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Gastrointestinal Outbreaks

From January to March 2010, thirteen outbreaks of Norovirus infection were reported to the Epidemiology, Disease Control and Immunization Service (EDC-IS), up from four outbreaks in the entire 2008 and same number during 2009. Individual cases of Norovirus are not reportable in the State of Florida. That makes it difficult to track the onset, rise, peak, and fading of epidemics of this disease.

 

Objective

To demonstrate how the EDC-IS at the Miami-Dade County Health Department used ESSENCE to track gastrointestinal symptoms during a Norovirus epidemic.

Referenced File
Submitted by hparton on

We are developing a Bayesian surveillance system for realtime surveillance and characterization of outbreaks that incorporates a variety of data elements, including free-text clinical reports. An existing natural language processing (NLP) system called Topaz is being used to extract clinical data from the reports. Moving the NLP system from a research project to a real-time service has presented many challenges.

 

Objective

Adapt an existing NLP system to be a useful component in a system performing real-time surveillance.

Referenced File
Submitted by hparton on

GI disease outbreaks can be focal (for example, restaurant associated), generalized (for example, seasonal rotavirus increases) or intermediate (for example, widely disseminated contaminated commercial products). Health departments (HDs) are commonly notified of focal outbreaks by passive reporting, whereas generalized outbreaks in non-institutional settings are seldom reported as clusters. Intermediate outbreaks are often detected via laboratory testing, which may be subjected to backlogs and delays. Healthcare systems routinely collect in EMRs clinical data related to GI disease, such as ambulatory care diagnoses, that could be exploited for surveillance. Multiple syndromic and laboratory data sources could potentially be used to prospectively detect generalized and intermediate GI disease outbreaks for situational awareness and possible epidemiological investigation.

Objective

To identify which syndromic and laboratory-based data streams from electronic medical records (EMRs) may be used to detect gastrointestinal (GI) disease outbreaks in a timely manner.

Referenced File
Submitted by teresa.hamby@d… on

National telephone health advice service data have been investigated as a source for syndromic surveillance of influenza-like illness and gastroenteritis . Providing a high level of coverage, the system might serve as an early outbreak detection tool. We have previously found that telephone triage service data of acute gastroenteritis was superior to web queries as well as over-the-counter pharmacy sales of anti-diarrhea medication to detect large water- and foodborne outbreaks of gastrointestinal illness in Sweden during the years 2007–2011 (4). However, information is limited regarding the usefulness, characteristics, and signal properties of local telephone triage data for monitoring and identifying outbreaks at the community level.

Objective

Our aim was to use telephone triage data to develop a model for community-level syndromic surveillance that can detect local outbreaks of acute gastroenteritis (AGE) and influenza-like illness (ILI) and allow targeted local disease control information.

Submitted by knowledge_repo… on

In February of 2007, the Bureau of Epidemiology (BOE) received a request from Houston Department of Public Works to investigate a possible rise in gastrointestinal (GI) illness associated with complaints about poor water quality in a Northeastern Houston neighborhood. To investigate this complaint, BOE combined case report data with syndromic data from our Real-Time Outbreak Disease Surveillance (RODS). The Houston RODS collects and synthesizes real-time chief complaint data from 34 area hospitals and health facilities, representing approximately 70% coverage of licensed ER beds in Harris County. The system uses a Naïve Bayes Classifier to categorize ER chief complaints into 7 different syndromes, including GI illness.

 

Objective

To investigate public concern over a possible increase in GI illness associated with water quality complaints in Northeast Houston.

Referenced File
Submitted by elamb on

Although Electronic Surveillance System for the Early Notification of Community Based Epidemics (ESSENCE) provides tools to detect a significant alert regarding an unusual public health event, combining that information with other surveillance data, such as 911 calls, school absenteeism and poison control records, has proved to be more sensitive in detecting an outbreak. On Monday, June 16, Florida Poison Information Network, which takes after-hours and weekend calls for Miami-Dade County Health Department (MDCHD), contacted the Office of Epidemiology and Disease Control about five homeless persons that visited the same hospital simultaneously with gastrointestinal symptoms on Saturday, June 14. Poison control staff asked MDCHD to investigate further to determine whether it was an outbreak.

 

Objective

To illustrate how MDCHD utilized ESSENCE in order to track a gastrointestinal outbreak in a homeless shelter.

Referenced File
Submitted by elamb on

On June 22, 2007 increases in over-the-counter (OTC) electrolyte and child anti-fever medication sales were detected through routine OTC surveillance. Increases in emergency department (ED) data for gastrointestinal (GI) illness among <5 year olds were observed on June 23 and 24. Further analyses indicated clustering within one borough of NYC, with three EDs having most of the visits. Because NYC has had limited success in detecting spatial outbreaks using syndromic surveillance in the past, an investigation was not immediately initiated.

DOHMH was notified of a multi-state outbreak of S. wandsworth suspected to be associated with the snack food Veggie Booty® on June 26. Cases were predominantly young children and included 8 confirmed cases among NYC residents with onset dates from March 4 – May 19.

 

Objective

To determine whether increases in GI illness detected through OTC drug sales and ED syndromic surveillance were linked to a multi-state outbreak of S. wandsworth associated with the consumption of Veggie Booty® snack food.

Referenced File
Submitted by elamb on

Objective

Understanding the baseline dynamics of syndrome counts is essential for use in prospective syndromic surveillance. Therefore we studied to what extent the known seasonal dynamics of gastro-intestinal (GI) pathogens explain the dynamics in GI syndrome in general practitioner and hospital data.

 

Referenced File
Submitted by elamb on

The North Carolina Bioterrorism and Emerging Infection Prevention System (NC BEIPS) receives daily emergency department (ED) data from 33 (29%) of the 114 EDs in North Carolina. These data are available via a Web-based portal and the Early Aberration Reporting System to authorized NC public health users for the purpose of syndromic surveillance (SS). Users currently monitor several syndromes including: gastrointestinal severe, fever/rash illness and influenza-like illness. The syndrome definitions are based on the infection-related syndrome definitions of the CDC and search the chief complaint (CC) and, when available, triage note (TN) and initial temperature fields. Some EDs record a TN, which is a brief text passage that describes the CC in more detail. Most research on the utility of ED data for SS has focused on the use of CC. The goal of this study was to determine the sensitivity, specificity, and both positive and negative predictive value of including TN in the syndrome queries.

 

Objective

This study evaluates the addition of TN to syndrome queries used in the NC BEIPS.

Referenced File
Submitted by elamb on
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