Syndromic Surveillance

The current surveillance system for opioid-related overdoses at UDOH has been limited to mortality data provided by the Office of the Medical Examiner (OME). Timeliness is a major concern with OME data due to the considerable lag in its availability, often up to six months or more. To enhance opioid overdose surveillance, UDOH has implemented additional surveillance using timely syndromic data to monitor fatal and nonfatal opioid-related overdoses in Utah.

Objective:

To monitor opioid-related overdose in real-time using emergency department visit data and to develop an opioid overdose surveillance report for Utah Department of Health (UDOH) and its public health partners.

Infectious disease surveillance for generating early warnings to enable a prompt response during mass gatherings has long been a challenge in India as well as in other parts of the world. Ujjain, Madhya Pradesh in Central India hosted one of the largest religious festival in the world called ‘Simhasth kumbh mela’ on the banks of River Kshipra, where more than 50 million attendees came for holy dip during April 22 to May 21, 2016. The attendees included pilgrims (residents and visitors), observers, officials and volunteers. We developed an android application with automated summary reports and an interactive dashboard for syndromic surveillance during the gathering.

Objective:

To develop, test and study tablet-based participatory syndromic surveillance system for common infectious disease conditions at community level in Simhashta religious mass gathering in Ujjain, India, 2016.

Standard syndrome definitions for ED visits in ESSENCE rely on chief complaints. Visits with more words in the chief complaint field are more likely to match syndrome definitions. While using ESSENCE, we observed geographic differences in chief complaint length, apparently related to differences in electronic health record (EHR) systems, which resulted in disparate syndrome matching across Idaho regions. We hypothesized that chief complaint and diagnosis code co-occurrence among ED visits to facilities with long chief complaints could help identify terms that would improve syndrome match among facilities with short chief complaints.

Objective:

We sought to use free text mining tools to improve emergency department (ED) chief complaint and discharge diagnosis data syndrome definition matching across facilities with differing robustness of data in the Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE) application in Idaho’s syndromic surveillance system.

On October 2016, the Indian Ocean Regional Health Agency was alerted about an increase in ED visits related to adverse reactions associated with use of SC on Mayotte Island. In this context, an investigation based on a syndromic surveillance system was implemented by the regional unit of the French national public health agency.

Objective:

To confirm and to characterize the increase in emergency department (ED) visits related to the use of synthetic cannabinoids (SC).

Syndromic Surveillance (SS), traditionally applied to infectious diseases, is more recently being adapted to chronic disease prevention. Its usefulness rests on the large number of diverse individuals visiting emergency rooms with the possibility of real-time monitoring of acute health effects, including effects from environmental events and its potential ability to examine more long-term health effects and trends of chronic diseases on a local level.

Objective:

To create chronic disease categories for emergency department (ED) chief complaint data and evaluate the categories for validity against ED data with discharge diagnoses and hospital discharge data.

Syndromic surveillance uses near-real-time emergency department and other health care data for enhancing public health situational awareness and informing public health activities. In recent years, continued progress has been made in developing and strengthening syndromic surveillance activities. At the national level, syndromic surveillance activities are facilitated by the National Syndromic Surveillance Program (NSSP), a collaboration among state and local health departments, the CDC, other federal organizations, and other organizations that enabled collection of syndromic surveillance data in a timely manner, application of advanced data monitoring and analysis techniques, and sharing of best practices. This panel will highlight the importance of success stories. Examples of successes from state and local health departments will be presented and the audience will be encouraged to provide feedback.

Objective:

This panel will: 

• Discuss the importance of identifying and developing success stories
• Highlight successes from state and local health departments to show how syndromic surveillance activities enhance situational awareness and address public health concerns
• Encourage discussion on how to further efforts for developing and disseminating success stories.

