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Yang Biru

Syndromic data is shifting the way surveillance has been done traditionally. Most recently, surveillance has gone beyond city limits and county boundary lines. In southeast Texas, a regional consortium of public health agencies and stakeholders in the 13-County area governs the local ESSENCE system. The Houston Health Department, (HHD) is responsible for deploying ESSENCE to the entire region. To effectively monitor the health of the region's population, a need arose to establish clear guidelines for disease investigation and data sharing triggered by syndromic surveillance across the area. Since Houston's instance of ESSENCE serves all 13 counties, the consortium instituted a cross- jurisdictional etiquette group. The purpose of the group is to determine the standard protocol for responding to ESSENCE alerts and best practices for data sharing and use among consortium members.

Objective: To demonstrate the importance of a cross-jurisdictional etiquette workgroup in the Texas Southeast region that leverages on the Syndromic Surveillance Consortium. To promote data sharing and communicate the findings of disease to assist rapid investigation and data sharing.

Submitted by elamb on

On August 25, 2017 Hurricane Harvey moved onshore near Port Aransas, Texas, eventually overwhelming areas of Houston with between 41-60 inches of rain (Houston Health Department [HHD], 2017). As a category 4 storm, with wind speeds as high as 130 mph, Harvey broke several rainfall records across the state and ended the prolonged period of twelve years in which no major hurricanes had made landfall in the United States (Mersereau, 2017). Harvey ambled at a leisurely pace through Houston and resulted in devastating flooding that destroyed homes and required the evacuation of approximately 37,000 Houstonians to over 78 shelter facilities across the affected area (HHD, 2017). Through concerted efforts, the American Red Cross and the HHD established the shelter at the George R. Brown Convention Center (GRB) and delivered or coordinated social services, medical and mental health services, disease surveillance and food/sanitary inspection services for the duration of the need for the shelter (HHD, 2017).

Objective: To provide recommendations for future preparedness response efforts based on an assessment of the Post-Hurricane Harvey After-Action Report (AAR).

Submitted by elamb on

Extreme heat events over the past 30 years have resulted in unprecedented increase in the numbers of heat-related morbidity and mortality across the world (1-3). During the same time frame, Houston residents has experienced three of the hottest summers on record since 1889, with 2011 being the hottest summer on record (4). Therefore, preparing for extreme heat events and monitoring their effects on public health is a vital role for the Houston Department of Health and Human Services (HDHHS). Since heat-related illnesses are not a reportable condition in the state of Texas, HDHHS authorities rely on other sources to provide information on the impact of heat on the population. HDHHS is currently able to monitor emergency departments (ED) visits across the Houston metropolitan area, Harris County, and the surrounding jurisdictions by using a syndromic surveillance system called Real-time Outbreak Disease Surveillance (RODS). The RODS system collects de-identified patient data that consists of their chief complaint and basic demographics (e.g. age, sex, zip code). This study is aimed at evaluating the ability of RODS to detect heat-related illnesses during heat event of the years 2009-2012 as well as identifying the areas of Houston that had the highest incidence of heat-related morbidity.

Objective

To evaluate the ability of a syndromic surveillance system to detect heat-related illnesses during a heat wave in Houston and to identify areas in Houston that requires additional resources to prevent heat-related illnesses.

Submitted by knowledge_repo… on

The Houston Department of Health Department of Health and Human Services (HDHHS) monitors emergency departments (ED) chief complaints across the Houston metropolitan area, Harris County, and the surrounding jurisdictions by Real-time Outbreak Disease Surveillance (RODS). The influenza-like illnesses (ILI) data is collected by sentinel surveillance provider network of 12 physicians and RODS, an electronic syndromic surveillance database consisting of about 30 EDs in metropolitan Houston. Previous research indicates that there is a relationship between new HIV diagnoses and neighborhood poverty. However, there is limited research on health disparity to investigate the association between influenza-like illnesses (ILI) and social determinants of health (SDH), such as poverty.

Objective

To investigate the association between social determinants of health and influenza-like illnesses in Houston/Harris County and to identify neighborhoods for targeted surveillance or interventions.

Submitted by knowledge_repo… on

In 2011, injury by firearms accounted for 32,351 deaths (10.4 deaths per 100,000 population) in the United States. This rate was higher than any infectious or parasitic disease (the highest being 2.5 for both viral hepatitis and HIV disease). Furthermore, death by gunshots accounted for over half of all suicides and over two-thirds of all homicides in the US. Despite the disproportionate media coverage of mass shootings and assault weapon violence, the vast majority of these deaths are attributable to non-mass shootings and to handguns. Though a contentious issue in the United States, understanding this cause of death is vital to confronting the issue locally and nationally. Traditionally, death certificates, crime data, cross-sectional studies, and retrospective studies have most commonly been utilized in this endeavor; however, the collection of real-time emergency department (ED) visit information presents a unique opportunity to track gunrelated injuries to supplement our current understanding of this issue. The Houston Department of Health and Human Services (HDHHS) has been receiving this information for over a decade from EDs in the greater-Houston area, and the department is currently connected to 32 of the largest EDs in the area. The current study aims to enhance the understanding of gunshot-related injuries in the Houston area and present a model for utilizing RODS information for this purpose.

