Infectious Disease

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

While the link between excess winter mortality and winter respiratory diseases in the elderly is well described, the impact of the epidemic of influenza in the elderly is mainly assessed in France through specific surveillance in the general population. Syndromic surveillance data enables to monitor ED attendances and hospitalizations for various diagnostic codes groupings throughout the influenza epidemic, some of which often cited as influenza proxies, such as cardiorespiratory diagnostic groups.

In mainland France, the 2014-15 season was characterized by an intense influenza epidemic in the community (sub-type A(H3N2) dominant virus). Hospital overcrowding was early reported, partly linked to serious clinical presentations among the elderly, and leading to the triggering of a national emergency plan.

We hypothesized that ED numbers of clinical influenza cases underestimate the influenza burden among patients aged 65 years and over, especially when a A(H3N2) influenza subtype circulates.

Objective

To estimate the real burden of influenza epidemic on emergency departments (ED) attendances and hospitalizations among patients over 65 years in order to better understand determinants of overcrowding and mortality excess.

Approximately 2.7 million Americans live with chronic HCV, with roughly 30,000 new cases in 2013. Fortunately, recent clinical trials have shown great advances using interferon-free, oral direct-acting antivirals, with cure rates over 95% . But only a few people have been treated, and most are unaware of the infection. This presents an opportunity for public health to address unmet needs, but most jurisdictions have limited surveillance and prevention efforts. Leveraging HCV surveillance, this analysis presents a cost-effective method to improve situational awareness and guide prevention efforts in Houston.

Objective

To describe the use of Hepatitis C Virus (HCV) viral load (VL) results and geospatial analysis to guide prevention efforts.