Infectious Disease

Poliomyelitis a disease targeted for eradication since 1988 still pose public health challenge. The Eastern Mediterranean and African Regions out of the six World Health Organization (WHO) Regions are yet to be certified polio free. The certification of the WHO Africa region is largely dependent on Nigeria, while the WHO Eastern Mediterranean is dependent on Pakistan and Afghanistan. Surveillance for acute flaccid paralysis (AFP) is one of the critical elements of the polio eradication initiative. It provides the needed information to alert health managers and clinician to timely initiate actions to interrupt transmission of the polio disease and evidence for the absence of the wild polio virus. One of the core assignments of the certification committee in all regions is to review documentation to verify the absence of wild poliovirus. Good and complete documentation is the proxy indication of the quality of the system while poor documentation translates to possibilities of missing wild poliovirus in the past. We evaluated the performance of the AFP surveillance system in Bauchi, which is among the 11 high risks states for wild polio virus in Nigeria to identify and address gaps in the surveillance system.

Objective

To identify and address gaps in acute flaccid surveillance for polio eradication in Buchi state

Newcastle disease (ND) is the most important infectious viral disease of poultry. The world-wide economic loss from it is 2-3 billion USD per year. ND is reportable to the World Organization for Animal Health (OIE). ND is caused by virulent strains of avian Paramyxoviruses belonging to type 1. Industrial poultry farming is rapidly developing in Ukraine. Ornithological fauna of Ukraine includes about four hundred species of birds, 207 of which nest within its borders. The territory of Ukraine transits 3 out of 14 transcontinental global migration flows. The wild birds are the main natural reservoir of ND agents. It is necessary to control the intensity of post-vaccination immunity in poultry and the timing of revaccinations. OIE recommends enzyme linked immunosorbent assays (ELISA) and HI test for these purposes. However, it should be noted that HI test, possessing high specificity and sensitivity, is much cheaper. Therefore, it is the excellent means for ND timely surveillance.

Objective

A test kit for the detection of antibodies to Newcastle disease virus (NDV) based on haemagglutination inhibition (HI) assay has been developed and introduced into practice for the first time in Ukraine.

Since the majority of emerging infectious diseases over the past several decades have been zoonotic, animal health surveillance is now recognized as a key element in predicting public health risks. Surveillance of animal populations can provide important early warnings of emerging threats to human populations from bioterrorism or naturally occurring infectious disease epidemics. This study investigated current animal data collection and surveillance systems, isolated major gaps in state and national surveillance capabilities, and provided recommendations to fill those gaps.

Objective

To identify gaps in current U.S. animal data collection and surveillance systems, describe how surveillance of animal populations can provide important early warnings of emerging threats to human populations from infectious disease epidemics, and explain the benefits of integrating human and animal surveillance data into a common linked system.

The Florida Department of Health in Hillsborough County (FDOH- Hillsborough) conducts enhanced syndromic surveillance on a daily basis. The Electronic Surveillance System for the Early Notification of Community-based Epidemics in Florida (ESSENCE-FL) is the syndromic surveillance system used by epidemiologists within the Florida Department of Health (FDOH). During the time of this study, ESSENCE-FL receives data from 210 of emergency departments (ED) and 33 urgent care centers (UCC) throughout the state of Florida, including 12 EDs and 3 UCCs in Hillsborough County. In 2014, the ESSENCE-FL system added a feature that delivers an automatic daily email to designated primary ESSENCE-FL users in each county containing all visits which have been detected by the state’s visits of interest (VOI) query. The email contains all visits which have been detected by the visits of interest (VOI) query for each ESSENCE-FL users designated county. The VOI query utilizes the combined chief complaint and discharge diagnosis (CCDD) field of a visit for keywords related to reportable diseases and exposures of public health interest. In addition to this VOI email, Hillsborough County analyzes time of arrival alerts, specialized emerging infectious disease queries, poison information center data, and volume levels of syndromes and subsyndromes predetermined by ESSENCE-FL. A daily summary report of the enhanced daily surveillance analysis is then provided to area public health officials within FDOH-Hillsborough and the surrounding counties. This study examines how visits requiring additional investigation are detected and the resources required to complete the investigation.

