ISDS Conference

An outbreak of dengue fever has occured in French Guiana since the end of November 2005 until July 2006. The dengue serotype circulating was DEN-2, responsible of more than 2 000 confirmed cases and 4 deaths. The previous surveillance system was only based on the laboratories data, and didn’t permit to assess the real situation of dengue infection within the population of French Guiana. Actually, the dengue fever being a viral infection for which no etiological treatments nor immunization were available, a lot of general practioners didn’t send their patients to laboratories but prescribed only a symptomatic treatment. A survey made on the field during February 2006 in a town of 5000 inhabitants in the West of French Guiana showed that the real situation within the population was really more important than the one evaluated by the current surveillance system (135 suspected cases for only 13 confirmed cases reported by the network of laboratories). For that reason, it was decided to put in place a syndromic surveillance system, which can permit to have a better knowledge of the situation for dengue fever. The objectives of this new system were i) to detect earlier the beginning of an outbreak ii) to have a better estimation of the impact of the outbreak within the population and iii) to permit the evaluation of the Public Health strategy set up.

Objective

This paper describes a new syndromic surveillance system installed in French Guiana in April 2006 during an outbreak of dengue fever.

In July 2006, an important heat wave occurred in France, and generated alarm of all the public health services. In Gironde, a department in region Aquitaine, the level of "warning and actions" of the Heat Health Watch Warning System, based on an analysis of weather-mortality relationship, was activated from the 16th and the 27th of July, when the limits of biometeorological indicators were reached [1].

Objective

To assess health impact of heat wave occurred in July 2006 through data from emergency activity and mortality from syndromic surveillance systems in Gironde, a department in south-western France.

The syndromic surveillance system “2SE FAG” has been installed within the French Armed Forces in French Guiana (3000 people) in October 2004 [1-2]. During the conception and the deployment of such a system, ergonomic issues were highlighted and training of stakeholders as well [3]. Daily exchanges with users have already permitted to enhance the system. An standardized and quantified evaluation among the users had to be done after 18 months of functioning. The objectives of this work were to evaluate the knowledge, the attitude and the practice of the stakeholders of the system.

Objective

This paper describes an evaluation survey made within the users of a real time surveillance system in French Guiana.

Previous reports from participating facilities in North Dakota illustrated that ILI syndrome data from syndromic surveillance data, which is based on chief complaints logs, had a close correlation to the traditional ILI surveillance and that frequency slope of the ILI syndrome was also closely correlated to that of the cases that tested positive for influenza. The facility used in this report submits ICD-9 codes to the North Dakota Department of Health (NDDoH). By comparing the NDDoH ILI syndrome to influenza laboratory testing data and ICD-9 code specific to influenza (487) we found that syndromic surveillance data for ILI closely followed the influenza testing trend as well as the ICD-9 code trend.

Objective

The objective of this report is to evaluate the correlation between influenza-like illness (ILI) syndrome classification using chief complaint data and discharge diagnosis International Classification of Disease, Ninth Revision (ICD-9) code for influenza with the laboratory data from one hospital in North Dakota over a period of three influenza seasons.

A pandemic caused by influenza A/H5N1 or another novel strain could kill millions of people and devastate economies worldwide. Recent computer simulations suggest that an emerging influenza pandemic might be contained in Southeast Asia through rapid detection, antiviral distribution, and other interventions [1]. To facilitate containment, the World Health Organization (WHO) has established large, global antiviral stockpiles and called on countries to develop rapid pandemic detection and response protocols [2]. However, developing countries in Southeast Asia would face significant challenges in containing an emerging pandemic. Limited surveillance coverage and diagnostic capabilities; poor communication and transportation infrastructure; and lack of resources to investigate outbreaks could cause critical delays in pandemic recognition. Wealthy countries have committed substantial funds to improve pandemic detection and response in developing countries, but tools to guide system planning, evaluation, and enhancement in such places are lacking.

Objective

We propose a framework for evaluating the ability of syndromic, laboratory-based, and other public health surveillance systems to contain an emerging influenza pandemic influenza in developing countries, and apply the framework to systems in Laos.

