Intervention

Clark County, Indiana is geographically located in between the urban area of Louisville, Kentucky and Scott County, Indiana. Scott County is the site for the largest HIV outbreak in the history of the United States, directly related to high rates of IV drug abuse. The unique geographic location of Clark County in combination with the recent HIV and Hepatitis C outbreaks in Clark and neighboring counties has greatly informed the development of an effective response to overdoses and the opioid epidemic in general. Furthermore, Clark County has a unique population distribution, with a population of over 125,000 and a land area of over 300 square miles. Despite this large area, over 80% of the population lives within 9 miles of the southern border of the county. This leads to a mix of both urban and rural challenges. There are several areas of the county that have greater than 15 minute emergency response times, which is often the difference between life and death in an overdose situation. These factors led to the development of the Clark County Rapid Response Project. The rapid response project is a community-based, multidisciplinary framework to address the opioid addicted patient, from initial use to successful recovery. The project uses data driven technology to initiate the care of opiate overdose patients and administer lifesaving interventions.

Objective: To use novel technologies to develop a rapid response framework to reach opioid overdose patients in an area which is challenging from both a geography and population distribution standpoint.

Schools inherently foster the transmission of infections from person to person because they are a group setting in which people are in close contact and share supplies and equipment. Surveillance is important in schools and actions that can help control the spread of infections are the key to effective disease control in the community [1]. School health physicians should play an important role in surveillance. Their training on data collection, analysis, reporting and importance of feedback is recommended in order to improve the disease surveillance system and therefore the prevention and control of diseases.

Objective

We assessed the effect of a training program on the knowledge of school physicians regarding surveillance. The purpose of evaluation is to improve the information provided and thereby help improve service provision and delivery.

Argus is an event-based surveillance system which captures information from publicly available Internet media in multiple languages. The information is contextualized and indications and warning (I&W) of disease are identified. Reports are generated by regional experts and are made available to the system's users. In this study a small-scale disease event, plague emergence, was tracked in a rural setting, despite media suppression and a low availability of epidemiological information.

Objective

To demonstrate how event-based biosurveillance can be utilized to closely monitor disease emergence in an isolated rural area, where medical information and epidemiological data are limited, toward identifying areas for public health intervention improvements.

Work on vaccination timing and promotion largely precedes the 2009 pandemic. Post-pandemic studies examining the wide range of local vaccination efforts mostly have been limited to surveys assessing the role of administrative strategies, logistical challenges, and perceived deterrents of vaccination [1].

Objective

To assess the effectiveness of a Public Health automated phone campaign to increase vaccination uptake in targeted neighborhoods. To identify alternative predictors of variation in vaccination uptake, specifically to assess the association between vaccination uptake, and weather conditions and day-of-week.

We present the EpiEarly, EpiGrid, and EpiCast tools for mechanistically-based biological decision support. The range of tools covers coarse-, medium-, and fine-grained models. The coarse-grained, aggregated time-series only data tool (EpiEarly) provides a statistic quantifying epidemic growth potential and associated uncertainties. The medium grained, geographically-resolved model (EpiGrid) is based on differential equation type simulations of disease and epidemic progression in the presence of various human interventions geared toward understanding the role of infection control, early vs. late diagnosis, vaccination, etc. in outbreak control. A fine-grained hybrid-agent epidemic model (EpiCast) with diurnal agent travel and contagion allows the analysis of the importance of contact-networks, travel, and detailed intervention strategies for the control of outbreaks and epidemics.

Objective:

We will demonstrate tools that allow mechanistic contraints on disease progression and epidemic spread to play off against interventions, mitigation, and control measures. The fundamental mechanisms of disease progression and epidemic spread provide important constraints on interpreting changing epidemic cases counts with time and geography in the context of on-going interventions, mitigations, and controls. Models such as these that account for the effects of human actions can also allow evaluation of the importance of categories of epidemic and disease controls.

Public Health England's syndromic surveillance service monitor presentations for gastrointestinal illness to detect increases in health care seeking behaviour driven by infectious gastrointestinal disease. We use regression models to create baselines for expected activity and then identify any periods of signficant increases. The introduction of a rotavirus vaccine in England during July 2013 (Bawa, Z. et al. 2015) led to a reduction in incidence of the disease, requiring a readjustment of baselines.

Objective:

To adjust modelled baselines used for syndromic surveillance to account for public health interventions. Specifically to account for a change in the seasonality of diarrhoea and vomiting indicators following the introduction of a rotavirus vaccine in England.