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Surveillance

Description

In 2014, CDC started receiving an increase in reports of children in the United States with unexplained limb weakness or paralysis (120 total cases). These children were later confirmed by neurology experts to have a rare condition called acute flaccid myelitis (AFM). The Council of State and Territorial Epidemiologists created a standardized case definition for AFM in 2015, allowing CDC to establish standardized surveillance to monitor AFM, determine possible causes and risk factors, and attempt to estimate the baseline incidence. Through this surveillance, CDC identified another increase in AFM cases in 2016 (149 total cases), and obtained valuable information on the clinical presentation to help characterize this illness and the epidemiology of AFM. However, despite the ongoing investigation, many questions still remain about AFM, including why the increases occurred and what has caused most of the AFM cases. The lack of AFM knowledge has made preventing AFM, finding effective treatments for patients, and developing communication messages challenging.

Objective: To assess the type, tone, consistency, and accuracy of communications surrounding a rare polio-like condition called acute flaccid myelitis between 2014-2017 from from CDC, other health agencies, researchers, news media outlets, and the public.

Submitted by elamb on
Description

Although cases of acute HAV have declined in recent years, elevated numbers of HAV infections began to be reported by California and Michigan in the fall of 2016.1,2 Since this time, associated outbreaks have been reported in 9 additional states (Arizona, Utah, Kentucky, Missouri, Tennessee, Indiana, Ohio, Arkansas, and West Virginia).3 No common source of food, beverages or drugs have been identified and transmission appears to be primarily person-to-person with high-risk individuals including people experiencing homelessness, those who use illicit drugs and their close direct contacts. In June 2018, CDC issued a Health Alert Network Advisory providing additional guidance on identification and prevention of HAV and updates on the outbreaks.4 This prompted our office to more closely review our HAV surveillance, to identify Veterans who may be part of these outbreaks, and assess risk factors and outcomes of HAV infection.

Objective: To conduct surveillance for acute Hepatitis A virus (HAV) infections in Veterans from states reporting outbreaks among high-risk individuals beginning in fiscal year (FY) 2017.

Submitted by elamb on
Description

The Infectious Disease Epidemiology Section (IDEpi) in the Louisiana Office of Public Health (OPH) has several applications for syndromic surveillance including situational awareness during unusual and/or high profile events, such as the uncharacteristic winter weather Louisiana experienced during the 2017-2018 winter season. December 8th, 2017 saw freezing temperatures with some parts of the state experiencing snow, and January 16- 18, 2018 saw record breaking freezing temperatures throughout the state. Both weather events led to many state office, school and business closures. The freezing temperatures from January 16th -18th led to office closures that lasted longer than the freezing temperatures due to the infrastructure damage the freezing temperatures caused. For example, Orleans parish experienced low water pressure throughout its water systems due to broken pipes following the freeze, leading to boil water advisories. Many people throughout Louisiana had broken pipes at their homes, resulting in flooding and further contributing to low water pressure in some areas. IDEpi used syndromic surveillance to monitor the impacts of the severe winter weather and its aftermath on weather related personal injuries throughout the state.

Objective: The Louisiana Early Event Detection System (LEEDS), Louisiana's syndromic surveillance system, was used to monitor uncharacteristically low temperatures during the 2017-2018 winter season and determine the impact of these temperatures on the number of weather related personal injuries in emergency departments throughout Louisiana.

Submitted by elamb on
Description

As part of a greater statewide excessive heat response plan, New Hampshire (NH) has been performing HRI surveillance since 2010 to guide response efforts and ultimately reduce HRI morbidity and mortality during situations of excessive heat. Historically, NH hospital Emergency Department Heat illness discharges average around 150 per year, typically in the summer months. NHÕs Excessive Heat Emergency Response Plan documents appropriate state-wide readiness, alerting, emergency, and recovery level of response for heat emergencies with its partners. Together with near real-time surveillance data, flexible query tools, and communication templates, NH is better able to respond to excessive heat emergencies at a moment's notice and take action with its partners to reduce HRI emergencies. Objective: During this presentation NH Division of Public Health Services (NH DPHS) will share how it was able to develop an effective HRI surveillance response through the development of partners, which allowed State of NH decision makers to affect action beyond detection.

Submitted by elamb on
Description

Situational awareness is important for both early warning and early detection of a disease outbreak, and analytics and tools that furnish information on how an infectious outbreak would either emerge or unfold provide enhanced situational awareness for decision makers/analysts/public health officials, and support planning for prevention or mitigation. Data sharing and expert analysis of incoming information are key to enhancing situational awareness of an unfolding event. In this presentation, we will describe a suite of tools developed at Los Alamos National Laboratory (LANL) that provide actionable information and knowledge for enhanced situational awareness during an unfolding event; The biosurveillance resource directory (BRD), the biosurveillance analytics resource directory (BaRD) and the surveillance window app (SWAP).

