Epidemiology

Rift Valley fever (RVF) is a mosquito-borne viral zoonosis. This study aimed to estimate the prevalence of antibodies to RVF virus (RVFV) in cattle, sheep, and goats in South Africa, near the 2010-2011 outbreak epicenter and identify factors associated with seropositivity.

Objective: The objective of this study was to estimate the prevalence of antibodies to RVFV in domestic cattle, sheep, and goats in a study area in the central interior of South Africa, and to identify factors associated with seropositivity.

It can be difficult to distinguish between truth, half-truth, fiction, and misinformation as we watch the news, read headlines, and scroll through various social media feeds. Fortunately, epidemiologists have the tools needed to serve as a practical resource for colleagues, partners, and communities. The Scrutinizer Challenge is an opportunity for epidemiologists to tackle at least one news story or study a month that is relevant to public health. The goal is that we would do the research necessary to examine data sources and implications of news stories and studies. This process can help us deliver consistent and reliable messages to share with colleagues, partners, and communities. It also provides an opportunity for epidemiologists that practice in different settings to consolidate resources and develop working relationships that may be needed to more thoroughly examine issues.

Objective: Epidemiologists will be better prepared to serve as a practical resource within their communities and spheres of influence by taking the time to examine data sources behind and implications of news stories and studies that are being widely circulated.

Arboviral infections have become a significant public health problem with the emergence and re-emergence of arboviral diseases worldwide in recent decades. Given the increasing number of cases, geographic spread, but also health, social and economic impact of arboviral outbreaks, estimating their true burden represents a crucial issue but remains a difficult task. In French Guiana, the epidemiology of arboviral diseases has been marked by the occurrence several major dengue fever (DENV) outbreaks over the past few decades, recent emergences of Chikungunya (CHKV) and Zika virus (ZIKV) and the circulation of Mayaro virus (MAYV).

Objective: To assess the level of circulation of DENV, CHIKV, ZIKV, MAYV in French Guiana.

Legionellosis is a respiratory disease that can lead to serious illness such as pneumonia, and can even result in death. Since 2010, increased reports of legionellosis have been received in Toronto during the summer months and led to a five-fold increase by 2012. This underscored the need to rule out common sources through a rapid assessment of exposure data (i.e., locations visited) for any spatio-temporal links. Legionella bacteria from a single source can affect individuals at distances as great as 10 km (1) but dispersion of Legionella bacteria is generally within 1 km of the source (2). This information was used to describe an area of potential risk around each exposure location. Adding temporal information from dates of potential exposures could provide a useful tool for outbreak detection. An automated tool was developed to link spatial and temporal data to assess need for further follow up.

Objective:

To develop an outbreak detection tool which uses spatial information related to temporally clustered legionellosis cases reported in Toronto, Canada.

Unpublished statewide 2009 H1N1 epidemiological data suggests that rates of lab-confirmed H1N1-related hospitalization were three to four times higher in Black and Hispanic populations compared to White, non-Hispanic populations (Alfred DeMaria, MDPH, personal communication, 2010). There is an absence of socioeconomic data in most public health surveillance systems, and population-based statewide descriptions of H1N1-related hospitalizations according to race/ethnic group and SES have not been described.

Objective

1) Investigate 2009 H1N1-related ICU admissions in Massachusetts by race/ethnic group;

2) Investigate the association between ICU stay and race/ethnic group adjusted for socioeconomic status (SES).

Taiwan had established a nation-wide emergency department (ED)-based syndromic surveillance system since 2004, with a mean detection sensitivity of 0.67 in 2004-06 [1]. However, this system may not represent the true epidemic situation of infectious disease in community, particularly those who don't seek medical care [2]. Moreover, the epidemiological settings, sources of the infection and social network all together may still facilitate the transmissions. These rooted problems cannot be rapidly solved.

Objective

This study has two specific aims:

(1) to establish a web-based, public-access infectious disease reporting system (www.eid.url.tw), using newly designed public syndrome groups and based on computational and participatory epidemiology

(2) to evaluate this system by comparing the epidemiological patterns with national-wide electronic health-database and traditional passive surveillance systems from Taiwan-CDC.

Syndromic surveillance systems were designed for early outbreak and bioterrorism event detection. As practical experience shaped development and implementation, these systems became more broadly used for general surveillance and situational awareness, notably influenza-like illness (ILI) monitoring. Beginning in 2006, ISDS engaged partners from state and local health departments to build Distribute, a distributed surveillance network for sharing de-identified aggregate emergency department syndromic surveillance data through existing state and local public health systems. To provide more meaningful cross-jurisdictional comparisons and to allow valid aggregation of syndromic data at the national level, a pilot study was conducted to assess implementation of a common ILI syndrome definition across Distribute.

Objective

Assess the feasibility and utility of adopting a common ILI syndrome across participating jurisdictions in the ISDS Distribute project.

Epidemic acute gastroenteritis (AGE) is a major contributor to the global burden of morbidity and mortality. Rotavirus and norovirus epidemics present a significant burden annually, with their predominant impact in temperate climates occurring during winter periods. Annually, epidemic rotavirus causes an estimated 600,000 deaths worldwide, and 70,000 hospitalizations in the US, primarily among children <5 years of age. The US burden from norovirus is estimated at 71,000 hospitalizations annually, with the impact more generally across age groups. Changes in rotavirus vaccine use have significantly reduced the impact of epidemic rotavirus.

Objective 

We describe the initial phase of the ISDS Distribute pilot for monitoring AGE syndromic emergency department visits, and present preliminary analysis of age-specific trends documenting a dramatic shift in AGE consistent with US rotavirus vaccine policy and use.

In the last decade, the scope of public health (PH) surveillance has grown, and biosurveillance capacity has expanded in Duval County. In 2004, the Duval County Health Department (DCHD) implemented a standalone syndromic surveillance (SS) system which required the manual classification and entry of emergency department (ED) chief complaints by hospital staff. At that time, this system, in conjunction with other external systems (e.g. CDC ILInet, FluStar, NRDM) were used to conduct surveillance for health events. Recommendations from a 2007 ISDS panel were used to strengthen surveillance within Duval County. Later that year, the Florida DOH moved to a statewide SS system and implemented ESSENCE which has been expanded to include 1) ED record data from 176 hospitals (8 within Duval County); 2) Reportable disease case records from Merlin; 3) Florida Poison Information Network consultations; and, 4) Florida Office of Vital Statistics death records (1). ESSENCE has subsequently become a platform for rapid data analysis, mapping, and visualization across several data sources (1). As a result, ESSENCE has improved business processes within DCHD well beyond the initial scope of event detection. These improvements have included 1) expansion of the ability to create visualizations (e.g. epi-curves, charts, and maps); 2) reduction in the time required to produce reports (e.g. newsletters, media responses); 3) reduction in staff training needs; and 4) augmentation of epidemiology processes (e.g. active case finding, emergency response, quality improvement (QI)), and closing the PH surveillance loop.

Objective

This paper reviews the evolution of biosurveillance in Duval County, FL and characterizes the subsequent improved execution of epidemiology functions as a result of the implementation of the Early Notification of Community-based Epidemics (ESSENCE) system.