School Absenteeism

The Miami-Dade County Health Department currently utilizes Emergency Department based Syndromic surveillance data, 911 Call Center data, and more recently Public School Absenteeism data. Daily monitoring of school absenteeism data may enhance early outbreak detection in Miami-Dade County in conjunction with the use of other syndromic systems. These systems were employed to detect any possible outbreaks resulting from a large outdoor festival occurring March 11th, 2007. This event had an estimated 1 million visitors and it ended at 7:00 p.m.

Objective

Utility of school absenteeism data to enhance syndromic surveillance activities for unusual public health events or outbreak detection.

School absenteeism data could be used as an early indicator for disease outbreaks. The increase in absences, however, may be driven by non-sickness related factors. Reason for absence combined with syndrome-specific information might make absenteeism data more useful for early outbreak detection.

Objective

This is a pilot evaluation to determine the usefulness of syndrome-specific school absenteeism data for public health surveillance systems.

Recognizing the threat of pandemic influenza and new or emerging disease such as SARS, the U.S. Department of Health and Human Services has recommended that schools work in partnership with their local health departments “to develop a surveillance system that would alert the local health department to substantial increases in absenteeism among students.”3 Tarrant County’s pilot project system meets that need and transcends absenteeism data; it seeks to quantify ILI in schools and lets school nurses view daily maps of changing disease patterns, access flu prevention resources, and receive and respond to action items suggested by TCPH. While the focus is on seasonal flu, best practices for mitigating seasonal flu also apply to pandemic flu. Because the system uses open source software4 , it’s affordable and replicable for other public health agencies seeking to strengthen their school partnerships as well as their local or regional biosurveillance capabilities.

Objective

This oral presentation will share key findings and next steps following the first year of a pilot project in which Tarrant County, Texas schools used a Web-based system to share their daily health data with Tarrant County Public Health (TCPH) epidemiologists, who can use ESSENCE1 to analyze the data. The projectís ongoing goal is to reduce the magnitude of flu outbreaks by focusing on school-aged children and youth, where infectious diseases often emerge first and spread rapidly.2

Capital Health is a regional health care organization, which provides services for over one million inhabitants in the Edmonton area of Alberta, Canada. Traditionally, disease surveillance under its jurisdiction has been paper-based and records maintained by different departments in several locations. Before the Alberta Real Time Syndromic Surveillance Net (ARTSSN), there was no centralized database or unified approach to surveillance and automated reporting despite rich electronic health data in the region. The existing labor-intensive manual surveillance process is inefficient and inherently susceptible to human error. Its effectiveness is sub-optimal in detecting outbreaks of emerging infectious diseases, and clusters of injuries or toxic exposures. The ultimate objective of ARTSSN is to enhance public health surveillance through earlier and more sensitive detection of clusters and trends, with subsequent tracking and response through an integrated, automated surveillance and reporting system.

Objective

ARTSSN is a pilot public health surveillance project developed for the Capital Health region of Alberta, Canada and funded by Alberta Health and Wellness. This paper describes the advantages of using ARTSSN and comparing information derived from multiple electronic data sources simultaneously for real time syndromic surveillance.

A large event such as the Super Bowl that attracts over 120,000 visitors to an area within a short period of time has the potential to increase the risk of communicable diseases and environmental hazards in a community in addition to the possibility of a bioterrorist attack. Though Miami-Dade County Health Department has in place a syndromic surveillance system, additional public health measures were implemented to ensure the health and safety of all residents and visitors in the weeks surrounding the February 4th event.

OBJECTIVE

To identify unusual patterns of communicable diseases, health events or bioterrorism-related activity in Miami-Dade County immediately before, during and after Super Bowl XLI.

The ability to provide real time syndromic surveillance throughout the Capital Health Region is currently undeveloped. There are limited mechanisms for routine real time surveillance of disease or conditions of public health interest, e.g. communicable diseases, toxic exposure or injury. Toxic exposure and injury while preventable are not notifiable in Alberta and as a consequence there is no real-time surveillance system to identify burden of disease or opportunities for intervention. The notifiable disease system is reliant on paper-based forms which are slow, prone to human error, and labor intensive to convert to electronic database format for flexible analysis and interpretation. Finally there is no system to link the data collected on the same individual in each database without compromising confidentiality. ARTSSN is designed to remedy these deficiencies.

Objective

In this presentation we describe the creation of an IT architecture and infrastructure to integrate data from four sources to support real-time syndromic surveillance for injuries, toxic exposures and notifiable diseases in Capital Health, Alberta, Canada.