Objective

To develop a suite of tools that provides actionable information and knowledge for enhanced situational awareness during an unfolding event such as an infectious disease outbreak.

Submitted by elamb on
Description

The Influenza Division (ID) in the Centers for Disease Control and Prevention (CDC) maintains the WHO/NREVSS surveillance system, a network of laboratories in the U.S. that report influenza testing results. This system has seen many changes during the past 40 years, especially since the 2009 H1N1 pandemic. This was due in large part to increased adoption of HL7 messaging via PHLIP. PHLIP data is detailed, standardized influenza testing information, reported in near real-time. The data received through this and other report methods is published online in national and regional aggregate form in FluView, a weekly surveillance report prepared by CDC.

Objective

Describe the changes to the World Health Organization/National Respiratory and Enteric Virus Surveillance System (WHO/NREVSS) influenza surveillance system over time, with a focus on the Public Health Laboratory Interoperability Project (PHLIP) and how it has influenced the system

Submitted by elamb on
Description

Schools inherently foster the transmission of infections from person to person because they are a group setting in which people are in close contact and share supplies and equipment. Surveillance is important in schools and actions that can help control the spread of infections are the key to effective disease control in the community [1]. School health physicians should play an important role in surveillance. Their training on data collection, analysis, reporting and importance of feedback is recommended in order to improve the disease surveillance system and therefore the prevention and control of diseases.

Objective

We assessed the effect of a training program on the knowledge of school physicians regarding surveillance. The purpose of evaluation is to improve the information provided and thereby help improve service provision and delivery.

Submitted by elamb on
Description

Despite the number of infections, hospitalizations, and deaths from influenza each year, developing the ability to predict the timing of these outbreaks has remained elusive. Public health practitioners have lacked a reliable, easy-to-implement method for predicting the onset of a period of elevated influenza incidence in a community. We (a team of statisticians, epidemiologists, and clinicians) have developed a model to help public health practitioners develop simple, adaptable, data-driven rules to define a period of increased disease incidence in a given location. We call this method the Above Local Elevated Respiratory illness Threshold (ALERT) algorithm. The ALERT algorithm is a simple method that defines a period of elevated disease incidence in a community or hospital that systematically collects surveillance data on a particular disease.

Objective

Our objective was to develop a simple, easy-to-use algorithm to predict the onset of a period of elevated influenza incidence in a community using surveillance data.

Submitted by elamb on
Description

Numerous studies have demonstrated a causal relationship between human papillomavirus (HPV) and cervical cancer1. By 2007 two vaccines targeting HPV were available in the United States. Both vaccines have shown close to 100% efficacy against HPV types 16 and 18, the cause of 70% of all cervical cancers2. It is hypothesized that with routine vaccination the prevalence of HPV and HPV-associated cancers should decline3. A need exists for surveillance with national coverage2. The purpose of this study is to present a method to estimate rate of change of high-risk HPV in the United States since 2004 in women using national reference laboratory data.

Objective

To establish and evaluate an HPV surveillance protocol and determine the rate of change of high-risk HPV in the United States since 2004 using archived reference laboratory data.

Submitted by elamb on
Description

The importance of providing information on epidemic prone diseases in a timely and complete manner cannot be over-emphasized. In many countries WDSS form a core component of national health system notification and response plans. Countries are required to establish WDSS for diseases that have demonstrated ability to cause serious public health impact and spread rapidly across geographic regions. Ministries of Health, the World Health Organisation (WHO) and other sector ministries rely on accurate and timely information to ensure an effective response. Zimbabwe MOHCW's WDSS is a critical component of the health management information system (HMIS). At least fourteen diseases and public health events that include non-specific diarrheal disease, cholera, malaria, vaccine preventable diseases, snake and dog bites have been reported through the system. Due to an unstable macro-economic environment, Zimbabwe's WDSS has struggled with incomplete and delayed reporting from facilities to the district and national level. According to WHO both timeliness and completeness of data were oscillating below 40% since 2005 through 2011. The MOHCW has measured timeliness as a proportion of facility reports received at the national office every Wednesday, completeness of the national report as a proportion of facilities contributing to the report. Rural facilities have reported challenges in transmitting data to the next administrative level. In December 2010, only 8.8% of rural health facilities had a functional fixed-line telephone and only 11.3% had a functional VHF radio. We document the processes in revitalizing the Zimbabwe, MOHCW's WDSS in the period 2009 -2013.

Objective

Documentation of the processes in revitalizing the Zimbabwe, Ministry of Health and Child Welfare (MOHCW)'s weekly disease surveillance system (WDSS) in the period 2009 -2013.

Submitted by elamb on