Infectious Disease

Port Loko District has had over 1400 confirmed EVD cases during this outbreak. However, transmission declined rapidly in early 2015; by mid-April, a few weeks had passed with no known cases. Simultaneously, reporting of sick persons had plummeted across the district and the number of deaths reported in some areas was fewer than expected. These circumstances signaled the need for the EVD surveillance system to broaden its focus from using district surveillance officers (DSOs) to respond to reports of ill and deceased persons (hereafter, “sick and death alerts”) to a more proactive and comprehensive system that relied strongly on community engagement and surveillance through existing structures such as Peripheral Health Units (PHUs), schools and local authorities. While the involvement of local authorities and the community had been central to reporting suspected EVD cases earlier in the outbreak, the decrease in alerts suggested that engagement was diminishing. The reopening of schools and reemergence of the primary healthcare system provided opportunities to decentralize surveillance and strengthen the involvement of these structures. The primary objective was improving EVD surveillance, but the effort was also used to bolster routine surveillance, in preparation for implementating Integrated Disease Surveillance and Reporting.

Objective

Describe the evolution of Ebola Virus Disease (EVD) surveillance from a largely reactive system structured primarily around responding to reports of illness and death, to one that was more methodical, proactive and comprehensive

Anthrax is a widely distributed endemic infection in Georgia, affecting nearly the entire country. Many of the human cases that are annually registered are agriculturally acquired. Anthrax remains a public health risk due to active, resistant soil foci. More than 2,000 anthrax affected areas are registered in the country; around 10% of them are active. Recent reports have indicated an increase in the number of human cases as a result of contact with the environment, this is hypothesized to be due to expansion of affected foci, and this has raised concerns of the disease spreading to new areas. The control of anthrax foci is one of the main goals of the public health and veterinary service’s in Georgia. A surveillance program of anthrax foci across pipeline constructions in Georgia has been ongoing since 2003. Field trips are conducted by National Center for Disease Control and Public Health mobile teams to investigate each possible affected area across pipeline constructions.

LD, caused by Borrelia burgdorferi in North America is transmitted to humans from wild animal reservoir hosts by Ixodes spp. ticks1 in their woodland habitats2. LD risk in Canada occurs where tick vectors are established in southern British Columbia (I. pacificus) and in southern parts of central and eastern Canada where I. scapularis is spreading from the United States (US)3. LD became nationally notifiable in Canada in 2009 and demographic data on human cases is submitted by provinces to Canadian Notifiable Disease Surveillance System of the Public Health Agency of Canada (PHAC). A Lyme Disease Enhanced Surveillance system was initiated by PHAC in 2010 to obtain more detailed data on LD cases. These surveillance systems aim to identify changing trends in LD incidence, the population at risk and the types of clinical disease in Canada. Surveillance data for 2009-2012 are analyzed to describe the early patterns of LD emergence in Canada. Patterns of LD cases (age, season of acquisition and presenting manifestations) were compared against those reported in the US.

Objective

To summarize the first 4 years (2009-2012) of national surveillance for LD in Canada and to conduct a preliminary comparison of presenting clinical manifestations in Canada and the United-States

Communities and sections that are consistently underreporting both illness and death pose a significant risk to surveillance and their efficacy is dependent upon the reporting of community structures such as government structures (primary health units (PHUs), schools), EVD response structures (contact tracers, community events based surveillance (CEBS), social mobilization), and traditional structures (chiefs, traditional healers, village task forces, religious institutions). All structures are required to report to the District Ebola Response Center (DERC) as depicted in Figure 1. Frequent and protocolized information sharing is central to the reporting efficacy within this structure to ensure early capture of all EVD-related incidents.

Objective

Systematically assess and strengthen the capacity of communities and sections in Port Loko District, Sierra Leone to detect significant events related to the reporting of Ebola virus disease (EVD) such as sick persons, secret burials and deaths. The components of the enhanced surveillance system will be described.

Like in other African countries, most HIV research in Tanzania focuses on adults 15-49 years, ignoring persons aged 50 years and above. In Tanzania, the HIV testing rate (ever tested) for 15 - 49 year olds has increased from 37% to 62% for women and 27% to 47% for men between 2008 and 2012. Limited data is available on HIV testing and prevalence among older adults specifically. Some studies in Sub-Saharan Africa have, however, reported a high HIV prevalence among older people.

Objective

This study aimed to estimate socio-demographic inequalities in HIV testing and prevalence among adults aged 50+ years, living in Ifakara town, Tanzania, in 2013.

 Numerous methods using social media for syndromic surveillance and disease tracking have been developed. Many websites use Twitter and other social media to track specific diseases or syndromes.1 Many are intended for public use and the extent of use by public health agencies is limited.2 Our work builds on 4 years of experience by our multi-disciplinary team3 with a focus on local surveillance of influenza. 4,5

Objective

Create a flexible user-friendly geo-based social media analytic tool for local public health professionals. With the goal of increasing situational awareness, system has capability to process, sort and display tweets with text terms of potential public health interest. We continue to refine the Social Media and Research Testbed (SMART) via feedback from surveillance professionals.

Flea-borne diseases in Kazakhstan have been a significant health risk to inhabitants and visitors for ages, particularly plague. Flea-borne rickettsial disease threats are unknown in Kazakhstan, we therefore initiated a study to detect and identify flea-borne rickettsiae among fleas collected in the Almaty Oblast, in southeastern Kazakhstan.

Natural language processing algorithms that accurately screen clinical documents for suspected pneumonia must extract and reason about whether these mentions provide evidence that supports, refutes, or represents uncertainty. Our efforts extend existing algorithms [1] and taxonomies [2] that can be leveraged by NLP tools for more accurate handling of uncertainty for suspected pneumonia case review.

Objective

We sought to classify evidence that supports, refutes, or contributes uncertainty when reviewing cases of suspected pneumonia. We extend an existing taxonomy of uncertainty to classify these phenomena with the goal of improving existing Natural Language Processing (NLP) algorithms.

School children are the primary introducers and significant transmission sources of influenza virus among their families and surrounding communities [1,2]. Therefore, schools play an important role in amplifying influenza transmission in communities. Using school-related data sources may be an informative addition to existing influenza surveillance. Unplanned school closures (USCs) are common, occur frequently for various reasons, and affect millions of students across the country [3]. Information about USCs is publicly available in real-time. For this study, we evaluated usability of applying USC data for ILI surveillance.

Objective

Evaluate usability of alternative data sources, such as public announcements of unplanned school closures, for additional insight regarding influenza-like illness (ILI) activity.

Using influenza like illness (ILI) data from the repository held by AFHSC, and publically available malaria data we characterized similarities and differences between military and civilian outbreaks. Pete Riley et al. utilized a similar ILI dataset to investigate civilian and military outbreaks similarity during the 2009 flu epidemic. They found, overall, high similarity between civilian and military outbreaks, with military peaking roughly one week after civilian. Our analysis is meant to extend their analysis temporally, geographically, and to see if such trends hold true for other diseases.

Objective

Compare and contrast military and civilian outbreaks for malaria and influenza like illness to identify indicators for early warning and detection