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Infectious Disease

Description

Sexually transmitted disease treatment guidelines have incrementally added repeat testing recommendations for Chlamydia trachomatis infections over time, including test-of-cure 3 to 4 weeks following completion of treatment for pregnant women and test-of-reinfection for all patients approximately 3 months after infection. However, few studies have investigated adherence to these recommendations and whether the evolution of guidelines have led to changes in repeat testing patterns over time.

Objective:

To evaluate current rates and temporal trends in adherence with national guidelines recommending chlamydia test-of-cure for pregnant females and test-of-reinfection for all patients.

Submitted by elamb on
Description

In May 2015, the MERS-CoV outbreaks in South Korea was sparkled from a hospital of Gyeonggi-do province. In response to this outbreak, the provincial government and infectious disease control center (GIDCC) initiated an emergency department (ED) based Gyeonggi-do provincial acute febrile illness (AFI) surveillance network (GAFINet) to monitor for a subsequent outbreak of emerging or imported infectious diseases since September 2016. Gyeonggi-do province is located in the North-West of South Korea, surrounds the capital city Seoul, and borders North Korea (Figure 1). Considering the geographical coverage, GAFINet Initiative involves ten hospitals, consisted of four university-affiliated hospitals and six provincial medical centers in Gyeonggi-do province. These hospitals participated in this network voluntarily, and most staffs including five infectious diseases specialists had direct or indirect experiences in dealing with MERS-CoV patients.

Objective:

The objectives are to introduce a provincial level surveillance system, which has been initiated in response to the MERS-CoV outbreak of South Korea, and describe findings from systematic investigation of individual admissions attributed to acute febrile illness for the first year.`

Submitted by elamb on
Description

On 3/29/2017, the Maricopa County Department of Public Health (MCDPH) received three reports of confirmed HAV infection from an onsite clinic at Campus A that assists individuals experiencing homelessness, a population at risk for HAV transmission. To identify the scope of the problem, the department initiated rapid HAV infection case detection using NSSP ESSENCE.

Objective:

To demonstrate the utility of the National Syndromic Surveillance Program’s (NSSP) version of the Electronic Surveillance System for Early Notification of Community-based Epidemics (ESSENCE) for case detection during a 2017 outbreak of hepatitis A virus (HAV) infection among persons experiencing homelessness in Maricopa County, Arizona.

Submitted by elamb on
Description

An estimated one in six Americans experience illness from the consumption of contaminated food (foodborne illness) annually; most are neither diagnosed nor reported to health departments1. Eating food prepared outside of the home is an established risk factor for foodborne illness2. New York City (NYC) has approximately 24,000 restaurants and >8.5 million residents, of whom 78% report eating food prepared outside of the home at least once per week3. Residents and visitors can report incidents of restaurant-associated foodborne illness to a citywide non-emergency information service, 311. In 2012, the NYC Department of Health and Mental Hygiene (DOHMH) began collaborating with Columbia University to improve the detection of restaurant-associated foodborne illness complaints using a machine learning algorithm and a daily feed of Yelp reviews to identify reports of foodborne illness4. Annually, DOHMH manages over 4,000 restaurant-associated foodborne illness reports received via 311 and identified on Yelp which lead to the detection of about 30 outbreaks associated with a restaurant in NYC. Given the small number of foodborne illness outbreaks identified, it is probable that many restaurant-associated foodborne illness incidents remain unreported. DOHMH sought to incorporate and evaluate an additional data source, Twitter, to enhance foodborne illness complaint and outbreak detection efforts in NYC.

Objective:

To incorporate data from Twitter into the New York City Department of Health and Mental Hygiene foodborne illness surveillance system and evaluate its utility and impact on foodborne illness complaint and outbreak detection.

Submitted by elamb on
Description

Timely identification of arboviral disease is key to prevent transmission in the community, but traditional surveillance may take up to 14 days between specimen collection and health department notification. Arizona state and county health agencies began monitoring National Syndromic Surveillance Program BioSense 2.0 data for patients infected with West Nile virus (WNV), St. Louis encephalitis virus (SLEV), chikungunya, or dengue virus in August 2015. Zika virus was added in April 2016. Our novel methods were presented at the International Society for Disease Surveillance 2015 Annual Conference. Twice per week, we queried patient records from 15 Maricopa County BioSense-enrolled emergency department and inpatient hospitals for chief complaint keywords and discharge diagnosis codes. Our Case Investigation Decision Tree helped us determine whether records had a high or low degree of evidence for arboviral disease and necessitated further investigation. This study evaluated how Arizona’s protocol for conducting syndromic surveillance compared to traditional arboviral surveillance in terms of accuracy and timeliness in Maricopa County from August 2015 through December 2016.

