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Interagency Collaboration

The use of syndromic surveillance systems to detect illness and outbreaks in the mid 1990s in New York City resulted in recommendations for increased use of these systems for detection of bioterrorist agents, and tracking influenza throughout the region. Discussions on approaches to best respond to surveillance system signals led to initial efforts to organize a coordinating group of various public health agencies throughout the New York City region. These efforts were strengthened after the events of September 11, 2001, and resulted in the development of a regional workgroup consisting of epidemiologists and other staff from all state, county, and municipal health departments who operate, respond to, or oversee public health preparedness surveillance systems throughout the greater New York City metropolitan area.

 

Objective

The rapid and effective coordination of the multi-jurisdictional communications and response to a surveillance system signal are an important goal of public health preparedness planning. This goal is particularly challenging if the signal indicates a possible risk that could adversely affect populations in multiple states and municipalities. This paper examines the value of a regional workgroup in the activation, integration, and coordination of multiple surveillance systems along with efforts to coordinate risk communication messaging. Recommendations for the development of similar groups in other regions are discussed.

Referenced File
Submitted by hparton on

On 27 April 2005, a simulated bioterrorist event—the aerosolized release of Francisella tularensis in the men’s room of luxury box seats at a sports stadium—was used to exercise the disease surveillance capability of the National Capital Region (NCR). The objective of this exercise was to permit all of the health departments in the NCR to exercise inter-jurisdictional epidemiological investigations using an advanced disease surveillance system. Actual system data could not be used for the exercise as it both is proprietary and contains protected, though de-identified, health information about real people; nor is there much historical data describing how such an outbreak would manifest itself in normal syndromic data. Thus, it was essential to develop methods to generate virtual health care records that met specific requirements and represented both ‘normal’ endemic visits (the background) as well as outbreak-specific records (the injects).

 

Objective

This paper describes a flexible modeling and simulation process that can create realistic, virtual syndromic data for exercising electronic biosurveillance systems.

Referenced File
Submitted by elamb on

The objectives of the two day International Society for Disease Surveillance (ISDS) funded consultation were to develop expert, consensus-based recommendations that address specific, unanswered questions that hinder advances in cross border syndromic surveillance. The consultation included a discussion of the details of existing Canadian (Can) and United States (US) syndromic surveillance systems and the opportunities and challenges for new developments. Particular focus was placed on the ability to detect and respond to a bioterrorism event or infectious disease outbreak across borders.

Referenced File
Submitted by elamb on

NBIC is charged with enhancing the capability of the Federal Government to enable early warning and shared situational awareness of acute biological events to support better decisions through rapid identification, characterization, localization, and tracking. A key aspect of this mission is the requirement to integrate and collaborate with federal and, state, local, tribal, and territorial (SLTT) government agencies. NBIC develops and disseminates a variety of products to its stakeholders, including daily reports, ad-hoc reports, analytic collaborations, and leadership briefings upon request. Stakeholders interact with and utilize NBIC’s products in different ways, depending on the mission and jurisdiction involved. Specific collaborations with individual stakeholders are most frequent and evident during major infectious disease events, such as the recent Zika epidemic in the Americas and the associated microcephaly and other neurological disorders PHEIC. Collaborative efforts and known outcomes among varying levels of government are described in detail below in order to highlight NBIC’s integration focus and capabilities in this role.

Objective:

An important part of the National Biosurveillance Integration Center’s (NBIC) mission is collaboration with federal, state, local, tribal, and territorial governments for the purpose of enhancing early warning, shared situational awareness, and related decision support for infectious disease events. Several such collaborations occurred at multiple jurisdictional levels during the recent Zika epidemic in the Americas and the associated microcephaly and other neurological disorders Public Health Event of International Concern (PHEIC). The collaborations and their known outcomes from this major infectious disease event are described below, and NBIC stands ready to support similar efforts for future events.

Submitted by elamb on

Public health departments need enhanced surveillance tools for population monitoring, and external researchers have expertise and methods to provide these tools. However, collaboration with potential solution developers and students in academia, industry, and government has not been sufficiently close or well informed for rapid progress. Many peer-reviewed papers on biosurveillance methods have been published by researchers, but few methods have been adopted in systems used by health departments. In a 2013 BioSense User Group survey with responses from users in more than 40 U.S. states, access to improved analytic methods was a top priority. Among the tools most desired by respondents were the ESSENCE biosurveillance system with multiple analytic tools and statistical software packages such as SAS. Multiple obstacles have slowed the progress of practitioners and developers who seek the development and implementation of useful analytic tools. First, the epidemiological challenges and associated operational constraints are not sufficiently understood among academic developers. Many health departments do not have the resources to hire such developers beyond maintenance of information technology, and the health monitors are typically too busy to publish in peer-reviewed journals. Second, data cannot be shared because of privacy and proprietary limitations with varying local rules. Data-sharing has posed difficult administrative problems, both within and external to health departments, in the course of ISDS Technical Conventions committee efforts to promote interactions through use case problems. Third, aspects of situational awareness vary widely among health monitors at different jurisdictional levels, so analytical challenges and constraints vary widely among potential users. Practitioners have pointed out that “surveillance is local”, but local operational and data environments vary widely. A fourth main issue is cross-cultural: Understaffed health departments must respond to successive crises and often lack the time for requirements analysis and technical publication. Such client work situations complicate interaction with academic environments of semester schedules and limited grants and transient student support. This panel brings together academic statisticians who have had successful direct relationships with public health departments to discuss how they have dealt with these challenges.

Objective

The session will explore past collaborations between the scientist panelists and public health departments to highlight approaches that have and have not been effective and to recommend effective, sustainable relationship strategies for the mutual advancement of practical disease surveillance and relevant academic research.

Submitted by teresa.hamby@d… on

H5N1 virus occurs mainly in birds. It is highly contagious and deadly among them. However, transmission in human is rare. The first and only confirmed case of human infection with avian influenza H5N1 virus in Nigeria was in 2006. Sporadic infection among poultry has been occurring in Nigeria with yearly estimated loss of millions of Dollars. Six Local Government Areas of Oyo State, Nigeria reported confirmed cases of H5N1 among birds. Affected birds were culled and human avian influenza surveillance was instituted.

Submitted by uysz on

Food safety is a global issue with diverse challenges along various critical points in the food production chain. In India, food safety programs including establishment of surveillance programs and quantitative approaches through integration of various scientific disciplines, streamlined data collection, and analyses were still limited and inconsistently applied. There was need to build capacity of public health workforce in the areas of food surveillance, food borne disease surveillance, incident reporting, investigation of an outbreak and inspection.

Submitted by uysz on

Zoonotic diseases compose a large proportion of the disease burden faced by African countries (e.g. Ebola). A One Health approach to disease control has been embraced across the continent, yet public health and veterinary surveillance systems in most countries remained vertically isolated under separate Ministries. Data exchange, if it occurs, is ad hoc and informal.

Submitted by uysz on
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