Syndromes

The 2014 Ebola outbreak in West Africa is one of the largest Ebola outbreaks in history. Early detection is critical for rapid initiation of treatment, infection control and emergency response plans. To facilitate clinicians’ ability to detect Ebola, various syndrome definitions have been developed.

Objective

To develop and validate an Ebola virus disease syndrome definition within the GUARDIAN (Geographic Utilization of Artificial Intelligence in Real-Time for Disease Identification and Alert Notification) surveillance system.

The LAC SSS has been in existence since 2004. Currently, the system collects data from over 50 hospitals daily and performs a chief complaint-based syndrome classification analysis of all ED visits. The keyword “fever” is of special interest due to its inclusion within several syndrome category definitions such as influenza, meningitis, etc. However, inclusion of such terms in syndrome definitions may be a disadvantage as such keyword searches would depend upon the consistency in which the term “fever” is reported. In 2014, several LAC syndromic surveillance hospital data connections were upgraded to include notes recording patient body temperature. To evaluate the newly added temperature information, analyses were conducted on those observations that included body temperature, chief complaint, and diagnosis information.

Objective

The Los Angeles County (LAC) Emergency Department (ED) Syndromic Surveillance System (SSS) classifies patients into syndrome categories based on stated chief complaints. In an effort to evaluate the accuracy of patient- stated chief complaints and final diagnoses, both “fever” chief complaints and diagnoses were compared with patient body temperature readings.

NC DETECT receives ICD-9-CM codes for emergency department (ED) visits and uses these codes in case definitions for syndromic surveillance (e.g. infectious disease, injury, etc.). Hospitals will begin using ICD-10-CM codes on October 1, 2015. As a result, preparations have been made to accommodate ICD-10-CM codes in NC DETECT for data transmission, receipt, processing and use in the NC DETECT Web Application.

Objective

To describe lessons learned from the transition to ICD-10-CM.

In most disadvantaged communities in Northern Nigeria, adolescent girls engage in economic activities so that they can save money for household items to be bought for them when they are given out for marriage. These girls right from before they reach teenage age hawk items which include ready-to-eat foods. Various socio-cultural and environmental factors reinforce vulnerability of foods to microorganisms. Food safety awareness, knowledge and practices among food vendors can be affected by interplay between individual and outdoor factors. Teenagers engage in hawking food without understanding food-related risks for the preservation of their health and the health of others. Food hygiene is the conditions and measures necessary to ensure the safety of food from production to consumption. Lack of adequate food hygiene can lead to foodborne diseases and death of the consumer. Mishandling of food can occur during food preparation, handling and storage; and studies show that consumers have inadequate knowledge about measures needed to prevent food-borne illness. There are a number of factors which are likely to contribute to outbreaks of food-borne illness in the home, including a raw food supply that may be contaminated, a lack of food safety knowledge among the general public, mistakes in food handling and preparation at home.

Real-time emergency department (ED) data are currently received from 78 of 80 New Jersey acute care and satellite EDs by Health Monitoring Systems Inc.’s (HMS) EpiCenter system. EpiCenter collects, manages and analyzes ED registration data for syndromic surveillance, and provides alerts to state and local health departments for surveillance anomalies. After the 2012 Superstorm Sandy devastated parts of New Jersey, NJDOH initiated a plan to develop severe weather surveillance using EpiCenter to provide the Department with the ability to track both health and mental health concerns during adverse weather conditions to alert the public about emerging health hazards.

Objective

To describe the development and validation of a mental health classification to track emergency department visits for potential needed public health response during severe weather events.

Syndromic surveillance refers to the monitoring of disease related events, sets of clinical features (i.e. syndromes), or other indicators in a population. Tennessee obtains emergency department data for syndromic surveillance in standardized HL7 format following the field and value set standards published by the Public Health Information Network. Messages contain information previously unavailable to syndromic surveillance systems, including quantitative values such as recorded temperature. Data are received daily and processed by a Tennessee ESSENCE application and the national BioSense platform.

These systems use chief complaint keywords, ICD9 codes, and other algorithms to assign syndromes for each record. The differences between the BioSense and ESSENCE syndrome assignments have not been well defined. Detailed comparisons of syndrome assignment across tools are difficult to perform due to the intensity of the manual review required. However, definitions of fever can be easily confirmed in HL7 messages when the recorded temperature is provided. Currently, both the BioSense and ESSENCE syndrome definitions exclude recorded temperature from consideration when assigning syndromes.

To compare the performance of the fever syndromes used by BioSense and ESSENCE, recorded temperature data was used as the gold standard.

Objective

To objectively compare the BioSense and ESSENCE fever syndromes using recorded temperature as a gold standard.