Poster

Swimming in contaminated pools can cause gastroenteritis from water contaminated by viruses, bacteria, or parasites. Germs that cause gastroenteritis are shed in feces of infected persons, and easily spread to uninfected persons swimming in pools. Symptoms of gastrointestinal illness can include nausea, vomiting, watery or bloody diarrhea, and weight loss. Common causes of swimming-related gastroenteritis included viruses (norovirus), parasites (giardia, cryptosporidium), and bacteria (Escherichia coli, Shigella). Cryptosporidium is most common agent associated with swimming pool outbreaks. In 2011-2012, public health officials from 32 States reported 90 swimming-pool associated outbreaks to CDC’s Waterborne Disease and Outbreak Surveillance System (WBDOSS). These 90 outbreaks resulted in 1,788 cases, 95 hospitalizations, 1 death. 52% of these outbreaks were caused by Cryptosporidium.

Objective:

To prevent and identify gastrointestinal outbreaks due to swimming pools using a two-part surveillance system i) Model Aquatic Health Code (MAHC) Guideline Survey and ii) syndromic surveillance

Livestock sector contributes more than 58% to agriculture-based economy of Pakistan. Diseases of socio-economic importance are posing an enormous pressure to the growth of this sector. Zoonotic diseases are generally neglected in wake of epizootics having epidemic potential. One Health is a multi-sectoral approach to control zoonotic diseases at animal level to mitigate risk of transfer to the humans and environment. Despite various control programs, zoonosis is known to cause public health emergencies at various regional and national levels. OIE declared brucellosis as a model bacterial disease to control zoonosis in developing countries. Genus Brucella is expanding with its discovery in various amphibian species and marine mammals and demands control efforts at various levels. Reporting of zoonosis is less than actual prevalence in third world countries like Pakistan where disease is considered endemic but no official data is available. In this study, brucellosis was used as a model disease to emphasize the significance of One Health.

Objective:

To detect the presence of brucella in serum samples of occupationally exposed human and animals by conventional screening methods. To perform epidemiosurvelliance of brucella molecular based tests including genus and species specific PCR. To check the brucella prevalence in occupationally exposed human.

Zimbabwe's National Health Laboratory Services faces multiple challenges related to inadequate financial support and skilled human resources, insufficient infrastructure, and inefficient tracking of clinical samples collected by health facilities. The slow turnaround time and poor management of the sample testing process, as well as delivery of results remain critical challenges. Compounding these problems further is a manual system for tracking large volumes of samples. This laborious and time-consuming process is inefficient for management of high amounts of incoming medical samples, frequently resulting in incomplete and inaccurate data. Additionally, health facilities are unable to monitor clinical samples and results in transit, leading to misplaced samples and missing results. Furthermore, although the laboratory service runs on a tiered network system - with lower level laboratories referring surveillance samples to higher level laboratories, processing of samples is not fulfilled promptly. The solutions to these challenges are divergent - sometimes even pointing in different directions. To this end, the Zimbabwe Ministry of Health and Child Care (MoHCC) has identified and integrated a LIMS to improve tracking of samples from the time of collection through results delivery.

Objective:

Understand the challenges that exist in the Zimbabwe health systems, that could be addressed through the integration of a Laboratory Information Management System (LIMS). Understand key aspects for consideration when selecting and adapting a LIMS in a resource limited setting. Showcase improvements in laboratory information management processes following adoption of a LIMS.

In January 2016, the Caribbean Public Health Agency (CARPHA), serving 24 Member States(MS), began executing a regional Tourism and Health program (THP), recognizing that the health of Caribbean economies is closely related to the health of its tourism industry since the Caribbean is most tourism-dependent region in the world; that tourism is vulnerable to health, safety and environmental (HSE) threats; and that travel and tourism impacted on global health security. High and increasing visitors to the Caribbean can increase the health, safety and security risks by the introduction and spread of diseases, by both residents and visitors. This was exemplified by the H1N1 pandemic (2009), Chikungunya (2013), and the recent Zika epidemic. However, even though more people visit the Caribbean than reside, there is no regional visitor/tourism surveillance system. There is also no regional mandate and policy for the reporting of visitor/tourism illnesses. This coupled with inadequate training, lack of standards and collaboration between tourism health stakeholders have contributed to disease spread. The THP is an innovative, multifaceted, integrated, regional program with components of a web based real time Tourism and Health Information Surveillance and Response system (THiS), food safety and environmental sanitation training, standards and multisectoral health and tourism partnerships. It aims to promote the health, safety and security of Caribbean visitors and residents. The THP is novel in that it involves the implementation of a non- traditional, health information and surveillance system (visitor based illnesses), new data users (private sector, hotels, passenger ships, visitors), new partners (tourism sector) and at regional level. Given the novelty and the multisectoral nature of the THP, a critical factor to support its implementation and sustainability was the development of regional mandate and policy to facilitate real time surveillance and response to detect and reduce the spread of illness.

