Tularemia v1

Query purpose: 

Created by the CDC National Syndromic Surveillance Program (NSSP) for use with emergency department data to develop queries for all National Notifiable Diseases defined by the National Notifiable Disease Surveillance System (NNDSS). Please note that while the disease queries are developed using the NNDSS case definition as the basis for identifying patient visits of interest, the queried patient visits themselves may or may not represent a case patient in NNDSS and further public health investigation will most often be required. This query is intended to be a version 1 and may be further improved upon by the NSSP community of practice in the future. This query is intended to be narrow and capture visits with specific terms to support greater monitoring and actionable public health data. More complex and/or broader queries may exist that more broadly capture symptoms or travel-based terms.

How it was developed: 

1. The CDC team used the NNDSS case definition of tularemia to identify diagnostic codes (International Classification of Diseases, 9th & 10th Revision (ICD-9-CM, ICD-10-CM), SNOMED Clinical Terms (CT)) and chief complaint free-text for syndrome development. 
2. The codes and free text were then categorized as inclusion or exclusion terms. These terms were formatted for querying in ESSENCE.
3. Text analysis was conducted on the initial query to find additional inclusion or exclusion terms.
4. The query was cross-checked internally as NSSP and by CDC subject matter experts as needed.

How it works:

The Chief Complaint Discharge Diagnosis (CCDD) parsed field is used to query both the discharge diagnosis codes and chief complaint free text, and exclusions are incorporated as necessary.

• Inclusion based on tularemia chief complaint free text terms:
  • The visit is included if it contains:
    1. A chief complaint related to tularemia and its misspellings – (“tularami” or “tularni” or “tularemi” or “tulareni” or “tuleremi” or “tulereni”) OR
    2. A chief complaint related to Francisella tularensis – (“f tular” or “francesella t” OR “francisella t” or “fransesella t” or “fransisella t” or “francisela t” or “fransisela t” or “francesela” or “fransesela”) OR
    3. A chief complaint related to the alternative name rabbit fever – (“rabbit fever”) OR
    4. A chief complaint related to the alternative name deer fly fever – (“deer fly fev” or “deerfly fev”) OR
• Inclusion based on ICD-10 discharge diagnosis codes related to tularemia:
  • The visit is included if it contains:
    1. A discharge diagnosis related to Tularemia – (A21) OR
• Inclusion based on ICD-9 discharge diagnosis codes related to tularemia:
  • The visit is included if it contains:
    1. A discharge diagnosis code of Ulceroglandular tularemia – (021.0) OR
    2. A discharge diagnosis code of Enteric tularemia – (021.1) OR
    3. A discharge diagnosis code of Pulmonary tularemia – (021.2) OR
    4. A discharge diagnosis code of Oculoglandular tularemia – (021.3) OR
    5. A discharge diagnosis code of Other tularemia – (021.8) OR
    6. A discharge diagnosis code of Unspecified tularemia – (021.9) OR
• Inclusion based on SNOMED discharge diagnosis codes related to tularemia:
  • The visit is included if it contains:
    1. A discharge diagnosis code of Tularemia – (19265001) OR
    2. A discharge diagnosis code of Pulmonary tularemia – (45556008) OR
    3. A discharge diagnosis code of Glandular tularemia – (21857006) OR
    4. A discharge diagnosis code of Typhoidal tularemia – (398554008) OR
    5. A discharge diagnosis code of Oropharyngeal tularemia – (398575000) OR
    6. A discharge diagnosis code of Oculoglandular tularemia – (73363000) OR
    7. A discharge diagnosis code of Ulceroglandular tularemia – (37722001) OR
    8. A discharge diagnosis code related to the disease agent Francisella tularensis – (50255000 or 51526001 or 60502008 or 91508008)
• There are no exclusions to this query.