Surveillance Systems

NYS (excluding NYC) has a very robust Communicable Disease Electronic Surveillance System (CDESS). This system provides disease specific modules, as well as a tracking system for contacts, and a perinatal infant tracking system. This system provides an easy way for users to quickly download a file with all of their data.

NYS (excluding NYC) tracks, on average, 300 infants of hepatitis B surface antigen (HBsAg) positive mothers annually. CDESS provides an infant tracking module for local health departments (LHDs) to enter and monitor vaccine information, add multiple infants per mother, and track patient movement and loss to follow-up. The tool allows LHDs to analyze infants’ data by birth year cohort, with all of their current vaccination and serology information available in one record.

In 2013 and 2014, more than 13,000 cases of gonorrhea were reported to CDESS in NYS (excluding NYC). From November 2013 through May 2014, only 61% of cases were adequately treated with a regimen recommended by the Centers for Disease Control and Prevention (CDC) STD Treatment Guidelines for Gonorrhea , and 29% were missing treatment information. The CDESS system allows the LHDs to track patients who have inadequate and/or missing treatment information.

Objective

Improved methods for user analysis of communicable disease surveillance data in New York State (NYS), excluding New York City (NYC).

In South Korea, the NNDSS is organized at three levels: local, provincial, and central. At the local level, physicians report the cased to the Public Health Center (PHC) and PHC conduct control measures. At the provincial level, the PHC reports the cases to the Department of Health (DOH) of the province and DOH obliged to report the cases to the Korea Centers for Disease Control and Prevention (KCDC) and feedback of the surveillance data to PHC and physicians. At the central level, the Disease Web Statistics System (http://is.cdc.go.kr/ dstat/index.jsp) provides real-time data on 54 national notifiable infectious diseases.

Although there are variations according to the disease and surveillance step, the KNNDSS generally functions well in terms of timeliness and Yu et al. reported that 89.7% of mumps, one of the most incident contagious disease in South Korea, reported in 15 days after the physician’s notification. To improve the timeliness of feedback at the provincial level, we explored the KNNDSS data and suggested an evidence based duration for publication of the weekly reports, in consideration of reducing the publication schedule.

Objective

This study will explore the timeliness of the Korean National Notifiable Disease Surveillance System (KNNDSS) at provincial Level, and suggest a reasonable duration for publication the weekly reports to improve timely feedback of infectious disease surveillance data to physicians and community.

Foodborne illness affects 1 in 4 Americans, annually. However, only a fraction of affected individuals seek medical attention. To supplement traditional approaches to foodborne disease surveillance, researchers and public health departments are considering reports of foodborne illness on social media sites. In this project, we work with local public health departments to develop a platform that uses digital data sources such as, Twitter and Yelp, to supplement foodborne disease surveillance efforts. In addition to monitoring reports of illness, this platform can also be used to respond to suspected foodborne illness reports and spur restaurant inspections to ensure food safety. To this end, we have developed a Dashboard that monitors social media chatter for reports of food poisoning in real-time. The Dashboard facilitates responding to illness reports and contacting consumers to provide additional information through a reporting form. The Dashboard is low cost, easy to use and designed to enable easy implementation for any region.

Objective

Develop a platform to enable local surveillance of foodborne illness reported on social media and restaurant review sites for supplementing traditional foodborne disease surveillance programs. In this presentation, we will discuss our collaboration with local public health departments to develop a foodborne disease surveillance Dashboard.

The widespread adoption of Electronic Health Records and the formation of Health Information Exchanges has opened up new possibilities for public health monitoring. Since 2009, The New York City (NYC) Department of Health and Mental Hygiene (DOHMH) has been developing two public health surveillance systems for chronic diseases. The first is the NYC Macroscope, which is built on a distributed query network (the Hub) of 740 New York City ambulatory practices all using proprietary software from one EHR vendor (eClinicalWorks). The second model, Query Health, still in its initial phase, accesses data collected by Healthix, the largest NYC HIE. This study compares these two models for potential disease surveillance and public health application.

Objective

To compare two clinical surveillance systems in development in New York City, one built on a distributed query network of electronic health records (EHRs) and the other accessing data from a Health Information Exchange (HIE).

Improving surveillance and response is a critical component of the Global Health Security Agenda. While it is impossible to predict where the next Ebola outbreak will occur, it is very likely that another outbreak will occur in the DRC. Of the 20 known outbreaks, 7 have occurred in the DRC, one as recently as 2014. To rapidly detect and respond to an Ebola outbreak, we sought to develop a real-time surveillance and response system for use in DRC and similar settings. RTI International developed Coconut Surveillance mobile software, which is currently used for real-time malaria surveillance and response in Zanzibar, Africa, where malaria elimination efforts are underway. We took this system and adapted it for Ebola as a possible tool for surveillance and response to Ebola and other (re)emerging diseases. Plans include pilot testing functionality at clinical sites in DRC, where surveillance infrastructure is limited at the local level. Coconut Surveillance is a mobile disease surveillance and rapid response system currently used for malaria elimination activities. It receives suspected positive case alerts from the field via mobile phones and uses mobile software to guide surveillance officers through a follow-up process. Coconut Surveillance runs on Android mobile devices that are used to coordinate work in the field as well as provide decision support during data collection and case management. In addition to standard case information, the GPS coordinates of the case’s household are captured as well as malaria status of all household members. Data are collected and accessed off-line, and are synchronized with a shared database when Internet connectivity is available. This tool has been used successfully in Zanzibar for more than three years and has been recognized as one of the most advanced applications of its kind.

