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Incorporating Wisconsin Syndromic Data in ILI Surveillance

Public Health Problem (100 words)

The 2017-2018 influenza season was the first to be classified as "high severity" across all age groups since 2003.1 Influenza-like illness (ILI) peaked at 7.5%, the highest since the 2009 pandemic.1 It was also the longest season in recent history, coming in at or above the national baseline for 19 weeks.1 

In Wisconsin, 7,520 people were hospitalized and 379 people died due to influenza-related complications during the 2017-2018 season.2 Broadening the reach of weekly ILI surveillance is crucial in preparing for the future. Syndromic data has the potential to dramatically increase the reach and volume of data used in ILI surveillance.

 

Success Story Narrative (400 words)

The Wisconsin Department of Health Services (DHS) collects ILI data through the U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet).3 ILINet is operated by the Centers for Disease Control and Prevention (CDC) and receives data from outpatient health care facilities.3 BioSense is a separate database that contains syndromic surveillance data and consists of nearly 700 reporting facilities in Wisconsin. Approximately 85% of emergency rooms in Wisconsin are currently reporting to BioSense. 

The Syndromic Surveillance Team reached out to the Bureau of Communicable Diseases (BCD) to assess the possibility of incorporating syndromic data into the process of tracking ILI in Wisconsin. BCD staff reached out to the CDC and determined that high performing emergency rooms could be onboarded to ILINet from BioSense. Major hospitals throughout Wisconsin were selected for review by the CDC. The CDC then held a meeting with BCD and the Syndromic Surveillance Team to review the predetermined list and select facilities for onboarding. Ultimately, 20 facilities were selected for onboarding to ILINet based on the reliability of reporting in recent history. Before this process, ILINet had 22 reporting facilities in Wisconsin.

Outcomes And Impact (400 words)

The addition of BioSense facilities to ILINet is giving professionals a more robust dataset to work with. Selected facilities were successfully onboarded to ILINet in August prior to the beginning of the 2018-2019 influenza season. In the first two months of flu season (September 21 – November 21), the facilities from BioSense reported 1,773 ILI related visits. These numbers have and will continue to contribute to the DHS weekly ILI reports.4 These weekly reports give data regarding ILI in Wisconsin from different sources in addition to ILINet, including the Wisconsin Electronic Disease Surveillance System and laboratory data. Syndromic data within ILINet is specifically used in the regional data section of the report due to its ability to provide patient location down to the zip code. 

Through this process, syndromic data has proved itself to be a rich source of information. Now that syndromic data has been incorporated into ILI surveillance, it has opened the door to other potential uses for this data. Syndromic data use will continue to increase as more disease areas begin to take advantage of BioSense. Although the original intent of this data was to track and monitor infectious diseases and potential immediate threats, it can also monitor chronic diseases and the impact of natural disasters. This shows that using and incorporating this data into familiar models will positively impact the future of syndromic data use. 

Lessons Learned (400 words)

Syndromic data can be used through BioSense in addition to other CDC programs. Thinking outside the box by onboarding facilities from one database to another can serve to increase the reach of surveillance efforts. 

Taking a closer look at recent reporting history allowed us to select facilities for onboarding and identify facilities that need help improving. Focusing in on one group of facilities at a time will improve overall syndromic data quality. With better data quality will come more opportunities for syndromic data. 

Resources:

  1. Centers for Disease Control and Prevention. (2018). Summary of the 2017-2018 Influenza Season. CDC. Retrieved from: https://www.cdc.gov/flu/about/season/flu-season-2017-2018.htm
  2. Channel 3000. (2018). 379 in Wisconsin died of flu during 2017-2018 flu season, state health officials say. Channel 3000. Retrieved from: https://www.channel3000.com/health/379-wisconsinites-died-of-flu-during…
  3. Centers for Disease Control and Prevention. (2018). Overview of Influenza Surveillance in the United States. CDC. Retrieved from: https://www.cdc.gov/flu/weekly/overview.htm
  4. Division of Public Health Bureau of Communicable Diseases. (2018). Respiratory Virus Surveillance Report. Wisconsin Department of Health Services. Retrieved from: https://www.dhs.wisconsin.gov/influenza/weekly-influenza-report.pdf
Submitting Author Name
Erin Swartz
Submitting Author Title
Syndromic Surveillance Program Evaluator and Data Analyst
Submitting Author Organization
Wisconsin Department of Health Services
Submitting Author Phone
608-267-0242
Submitting Author Email
Erin.Swartz@dhs.wisconsin.gov
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