Objective

Enhanced daily surveillance is used to identify reportable diseases, outbreaks, and clusters and provides situational awareness. This project examines how health care visits requiring additional information are detected using enhanced syndromic surveillance and the resources required from detection through completion.

Syndromic surveillance is an alternative type of public health surveillance which utilizes pre-diagnostic data sources to detect outbreaks earlier than conventional (laboratory) surveillance and monitor the progression of illnesses in populations. These systems are often noted for their ability to detect a wider range of cases in under- reported illnesses, utilize existing data sources, and alert public health authorities of emerging crises. In addition, they are highly versatile and can be applied to a wide range of illnesses (communicable and non-communicable) and environmental conditions. As a result, their implementation in public health practice is expanding rapidly. This scoping review aimed to identify all existing literature detailing the necessary components in the defining, creating, implementing, and evaluating stages of human infectious disease syndromic surveillance systems. 

An increasing number of geo-coded information streams are available with possible use in disease surveillance applications. In this setting, multivariate modeling of health and non-health data allows assessment of concurrent patterns among data streams and conditioning on one another. Therefore it is appropriate to consider the analysis of their spatial distributions together. Specifically for vector-borne diseases, knowledge of spatial and temporal patterns of vector distribution could inform incidence in humans. Tularemia is an infectious disease endemic in North America and parts of Europe. In Finland tularemia is typically mosquito-transmitted with rodents serving as a host; however, a country-wide understanding of the relationship between rodents and the disease in humans is still lacking. We propose a methodology to help understand the association between human tularemia incidence and rodent population levels. 

Objective

We seek to integrate multiple streams of geo-coded information with the aim to improve public health surveillance accuracy and efficiency. Specifically for vector-borne diseases, knowledge of spatial and temporal patterns of vector distribution can help early prediction of human incidence. To this end, we develop joint modeling approaches to evaluate the contribution of vector or reservoir information on early prediction of human cases. A case study of spatiotemporal modeling of tularemia human incidence and rodent population data from Finnish health care districts during the period 1995-2013 is provided. Results suggest that spatial and temporal information of rodent abundance is useful in predicting human cases. 

In September, 2015, Nigeria was delisted from the list of polio endemic countries globally. To be certified polio free, the country must attain and maintain certification standard Acute Flaccid Paralysis(AFP) surveillance for additional two-years. In Oyo State, no case of Wild Polio Virus (WPV) has been reported since February, 2009.

Objective

We evaluated the AFP surveillance system in Oyo State to assessits attributes and determine if it was meeting its set objectives.

Since the emergence of avian influenza A(H7N9) virus in 2013, extensive surveillances have been established to monitor the human infection and environmental contamination with avian influenza virus in southern China. At the end of 2015, human infection with influenza A(H5N6) virus was identified in Shenzhen for the first time through these surveillances. These surveillances include severe pneumonia screening, influenza like illness (ILI) surveillance, follow-up on close contact of the confirmed case, serological survey among poultry workers, environment surveillance in poultry market.

Objective

To determine avian influenza A(H5N6) virus infection in human and environment using extensive surveillances. To evaluate the prevalence of H5N6 infection among high risk population. 

Malaria is a parasitic disease caused by Plasmodium falciparum. About 3.2 billion people worldwide are at risk of malaria. Children and pregnant women are particularly vulnerable to the disease. Sub- Saharan Africa carries a high share of the global malaria burden. Effective malaria surveillance system is essential in the control and elimination of malaria. Worldwide, there were an estimated 198 million cases of malaria in 2013 and 584,000 deaths. 

Objective

To describe the process of operation of the system and assess its key attributes, to determine the effectiveness and efficiency of the surveillance system and make appropriate recommendations to stakeholders for its improvement.