Zika virus disease became a significant public health problem in Brazil in 2015 and quickly spread to other South American and Central American countries. While not an overly severe illness for many, Zika virus disease has been shown to increase the probability of severe birth defects in babies when their mothers are infected with the virus during pregnancy. Zika virus disease has also been associated with Guillain-Barré syndrome.
NBIC is charged with enhancing the capability of the Federal Government to enable early warning and shared situational awareness of acute biological events to support better decisions through rapid identification, characterization, localization, and tracking. A key aspect of this mission is the requirement to integrate and collaborate with federal and, state, local, tribal, and territorial (SLTT) government agencies. NBIC develops and disseminates a variety of products to its stakeholders, including daily reports, ad-hoc reports, analytic collaborations, and leadership briefings upon request. Stakeholders interact with and utilize NBICâs products in different ways, depending on the mission and jurisdiction involved. Specific collaborations with individual stakeholders are most frequent and evident during major infectious disease events, such as the recent Zika epidemic in the Americas and the associated microcephaly and other neurological disorders PHEIC. Collaborative efforts and known outcomes among varying levels of government are described in detail below in order to highlight NBICâs integration focus and capabilities in this role.
An important part of the National Biosurveillance Integration Centerâs (NBIC) mission is collaboration with federal, state, local, tribal, and territorial governments for the purpose of enhancing early warning, shared situational awareness, and related decision support for infectious disease events. Several such collaborations occurred at multiple jurisdictional levels during the recent Zika epidemic in the Americas and the associated microcephaly and other neurological disorders Public Health Event of International Concern (PHEIC). The collaborations and their known outcomes from this major infectious disease event are described below, and NBIC stands ready to support similar efforts for future events.
As a part of the Zika Birth Defects Surveillance, a national effort coordinated by the Centers for Disease Control and Prevention (CDC), NYC is conducting enhanced surveillance of all births with defects included in the congenital Zika syndrome (CZS) phenotype among infants born in NYC beginning in 2016. The intent of the project is to provide background on the prevalence of these conditions, regardless of cause. The surveillance project builds on the New York State (NYS) Congenital Malformations Registry, a passive, mandatory reporting system that relies on reporting from hospitals and providers. For the Surveillance project, potential cases of Zika-related birth defects (ZBD) are identified by hospital and administrative data of birth records with one or more of the International Classification of Diseases, 10th Revision (ICD-10) diagnostic codes associated with CZS.1 The list of included diagnostic codes was specified by the NYS registry following guidance established by CDC. Full medical record chart abstraction of the birth hospital visit of potential cases is then conducted applying further inclusion guidelines to identify ZBD cases. Recent reports of late presentation of birth defects consistent with CZS suggest that some cases are being missed due to identification and diagnosis of the condition after birth.2 As one component of a broader strategy to obtain a more accurate surveillance count, we seek to identify potential ZBD cases first diagnosed in the 6-month postpartum period using Medicaid claims data.
To assess the use of Medicaid claims data to conduct surveillance for cases of Zika-related birth defects identified after birth among infants born in New York City (NYC).
This syndrome was created as a part of the Arizona Arboviral Syndrome Surveillance Project, which includes bi-weekly monitoring of syndromic data to enhance traditional surveillance. The syndrome was initially created using BioSesne 2.0 phpMyAdmin and later transitioned to ESSENCE.
This presentation gives an overview of Zika. Topics include the history of the disease, clinical symptoms and treatment, and surveillance of human cases and the mosquitos that spread the virus.
CDC has updated the estimated range maps for Ae. aegypti and Ae. albopictus mosquitoes by using a model that predicts possible geographic ranges for these mosquitoes in the contiguous United States. The model used county-level records, historical records, and suitable climate variables to predict the likelihood (very low, low, moderate, or high) that these mosquitoes could survive and reproduce if introduced to an area during the months when mosquitoes are locally active. Maps are not meant to represent risk for spread of any specific disease
In general, data from public health surveillance can be used for short- and long-term planning and response through retrospective data analysis of trends over time or specific events. Combining health outcome data (e.g., hospitalizations or deaths) with environmental and socio-demographic information also provides a more complete picture of most vulnerable populations. Using syndromic surveillance systems for climate and health surveillance offers the unique opportunity to help quantify and track in near-real time the burden of disease from climate and weather impacts.
DENV, CHIKV and ZIKV are all transmitted by mosquitoes and have occurred in outbreaks in the Caribbean. Common symptoms (which can be severe and disabling) are similar among the 3 viruses and include fever, joint pain/swelling, headache, muscle pain and rash. In December 2015, the first endemic case of ZIKV infection was reported by VACHS. Since that time, an increasing number of ZIKV infections have been reported in Puerto Rico. Due to the growing ZIKV outbreak, we performed ongoing testing and surveillance.
We describe surveillance for Dengue virus (DENV), Chikungunya virus (CHIKV) and Zika virus (ZIKV) in VA Caribbean Healthcare System (VACHS) from the start of ZIKV transmission in Puerto Rico.
The Florida Department of Health (DOH) utilizes the Electronic Surveillance System for the Early Notification of Community Based Epidemics (ESSENCE-FL) as its statewide syndromic surveillance system. ESSENCE-FL comprises of chief complaint data from 231 of 240 EDs, representing 96 percent of the total number of EDs in Florida. Historically, syndromic surveillance has categorized patient chief complaint data into syndromes for the purpose of disease surveillance or outbreak detection. Triage notes are much longer freetext, pre-diagnostic data that capture the presenting symptoms and complaints of a patient.
This study assesses the utilization of triage notes from emergency departments (EDs) and urgent care centers (UCCs) for active case finding in ESSENCE-FL during the Zika response.
Local transmission of Zika virus has been confirmed in 67 countries worldwide and in 46 countries or territories in the Americas. On February 1, 2016 the World Health Organization declared a Public Health Emergency of International Concern due to the increase in microcephaly cases and other neurological disorders reported in Brazil. Several countries issued travel warnings for pregnant women travelling to Zika-affected countries with Brazil, Colombia, Ecuador, and El Salvador advising against pregnancy. The risk of local transmission in unaffected regions is unknown but potentially significant where competent Zika vectors are present and also given the additional complexities of sexual transmission and population mobility. Despite the rapid spread of Zika virus across the Americas and global concerns regarding its effects on fetuses, little is known about the pattern of spread. Knowledge of the direction and the speed of movement of disease is invaluable for public health response planning, including the timing and placement of interventions.
To estimate the velocity of Zika virus disease spread in Brazil using data on confirmed Zika virus disease cases at the municipal-level.