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The rate of drug overdose deaths in the United States has increased steadily since 2000. Injection drug use, a practice associated with infectious disease transmission, has likely increased along with this upward trend in drug overdoses. Injection drug use surveillance is difficult to conduct at a public health department because there are no specific Internal Classification of Diseases codes to identify this risk behavior in hospital discharge or vital registration data. Maricopa County Department of Public Health Office of Epidemiology aimed to identify indications of injection drug use within data from the Office of the Medical Examiner.

Objective: To determine whether data from the Office of the Medical Examiner are useful for conducting injection drug use surveillance in Maricopa County, Arizona, and to describe the characteristics of decedents who died from a drug overdose, were investigated by the county's medical examiner, and had an indication of injection drug use.

Submitted by elamb on

In January 2017, the NSSP transitioned their BioSense analytical tools to Electronic Surveillance System for Early Notification of Community-Based Epidemics (ESSENCE). The chief complaint field in BioSense 2.0 was a concatenation of the record's chief complaint, admission reason, triage notes, and diagnostic impression. Following the transition to ESSENCE, the chief complaint field was comprised of the first chief complaint entered or the first admission reason, if the chief complaint was blank. Furthermore, the ESSENCE chief complaint field was electronically parsed (i.e., the original chief complaint text was altered to translate abbreviations and remove punctuation). This abstract highlights key findings from Maricopa County Department of Public Health's evaluation of the new chief complaint field, its impact on heat-related illness syndromic surveillance, and implications for ongoing surveillance efforts.

Objective:

To evaluate the effect and implications of changing the chief complaint field during the National Syndromic Surveillance Program (NSSP) transition from BioSense 2.0 analytical tools to BioSense Platform ESSENCE.

Submitted by elamb on

On 3/29/2017, the Maricopa County Department of Public Health (MCDPH) received three reports of confirmed HAV infection from an onsite clinic at Campus A that assists individuals experiencing homelessness, a population at risk for HAV transmission. To identify the scope of the problem, the department initiated rapid HAV infection case detection using NSSP ESSENCE.

Objective:

To demonstrate the utility of the National Syndromic Surveillance Program’s (NSSP) version of the Electronic Surveillance System for Early Notification of Community-based Epidemics (ESSENCE) for case detection during a 2017 outbreak of hepatitis A virus (HAV) infection among persons experiencing homelessness in Maricopa County, Arizona.

Submitted by elamb on

Timely identification of arboviral disease is key to prevent transmission in the community, but traditional surveillance may take up to 14 days between specimen collection and health department notification. Arizona state and county health agencies began monitoring National Syndromic Surveillance Program BioSense 2.0 data for patients infected with West Nile virus (WNV), St. Louis encephalitis virus (SLEV), chikungunya, or dengue virus in August 2015. Zika virus was added in April 2016. Our novel methods were presented at the International Society for Disease Surveillance 2015 Annual Conference. Twice per week, we queried patient records from 15 Maricopa County BioSense-enrolled emergency department and inpatient hospitals for chief complaint keywords and discharge diagnosis codes. Our Case Investigation Decision Tree helped us determine whether records had a high or low degree of evidence for arboviral disease and necessitated further investigation. This study evaluated how Arizona’s protocol for conducting syndromic surveillance compared to traditional arboviral surveillance in terms of accuracy and timeliness in Maricopa County from August 2015 through December 2016.

Objective:

To evaluate Arizona’s arboviral syndromic surveillance protocol in Maricopa County.

Submitted by elamb on

Arizona is facing multiple public health threats from arboviral diseases. State and local public health departments are monitoring two mosquito-borne outbreaks within its borders and two in adjacent territories. To prevent transmission, viremic patients must be identified in a timely manner and encouraged to avoid additional mosquito exposure and vector control actions must be implemented. Using traditional surveillance, however, health departments may not be alerted until the laboratory confirms and reports a positive result, which may take up to 14 days after specimen collection. The Arizona Department of Health Services (ADHS) partnered with local public health jurisdictions to enhance traditional arboviral surveillance by incorporating syndromic surveillance.

Objective

To develop a protocol for enhancing traditional arboviral surveillance with syndromic surveillance and to evaluate the protocol for accuracy, effectiveness, and timeliness

Submitted by Magou on

Monitoring heat-related illness (HRI) is a public health priority in Maricopa County, Arizona. Since 2006, Maricopa County Department of Public Health has utilized data from hospital discharges, medical examiner preliminary reports, and death certificates to quantify heat-related morbidity and mortality, but these surveillance methods take time. Identifying HRI more quickly would improve situational awareness and allow public health officials to launch a more immediate response to extreme heat events. Arizona began using BioSense 2.0 in July 2014 to collect chief complaint and diagnosis data for syndromic surveillance. The BioSense Front End Application uses a standard query definition for HRI (i.e., “Heat, excessive”), but this definition may perform differently for each jurisdiction.

Objective

To evaluate the pre-defined “Heat, excessive” query in BioSense 2.0 using recent Maricopa County, Arizona data; quantify the number of cases retrieved by the query due to chief complaint terms rather than clinical diagnosis; and provide a list of terms to be considered for exclusion criteria while developing a custom query

Submitted by teresa.hamby@d… on

The mission of the Maricopa County Department of Public Health (MCDPH; Arizona) is to protect and promote the health and well-being of its residents and visitors. Surveillance efforts allow epidemiologists to quantify and characterize public health threats, but traditional methods take time. In an effort to enhance situational awareness, the Office of Epidemiology dedicated resources to begin developing a robust syndromic surveillance program. This abstract outlines steps for enhancing syndromic surveillance at a local public health department.

Objective

To demonstrate how a local public health department used the Centers for Disease Control and Prevention (CDC) Framework for Program Evaluation and a logic model to enhance its syndromic surveillance program.

Submitted by teresa.hamby@d… on
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