Objective:

To evaluate Arizona’s arboviral syndromic surveillance protocol in Maricopa County.

Submitted by elamb on
Description

Measles is a vaccine preventable, highly transmissible viral infection that affects mostly under-five year children. The disease is caused by a Morbillivirus; member of the Paramyxovirus family.

Objective:

We reviewed measles specific Integretaged Disease Surveillance and Response (IDSR) data from Nigeria over a five-year period to highlights its burden and trends, and make recommendations for improvements.

Submitted by elamb on
Description

GAS pharyngitis affects hundreds of millions of individuals globally each year, and over 12 million seek care in the United States annually for sore throat. Clinicians cannot differentiate GAS from other causes of acute pharyngitis based on the oropharynx exam, so consensus guidelines recommend use of clinical scores to classify GAS risk and guide management of adults with acute pharyngitis. When the clinical score is low, consensus guidelines agree patients should neither be tested nor treated for GAS. A prediction model that could identify very-low risk patients prior to an ambulatory visit could reduce low-yield, unnecessary visits for a most common outpatient condition. We recently showed that real-time biosurveillance can further identify patients at low-risk of GAS. With increasing emphasis on patient-centric health care and the well-documented barriers impeding clinicians’ incorporation of prediction models into medical practice, this presents an opportunity to create a patient-centric model for GAS pharyngitis based on history and recent local epidemiology. We refer to this model as the “home score,” because it is designed for use prior to a physical exam.

Objective

1. To derive and validate an accurate clinical prediction model (“home score”) to estimate a patient’s risk of group A streptococcal (GAS) pharyngitis before a health care visit based only on history and real-time local biosurveillance, and to compare its accuracy to traditional clinical prediction models composed of history and physical exam features. 2. To examine the impact of a home score on patient and public health outcomes.

Submitted by rmathes on
Description

Zanzibar is comprised primarily of two large islands with a population of 1.3 million. Indoor Residual Spraying (IRS) campaigns, distribution of long-lasting insecticide treated bed nets (LLINs), ensuring treatment medication is available, and use of Rapid Diagnostic Tests (RDTs) have reduced Malaria prevalence from 39% in 2005[1] to less than 1% in 2011-2012. This is the third time Zanzibar has been close to eliminating malaria, but there are serious challenges. These include vector resistance to pyrethroids, the shortlived efficacy of LLINs, and resistance to behavior change. Constant traffic with mainland Tanzania and foreign countries also poses the risk of outbreaks. An effective and sustained surveillance and rapid response system is essential to control outbreaks and optimize interventions.

Objective

This presentation aims to share the results of a six-year effort to use mobile health (mHealth) technology to help eliminate malaria from a well-defined geographic area. This presentation will review the history, technology, results, lessons-learned, and applicability to other contexts.

Submitted by uysz on
Description

The Electronic Surveillance System for the Early Notification of Community-Based Epidemics (ESSENCE-FL) receives daily (or bi-hourly) data from 184 emergency departments (ED) from around Florida. Additionally, 30 urgent care centers submit daily data to the system. These 214 facilities are grouped together in an acute care data source category. Five to six days after the start of each school year in Florida, ESSENCE-FL shows increased respiratory illness visits in the school aged population. Previous analyses of these data have shown that this increase is a result of increased transmission of the common cold among school children. In early September 2014, during this sustained yearly increase in respiratory visits, reports of more severe infection caused by Enterovirus D68 (EV-D68) in children in other parts of the country began circulating. Public health officials in Florida, as well as the media, questioned whether children in the state were being infected by this virus capable of causing more severe illness, especially among asthmatics. As is the case with many incipient outbreaks, syndromic surveillance played an integral role in early efforts to detect the presence of this illness. The task of providing situational awareness during this period was complicated by this outbreak coinciding with the start of the school year.

Objective

To provide situational awareness using Florida’s syndromic surveillance system during a 2014 outbreak of EV-D68 in other regions of the country.

Submitted by uysz on