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ISDS Conference

Description

In 2012, an outbreak of Mycobacterium chelonae infections in tattoo recipients in Rochester, NY was found to be associated with premixed tattoo ink contaminated before distribution.1 In May 2012, a case of M. chelonae was reported in a New York City (NYC) resident who received a tattoo with ink alleged to have been diluted with tap water. When a second case of M. chelonae in a tattoo recipient was reported in March 2013, an investigation was initiated. M. chelonae is not reportable in NYC other than in clusters reported by providers or laboratories. To determine if there were additional tattoo-associated M. chelonae infections, we searched for cases using NYC ED syndromic surveillance.

Objective

To investigate tattoo-associated skin infections due to Mycobacterium chelonae using Emergency Department (ED) syndromic surveillance.

Submitted by elamb on
Description

There is a significant body of literature on the use of social media for monitoring ailments such as influenza-like illness1 and cholera,2 as well as public opinions on topics such as vaccination.3 In general, these studies have shown that social media correlates well with official data sources,1,2,3 with the trends identifiable before official data are available.2 However, less is known about the impact of integrating social media into public health practice, and resulting interventions. Therefore, the ISDS Social Media for Disease Surveillance Workgroup initiated a systematic literature review on the use of social media for actionable biosurveillance.

Objective

The objective of this study is to systematically review the literature on the use of social media for biosurveillance in order to evaluate whether this data source can improve public health practice or community health outcomes.

Submitted by elamb on
Description

Data streams related to case severity have been added to the Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE), a disease-monitoring application used by the Department of Defense (DoD), as an additional analytic capability to alert the user when indications for events requiring expanded medical resources exist in clinical data streams. Commonly used indicators are admission and death, but fatalities are rare and many DoD clinics lack admitting capability, so we sought to derive additional severity indicators from outpatient records. This abstract describes the technical details and the thought process behind two novel derived indicators: Sick-in-Quarters (SIQ) and Escalating Care.

Objective

To evaluate new severity indicators that mimic a public health professional or clinician's judgment in determining the severity of a public health event when detected by a surveillance system.

Submitted by elamb on
Description

Under-ascertainment of severe outcomes of influenza infections in administrative databases has long been recognised. After reviewing registered deaths following an influenza epidemic in 1847, William Farr, of the Registrar-General's Office, London, England, commented: ''the epidemic carried off more than 5,000 souls over and above the mortality of the season, the deaths referred to that cause [influenza] are only 1,157"[1]. Even today, studies of the population epidemiology, burden and cost of influenza frequently assume that influenza's impact on severe health outcomes reaches far beyond the number of influenza cases counted in routine clinical and administrative databases. There is little current evidence to justify the assumption that influenza is poorly identified in health databases. Using population based record linkage, we evaluated whether the assumption remains justified with modern improvements in diagnostic medicine and information systems.

Objective

To estimate the degree to which illness due to influenza is under-ascertained in administrative databases, to determine factors associated with influenza being coded or certified as a cause of death, and to estimate the proportion of coded influenza or certified influenza deaths that is laboratory confirmed.

Submitted by elamb on
Description

The 122 Cities Mortality Reporting System (CMRS) has been used for pneumonia and influenza monitoring in the U.S. since the early 20th century. The 122 CMRS is regarded as the timeliest source of mortality data, with the majority of deaths being reported to the system within two weeks. However, while it excels at timeliness it lacks detail, accuracy and completeness. Deaths are counted during the week that the death certificate was filed and not during the week in which the death occurred and the system only covers approximately 25% of the U.S. population. Also, while the standard case definition for 122 CMRS is a death in which pneumonia or influenza is listed anywhere on the death certificate; not all sites follow this definition (i.e. some sites only use pneumonia or influenza listed only as the underlying cause of death) [1]. 

Objective

To increase the accuracy, completeness, and detail of data as well as decrease the resources needed to conduct pneumonia and influenza mortality surveillance in the U.S.

