Emergency Department (ED)

Two major heat waves occurred in France in July 2015. A first episode characterized by early onset, intensity, large geographical coverage and duration occurred between 29th of June 8th of July. A second episode less intense was localized on the South-East of the country from 15th to 23rd of July.

The French heat warning system has been operating by InVS since 2004 as part of the French National Heat Wave Plan. Warnings are based on meteorological forecasts and on real-time follow-up of specific health indicators to support decision-making. The evolutions in emergency health care facilities during the July heat waves are presented.

Objective

To present the evolution of heat-related pathologies during heat waves occurring in July 2015 in France

Since the terrorist attacks against the satirical newspaper Charlie Hebdo in January 2015, France has activated the highest level of its national anti-terrorist security plan. A new terrorist attack occurred the 26th of June at 9:50 AM in a gas production plant located in the industrial area of Saint Quentin Fallavier nearby Lyon (East -South-of France). The plant produces several different chemical products like gas and plastics and employed 40 people. The attack resulted in an explosion followed by fire. The French Institute for Public Health Surveillance (InVS) was alerted at 11 AM and decided to implement with its Rhône-Alpes regional office a protocol to timely assess the potential health impact on the population living or working around the attack area on emergency health care facilities (EHCF).

Objective

To timely assess the potential health impact on the population living or working in a terrorist attack area using syndromic surveillance

A local foundation commissioned a project to determine the leading causes of childhood injury in Wake County, NC. Multiple sources of secondary data, including syndromic surveillance data, were used to describe leading causes of childhood injury in the county.

Objective

To utilize secondary data sources to describe childhood injury and prioritize prevention efforts in Wake County, NC.

 

In December 2013, an emergence of chikungunya was observed in the French Caribbean region. Starting on the Saint-Martin island, the epidemic of chikungunya spread in Martinique on December 2013. The first cases were then observed in Guadeloupe in December 2013 and in January 2014 in the French Guyana. A specific surveillance system has been implemented based on a sentinel general practitioners’ network enabling the estimation of the number of cases clinically suggestive. Severity of this arbovirus is assessed using the number of hospitalized cases. The syndromic surveillance system SurSaUD, based on the daily collection of two complementary morbidity data sources, is also implemented in these territories and has contributed to the surveillance of this outbreak.

Objective

Description of the temporal pattern of the chikungunya epidemic and the characteristics of patients in the French overseas territories of Americas using the French syndromic surveillance system SurSaUD.

 

CO poisoning is a leading cause of mortality and morbidity in disaster and post-disaster situations, when widespread power outages most likely occur (1, 2). The NYSDOH Syndromic Surveillance System receives daily ED visit chief complaint data from 140 NYS (excluding New York City) hospitals. Daily power outage data are available from the NYS Department of Public Service (NYSDPS). These data can be used to estimate the risk of CO-EDs and provide useful information for public health situational awareness and emergency response management during disaster events.

Objective

1) To identify carbon monoxide (CO) poisoning in three most affected New York State (NYS) counties (Nassau, Suffolk, and Westchester) during and immediately after Hurricane Sandy with hospital emergency department (ED) chief complaint data reported daily to the New York State Department of Health (NYSDOH). 2) To explore the relationship between power outage and the numbers of CO-related ED visits (CO-EDs).

In June 2004, the French syndromic surveillance system based on the ED has been implemented by the French institute for public health surveillance (InVS), starting with 23 ED. In August 2014, about 600 ED (40,000 daily attendances) are included in the Oscour network, recording 80% of the national total attendances.

Asthma is one of the about 60 syndromic indicators monitored each day and followed all over the year.

This indicator presents important fluctuations and can be influenced by several environmental and infectious but also societal factors. Particularly factors like air pollution are known to have both short and long term impact on asthma while thunderstorms are associated with acute outbreaks of asthma.

Objective

Description of the temporal pattern of the daily number of attendances in emergency departments (ED) for asthma in Paris area and identification of the main factors influencing this indicator.

In 2003, the Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia estimated that approximately 1 million people in the United States were living with HIV/AIDS, and that approximately 25% of these were undiagnosed and unaware of their HIV infection. For many such patients the ED may be the only part of the health care system that is utilized. In 2006, the CDC revised their recommendations for HIV testing in a variety of care settings including the ED. In spite of this change, most EDs throughout the United States still do not offer routine HIV testing. Implementing successful ED based testing models may lead to greater acceptance of ED based testing, earlier detection, and further reduction in the transmission of HIV in the United States.

Objective

To design and implement an ED based rapid HIV screening program targeting high risk patients presenting with signs, symptoms, or concerns for sexually transmitted diseases; to determine the prevalence rate of HIV infection in the tested population; to determine the proportion of HIV-positive patients with successful linkage to outpatient care after ED discharge.

Hurricane ‘Superstorm’ Sandy struck New Jersey on October 29, 2012, causing harm to the health of New Jersey residents and billions of dollars of damage to businesses, transportation, and infrastructure. Monitoring health outcomes for increased illness and injury due to a severe weather event is important in measuring the severity of conditions and the efficacy of state response, as well as in emergency response preparations for future severe weather events. Following the experience with Hurricane Sandy and the foreseeable need to be prepared for future severe weather events, NJDOH initiated a project to develop a suite of 20 indicators in EpiCenter, an online system which collects emergency department chief complaint data in realtime, to perform syndromic surveillance of extreme weather–related conditions.

Objective

To introduce and describe methods for evaluating and refining custom classifier keyword lists for syndromic surveillance of several post-severe weather event conditions and to report findings from New Jersey’s syndromic surveillance of selected conditions in the aftermath of Hurricane Sandy.

The Louisiana Office of Public Health (OPH) Infectious Disease Epidemiology Section conducts emergency department (ED) syndromic surveillance using the Louisiana Early Event Detection System (LEEDS). LEEDS automatically processes electronic chief complaint, admit reason and diagnosis data to identify ED visits indicative of specific syndromes. In response to local transmission of chikungunya virus in the Caribbean and the first travel-associated case in Louisiana in May of 2014, OPH conducted an arboviral syndromic surveillance study to validate arboviral syndromes and evaluate the utility and practicality of detecting and monitoring arboviral disease using ED chief complaint, admit reason and diagnosis text data.

Objective

To validate arboviral syndromes and evaluate the utility and practicality of detecting and monitoring arboviral disease using ED chief complaint, admit reason and diagnosis text data.

Rabies post-exposure prophylaxis (PEP) can prevent fatal encephalitis associated with exposure to the rabies virus. However, overuse and inappropriate administration of rabies PEP are common.1 Mandatory reporting of potential rabies exposures provides opportunities for public health practitioners to monitor the appropriateness of PEP administration and offer recommendations. In Illinois, potential human exposure to rabies, including any person started on PEP and any person with contact to a bat, must be reported to the local health authority. Previous investigations into the completeness of rabies reporting have concluded that active surveillance in addition to mandatory reporting may be useful.2 As rabies PEP is often given in an emergency department setting, syndromic surveillance records may provide a basis for estimating completeness of reporting and identifying candidates for active surveillance follow up.

Objective

To determine whether unreported cases of potential human exposure to rabies can be detected using an emergency department (ED) syndromic surveillance system and to assess both reporting completeness and compliance with clinical guidelines related to rabies exposures in suburban Cook County.