Emergency Department (ED)

Syndromic surveillance has been used been used as method of surveillance for various events in recent years. For example, post September 11th, 2001 anthrax attacks in New York City, World Youth Day in Toronto 2002, Salt Lake City 2002 Olympics, Democratic National Convention Boston 2004, and the G8 Summit in Scotland 2005.

Objective

Historical Emergency Department (ED) visits were examined to characterize ED utilization for the weeks before, during and after Queen’s University Homecoming weekend in Kingston, Ontario, Canada. This information was used to prospectively monitor the 2006 Homecoming period and inform key stakeholders.

Data quality for syndromic surveillance extends beyond validating and evaluating syndrome results. Data aggregators and data providers can take additional steps to monitor and ensure the accuracy of the data. In North Carolina, hospitals are mandated to transmit electronic emergency department data to the North Carolina Disease Event Tracking and Epidemiologic Tool (NC DETECT) system at least every 24 hours. Protocols have been established to ensure the highest level of data quality possible. These protocols involve multiple levels of data validity and reliability checks by NC DETECT staff as well as feedback from end-users concerning data quality. Hospitals also participate in the data quality processes by providing metadata including historical trends at each facility.

Objective

The purpose of this project is to describe the initiatives used by the NC DETECT to ensure the quality of ED data for surveillance.

An important problem in biosurveillance is the early detection and characterization of outdoor aerosol releases of B. anthracis. The Bayesian Aerosol Release Detector (BARD) is a system for simulating, detecting and characterizing such releases. BARD integrates the analysis of medical surveillance data and meteorological data. The existing version of BARD does not account for the fact that many people might be exposed at a location other than their residence due to mobility. Incorporation of a mobility model in biosurveillance has been investigated by several other researchers. In this paper, we describe a refined version of the BARD simulation algorithm which incorporates a model of work-related mobility and report the results of an experiment to measure the effect of this refinement.

Objective 

To refine the simulation algorithm used in the BARD so that it takes into account the work-related mobility and to compare the refined simulator with the existing one.

On June 7, 2008, federal food protection and public health agencies alerted consumers of a nationwide outbreak of Salmonella Saintpaul infections. As of June 30, 2008, 851 persons infected with Salmonella Saintpaul with the same genetic fingerprint had been identified in 36 states and the District of Columbia since April 20081. On June 13, 2008, Maryland confirmed its first case of Salmonella Saintpaul infection matching the national outbreak strain and as of June 30, 2008, 29 cases of Salmonella related to the outbreak have been identified.

Objective 

The purpose of this paper is to describe the use of syndromic surveillance emergency department data as a tool for enhanced case finding of outbreak-related illnesses.

A syndromic surveillance system has been implemented at Kingston, Frontenac and Lennox & Addington Public Health in Kingston Ontario as part of a pilot project funded by the Ontario Ministry of Health and Long-Term Care – Public Health Division. The information captured by the Real-time Outbreak and Disease Surveillance-based syndromic surveillance system includes Febrile Respiratory Illness screening results (implemented since SARS) for Emergency Department (ED) visits and information detailing hospital admissions.

Objective

To use an electronic real-time ED monitoring tool to involve public health, acute care and laboratory stakeholders in an integrated alerting and response process for community-wide influenza.

The threat of terrorism and high-profile disease outbreaks has drawn attention to public health syndromic surveillance systems for early detection of natural or man-made disease events. In this sense, the Miami-Dade County Health Department has implemented ESSENCE (Electronic Surveillance System for the Early Notification of Community-based Epidemics) in 2005; which has been developed and updated by the Johns Hopkins University.

Objective 

This paper describes the dual monitoring process of Influenza-like Illness (ILI) syndrome in Miami-Dade County using the ESSENCE syndromic surveillance system, and their potential use as part of the seasonal influenza and pandemic influenza surveillance strategies.

The purpose of syndromic surveillance is the early identification of disease outbreaks. Classification of chief complaints into syndromes and the type of statistics used for aberration detection can affect outbreak detection sensitivity and specificity. Few data are available on the relationship between chief complaints and demographics such as gender, age, or race. For example, myocardial infarction in women would be misclassified using definitions based solely on “male” symptoms such as chest pain because women more commonly report neck, jaw, and back pain.

Objective

We evaluated the sensitivity and specificity of a gastrointestinal syndrome group using the Boston Public Health Commission syndromic surveillance system.

Traditionally Emergency Department syndromic surveillance methods have relied on ICD-9 codes and chief complaints. The implementation of electronic medical record keeping has made much more information available than can potentially be used for surveillance. For example, information such as vital signs, review of systems and physical exam data are being stored discreetly. These data have the potential to detect specific diseases or outbreaks in a community earlier that the traditionally used ICD-9 and chief complaint.

Objective

This paper describes the integration of novel data sets from an Emergency Department Electronic Medical Record into a syndromic surveillance application.

Surveillance strategies following major natural disasters have varied widely with respect to methods used to collect and analyze data. Following Hurricane Katrina, public health concerns included infectious disease outbreaks, injuries, mental health and exacerbation of preexisting chronic conditions resulting from unprecedented population displacement and disruption of public health services and health-care infrastructure.

Objective

This paper describes the public health surveillance response to hurricane Katrina in New Orleans and surrounding Parishes; particularly illustrating the methods, results, and lessons learned for implementing passive, active and electronic syndromic surveillance systems during a major disaster.

In May 2000 accidental contamination of the water supply led to an outbreak of severe gastroenteritis in Walkerton Ontario, Canada. Of 1346 cases associated with exposure to Walkerton water, 65 were admitted to hospital, 27 developed Hemolytic-Uremic Syndrome, and six died. Estimates that 42% of cases were unreported indicate that the actual number of cases was likely 2321.

Objective

This abstract reports preliminary results of a retrospective study of the effectives of ER syndromic surveillance in detecting this outbreak.