Syndromic Surveillance

The HEDSS system was implemented in 2004 to monitor disease activity [1]. Twenty of 32 emergency departments (ED) and 1 urgent care clinic provide data. Chief complaints are routinely categorized into 8 syndromes. Although previous studies have shown that ED syndomic surveillance is not useful for early detection of GI outbreaks [2], it has demonstrated utility in monitoring trends in seasonal norovirus activity[3]. An evaluation to assess the utility of HEDSS to characterize endemic and out-break levels of GI illness has not been previously conducted in Connecticut.

Objective

To evaluate the utility of the Connecticut Hospital Emergency Department Syndromic Surveillance System (HEDSS) to monitor gastrointestinal (GI) illness in the community.

Syndromic surveillance of ED and PCC data has been widely used for the detection, tracking monitoring and monitoring of health events (e.g. bioterrorism, , disease outbreaks, environmental exposures) over the past decade. In recent years, these data have been found to be useful for public health programs not normally associated with syndromic surveillance (e.g. injury prevention, drug abuse, environmental health). In 2010, the first calls referencing exposure to products marketed as "legal highs" and "bath salts" were received by PCCs in the United States. Synthetic drugs, such as those commonly known as "bath salts," often are labeled as "not for human consumption" and thereby circumvent normal legal control procedures that control the sale and distribution of recreational drugs. The purpose of this study was to evaluate the emerging trends for the use of "bath salts" in Ohio.

Objective

Correlation and time series analyses were completed to evaluate the emerging trends in designer drug use for "Bath Salts" in Ohio using emergency department (ED) chief complaint and poison control center (PCC) human exposure data.

Emergency management during a disaster entails innumerable challenges. Each disaster uniquely shapes the types and timing of information needed both to manage the disaster and to measure the impact on available resources, the environment, and community systems. Traditional public health surveillance methods typically preclude providing a real-time, comprehensive estimate of public health impacts related to the disaster while the disaster is unfolding. Traditional methods can also be resource intensive, costly, require active cooperation of medical systems involved in a disaster response, and are often conducted post-disaster.

Syndromic surveillance of emergency department chief complaints and over-the-counter medication sales was reinstituted in the Austin area in the fall of 2010. In 2011, the Austin area was hit with three natural disasters: a winter ice storm; a summer of extreme heat/extended drought; and a week of significant wildfires. Each disaster varied greatly in type, size, intensity, and duration. The Austin/Travis County Health and Human Services Department, in partnership with Austin/Travis County EMS, was able for the first time to provide near-real time data to emergency managers on the potential health impact during each of the 2011 disasters using the syndromic and EMS electronic data systems. The data were used to provide situational awareness and guide selected response actions during the course of the disaster, as well as, document potential areas for future mitigation efforts.

Objective

Using case studies of three natural disasters that occurred in the Austin, Texas Metro area in 2011, demonstrate the role syndromic surveillance and emergency medical services data played during the response to each different type of disaster.

Heat waves have serious health impacts such as heat exhaustion, heat stroke, dehydration, and death. Heat illness morbidity and mortality can be reduced with the identification of vulnerable populations and targeted public health interventions. In June and July of 2011, a heat wave occurred in Nebraska in which 28 days reached 90 degrees F or higher. Syndromic surveillance data were used to describe heat-related illness emergency department (ED) visits during this time.

Objective

The purpose of this study was to develop methodology to accurately identify and track heat illness in a timely manner using syndromic surveillance data.

Mining text for real-time syndromic surveillance usually requires a comprehensive knowledge base (KB) which contains detailed information about concepts relevant to the domain, such as disease names, symptoms, drugs, and radiology findings. Two such resources are the Biocaster Ontology [1] and the Extended Syndromic Surveillance Ontology (ESSO) [2]. However, both these resources are difficult to manipulate, customize, reuse and extend without knowledge of ontology development environments (like Protege) and Semantic Web standards (like RDF and OWL). The cKASS software tool provides an easy-to-use, adaptable environment for extending and modifying existing syndrome definitions via a web-based Graphical User Interface, which does not require knowledge of complex, ontology-editing environments or semantic web standards. Further, cKASS allows for - indeed encourages - the sharing of user-defined syndrome definitions, with collaborative features that will enhance the ability of the surveillance community to quickly generate new definitions in response to emerging threats.

Objective

We describe cKASS (clinical Knowledge Authoring & Sharing Service), a system designed to facilitate the authoring and sharing of knowledge resources that can be applied to syndromic surveillance.

For public health surveillance to achieve its desired purpose of reducing morbidity and mortality, surveillance data must be linked to public health response. While there is evidence of the growing popularity of syndromic surveillance (1,2), the impact or value added with its application to public health responses is not well described (3).

Objective

To describe if and how syndromic surveillance data influenced public health decisions made during the 2009 H1N1 pandemic within the context of other existing public health surveillance systems.

In March-April, 2011, Salt Lake Valley Health Department (SLVHD) investigated an outbreak of measles (N=9) resulting from a single imported case from Europe. Syndromic surveillance was used to identify measles-like illness (MLI) and enhance early case detection, which is crucial for proper public health intervention [1].

Objective

To detect measles cases during an outbreak using syndromic surveillance.

Triple-S (Syndromic Surveillance Survey, Assessment towards Guidelines for Europe) was launched in 2010 for a 3-year period. Co-financed by the European Commission through the Executive Agency for Health and Consumers, the project is coordinated by the French Institute for Public Health Surveillance and involves 24 organisations from 13 countries. Both human and veterinary syndromic surveillance are considered.

Objective

The first results of the inventory of syndromic surveillance systems in Europe, conducted in the framework of the European project Triple-S, are presented.

In May of 2001, Boston released a strategic transportation plan to improve bicycle access and safety. [1] According to the Boston Transportation Department, ridership has increased 122% between 2007 and 2009. [2] A collaborative public health and public safety task force was initiated in 2010 to foster a safe and healthy bicycling environment.

Objective

To quantify the injury burden and identify possible risk factors using bicycle related injury (BRI) visits at Boston emergency departments (ED).

The Centers for Disease Control and Prevention case definition of influenza-like illness (ILI) as fever with cough and/or sore throat casts a wide net resulting in lower sensitivity which can have major implications on public health surveillance and response.

Objective

This study investigates additional signs and symptoms to further enhance the ILI case definition for real-time surveillance of influenza.