Monitoring for Local Transmission of Zika Virus using Emergency Department Data

The first travel-associated cases of Zika virus infection in New York City (NYC) were identified in January 2016. Local transmission of Zika virus from imported cases is possible due to presence of Aedes albopictus mosquitos. Timely detection of local Zika virus transmission could inform public health interventions and mitigate additional spread of illness. Daily emergency department (ED) visit surveillance to detect individual cases and spatio-temporal clusters of locally-acquired Zika virus disease was initiated in June 2016. 

Objective

July 16, 2017

Investigating a Syndromic Surveillance Signal with Complimentary Data Systems

From June 4-8, 2015, the New York City (NYC) syndromic surveillance system detected five one-day citywide signals in sales of over-the-counter (OTC) antidiarrheal medications using the CUSUM method with a 56-day moving baseline. The OTC system monitors sales of two classes of antidiarrheal medications, products with loperamide or bismuth, from two NYC pharmacy chains. To determine if this increase reflected a concerning cluster of diarrheal illness, we examined multiple communicable disease surveillance data systems.

Objective

October 10, 2017

Epidemiology of Gunshot-Related Injuries in NYC Emergency Departments from 2004-2014

Syndromic surveillance has demonstrated utility for situational awareness for non-infectious conditions, including tracking and monitoring gun-related violence and homicides. While New York State reports an overall decrease in gun-related crimes, in NYC identifying smaller scale aberrations of gunshot-related violence can prompt more efficient response by city groups. We examined the temporal and borough-level characteristics of gunshot-related emergency department (ED) visits in NYC.

Objective

October 13, 2017

Tracking HIV Post-Exposure Prophylaxis using Syndromic Surveillance in NYC Emergency Departments

HIV post-exposure prophylaxis (PEP) involves taking antiretroviral medication after potential exposure to HIV to reduce the probability of becoming infected.

November 06, 2017

Detecting Unanticipated Increases in Emergency Department Chief Complaint Keywords

The CC text field is a rich source of information, but its current use for syndromic surveillance is limited to a fixed set of syndromes that are routine, suspected, expected, or discovered by chance. In addition to syndromes that are routinely monitored by the NYC Department of Health and Mental Hygiene (e.g., diarrhea, respiratory), additional syndromes are occasionally monitored when requested by outside sources or when expected to increase during emergencies.

August 22, 2018

Using Syndromic Surveillance to Investigate Tattoo-related Skin Infections in NYC

In 2012, an outbreak of Mycobacterium chelonae infections in tattoo recipients in Rochester, NY was found to be associated with premixed tattoo ink contaminated before distribution.1 In May 2012, a case of M. chelonae was reported in a New York City (NYC) resident who received a tattoo with ink alleged to have been diluted with tap water. When a second case of M. chelonae in a tattoo recipient was reported in March 2013, an investigation was initiated. M. chelonae is not reportable in NYC other than in clusters reported by providers or laboratories.

May 02, 2019

Long-Term Asthma Trend Monitoring in New York City: A Mixed Model Approach

Over the last decade, the application of syndromic surveillance systems has expanded beyond early event detection to include longterm disease trend monitoring. However, statistical methods employed for analyzing syndromic data tend to focus on early event detection. Generalized linear mixed models (GLMMs) may be a useful statistical framework for examining long-term disease trends because, unlike other models, GLMMs account for clustering common in syndromic data, and GLMMs can assess disease rates at multiple spatial and temporal levels (1).

May 17, 2018

Comparison of respiratory, febrile and influenza-like illness syndromes to detect laboratory-reported H1N1 and RSV, Influenza Season 2009–10, New York City

The New York City (NYC) Department of Health and Mental Hygiene monitors visits daily from 49 of 54 NYC emergency departments (EDs), capturing 95% of all ED visits. ED visits for influenza-like illness (ILI) have reflected influenza activity in NYC, better than the more broadly defined fever/flu and respiratory syndromes, but the correlation with H1N1 is unknown. 

Laboratory-confirmed influenza and respiratory syncytial virus (RSV) were made reportable in NYC in February 2008. DOHMH receives electronic reports of positive tests. 

June 14, 2019

Increased emergency department presentations for head trauma following media coverage of a fatal epidural hematoma

Previous reports have demonstrated the media’s influence on emergency departments (ED) visits in situations such as dramatized acetaminophen overdose, media report of celebrity suicides, television public announcements for early stroke care and cardiac visits following President Clinton’s heart surgery. No previous study has demonstrated the influence of media-publicized trauma on ED visits. On 16 March 2009, the actress Natasha Richardson suffered a traumatic brain injury leading to her death on 18 March; these events were widely publicized by national news sources.

June 26, 2019

Increased emergency department presentations for head trauma following media coverage of a fatal epidural hematoma

Previous reports have demonstrated the media’s influence on ED visits in situations such as dramatized acetaminophen overdose, media report of celebrity suicides, television public announcements for early stroke care and cardiac visits following President Clinton’s heart surgery. No previous study has demonstrated the influence of media-publicized trauma on ED visits. On 16 March 2009, the actress Natasha Richardson suffered a traumatic brain injury leading to her death on 18 March; these events were widely publicized by national news sources.

June 27, 2019

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