Cyclosporiasis v1

Query purpose: 

Created by the CDC National Syndromic Surveillance Program (NSSP) for use with emergency department data to develop queries for all National Notifiable Diseases defined by the National Notifiable Diseases Surveillance System (NNDSS). While the disease queries refer to the NNDSS case definition, the queried data may not align with what is classified as a case in 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 of cyclosporiasis to identify diagnostic codes (International Classification of Diseases, 9th & 10th Revision (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, and exclusions are incorporated as necessary.

• Inclusion based on cyclosporiasis chief complaint free text terms:
  • The visit is included if it contains:
    1. A chief complaint related to Cyclosporiasis (“cyclosporia” or “cyclospora”) OR
• Inclusion based on ICD-10 discharge diagnosis codes related to cyclosporiasis:
  • The visit is included if it contains:
    1. A discharge diagnosis code for Cyclosporiasis (A07.4) OR
• Inclusion based on ICD-9 discharge diagnosis codes related to cyclosporiasis:
  • The visit is included if it contains:
    1. A discharge diagnosis code for Cyclosporiasis (007.5) OR
• Inclusion based on SNOMED discharge diagnosis codes related to cyclosporiasis:
  • The visit is included if it contains:
    1. A discharge diagnosis code for Cyclosporiasis (716860005 or 240372001 or 721810002) OR
    2. A discharge diagnosis code for Cyclospora (103560006 or 103561005)
• There are no exclusions in this query.

Plain Language Description:

The definition uses discharge diagnosis codes and free-text chief complaint terms. The definition requires that an emergency department visit contains a reference to the disease by its discharge diagnosis code (in at least one of the following: ICD-10-CM, ICD-9-CM, SNOMED diagnostic codes), or by the disease or pathogen name listed in the chief complaint text. Therefore, the cyclosporiasis syndromic surveillance definition includes ICD-10-CM, ICD-9-CM, and SNOMED diagnostic codes for cyclosporiasis, along with direct mentions of cyclosporiasis using “cyclosporia” or the pathogen name “cyclospora” in chief complaint text.