Objective

To introduce a model to track gunshot-related injuries, describe gun-related injuries in Houston, and investigate the association between gun-related injuries and social determinants of health using syndromic surveillance data.

Submitted by teresa.hamby@d… on

Since November 2014, the Houston Health Department has been receiving antimicrobial resistance information for Streptococcus pneumoniae from a safety net hospital via electronic laboratory reporting (ELR). Antimicrobial characteristics and vaccination rates of pneumococcal disease are of public health interest due to potential implications in treatment and prevention. Ten states participate in the CDC’s Active Bacterial Core surveillance (ABCs) program. Texas, which represents a different and diverse demographic compared to other states, is not an ABCs participating state. No studies have compared local antimicrobial susceptibility percentages to those of the ABCs. The aim of this study is to 1) report the antimicrobial susceptibility of S. pneumoniae in a local cohort, 2) characterize the demographics of the cohort including the use of pneumococcal vaccine, and 3) compare antimicrobial susceptibility percentages of the local cohort to the 2013 ABCs program.

Objective

Our objective is to report the antimicrobial susceptibilities of Streptococcus pneumoniae received from a local safety net hospital via electronic laboratory reporting (ELR), and compare susceptibility percentages with those of the Centers for Disease Control and Prevention’s Active Bacterial Core surveillance (ABCs) program.

Submitted by Magou on

Approximately 2.7 million Americans live with chronic HCV, with roughly 30,000 new cases in 2013. Fortunately, recent clinical trials have shown great advances using interferon-free, oral direct-acting antivirals, with cure rates over 95% . But only a few people have been treated, and most are unaware of the infection. This presents an opportunity for public health to address unmet needs, but most jurisdictions have limited surveillance and prevention efforts. Leveraging HCV surveillance, this analysis presents a cost-effective method to improve situational awareness and guide prevention efforts in Houston.

Objective

To describe the use of Hepatitis C Virus (HCV) viral load (VL) results and geospatial analysis to guide prevention efforts.

Submitted by teresa.hamby@d… on

Syndromic surveillance systems are large and complex technology projects that increasingly require large investments of financial and political capital to be sustainable. What was once a minor surveillance tool in the mid-2000s has evolved into a program that is regarded as valuable to public health yet is increasingly difficult to maintain and operate for local health departments. The Houston Health Department installed a syndromic surveillance system (SyS) six years before Meaning Use became known to healthcare communities. The system chosen at the time was the Real-time Outbreak Disease Surveillance System (RODS) which, at the time and for its purpose, was a suitable platform for syndromic surveillance. During the past 13 years however, maintaining, operating, and growing a SyS by a local health department has become increasingly difficult. Inclusion in Meaningful Use elevated the importance and profile of syndromic surveillance such that network growth, transparency of operations, ease of data sharing, and cooperation with other state systems in Texas became program imperatives.

Objective

Describe and explain the transition of the syndromic surveillance program at the Houston Health Department (HHD) from being a locally managed and aging system to an ESSENCE system governed by a regional Consortium of public health agencies and stakeholders in the 13-county area of the southeast Texas

Submitted by Magou on

Since 2009, Houston Health Department (HHD) uses an electronic disease surveillance system (Maven) to receive ELRs from reporting facilities in the Houston jurisdiction. Currently, two large hospital systems, a blood bank, two large commercial labs, and two public health labs are sending ELRs to Maven. The overall percentage of disease reports received via ELR was over 50%. We hypothesize that the implementation of ELR has improved the timeliness and completeness of disease surveillance.

Objective

Review 5 years of surveillance data post electronic lab reporting (ELR) implementation and 8 years of data prior to ELR, to evaluate timeliness and completeness of disease surveillance.

Submitted by teresa.hamby@d… on

The Syndromic Surveillance Consortium of Southeast Texas (SSCSeT) consists of 13 stakeholders who represent 19 counties or jurisdictions in the Texas Gulf Coast region and receives health data from over 100 providers. The Houston Health Department (HHD) maintains and operates the syndromic surveillance system for the Gulf Coast region since 2007. In preparation for Meaningful Use (MU) the HHD has adapted and implemented guidance and recommendations from Centers for Disease Control and Prevention, Office of National Coordinator for Health Information Technology and others. HHDs goal is to make it possible for providers meet MU specification by facilitating the transmission of health related data for syndromic surveillance. The timing of the transition into MU overlaps with the change in syndromic surveillance systems. 

Presenters

Eunice R. Santos, Wesley McNeely, Biru Yang and Raouf R. Arafat - Office of Surveillance and Public Health Preparedness, Houston Health Department, Houston, TX, USA 

Submitted by uysz on
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