Cholera v1

Query purpose: 

Created by the CDC National Syndromic Surveillance Program (NSSP) for use with ED data as part of the rapid reportables project, which seeks to create queries for all National Notifiable Diseases defined by the National Notifiable Diseases Surveillance System (NNDSS). This query is intended to be a version 1 and may be further improved upon by the NSSP community of practice in the future. This query is intended to be narrow and capture visits with specific terms to support greater monitoring and actionable public health data. More complex and/or broader queries may exist that more broadly capture symptoms or travel-based terms.

How it was developed: 

1. The CDC team used the NNDSS case definition for cholera infections to identify diagnostic codes (International Classification of Diseases, 9th & 10th Revisions (ICD-9-CM, ICD-10-CM), SNOMED Clinical Terms (CT)) and chief complaint free text for syndrome development.
2. The codes and free text were then categorized as inclusion or exclusion terms. These terms were formatted for querying in ESSENCE.
3. Text analysis was conducted on the initial query to find additional inclusion or exclusion terms.
4. The query was cross-checked internally by NSSP and by CDC subject matter experts as needed.

How it works:

The Chief Complaint Discharge Diagnosis (CCDD) parsed field is used to query both the discharge diagnosis codes and chief complaint free text.

• Inclusion based on cholera-related chief complaint free-text terms:
  • The visit is included if it contains:
    1. Chief complaints related to the pathogen name – (“chol[ae]r[ae]”) OR
• Inclusion based on ICD-10 discharge diagnosis codes related to cholera:
  • The visit is included if it contains:
    1. A discharge diagnosis code of Cholera (A00) OR
• Inclusion based on ICD-9 discharge diagnosis codes related to cholera or vibrio cholerae:
  • The visit is included if it contains:
    1. A discharge diagnosis code of Cholera due to Vibrio cholerae (001.0) OR
    2. A discharge diagnosis code of Cholera due to Vibrio cholerae el tor (001.1) OR
    3. A discharge diagnosis code of Cholera, unspecified (001.9) OR
• Inclusion based on SNOMED discharge diagnosis codes related to cholera or Vibrio cholerae:
  • The visit is included if it contains:
    1. A discharge diagnosis code of Cholera (63650001) OR
    2. A discharge diagnosis code of Cholera - non-O1 group Vibrio (240350003) OR
    3. A discharge diagnosis code of Cholera - O139 group Vibrio cholerae (240351004) OR
    4. A discharge diagnosis code of Inflammation of intestine caused by Vibrio cholerae (1193750009) OR
    5. A discharge diagnosis code of Cholera caused by Vibrio cholerae El Tor (81020007) OR
    6. A discharge diagnosis code of Inflammation of small intestine caused by Vibrio cholerae (1193749009) OR
    7. A discharge diagnosis code of Non-O1 and non-O139 Vibrio cholerae infection (707525005) OR
    8. A discharge diagnosis code of Intestinal infection caused by Vibrio cholerae O1 (447282003) OR
    9. A discharge diagnosis code of Cholera caused by Vibrio cholerae O1 Classical biotype (240349003) OR
    10. A discharge diagnosis code of Intestinal infection caused by Vibrio cholerae non-O139 (446672004)
• All of the above must exclude:
  • Chief Complaint terms related to cholera vaccination or surgery – (“vac[x]”, “surg”) OR
  • ICD-10 discharge diagnosis codes related to cholera vaccination:
    1. A discharge diagnosis code of Encounter for immunization (Z23) OR
  • SNOMED discharge diagnosis codes related to cholera vaccination:
    1. A discharge diagnosis code of Adverse reaction to component of vaccine product containing Vibrio cholerae antigen (219082005)