Objective

We will describe a real-time mobile surveillance and case management system designed to organize data collected by multiple officers about cases and their contacts. We will discuss this surveillance system and its application for Ebola and other infectious diseases in the Democratic Republic of the Congo (DRC) and other similar settings. We will review the technology, results, challenges, lessons-learned, and applicability to other contexts.

Georgia Department of Public Health (DPH) epidemiologists have responded to multiple emergent outbreaks with diverse surveillance needs. During the 2009 H1N1 influenza response, it was necessary to electronically integrate multiple reporting sources and view population-level data, while during the 2014–2015 West African Ebola epidemic, it was necessary to easily collect and view individual level data from travelers to facilitate early detection of potential imported Ebola disease. DPH in-house information technology (IT) staff work closely with epidemiologists to understand and accommodate surveillance needs. Through this collaboration, IT created a robust electronic surveillance and outbreak management system (OMS) to accommodate routine reporting of notifiable diseases and outbreak investigations, and surveillance during emergent events.

Objective

To describe how flexible surveillance systems can be rapidly adapted and deployed, and increase the efficiency and accuracy of surveillance, during responses to outbreaks and all hazard emergent events.

In the Kingdom of Swaziland, a baseline assessment found that multiple functional units within the Ministry of Health (MoH) perform PHS activities. There is limited data sharing and coordination between units; roles and responsibilities are unclear. The Epidemiology and Disease Control Unit (EDCU) is mandated to coordinate efforts and strengthen PHS through implementing Integrated Disease Surveillance and Response (IDSR) to fulfill requirements of International Health Regulations (2005) (IHR[2005]), and the Global Health Security Agenda (GHSA).

Objective

To enable coordination of Swaziland Ministry of Health units for public health surveillance (PHS).

Zika virus disease and Zika virus congenital infection are nationally notifiable conditions that became prominent recently as a growing number of travel-associated infections have been identified in the United States. The Centers for Disease Control and Prevention (CDC) have dedicated significant time and effort on determining and addressing the risks and impact of Zika on pregnant women and their babies who are most vulnerable to the disease. CDC relies on two sources of information, reported voluntarily by healthcare providers, to monitor Zika virus disease: ArboNET and the newly established U.S. Zika Pregnancy Registry. A study by IMS Health compared U.S.trends of the Zika virus disease in general and pregnant women with Zika virus disease in particular observed in an IMS healthcare claims database and the CDC ArboNET and the newly established U.S. ZikaPregnancy Registry.

Objective

Demonstrate the value of consolidated claims data from community healthcare providers in Zika Virus Disease surveillance at local level.

CPC provides the 24/7/365 poison hotline for the entire state of North Carolina and currently handles approximately 80,000 calls per year. CPC consultation services that assist callers with poison exposure, diagnosis, optimal patient management, therapy, and patient disposition guidance remain indispensable to the public and health care providers. Poison control center data have been used for years in syndromic surveillance practice as a reliable data source for early event detection. This information has been useful for a variety of public health issues, including environmental exposures, foodborne diseases, overdoses, medication errors, drug identification, drug abuse trends and other information needs. The North Carolina Department of Health and Human Services started formal integration of CPC information into surveillance activities in 2004. CPC call data are uploaded in real time (hourly), 24/7/365, to the NC DETECT state database.

Objective

To describe Carolinas Poison Control Center (CPC) calls data collected in the NC DETECT syndromic surveillance system.

Poliomyelitis a disease targeted for eradication since 1988 still pose public health challenge. The Eastern Mediterranean and African Regions out of the six World Health Organization (WHO) Regions are yet to be certified polio free. The certification of the WHO Africa region is largely dependent on Nigeria, while the WHO Eastern Mediterranean is dependent on Pakistan and Afghanistan. Surveillance for acute flaccid paralysis (AFP) is one of the critical elements of the polio eradication initiative. It provides the needed information to alert health managers and clinician to timely initiate actions to interrupt transmission of the polio disease and evidence for the absence of the wild polio virus. One of the core assignments of the certification committee in all regions is to review documentation to verify the absence of wild poliovirus. Good and complete documentation is the proxy indication of the quality of the system while poor documentation translates to possibilities of missing wild poliovirus in the past. We evaluated the performance of the AFP surveillance system in Bauchi, which is among the 11 high risks states for wild polio virus in Nigeria to identify and address gaps in the surveillance system.

Objective

To identify and address gaps in acute flaccid surveillance for polio eradication in Buchi state