Zhang Guoyan

The threat of pandemic and seasonal influenza has drawn attention to syndromic surveillance systems for early detection of influenza-like illness. Since 2005, the Miami-Dade County Health Department has implemented ESSENCE (Electronic Surveillance System for the Early Notification of Community-based Epidemics) to monitor emergency department data for influenza-like Illness (ILI) using chief complaint information. This study evaluates the ability of the ESSENCE ILI chief complaint grouping for identifying true ICD-9 diagnosed influenza.

Objective

Previous studies have examined the utility of different methods of syndromic grouping. This study evaluates the utility of ESSENCE for ILI surveillance.

The Miami-Dade County Health Department currently utilizes Emergency Department based Syndromic surveillance data, 911 Call Center data, and more recently Public School Absenteeism data. Daily monitoring of school absenteeism data may enhance early outbreak detection in Miami-Dade County in conjunction with the use of other syndromic systems. These systems were employed to detect any possible outbreaks resulting from a large outdoor festival occurring March 11th, 2007. This event had an estimated 1 million visitors and it ended at 7:00 p.m.

Objective

Utility of school absenteeism data to enhance syndromic surveillance activities for unusual public health events or outbreak detection.

Although Electronic Surveillance System for the Early Notification of Community Based Epidemics (ESSENCE) provides tools to detect a significant alert regarding an unusual public health event, combining that information with other surveillance data, such as 911 calls, school absenteeism and poison control records, has proved to be more sensitive in detecting an outbreak. On Monday, June 16, Florida Poison Information Network, which takes after-hours and weekend calls for Miami-Dade County Health Department (MDCHD), contacted the Office of Epidemiology and Disease Control about five homeless persons that visited the same hospital simultaneously with gastrointestinal symptoms on Saturday, June 14. Poison control staff asked MDCHD to investigate further to determine whether it was an outbreak.

Objective

To illustrate how MDCHD utilized ESSENCE in order to track a gastrointestinal outbreak in a homeless shelter.

In 2005, three hurricanes made landfall in Florida, with Hurricane Wilma having the most severe impact on Miami-Dade County. Syndromic surveillance is typically used to detect bioterrorism or natural disease outbreaks before specific diagnoses are made. After Wilma, however, the Miami-Dade County Health Department assessed the utility of syndromic data for surveillance of hurricane-related injuries.

Objective

To determine the proportion of injuries in Miami-Dade County that could be related to the impact of Hurricane Wilma, which made landfall in Florida on October 25, 2005.

Syndromic surveillance is an investigational approach used to monitor trends of illness in communities. It relies on pre-diagnostic health data rather than laboratory-confirmed clinical diagnoses. Its primary purpose is to detect disease outbreaks, incidents and unusual public health events earlier than possible with traditional public health surveillance methods.

Objective

To describe how epidemiological principles are utilized to distinguish a real alert from statistically significant alerts in order to monitor and create daily reports in the Miami-Dade County Health Department using Electronic Surveillance System for the Early Notification of Community Based Epidemics. 

When the Chicago Bears met the Indianapolis Colts for Super Bowl XLI in Miami in January, 2007, fans from multiple regions visited South Florida for the game. In the past, public health departments have instituted heightened local surveillance during mass gatherings due to concerns about increased risk of disease outbreaks. For the first time, in 2007, health departments in all three Super Bowl-related regions already practiced daily disease surveillance using biosurveillance information systems (separate installations of the ESSENCE system, developed at JHUAPL). The situation provided an opportunity to explore ways in which separate surveillance systems could be coordinated for effective, short-term, multijurisdictional surveillance.

Objective

This paper describes an inter-jurisdictional surveillance data sharing effort carried out by public health departments in Miami, Chicago, and Indianapolis in conjunction with Super Bowl XLI.

The 2005 Youth Risk Behavior Survey of 9th to 12th graders in Miami-Dade County public schools found that 69.7% of students tried alcohol, 28.3% tried marijuana, and 6.3% tried cocaine in their lifetime. Results also showed that Hispanics had a higher percentage of usage when compared to Blacks or Whites. The 2007 White House Office of National Drug Control Policy special report entitled “Hispanic Teens and Drugs” also concluded that Hispanics were at the highest risk for substance abuse. With the county’s 60% Hispanic population, this issue is of concern for the community. This is the first study to compare multiple sources of data to describe substance abuse among youth from areas such as healthcare utilization to criminal charges.

Visitors from areas outside Miami-Dade County have the potential to introduce diseases and/or strains of microorganisms circulating in their regions of residence. Immunocompromised and immunonaive travelers are at higher risk of contagion by locally transmitted pathogens. The first encounter with a local health care facility for many of these visitors is often an Emergency Departments (ED). Little is known about this group of patients with regard to socio-demographic and temporal patterns. This knowledge is essential to further characterize their syndromic patterns as well as to integrate this knowledge to the growing use of syndromic surveillance as an early-warning public health tool.

Objective

To describe socio-demographic and temporal patterns of patients who reside outside Miami-Dade and who visited EDs of hospitals located in this County during 2007.

To illustrate how ESSENCE can been utilized to collaborate with healthcare practitioners in order to improve communicable disease reporting