Evaluation

Effective and valid surveillance of syndromes can be extremely useful in the early detection of outbreaks and disease trends. However, medical chart checks without patient identifiers and lack of diagnoses in A08 data has made validation difficult. With the rising availability of electronic health records (EHRs) to local health departments, the ability to evaluate syndromic surveillance systems (SSS) has improved. In LAC, ED data are collected from hospitals and classified into categories based on chief complaints. The most reported syndrome in LAC is the respiratory classification, which is intended to broadly capture respiratory pathogen activity trends. To test the validity of the LAC Department of Public Health (DPH) respiratory syndrome classification, ED syndromic surveillance data were analyzed using corresponding EHRs from one hospital in LAC.

Objective

To compare and validate syndromic surveillance categorization against electronic health records at one hospital emergency department (ED) in Los Angeles County (LAC).

In light of recent communicable disease outbreaks, the ability of Florida Department of HealthÕs (FDOH) syndromic surveillance system, ESSENCE-FL, to identify emergent disease outbreaks using reportable disease data and algorithms originally designed for emergency department chief complaint data was examined. Preliminary work on this analysis presented last year was recently updated and expanded to include additional diseases, further levels of locale, and detector algorithm comparisons. Cases are entered into Merlin, the Bureau of EpidemiologyÕs secure web-based reporting and epidemiologic analysis system, by all 67 county health departments and the de-identified case data are sent hourly to ESSENCE-FL. These data are then available for ad hoc queries, allowing users to observe unusual changes in disease activity and assist in timely identification of infectious disease outbreaks. Based on system algorithms, weekly case tallies are assigned an increasing intensity awareness status from normal to alert and are monitored by county and state epidemiologists to guide timely disease control efforts, but may not by themselves be definitive actionable information.

Objective

To determine if there is an association between known outbreak activity and ESSENCE generated alerts. 

The National Strategy for Biosurveillance defines biosurveillance as 'the process of gathering, integrating, interpreting, and communicating essential information related to all-hazards threats or disease activity affecting human, animal, or plant health to achieve early detection and warning, contribute to overall situational awareness of the health aspects of an incident, and to enable better decision-making at all levels.' However, the strategy leaves unanswered how 'essential information' is to be identified and integrated, or what the metrics qualify information as being 'essential'. Multi-Attribute Utility Theory (MAUT), a type of multi-criteria decision analysis, provides a structured approach that can offer solutions to this problem. While the use of MAUT has been demonstrated in a variety of fields, this method has never been applied to decision support in biosurveillance. We have developed a decision support analytic framework using MAUT that can facilitate identifying data streams for use in biosurveillance. We applied this framework to the problem of evaluating data streams for use in a global infectious disease surveillance system.

Objective

To describe how multi-criteria decision analysis can be applied to identifying essential biosurveillance information and demonstrate feasibility by applying it to prioritize data streams.

The HEDSS system was implemented in 2004 to monitor disease activity [1]. Twenty of 32 emergency departments (ED) and 1 urgent care clinic provide data. Chief complaints are routinely categorized into 8 syndromes. Although previous studies have shown that ED syndomic surveillance is not useful for early detection of GI outbreaks [2], it has demonstrated utility in monitoring trends in seasonal norovirus activity[3]. An evaluation to assess the utility of HEDSS to characterize endemic and out-break levels of GI illness has not been previously conducted in Connecticut.

Objective

To evaluate the utility of the Connecticut Hospital Emergency Department Syndromic Surveillance System (HEDSS) to monitor gastrointestinal (GI) illness in the community.

For public health surveillance to achieve its desired purpose of reducing morbidity and mortality, surveillance data must be linked to public health response. While there is evidence of the growing popularity of syndromic surveillance (1,2), the impact or value added with its application to public health responses is not well described (3).

Objective

To describe if and how syndromic surveillance data influenced public health decisions made during the 2009 H1N1 pandemic within the context of other existing public health surveillance systems.

Imbalances in wealth, education, infrastructure, socio-political leadership, healthcare, and demographics create opportunities and challenges when implementing public health interventions. Understanding these, while embracing "smart power," one can objectively assess a country's receptivity for support. Therefore, we developed a novel conceptual framework and toolset that objectively measured opportunities and challenges to inform decision-making, specifically about future implementation of the Electronic Integrated Disease Surveillance System (EIDSS) - a computer-based system for national reporting and monitoring of reportable human and veterinary infectious diseases in East Africa and the Middle East.

Hepatitis A virus (HAV) infection is usually mild in childhood but more severe in adolescents and adults'. An estimated 1.4 million cases of HAV infection occur annually in the world. The case-fatality rate among patients of all ages is approximately 0.3%, but tends to be higher among older persons (approximately 2% over 40 years of age). HAV is a notifiable disease on weekly basis where health centers and hospitals report cases to the health directorates which in turn report electronically to the Communicable Diseases Directorate, with subsequent paper reporting of detailed epidemiological description. The due time is Tuesday next week. Diagnosis is clinically based and depends on case definition..A previous study in Jordan revealed that reporting rate increased from 6.4 in 2004 to 7.9 in 2008/100,000, the highest reporting rate was in the North region mainly Mafraq.

Objective

The study aims to asses' HAV surveillance in Mafraq Health directorate, and to determine whether the increase in reporting is related to a public health issue or is a result of a relatively good surveillance.

The Biological Threat Reduction Program (BTRP) of the U.S. Defense Threat Reduction Agency (DTRA) delivers interventions to enhance surveillance of especially dangerous pathogens of both humans and animals within countries of the former Soviet Union. The program targets the different stages at which threats or their impact can be reduced, for example via i) the reduction of exposure to threats, or ii) measures for the containment of the threat. The program delivers training on surveillance-related subjects through regular events attended by representatives of the Ministry of Agriculture of Uzbekistan (UZ). This provides an opportunity to capture data and conduct simple interventions on specific subjects amenable to basic evaluation. Given the sensitive nature of pathogen-specific data, we focus on non-disease-specific interventions leading to the reduction of exposure to and release of any given hazard. Here we present an opportunistic approach for capturing data, at no additional cost, to assess i) baseline awareness of on-farm biosecurity measures among UZ veterinary officials and ii) the impact of training on their awareness of biosecurity. We also discuss the conceptual design of a study to assess on-farm biosecurity practices in UZ.

Objective

To describe approaches to the evaluation of surveillance-related efforts in resource-limited countries. Here we present an opportunistic approach to measure the success of efforts to improve on-farm biosecurity in Uzbekistan, leading to a reduction of generic threats to animal disease transmission.