continuity of operations. The GPC employee “Crisis Absence Reporting Tool” (CART) was designed to provide the Georgia Syndromic

Surveillance (GA SS) Program with employee absentee/ reason to inform Public Health and GPC leadership about health events occurring in their employees statewide.

The GA SS Program has been implemented in 13 (72%) of the 18 Health Districts. In each of these locations, data are transferred from an ED, ambulatory care center, or school district to the Georgia Division of Public Health (GDPH) for analysis and dissemination of results to all stakeholders. GDPH wanted to collaborate with a large corporation with a statewide employee base to conduct absentee and reason for absence SS to provide an additional perspective to the existing data streams used by GA SS.

In GA, the LHD are responsible for organizing pandemic planning committees comprised of community partners to discuss continuity of basic services and maintenance of the critical infrastructure at the local level during an influenza pandemic. Increasing SS capacity is an important component of Local Health District (LHD) pandemic planning strategies in GA.

 

Objective

To create a non-traditional partnership between the GPC and the GDPH to aid in adverse health event detection and response activities during an influenza pandemic or other health emergency. This will include augmenting CART with SS data from the GA SS Program. These data will be analyzed by GA SS and results disseminated to LHDs, who monitor and respond to SS data in their jurisdictions. Analyses will also be provided to GPC to aid in resource allocation to ensure the continuity of services in GA during emergencies.

Referenced File
Submitted by elamb on

On Monday, August 29, 2005, Hurricane Katrina struck the Gulf Coast. Outside of the affected areas of TX, LA, MS, and AL, GA received the largest number of these evacuees, approximately 125,000. By August 30, 2005, GA began receiving a total of approximately 1,300 NDMS patients from flights arriving at Dobbins Air Force Base. Within days, Georgia established 13 shelters for evacuees. Crowded shelters can increase the risk for communicable diseases. In addition, many evacuees left behind needed medications, thus increasing the risk for chronic disease exacerbations.

 

Objective

To assess public health needs among sheltered evacuees, the GA Department of Human Resources, Division of Public Health recommended daily surveillance.

Referenced File
Submitted by elamb on

The Georgia DPH has used its State Electronic Notifiable Disease Surveillance System (SendSS) Syndromic Surveillance (SS) module to collect, analyze and display analyses of ED patient visits, including DDx data from hospitals throughout Georgia for early detection and investigation of cases of reportable diseases before laboratory test results are available. Evidence on the value of syndromic surveillance approaches for outbreak or event detection is limited. Use of the DDx field within datasets, specifically as it might be used for investigation of outbreaks, clusters, and / or individual cases of reportable diseases, has not been widely discussed.

Objective:

To describe how the Georgia Department of Public Health (DPH) uses ICD-9 and ICD-10-based discharge diagnoses (DDx) codes assigned to Emergency Department (ED) patients to support the early detection and investigation of outbreaks, clusters, and individual cases of reportable diseases.

Submitted by elamb on
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