Wiese Michael

Objective:

To describe disease and illness surveillance utilized during the 2012 Republican National Convention (RNC) held August 26-30, 2012 in Tampa, FL.

Introduction:

While the Tampa Bay Area has previously hosted other high profile events that required heightened disease surveillance (e.g., two Super Bowls), the 2012 RNC marked the first national special security event (NSSE) held in Florida. The Hillsborough County Health Department (HCHD), in conjunction with the Pinellas County Health Department (PinCHD) coordinated disease surveillance activities during this time frame. This presentation will focus of the disease surveillance efforts of the Hillsborough County Health Department during the 2012 RNC. In addition to the surveillance systems that are used routinely, the HCHD Epidemiology Program implemented additional systems designed to rapidly detect individual cases and outbreaks of public health importance. The short duration of RNC, coupled with the large number of visitors to our area, provided additional surveillance challenges. Tropical Storm Isaac, which threatened Tampa in the days leading up to RNC, and an overwhelming law enforcement presence likely dissuaded many protestors from coming to Tampa. As a result, a tiny fraction of the number of protestors that were expected actually showed up.

Along with commensurate funding, an increased emphasis on syndromic surveillance systems occurred post September 11, 2001 and the subsequent anthrax attacks. Since then, many syndromic surveillance systems have evolved and have ever-increasing functionality and visualization tools. As outbreak detection using these systems has demonstrated an equivocal track record, epidemiologists have sought out other interesting and unique uses for these systems. Over the numerous years of the International Society for Disease Surveillance (ISDS) conference, many of these studies have been presented, however, there has been a dearth of discussion related to how these systems should be used on a routine basis. As the initial goal of these systems was to provide a near real-time disease surveillance tool, the question of how to most effectively conduct this type of routine surveillance is paramount.

Objective

To discuss how various emergency department based syndromic surveillance systems from across the country and world are being used and to develop best practices for moving forward.

 

Illnesses related to synthetic marijuana use have been reported in many states, including Florida. Because these visits can present with a variety of symptoms, as well as be attributed to numerous diagnosis codes, it can be difficult to identify and quantify these visits. The Electronic Surveillance System for the Early Notification of Community-based Epidemics in Florida (ESSENCE-FL) receives chief complaint (CC) and discharge diagnosis (DD) data as free text allowing uncommon or new terms to be searched for within each patient visit. The main source of data for ESSENCE-FL is emergency department (ED) and urgent care center (UCC) data. There are currently 210 EDs and 33 UCCs throughout Florida that send their data to the ESSENCE-FL server. Using ESSENCE-FL, a free text query of patient CCs and DDs was used to identify visits related to synthetic marijuana use. This study is designed to analyze these identified visits for trends over time, geographical distribution and descriptive statistics and demographics.

Objective

One of the numerous functions of syndromic data has been the identification of visits of public health interest using customized free text queries. A specific query of syndromic data was created to search for and identify emergency department (ED) and urgent care center (UCC) visits possibly related to the use of synthetic marijuana to describe and quantify this public health issue in Florida.

The Florida Department of Health in Hillsborough County (FDOH- Hillsborough) conducts enhanced syndromic surveillance on a daily basis. The Electronic Surveillance System for the Early Notification of Community-based Epidemics in Florida (ESSENCE-FL) is the syndromic surveillance system used by epidemiologists within the Florida Department of Health (FDOH). During the time of this study, ESSENCE-FL receives data from 210 of emergency departments (ED) and 33 urgent care centers (UCC) throughout the state of Florida, including 12 EDs and 3 UCCs in Hillsborough County. In 2014, the ESSENCE-FL system added a feature that delivers an automatic daily email to designated primary ESSENCE-FL users in each county containing all visits which have been detected by the state’s visits of interest (VOI) query. The email contains all visits which have been detected by the visits of interest (VOI) query for each ESSENCE-FL users designated county. The VOI query utilizes the combined chief complaint and discharge diagnosis (CCDD) field of a visit for keywords related to reportable diseases and exposures of public health interest. In addition to this VOI email, Hillsborough County analyzes time of arrival alerts, specialized emerging infectious disease queries, poison information center data, and volume levels of syndromes and subsyndromes predetermined by ESSENCE-FL. A daily summary report of the enhanced daily surveillance analysis is then provided to area public health officials within FDOH-Hillsborough and the surrounding counties. This study examines how visits requiring additional investigation are detected and the resources required to complete the investigation.

Objective

Enhanced daily surveillance is used to identify reportable diseases, outbreaks, and clusters and provides situational awareness. This project examines how health care visits requiring additional information are detected using enhanced syndromic surveillance and the resources required from detection through completion.