Infectious Disease

Deterioration of socio-economic conditions in Ukraine created a threat of the spread of communicable diseases, including vaccine preventable diseases. Children in Ukraine routinely receive two doses of the measles-mumps-rubella (MMR) vaccine according to the national immunization schedule. Measles is targeted for elimination in Ukraine. But now Ukraine crisis carries significant public health risk and requires changing tactics of surveillance and epidemiological control against measles.

Objective

To estimate the current measles situation in the Kharkiv oblast (eastern region of Ukraine) and to develop ways of improving the surveillance and control of measles in elimination phase during the crisis in Ukraine.

Public health practitioners endeavor to expand and refine their syndromic and other advanced surveillance systems that are designed to supplement their existing laboratory testing and disease surveillance toolkit. While much of the development and widespread implementation of these systems had been supported by public health preparedness funding, the reduction of these monies has greatly constrained the ability of public health agencies to staff and maintain these systems. The appearance of H3N2v and other novel influenza A viruses required agencies to carefully identify which systems provide the most cost-effective data to support their public health practice. Recent Enterovirus D68 outbreaks, along with the global emergence of influenza A (H7N9), the global emergence of influenza A (H7N9), Middle East Respiratory Syndrome Coronavirus (MERS-CoV), Ebola virus strains, and other viruses associated with high mortality, emphasize the importance of maintaining vigilance for the presence of emerging disease.

Objective

To identify and characterize challenges experienced by public health practitioners conducting surveillance for the presence of influenza, novel respiratory diseases, and globally emerging viruses in an era of limited resources.

Missed opportunities for influenza vaccination in office-based settings occur when patients (who are inclined to accept influenza vaccination if a provider recommends it) remain unvaccinated after a fall/winter healthcare visit. Healthcare providers can be very influential in encouraging patients to obtain influenza vaccination, but little is known in real-time during annual campaigns of how many and what type of providers are actually giving vaccinations in office settings. Many factors affect the ultimate population coverage including taking advantage of opportunities to vaccinate during medical visits. This suggests that provider vaccination behavior, if leveraged, could result in higher rates of influenza vaccine coverage. “Big” healthcare data in the form of high volume streams of electronic healthcare reimbursement claims (eHRCs) can potentially be used to track influenza vaccine administration practices in office-based settings in near real-time, thus empowering public health officials to provide this feedback to practitioners and potentially modify behaviors.

Objective

This paper describes the results of formative research to develop a new metric for public health officials to use in near-real-time tracking of the weekly participation of office-based providers in community influenza vaccination campaigns.

African swine fever virus (ASFV), pseudorabies virus (Aujrszky’s disease virus, ADV) and porcine circovirus type 2 (PCV-2) are some of the most dangerous DNA viruses causing high amounts of morbidity and mortality in commercial and backyard pig farms. Traditional diagnosis of porcine viral infections requires complex and lengthy combinations of virological and serological tests. This study aimed to develop a method for rapid detection of the DNA-containing viral pathogens of pig in clinical materials using conventional multiplex PCR platform.

Objective

The objective was to develope the multiplex PCR for detection of the DNA-contained emergent diseases agents in pigs (African swine fever, Aujeszky disease, Circoviral disease) for diseases surveilance in pig farms

In 2003, the Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia estimated that approximately 1 million people in the United States were living with HIV/AIDS, and that approximately 25% of these were undiagnosed and unaware of their HIV infection. For many such patients the ED may be the only part of the health care system that is utilized. In 2006, the CDC revised their recommendations for HIV testing in a variety of care settings including the ED. In spite of this change, most EDs throughout the United States still do not offer routine HIV testing. Implementing successful ED based testing models may lead to greater acceptance of ED based testing, earlier detection, and further reduction in the transmission of HIV in the United States.

Objective

To design and implement an ED based rapid HIV screening program targeting high risk patients presenting with signs, symptoms, or concerns for sexually transmitted diseases; to determine the prevalence rate of HIV infection in the tested population; to determine the proportion of HIV-positive patients with successful linkage to outpatient care after ED discharge.

Currently Centers for Disease Control and Prevention (CDC) employ threshold rules to declare epidemic outbreaks, such as influenza, separately in each population. However each year influenza starts in one population and spreads population-to-population throughout the country. Therefore there is a need for an algorithm to declare the epidemic that uses information from multiple populations.

Objective

Detect epidemics over multiple Populations using computational methods

Brucellosis is a zoonotic disease of veterinary, public health and economic significance in most developing countries, yet there are few studies that show integrated human and veterinary health care intervention focusing on integration at both activity and actors levels. The aim of our study, therefore, was to explore community perceptions on integration of animal vaccination and health education by veterinary and public health workers in the management of brucellosis.

Objective

To explore community perceptions on integration of animal vaccination and health education by veterinary and public health workers in the management of brucellosis.

Recently signed in Denver, the Paris Declaration demonstrates a collective resolution to end AIDS by continually monitoring these goals. However siloed data and in/out migration results in poor capacity to track population level care indicators for persons living with HIV (PLWH). Surveillance should not only enumerate PLWH but also support prevention and care programming (1). We designed and implemented the HIV Data to Care Tool to describe the continuum, from case finding to HIV care. This study describes a system to combine data sources to inform local HIV surveillance, outreach, and care. Development objectives included targeted community and clinical interventions and evaluation, user defined reports to identify subpopulation disparities, and a persistent data visualization readily available to stakeholders.

Objective

To describe Denver Public Health’s model for designing a business intelligence (BI) tool for HIV surveillance and outreach and the impact after implementation.

The Louisiana Office of Public Health (OPH) Infectious Disease Epidemiology Section conducts emergency department (ED) syndromic surveillance using the Louisiana Early Event Detection System (LEEDS). LEEDS automatically processes electronic chief complaint, admit reason and diagnosis data to identify ED visits indicative of specific syndromes. In response to local transmission of chikungunya virus in the Caribbean and the first travel-associated case in Louisiana in May of 2014, OPH conducted an arboviral syndromic surveillance study to validate arboviral syndromes and evaluate the utility and practicality of detecting and monitoring arboviral disease using ED chief complaint, admit reason and diagnosis text data.

Objective

To validate arboviral syndromes and evaluate the utility and practicality of detecting and monitoring arboviral disease using ED chief complaint, admit reason and diagnosis text data.

Rabies post-exposure prophylaxis (PEP) can prevent fatal encephalitis associated with exposure to the rabies virus. However, overuse and inappropriate administration of rabies PEP are common.1 Mandatory reporting of potential rabies exposures provides opportunities for public health practitioners to monitor the appropriateness of PEP administration and offer recommendations. In Illinois, potential human exposure to rabies, including any person started on PEP and any person with contact to a bat, must be reported to the local health authority. Previous investigations into the completeness of rabies reporting have concluded that active surveillance in addition to mandatory reporting may be useful.2 As rabies PEP is often given in an emergency department setting, syndromic surveillance records may provide a basis for estimating completeness of reporting and identifying candidates for active surveillance follow up.

Objective

To determine whether unreported cases of potential human exposure to rabies can be detected using an emergency department (ED) syndromic surveillance system and to assess both reporting completeness and compliance with clinical guidelines related to rabies exposures in suburban Cook County.