Syndromic surveillance uses near-real-time Emergency Department healthcare and other data to improve situational awareness and inform activities implemented in response to public health concerns. The National Syndromic Surveillance Program (NSSP) is a collaboration among state and local health departments, the Centers for Disease Control and Prevention (CDC), other federal organizations, and other entities, to strengthen the means for and the practice of syndromic surveillance. NSSP thus strives to strengthen syndromic surveillance at the national and the state, and local levels through the coordinated activities of the involved partners and the development and use of advanced technologies, such as the BioSense platform. Evaluation and performance measurement are crucial to ensure that the various strategies and activities implemented to strengthen syndromic surveillance capacity and practice are effective. Evaluation activities will be discussed at this session and feedback from audience will be sought with the goal to further strengthen evaluation activities in the future. 

Objective:

The objective of this session is to discuss syndromic surveillance evaluation activities. Panel participants will describe contexts and importance of selected evaluation and performance measurement activities in NSSP. Discussions will explore ways to strengthen evaluation in syndromic surveillance activities in the future.

Since 2008, drug overdose deaths exceeded the number of motor vehicle traffic-related deaths in Indiana and the gap continues to widen1. As the opioid crisis rages on in the United States the federal government is providing funding opportunities to states, but it often takes years for best practices to be developed, shared, and published. Indiana State Department of Health (ISDH) has developed a standard process for monitoring and alerting local health partners of increases in drug overdoses captured in Indiana’s syndromic surveillance system (ESSENCE). ISDH is launching a pilot project to encourage local partners to start a conversation about overdose response capabilities and planning efforts in their community. Other states have published articles about drug overdose syndromic surveillance (SyS) data being used to inform local public health action, however, the local overdose response activity details were vague 2,3. With the opioid crisis continuing to spiral out of control in the United States, it is imperative to work together as local, state, and national partners to find potential solutions to this crisis.

Objective:

The overall objective of this session is to discuss opportunities to use drug overdose syndromic surveillance (SyS) data to encourage action among local public health partners. After this roundtable discussion, participants will be able to:

• Identify opportunities to promote use of drug overdose SyS data to their health partners.
• Plan for potential drug overdose public health interventions.
• Develop relationships with roundtable attendees to continue the conversation and sharing of ideas about use of drug overdose SyS data.

As part of a wide-spread community discussion on the presence of monuments to Confederate Civil War figures, the Charlottesville city council voted to remove a statue of General Robert E. Lee. Multiple rallies were then held to protest the statue’s removal. A Ku Klux Klan (KKK) rally on July 8, 2017 (MMWR Week 27) and a Unite the Right rally on August 12, 2017 (MMWR Week 32) held in Charlottesville both resulted in violence and media attention. The violence associated with the Unite the Right rally included fatalities connected to motor vehicle and helicopter crashes. Syndromic surveillance has been used to study the impact of terrorism on a community’s mental health while more traditional data sources have looked at the impact of racially-charged civil unrest. Syndromic surveillance, however, has not previously been used to document the effect of racially-charged violence on the health of a community.

Objective:

To describe the impact of civil unrest on the mental health of a community in near real-time using syndromic surveillance.

In May 2015, the MERS-CoV outbreaks in South Korea was sparkled from a hospital of Gyeonggi-do province. In response to this outbreak, the provincial government and infectious disease control center (GIDCC) initiated an emergency department (ED) based Gyeonggi-do provincial acute febrile illness (AFI) surveillance network (GAFINet) to monitor for a subsequent outbreak of emerging or imported infectious diseases since September 2016. Gyeonggi-do province is located in the North-West of South Korea, surrounds the capital city Seoul, and borders North Korea (Figure 1). Considering the geographical coverage, GAFINet Initiative involves ten hospitals, consisted of four university-affiliated hospitals and six provincial medical centers in Gyeonggi-do province. These hospitals participated in this network voluntarily, and most staffs including five infectious diseases specialists had direct or indirect experiences in dealing with MERS-CoV patients.

Objective:

The objectives are to introduce a provincial level surveillance system, which has been initiated in response to the MERS-CoV outbreak of South Korea, and describe findings from systematic investigation of individual admissions attributed to acute febrile illness for the first year.`