Infectious Disease

Clostridium difficile (CD), a gram-negative, anaerobic, sporeforming bacterium causes symptoms ranging from mild to severe diarrhea and may result in death. Approximately 75% of CDI cases have symptom onset outside of health care settings. Annual US costs of treatment and infection containment have surpassed $4.8 billion. Risk factors for CDI include recent broad-spectrum antibiotic exposure, advanced age, severe underlying morbidities, immunocompromised status, long-term hospital stays, and residence in long-term-care facilities. Nationally, CO-CA cases have increased from 2.8/100,000 person in 1993 to 14.9/100,000 person in 2005.

Objective

Identify population-based Clostridium difficile infection (CDI) incidence stratified by Health Care Facility Onset (HCFO), Community Onset-Healthcare Facility Associated (CO-HCFA), and Community Onset-Community Associated (CO-CA) CDI in Denver County from 2011 - 2013 and describe demographic, health care facility exposure, and medication use risk factors.

Clinical quality measures (CQMs) are tools that help measure and track the quality of health care services. Measuring and reporting CQMs helps to ensure that our health care system is delivering effective, safe, efficient, patient-centered, equitable, and timely care. The CQM for influenza immunization measures the percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received (or reports previous receipt of) an influenza immunization. Centers for Disease Control and Prevention recommends that everyone 6 months of age and older receive an influenza immunization every season, which can reduce influenzarelated morbidity and mortality and hospitalizations.

Objective

To explain the utility of using an automated syndromic surveillance program with advanced natural language processing (NLP) to improve clinical quality measures reporting for influenza immunization.

Recreational drug use is a major problem in the United States and around the world. Specifically, drug abuse results in heavy use of emergency department (ED) services, and is a high financial burden to society and to the hospitals due to chronic ill health and multiple injection drug use complications. Intravenous drug users are at high risk of developing sepsis and endocarditis due to the use of a dirty or infected needle that is either shared with someone else or re-used. It can also occur when a drug user repeatedly injects into an inflamed and infected site or due to the poor overall health of an injection drug user. The average cost of hospitalization for aortic valve replacement in USA is about $165,000, and in order for the valve replacement to be successful, patients must abstain from using drugs.

Objective

To describe how the state syndromic surveillance system (NC DETECT) was used to initiate near real time surveillance for endocarditis, sepsis and skin infection among drug users.

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), and use of Rapid Diagnostic Tests (RDTs) have reduced Malaria prevalence from 39% in 2005 to less than 1% in 2011-2012. As malaria burden decreases, there is an increasing need to track and follow up individual cases to contain transmission that could lead to resurgence. One method being used to achieve these aims is reactive case detection (RACD). RACD is generally understood to be triggered whenever a case is identified by passive case detection. The response involves visiting the household of the newly reported case and screening family members. Depending on program protocol, it may also involve screening neighbors within a defined radius. RACD has been used or tested in Cambodia, China, India, Peru, Senegal, Swaziland, Tanzania, and Zambia. RACD can be resource intensive. Several studies raise questions concerning whether and how RACD can be prioritized and targeted effectively as case numbers continue to decline.

Objective

This presentation will share findings from more than three years of using mobile technology for reactive case detection (RACD) to help eliminate malaria in a well-defined geographic area. It will review the concepts of RACD, the application of mobile technology, lessons learned from more than three years of application, and considerations in applying this technology in other malaria elimination contexts.

Traditional influenza surveillance relies on reports of influenzalike illness (ILI) by healthcare providers, capturing individuals who seek medical care and missing those who may search, post, and tweet about their illnesses instead. Existing research has shown some promise of using data from Google, Twitter, and Wikipedia for influenza surveillance, but with conflicting findings, studies have only evaluated these web-based sources individually or dually without comparing all three of them1-5. A comparative analysis of all three web-based sources is needed to know which of the web-based sources performs best in order to be considered to complement traditional methods.

Objective

To comparatively analyze Google, Twitter, and Wikipedia by evaluating how well change points detected in each web-based source correspond to change points detected in CDC ILI data.

Rates of student absenteeism in schools have been mainly used to detect outbreaks in schools and prompt public health action to stop local transmission. A report by Kim Mogto et al.  stated that aggregated counts of school absenteeism (SAi) were correlated with PPFluA, but the sample may have been biased. The purpose of this study was to assess the correlation between aggregated rates of SAi and PPFluA for two cities, Calgary and Edmonton, in Alberta. In such situations, SAi could potentially be used as a proxy for PPFluA when there are not enough samples for stable laboratory estimates.

Objective

To assess the correlations between weekly rates of elementary school absenteeism due to illness (SAi) and percent positivity for influenza A from laboratory testing (PPFluA) when conducted at a city level from September to December over multiple years.

Rabies is an infectious disease which was and remains to be one of the most serious diseases of all species of hematothermal animals and humans, in many regions of the world. The epizootic situation on rabies in the Republic of Azerbaijan has been unfavorable for many years, which is confirmed by scientific data and the veterinary cases reporting in the EIDSS system. This system was introduced in the country in 2009 and is the electronic System of disease control. The program allows to provide monitoring and prevention of diseases within the concept “One World - One Health System” by integration of systems of observation of animal diseases, human diseases, and disease carriers.

Objective

to show the instability of an epizootic situation on rabies cases of animals in the Republic of Azerbaijan, on the example of the cases analysis in Electronic Integrated Disease Surveillance System (EIDSS) electronic reporting system

Stemming from the 2014-6 Ebola virus disease (EVD) outbreak, community event based surveillance (CEBS) was implemented in Sierra Leone using community health workers to generate alerts for trigger events suggestive of EVD transmission. Through September 30, 2015 (last month of active EVD transmission), the majority (86%) of alerts reflected community deaths; this was beneficial as Ebolarelated deaths were detected with delay during the epidemic’s peak. The Government had implemented a policy of mandatory swabbing and testing of all dead bodies. The policy changed on June 30, 2016 wherein only swabbing of deaths deemed to be high-risk for EVD is required. To assess whether this policy change has begun to affect community death reporting, we analyzed trends in death reporting before and after the policy change.

Objective

To assess whether the change in death swabbing policy in Sierra Leon has begun to affect community death reporting, we analyzed trends in death reporting before and after the policy change

Mitigating the spread of infectious disease is of great importance for policy makers. Taking the recent outbreak of Ebola as an example, it was difficult for policy makers to identify the best course of action based on the cost-effectiveness of what was available. In effort to address the needs of policy makers to mitigate the spread of infectious disease before an outbreak becomes uncontrollable, we have devised a cost-benefit disease control model to simulate the effect of various control methods on disease incidence and the cost associated with each of the scenarios. Here, we present a case study of Ebola used to quantify the cost effectiveness of vaccination and isolation methods to minimize the spread of the disease.

Objective

We evaluate the impact of changing strategy levels on the incidence of the disease and address the benefits of choosing one strategy over the other with regards to cost of vaccine and isolation.

MERS-CoV was discovered in 2012 in the Middle East and human cases around the world have been carefully reported by the WHO. MERS-CoV virus is a novel betacoronavirus closely related to a virus (NeoCov) hosted by a bat, Neoromicia capensis. MERS-CoV infects humans and camels. In 2015, MERS-CoV spread from the Middle East to South Korea which sustained an outbreak. Thus, it is clear that the virus can spread among humans in areas in which camels are not husbanded.

Objective

Here we use novel methods of phylogenetic transmission graph analysis to reconstruct the geographic spread of MERS-CoV. We compare these results to those derived from text mining and visualization of the World Health Organization’s (WHO) Disease Outbreak News.