Objective:

The Regional Tourism and Health program (THP) is a novel program, comprising of a tourism surveillance system, training, standards and multisectoral partnerships. The objective was to develop regional mandate and policy to support this new program and its non-traditional surveillance system.

The outbreak of infectious diseases with a propensity to spread across international boundaries is on an upward rise. Such outbreaks can be devastating with significant associated morbidity and mortality. The recent Ebola Virus Disease outbreak in West Africa which spread to Nigeria is an example. Nigeria like several other African countries implements the Integrated Disease Surveillance and Response (IDSR) system as its method for achieving the International Health Regulations (IHR). Yet, compliance to the IDSR is questioned. This study seeks to investigate the legal instruments in place and the factors affecting performance of the disease surveillance in the country.

Objective:

Assess the legal framework establishing disease surveillance in Nigeria and identify major factors affecting the performance of the surveillance system.

In 2015, there were 212 million new cases of malaria, and about 429,000 malaria death, worldwide. African countries accounted for almost 90% of global cases of malaria and 92% of malaria deaths. Currently, malaria data are scattered across different countries, laboratories, and organizations in different heterogeneous data formats and repositories. The diversity of access methodologies makes it difficult to retrieve relevant data in a timely manner. Moreover, lack of rich metadata limits the reusability of data and its integration. The current process of discovering, accessing and reusing the data is inefficient and error-prone profoundly hindering surveillance efforts. As our knowledge about malaria and appropriate preventive measures becomes more comprehensive malaria data management systems, data collection standards, and data stewardship are certain to change regularly. Collectively these changes will make it more difficult to perform accurate data analytics or achieve reliable estimates of important metrics, such as infection rates. Consequently, there is a critical need to rapidly re-assess the integrity of data and knowledge infrastructures that experts depend on to support their surveillance tasks.

Objective:

Malaria is one of the top causes of death in Africa and some other regions in the world. Data driven surveillance activities are essential for enabling the timely interventions to alleviate the impact of the disease and eventually eliminate malaria. Improving the interoperability of data sources through the use of shared semantics is a key consideration when designing surveillance systems, which must be robust in the face of dynamic changes to one or more components of a distributed infrastructure. Here we introduce a semantic framework to improve interoperability of malaria surveillance systems (SIEMA).

In 2016, the CDC funded 12 states, under the Enhanced State Opioid Overdose Surveillance (ESOOS) program, to utilize SyS to increase timeliness of state data on drug overdose events. In order to operationalize the objectives of the grant, there was a need to assess and monitor the quality of Kentucky’s SyS data, with limited resources. We leveraged the NSSP’s R Studio Server to automate quality assurance (QA) monitoring and reporting to meet these objectives.

Objective:

The aim of this project was to develop a nimble system to both monitor and report on the quality of Kentucky emergency department syndromic surveillance (SyS) data at system-wide and facility levels.

One in twenty-five patients in acute care hospitals develop at least one health care associated infection (HAI); this resulted in approximately 75,000 preventable deaths in 2011. Risk factors associated with developing HAIs include older patients, serviced at a large hospital, central catheter placement, receiving medical ventilation, and placement in a critical care unit. In Pinellas County, individuals 65 years of age and older comprise approximately 24% of the total population.

Objective:

To assess healthcare facilities’ level of readiness to respond to an HAI outbreak, the Florida Department of Health in Pinellas County (DOH-Pinellas) conducted an HAI outbreak tabletop exercise (TTX) on June 6, 2017. Other benefits of this TTX were to provide opportunities for collaborative learning, building community partnerships and evaluation of HAI preparedness activities in Pinellas County healthcare facilities.

In early 2017, HAV outbreaks were identified in San Diego County (490 cases) and Santa Cruz County (73 cases) in California, affecting primarily the homeless and/or illicit drug users. As of October 10, 2017, LAC had identified 12 outbreak-related HAV cases. Due to LAC’s proximity to San Diego County, and its own large homeless population, the syndromic surveillance team of the LAC Department of Public Health created a syndrome category and began querying its ED data to monitor for any increase in HAV-related visits.

Objective:

To create a hepatitis A virus (HAV) syndrome category with which to monitor emergency department (ED) visits for situational awareness during a currently emerging Hepatitis A community outbreak in Los Angeles County (LAC), and to evaluate its usefulness.

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.