Submitted by elamb on
Description

Pandemic 2009 H1N1 influenza and recent H7N9 influenza outbreaks made the public aware of the threat of influenza infection. In fact, annual influenza epidemic caused heavy disease burden and high economic loss around the world [1, 2]. Although the virological surveillance provided the high sensitivity and specificity for testing results, the timeliness and the cost of the test were not feasible for extensive public health surveillance. In addition, traditional sentinel physician surveillance also encountered many challenges such as the representativeness and reporting bias. The seamless surveillance system without extra labor reporting would be the ideal approach. Taiwan had as high as 99% of health insurance coverage. The real-time monitoring of the ILI clinical visits in the communities could reflect the severity of influenza epidemics. In this study, we used an innovative two-stage approach for detecting aberrations during 2009 pandemic influenza in Taiwan.

Objective

This study proposed a two-stage approach for early detection of aberrations of influenza-like illness (ILI) using the small-area based claim data of outpatient and emergency room visit.

Submitted by elamb on
Description

Clostridium difficile (CD) is an important cause of antibiotic and hospital-associated infection. This preventable infection also plays a major role in hospital readmissions, mostly in the elderly, leading to the CMS implementing rules to penalize hospitals with higher rates, in the Hospital Value Based Purchasing Program1.

Objective

To profile the demographic characteristics of the Medicare Advantage(MA) population with this infection and analyze trends in readmissions, mortality, emergency room(ER) visits and observation room(OR) stays from 2008-2011.

Submitted by elamb on
Description

As part of a greater statewide excessive heat response plan, New Hampshire (NH) has been performing HRI surveillance since 2010 to guide response efforts and ultimately reduce HRI morbidity and mortality during situations of excessive heat. Historically, NH hospital Emergency Department Heat illness discharges average around 150 per year, typically in the summer months. NHÕs Excessive Heat Emergency Response Plan documents appropriate state-wide readiness, alerting, emergency, and recovery level of response for heat emergencies with its partners. Together with near real-time surveillance data, flexible query tools, and communication templates, NH is better able to respond to excessive heat emergencies at a moment's notice and take action with its partners to reduce HRI emergencies. Objective: During this presentation NH Division of Public Health Services (NH DPHS) will share how it was able to develop an effective HRI surveillance response through the development of partners, which allowed State of NH decision makers to affect action beyond detection.

Submitted by elamb on
Description

The recent focus on the 'One Medicine' concept has resulted in an increased awareness that the control of diseases in animal populations, whether zoonotic or not, can be of great public health importance. Zoonotic and foodborne diseases represent an immediate threat to the health of human populations, while rapid spreading diseases in animals can compromise the food-supply and the economy of a country or region. On the other hand, animal populations can serve as sentinels, and continued surveillance can prevent the emergence and/or rapid spread of pathogens potentially harmful to humans. However, awareness of the activities developed in the field of animal health is still low among public health workers. To date, the cooperation between public health and animal health epidemiologists has mainly involved the control of outbreaks of foodborne diseases. Greater cooperation between the two fields, however, could improve prevention and reduce the number of such outbreaks.

Objective

To discuss opportunities to improve the synergy between animal and public health and increase awareness, among public health workers, of the concept of animal health.

Submitted by elamb on
Description

Situational awareness is important for both early warning and early detection of a disease outbreak, and analytics and tools that furnish information on how an infectious outbreak would either emerge or unfold provide enhanced situational awareness for decision makers/analysts/public health officials, and support planning for prevention or mitigation. Data sharing and expert analysis of incoming information are key to enhancing situational awareness of an unfolding event. In this presentation, we will describe a suite of tools developed at Los Alamos National Laboratory (LANL) that provide actionable information and knowledge for enhanced situational awareness during an unfolding event; The biosurveillance resource directory (BRD), the biosurveillance analytics resource directory (BaRD) and the surveillance window app (SWAP).

Objective

To develop a suite of tools that provides actionable information and knowledge for enhanced situational awareness during an unfolding event such as an infectious disease outbreak.

Submitted by elamb on