ISDS Conference

On March 7th and 8th of 2007 authorities from federal, state, county, and municipal jurisdictions/agencies having mass migration response responsibilities (as per the Department of Homeland Security Operation Vigilant Sentry, as well as State and Local plans) initiated the last of a series of mass migration exercise events. The mission of the exercise was to “unify” a federal, state, and local response to effectively mitigate a catastrophic mass migration incident, similar to the Mariel Boatlift (125,000+ migrants) in 1980. The exercise included volunteers who visited a few local emergency departments with specific scripts describing an acute medical condition.

Objective

Describe the use of the ESSENCE (Electronic Surveillance System for the Early Notification of Community-based Epidemics) system to detect unusual patterns of emergency department use during a full scale mass migration exercise in South Florida.

In 2005, three hurricanes made landfall in Florida, with Hurricane Wilma having the most severe impact on Miami-Dade County. Syndromic surveillance is typically used to detect bioterrorism or natural disease outbreaks before specific diagnoses are made. After Wilma, however, the Miami-Dade County Health Department assessed the utility of syndromic data for surveillance of hurricane-related injuries.

Objective

To determine the proportion of injuries in Miami-Dade County that could be related to the impact of Hurricane Wilma, which made landfall in Florida on October 25, 2005.

Respiratory viruses cause substantial morbidity and costly resource utilization among young children, especially during the winter months. Accurate estimates of the impact of these viruses are important in guiding prevention efforts and measuring the impact of public health interventions. Previous studies have focused on the rate of hospitalizations resulting from viral infections, particularly those attributable to influenza virus for which a vaccine is available, but have not included healthcare use in the emergency department (ED) nor considered the impact of other viruses such as respiratory syncytial virus (RSV), for which limited preventative methods are available. We used ED surveillance data for acute respiratory infection to measure the population-based impact of specific viruses.

Objective

To use surveillance data to estimate resource utilization and parental lost productivity associated with influenza and RSV infections among young children.

Centre for Health Protection (CHP) plans to conduct a pilot project in developing a syndromic surveillance system using data from Emergency Departments (ED) in Hong Kong. This is part of the Communicable Disease Information System initiative, which aims at enhancing the capability of Hong Kong in the control and prevention of communicable diseases.

Objective

This paper describes how the CHP of Hong Kong designed and deployed an online interactive system that uses the data from ED for syndromic surveillance.

Arthropod-borne diseases such as malaria, dengue, Chagas disease, filariasis, leishmaniasis, and trypanosomiasis place tremendous public health burdens upon developing countries. The operational value of Decision Support Systems for management of these and other arthropod-borne diseases is enhanced by a Geographic Information System (GIS) spatial backbone allowing for visualization of spatiotemporal arthropod vector and disease patterns. However, resource-poor environments in desperate need of GIS-based solutions to more effectively manage arthropod-borne diseases can be faced with the reality that even the most basic GIS data are lacking and that investment in the infrastructure (high end computers, sophisticated GIS software, technical personnel) needed to develop such data is costprohibitive. This problem was addressed by use of Google Earth which freely provides access to both satellite imagery and mapping tools capable of generating polygons, lines and placemarks.

Objective

As part of a Dengue Decision Support System project funded by the Innovative Vector Control Consortium, we used satellite imagery and mapping tools freely available through Google Earth to: 1) generate data for basic city structure that could be imported into a GIS; and 2) serve as the spatial underpinning of a Decision Support System for arthropod-borne disease management.

The BioSense system receives patient level clinical data from > 370 hospitals and 1100 ambulatory care Departments of Defense and Veterans Affairs medical facilities. Visits are assigned as appropriate to 78 sub-syndromes, including respiratory syncytial virus (RSV). Among infants and children < 1 year of age, RSV is the most common cause of bronchiolitis and pneumonia; 0.5% to 2% require hospitalization. Increasingly, RSV is also recognized as a major cause of pneumonia in elderly adults.

Objective

To analyze final diagnosis data available to BioSense and determine its potential utility for surveillance of RSV illness.

Syndromic surveillance is an investigational approach used to monitor trends of illness in communities. It relies on pre-diagnostic health data rather than laboratory-confirmed clinical diagnoses. Its primary purpose is to detect disease outbreaks, incidents and unusual public health events earlier than possible with traditional public health surveillance methods.

Objective

To describe how epidemiological principles are utilized to distinguish a real alert from statistically significant alerts in order to monitor and create daily reports in the Miami-Dade County Health Department using Electronic Surveillance System for the Early Notification of Community Based Epidemics. 

Medical surveillance in the military can be improved through the use of clinical laboratory results collected within the Military Health System. This presentation describes an effort to establish Electronic Laboratory Reporting in the military using existing Health Level 7 (HL7) messages. HL7 data is being evaluated for data integrity, completeness, reliability and validity. In addition, initial efforts to evaluate, standardize, and use this data to support investigations of interest over the past year are presented.

Objective

This presentation describes the HL7 clinical lab results dataset and how it can and has been used for medical surveillance in the military.

While mass media coverage of bird flu often provides specific information that may prevent or contain the disease, it is often less than ideal; the public may become fearful and panic at the news of a potential outbreak of bird flu which has a high fatality case rate of more than 60% with no available proven vaccine while supplies of antivirals may be in short supply. As reported by Reuters (3/17/2006) using data from the CDC, a correlation was made between the intense media coverage of bird flu outbreaks overseas in the Fall of ‘05, and a ‘spike’ in sales of Tamiflu which was higher than at any other time over the previous 5 years; documented by syndromic surveillance of Medicaid scrips (NYS DOH), and retail pharmacy sales (NYC DOHMH), authorities suspect the drug was stockpiled.

Objective

To ascertain whether mass media reportage of bird flu outbreaks during the moderate US flu season of 2006-7 influenced sales of antivirals in NYC and Upstate NY as monitored by syndromic surveillance, and to compare such data to that generated during the moderate flu season of 2005-06 following a period of intense media coverage in the Fall of 2005.

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.