Surveillance Systems

Livestock diseases in most developing countries are often widely distributed. The wide distribution of diseases often renders whole countries ineligible to participate in international trade of meat and meat products. These trade restrictions serve as a continuous primary source of revenue loss. The World Organisation for Animal Health (OIE) now promotes establishment of disease free zones to lessen the impact of trade restrictions. These “islands” of disease freedom not only serve as a first step in total disease freedom, but for many countries they also serve as a beacon of hope to ever returning to international trade. The selection of a region within a country to be designated as a disease free zone is likely to be based more on the fact that a particular region is yet to experience cases of a given disease than it is on the nation’s Veterinary department ability to keep the region disease free. As such, geographical regions that seem to have inherent protection against disease incursions usually due to geospatial features such as mountains, rivers, remoteness etc. serve as the best candidates for creation of disease free zones. Because the process of disease free zone creation is slow, it is important to ensure that disease surveillance is these regions is enhanced so that disease control authorities may serve as agile responders to disease incursions. This current presentation outlines the creation of a Provincial Epidemiological and Information Centre (PEIC) in Zambia’s Luapula province. This is only the second epidemiosurveillance centre in the country. Luapula province in the northern part of Zambia being one of only 3 provinces out of a total of 10 provinces that are free of theilleriosis in Zambia 2 has the potential of being Zambia’s largest disease free zone. The challenges as well as lessons learnt from setting up this epidemiosurveillance centre are presented.

Objective

This presentation outlines the steps and challenges involved in setting up a regional epidemio-surveillance centre in a resource constrained setting. While this Zambian experience is unique, the challenges encountered are typical of most developing countries and therefore the lessons learned can be applied to much of the developing world.

Syndromic surveillance has demonstrated utility for situational awareness for non-infectious conditions, including tracking and monitoring gun-related violence and homicides. While New York State reports an overall decrease in gun-related crimes, in NYC identifying smaller scale aberrations of gunshot-related violence can prompt more efficient response by city groups. We examined the temporal and borough-level characteristics of gunshot-related emergency department (ED) visits in NYC.

Objective

To describe epidemiological characteristics of gunshot-related injuries in New York City (NYC) using syndromic surveillance data

The influenza A(H7N9) virus emerged in early 2013 in China, with more than 130 laboratory-confirmed cases identified within a short period of about three months. Evidence-based public health response is essential for effective control of the disease, which relies on epidemiological and clinical data with good quality and timeliness. Publicly available information from sources such as official health website, online news, blogs or social media has the potential of rapid sharing of data to a wide community of experts for more comprehensive analyses. In our study we described the strength and limitation of these data for various types of epidemiological inferences.

Objective

This study described the strength and limitation of using line lists that built on publicly available data in various types of epidemiological inferences during the H7N9 epidemic in China, 2013.

Fever is a top cause of morbidity in all age groups in Bangladesh and often classified as fever of unknown origin (FUO) in absence of any pathognomonic sign. Bangladesh with its long monsoon, frequent flooding, stagnant water, high temperature, humidity and largest density of animal and human population serves as an ideal place for zoonotic transmission of Leptospira.

Objective

To evaluate the necessity of a coordinated leptospira surveillance in Bangladesh through a systematic review.

Knowledge Management is defined as “the process of capturing, distributing, and effectively using knowledge.” ISDS members have varying degrees of experience with public health surveillance and syndromic surveillance specifically, and will all benefit from more structured access to documentation on components related to syndromic surveillance, including but not limited to, the onboarding of facilities, data quality monitoring tools, case definitions, and data processing tools. To build a knowledge management capability, the first step is to gather initial requirements and priorities from the CoP.

Objective

The purpose of the roundtable is to seek feedback from attendees on the components needed to improve syndromic surveillance practice through access to the shared knowledge, practices, and tools of the ISDS Community of Practice (CoP).

From June 4-8, 2015, the New York City (NYC) syndromic surveillance system detected five one-day citywide signals in sales of over-the-counter (OTC) antidiarrheal medications using the CUSUM method with a 56-day moving baseline. The OTC system monitors sales of two classes of antidiarrheal medications, products with loperamide or bismuth, from two NYC pharmacy chains. To determine if this increase reflected a concerning cluster of diarrheal illness, we examined multiple communicable disease surveillance data systems.

Objective

To investigate a communicable disease syndromic surveillance signal using multiple data sources.

Many syndromic surveillance systems use spatio-temporal analysis to detect local outbreaks such as gastrointestinal illnesses and lower respiratory infections. In Reunion Island, the syndromic surveillance system is based mainly on ED visits. Spatial analysis was first used in 2013 to validate retrospectively a cluster of viral meningitis. At the end of 2014, the Regional Office of French Institute for Public Health Surveillance implemented a prospective computer-automated space-time analysis in order to launch daily analyses of ED visits.

Objective

To present the implementation and the first results of a prospective spatio-temporal analysis from emergency department (ED) data in Reunion Island.

The use of R is increasing in the public health disease surveillance community. The ISDS pre-conference workshops and newly formed R Group for Surveillance have been well attended and continue to grow in popularity. The use of R in the National Syndromic Surveillance Program (NSSP) has also been of value to many users who wish to analyze and visualize public health data using custom R scripts. This interest in R, combined with a desire from many ESSENCE users to create custom analytics and visualizations, led to a summer internship project to look into the feasibility and ways R could be integrated into ESSENCE.

Objective

The objective of this project is to give users the ability to run custom R scripts from within the ESSENCE system. This capability would allow for custom analytics and visualizations to be baked into the system for daily use. It would also provide a sandbox area for new ideas and features to be tested before being developed more fully into the ESSENCE codebase for a more seamless use in the future. The project must do this while maintaining a secure environment for public health data to reside.

Injuries are a major but neglected global public health problem. In the low- and middle-income countries (LMIC), the problem is particularly acute due to disproportionately high incidence of injuries. Most of these injuries are preventable with appropriate interventions. Lack of complete, accurate and timely injury data is one of the main obstacle for injury prevention in LMICs. In 2001, World Health Organization (WHO) published injury surveillance guidelines emphasizing the importance of injury surveillance at country levels to cope with this grave problem. Although most of the developed countries have developed their own injury surveillance systems, there is no customizable generic injury surveillance system which can be used in LMICs. However, District Health Information System 2 (DHIS2) is a free and open source application used in many countries to collect aggregated public health data. Although it is being used for aggregated public health data it has not being used for injury surveillance.

Objective

To customize and pilot an open source public health information tool (DHIS2) for injury surveillance in a resource constrained setting, Sri Lanka.

Synthetic cannabinoids include various psychoactive chemicals that are sprayed onto plant material, which is then smoked or ingested to achieve a “high.” These products are sold under a variety of names (e.g., synthetic marijuana, spice, K2, black mamba, and crazy clown) and are sold in retail outlets as herbal products and are often labeled not for human consumption. Law enforcement agencies regulate many of these substances; however, manufacturers may frequently change the formulation and mask their intended purpose to avoid detection and regulation.

On April 6, 2015, automated surveillance algorithms via surveillance through the National Poison Data System (NPDS), a web-based surveillance system of all calls to United States (US) poison centers (PCs), identified an increase in calls to PCs related to synthetic cannabinoid use. To identify risk factors and adverse health effects, CDC analyzed all calls to PCs about synthetic cannabinoid use from January to May, 2015.

Objective

The Centers for Disease Control and Prevention analyzed all calls to poison centers about synthetic cannabinoid use from January to May 2015 to identify risk factors and adverse health effects related to this emerging public health threat.