Surveillance

In the early morning of Friday January 20, 2017, Toronto Public Health (TPH) was notified of several reports of acute vomiting, diarrhea, and stomach pain/cramps among students living in residence at a post-secondary institution in Toronto, Canada. A public health investigation was initiated and it was quickly determined that a large number of students and visitors to the campus were affected. Following considerable media coverage, TPH began receiving an overwhelmingly high volume of reports from ill individuals who lived, visited, or worked at the college campus and had experienced gastrointestinal illness.

Objective:

To describe the use of an online survey tool to rapidly collect data from a large community outbreak of enteric illness in Toronto, Canada.

The Georgia DPH has used its State Electronic Notifiable Disease Surveillance System (SendSS) Syndromic Surveillance (SS) module to collect, analyze and display analyses of ED patient visits, including DDx data from hospitals throughout Georgia for early detection and investigation of cases of reportable diseases before laboratory test results are available. Evidence on the value of syndromic surveillance approaches for outbreak or event detection is limited. Use of the DDx field within datasets, specifically as it might be used for investigation of outbreaks, clusters, and / or individual cases of reportable diseases, has not been widely discussed.

Objective:

To describe how the Georgia Department of Public Health (DPH) uses ICD-9 and ICD-10-based discharge diagnoses (DDx) codes assigned to Emergency Department (ED) patients to support the early detection and investigation of outbreaks, clusters, and individual cases of reportable diseases.

Respiratory pathogens continue to present an ever increasing threat to public health. Influenza, Respiratory syncytial virus, human metapneumovirus and other respiratory viruses are major etiological agents for influenza like illnesses (ILI). Establishment of viral causes of ILI is critical for prevention and mitigation strategies to disease threats. Makerere University Walter Reed Project (MUWRP) together with the Ugandan Ministry of Health and partners undertook surveillance to determine viral causes of influenza-like illness in Uganda.

Objective:

To determine viral causes of influenza-like illness in Uganda.

Mortality rate of leptospirosis in Ukraine remains high year after year. The study of the peculiarities of lethal cases over a long period enables researchers to specify possible mechanisms of infection which cause the development of the severest cases of leptospirosis and to prevent disease emergence by applying adequate preventive measures.

Objective:

Study of the structure of lethal cases in patients diagnosed with leptospirosis in the Lviv Region.

Flaviviridae are one of the most widespread arboviruses in Ukraine. Mosquitoes are vectors of WNF in a majority of cases due to bites during swimming, fishing, work in suburban areas and outdoor recreation without use of individual protection from mosquitoes. A study of the species composition of bloodsucking mosquitoes is conducted in Ukraine. Existence of natural foci of WNF viruses has been well-proven all over the territory of Ukraine by testing IgG antibodies in different groups of population, including children. Also, infection of mosquitoes (RNA found in Culex pipiens (including Culex pipiens f. molestus, Culiseta annulata)) was registered. Infection of I. ricinus and D. reticulates was also determined, and it acts as a factor for circulation of virus in the wild too.

Objective:

To define the problems of epidemiological surveillance of West Nile fever (WNF) in Ukraine.

The global strategy for eliminating tuberculosis (TB) epidemic "End TB" has been implemented in the world since 2016. Its main goal is to reduce the 2015 TB incidence rate by 90% and 2015 TB mortality rate by 95% by 2035. In Ukraine, in 2016, the incidence rate of new cases of tuberculosis among the general population was 54.7 per 100 thousand of population (2015 - 55.9), the rate of decrease was 2.1 ± 0.1%. In Donetsk Oblast (that is under control of Ukrainian authorities), the incidence rate increased by 2.4% and was 56.4 per 100 thousand of population. The mortality rates were 19 ± 0.6% in the country and 29 ± 2.5% in Donetsk Oblast. However, according to the World Health Organization (WHO) estimates, we need to enhance the annual incidence rate reduction by 10% by 2025, and TB mortality rate should be reduced to 6.5% in order to achieve the strategy-targeted values. In Ukraine, as well as globally, there is a crisis of multidrug-resistant tuberculosis (MDR-TB). According to WHO estimates, Ukraine belongs to five European countries where 2/3 of MDR-TB cases were registered; the proportion of MDR-TB cases among newly diagnosed TB cases was 16%, and 48% of repeated cases. In Ukraine, this rate is equal to 24.3% and 58.2% in Donetsk Oblast, respectively. Such results in the Donetsk region may be related to the beginning of hostilities in eastern Ukraine in 2014, which lead to the active migration of population and breakdown of the supply of anti-TB drugs. According to monitoring data, 20% of with MDR-TB on the territory of the Donetsk region controlled by Ukraine were lost and did not seek medical assistance.

Objective:

Describe the common work of Donetsk State Phthisiological Service and non-governmental organizations that has been conducted since 2014 in order to achieve the global goal for tuberculosis elimination.

The re-emergence of an infectious disease is dependent on social, political, behavioral, and disease-specific factors. Global disease surveillance is a requisite of early detection that facilitates coordinated interventions to these events. Novel informatics tools developed from publicly available data are constantly evolving with the incorporation of new data streams. Re-emerging Infectious Disease (RED) Alert is an open-source tool designed to help analysts develop a contextual framework when planning for future events, given what has occurred in the past. Geospatial methods assist researchers in making informed decisions by incorporating the power of place to better explain the relationships between variables.

Objective:

The application of spatial analysis to improve the awareness and use of surveillance data.

Guillain-Barre Syndrome (GBS) is a severe paralytic neuropathy associated with virus infections such as Zika virus and Chikungunya virus. There were also case reports of dengue fever preceding GBS. With the aim to understand the mechanisms of GBS and dengue outbreaks, this ecological study investigates the relationships between GBS, dengue, meteorological factors in Hong Kong and global climatic factors from January 2000 to June 2016.

Objective:

To study the trends of GBS and dengue in Hong Kong, the ecological associations between GBS, dengue, and local meteorological factors. To examine the non-stationary oscillating association among these factors.

Environmental Public Health Zoonotic Disease surveillance includes veternary, environmental, and vector data. Surveillance systems within each sector may appear disparate from each other, although they are actually complimentaly and closely allied. Consolidating and integrating data in to one application can be challenging, but there are commonalities shared by all. The goal of the One Health Integrated Data Sysytem is to standardize data collection, streamline data entry, and integrate these sectors in to one application.

Objective:

Integrate and streamline the collection and analysis of environmental, veterinary, and vector zoonotic data using a One Health approach to data system development.

Falls are a leading cause of fatal and nonfatal injury in NC. As the size of the older adult population is predicted to increase over the next few decades, it is likely that the incidence of falls-related morbidity and mortality will increase in tandem. In order to address this public health emergency, the Injury and Violence Prevention Branch (IVPB) of the NC Division of Public Health has partnered with the Carolina Center for Health Informatics (CCHI) in the Department of Emergency Medicine at the University of North Carolina at Chapel Hill to perform falls surveillance activities. This abstract describes some of the specific research and surveillance activities currently ongoing in NC.

Objective:

To describe how a successful partnership between state public health and a university organization has used epidemiologic data, such as mortality, hospital discharge, and emergency department (ED) visit data, to inform falls prevention activities in North Carolina (NC).