Infectious Disease

Effective public health response to emerging infectious diseases, natural disasters, and bioterrorism requires access to real-time, accurate information on disease patterns and healthcare utilization. The ESSENCE surveillance system in use by the Department of Defense (DoD) relies primarily on outpatient clinical impression diagnosis, which accurately characterize broad disease syndromes but may not be sufficient for monitoring specific diseases. DoD outpatient military treatment facilities perform nearly 500,000 microbiology laboratory tests annually. Initiated electronically, the ordered test is recorded immediately; most provide specific results in 24 to 72 hours and may prove useful for monitoring population health. Although a syndrome classification has been developed for laboratory tests, the classification cannot be applied directly to the DoD data and no previous study has validated the use of automated laboratory test orders for syndromic surveillance.

Objective

To evaluate the association between military microbiology laboratory test orders and infectious disease patterns.

San Francisco has the highest rate of TB in the US. Although in recent years the incidence of TB has been declining in the San Francisco general population, it has remained relatively constant in the homeless population. Spatial investigations of disease outbreaks seek to identify and determine the significance of spatially localized disease clusters by partitioning the underlying geographic region. The level of such regional partitioning can vary depending on the available geospatial data on cases including towns, counties, zip codes, census tracts, and exact longitude-latitude coordinates. It has been shown for syndromic surveillance data that when exact patients’ geographic coordinates are used, higher detection rates and accuracy are achieved compared to when data are aggregated into administrative regions such as zip codes and census tracts. While the benefits of using a finer spatial resolution, such as patients’ individual addresses, have been examined in the context of spatial epidemiology, the effect of varying spatial resolution on detection timeliness and the amount of historical data needed have not been investigated.

Objective

The objective of this study is to investigate the effect of varying the spatial resolution in a variant of space-time permutation scan statistic applied to the tuberculosis data on the San Francisco homeless population on detection sensitivity, timeliness, and the amount of historical data needed for training the model.

Electronic laboratory-based surveillance can significantly improve the diagnostic specificity and response time of traditional infectious disease surveillance. Under the project “Models of Infectious Disease Agent Study”, we wished to evaluate the application of space-time outbreak detection algorithms utilizing SaTScan to a national database of routinely collected microbiology laboratory data.

Objective

This paper describes the application of the WHONET software integrated with SaTScan to the detection of Shigella outbreaks in a national database using a space-time cluster detection algorithm in simulated real-time and comparison of findings to outbreaks reported to the Ministry of Health.

The Utah Department of Health documented a single epidemic of cryptosporidiosis in Utah during 2007. Seven hundred eleven laboratory-confirmed cases were reported in Salt Lake County, Utah from July 27 through December 18. Illness onset date was available for 86% (611 of 711) of patients and ranged from May 30 through November 11. Approximately 32% (224 of 691) of patients sought care in area emergency departments or urgent care facilities, and 8.5% (50 of 590 with data available) of patients required hospitalization. Sixty-one percent (432 of 711) of patients were less than 13 years of age. Of 381 patients with data available on symptoms, nearly all (99%, 378) reported diarrhea. Other commonly reported symptoms included vomiting (57%, 218), abdominal pain (51%, 196), and nausea (44%, 168).

Objective

The objective of this study was to evaluate the potential for improved detection of enteric disease epidemics using a classification category based on variations of diarrhea appearing in the chief complaints from emergency department and urgent care facility visits.

Outbreaks of infectious diseases are identified in a variety of ways by clinicians and public health practitioners but not usually by analytic methods typically employed in syndromic surveillance. Systematic spatial-temporal analysis of statewide data may enable earlier detection of outbreaks and identification of multi-jurisdictional outbreaks.

Objective

Clusters of cases of individually-reportable infectious diseases were identified by a spatial-temporal retrospective analysis. Clusters were examined to determine association with previously reported outbreaks.

This study analyzes the critical tracing fraction (fc) to eliminate diseases like rubella when both asymptomatic and symptomatic cases are considered.

The purpose of this study was to compare the 2005- 2006 and 2006-2007 Influenza seasons using Influenza-like illness (ILI) data received from Emergency Departments in Miami-Dade County.

To determine the feasibility of using BioSense laboratory data to do surveillance on Clostridium difficile infection (CDI) and calculate overall and facility rates of disease.

A retrospective chart review was performed to examine chief complaint, syndrome classification and discharge diagnoses of laboratory confirmed Salmonella Enteritidis phage type (PT) 13 cases who visited the Emergency Departments (ED) of two local hospitals during a province-wide outbreak in Ontario in the fall of 2005. This assessment was used to assess the sensitivity of the ED syn-dromic surveillance system to detect a local foodborne outbreak, and to modify syndrome classification.

To measure the impact, within administrative geographic areas, of household income on rates of visits due influenza and RSV among children using real-time syndromic surveillance.