Security threats and the recent emergence of avian influenza in Europe have heightened the profile of and need for a good surveillance strategy during such events. The two main rationales for enhanced infectious disease surveillance at mass events include a perceived increased risk of infectious disease events and a need to detect and respond to events more quickly. Moreover, the requirements of the International Health Regulations (IHR) issued by the World Health Organization (WHO), which take effect in mid-2007, define the need for timely reporting of infectious diseases during international mass events [1]. Therefore, an enhanced surveillance, based on Germany’s pre-existing system of mandatory notifications was conducted in the12 World Cup cities.

Objective

In this abstract, we describe the major findings of an evaluation of our enhanced infectious disease surveillance activities during the FIFA Soccer World Cup 2006 in Germany.

One of the significant challenges that multi-user biosurveillance systems have is alarm management. Currently deployed syndromic surveillance systems [1–3] have a single user interface. However, different users have different objectives; the alarms that are important for one category of user are irrelevant to the objectives of another category of user. For example, a physician wants to identify disease on an individual-patient level, a county health authority is interested in identifying disease outbreak as early as possible within his local region, while an epidemiologist at the national level is interested in global situational awareness. The objective of a multi-agent decision support system is not only to recognize patterns of epidemiologically significant events but also to indicate their relevance to particular user groups’ objectives. Thus, instead of simply providing alerts of anomaly detections, the system architecture needs to provide analyzed information supporting multiple users’ decisions.

Disease surveillance systems are currently used for the early detection of disease outbreak before diagnosis is confirmed in order to mobilize a rapid response . The fear of epidemics or bioterrorism resulted in the development of systems for the general population; however research efforts for sensitive population groups are missing. Sensitive groups could be considered patients suffering from chronic diseases (such as diabetes and renal failure), elderly people and infants. It is well known that these groups are quite susceptible to diseases that can be easily spread under certain circumstances e.g. in a dialysis room where patients with renal failure receive their regular treatment. In addition to that, several diseases seem to affect them more. Therefore, the development of disease surveillance systems for sensitive population groups is an issue that should be addressed.

Objective

The aim of this study is to reveal the need for developing disease surveillance systems for sensitive populations.

The Veterans Health Administration (VHA) operates over 880 outpatient clinics across the nation. The Johns Hopkins Applied Physics Laboratory’s Electronic Surveillance System for the Early Notification of Community-Based Epidemics (ESSENCE) utilizes VHA ICD9 coded outpatient visit data for the detection of abnormal patterns of disease occurrence. The hemorrhagic illness (HI) syndrome category in ESSENCE is comprised of 25 different ICD9 codes, including 12 codes specific for viral hemorrhagic fever (VHF) (e.g., ebola, yellow fever, CrimeanCongo hemorrhagic fever, lassa, etc.) and 13 nonspecific conditions (e.g., purpura not otherwise specified (NOS), thrombocytopathy, and coagulation defect NOS).

Objective

We sought to evaluate the functionality of the diagnosis codes which fall into the syndrome category of hemorrhagic illness.

Following an Oct 12-13, 2006 snowstorm, almost 400,000 homes in western New York lost power, some for up to 12 days. News reports said that emergency rooms saw many patients with CO exposure; 3 deaths were attributed to CO poisoning. As part of NYS DOH’s syndromic surveillance system, electronic ED records with a free-text CC field listing the symptoms reported by the patient are sent to NYS DOH daily. Each CC is searched for text strings indicating complaints in one or more of 6 syndromes (asthma, fever, gastrointestinal (GI), neurological, respiratory, rash). The system also allows nonroutine searches of CCs for complaints of interest. NYS hospitals also submit ED records to the Statewide Planning and Research Cooperative System (SPARCS) that include diagnostic codes assigned after evaluation of the patient (due within 30 days of each calendar quarter).

Objective

To assess the ability to identify cases of carbon monoxide (CO) poisoning from chief complaints (CC) in hospital emergency department (ED) records submitted daily to the New York State (NYS) Department of Health (DOH) Electronic Syndromic Surveillance System.