Syndromic Surveillance

The success of syndromic surveillance depends on the ability of the surveillance community to quickly and accurately recognize anomalous data. Current methods of anomaly detection focus on sets of syndromic categories and rely on a priori knowledge to map chief complaints to these general syndromic categories. As a result, the mapping scheme may miss key terms and phrases that have not previously been used. Furthermore, analysts do not have a good way of being alerted to these new terms in order to determine if they should be added to the syndromic mapping schema. We use a dynamic dictionary of terms to side-step the downfalls of a priori knowledge in this rapidly evolving field by alerting the analyst to rare and brand new words used in the chief complaint field.

Objective

To automate the detection of very unusual emergency department chief complaints based on a comparison between a trained dictionary of terms and the unstructured chief complaint field.

This paper evaluates the expended and enhanced surveillance system specifically syndromic surveillance, which was implemented during the International Cricket Council Cricket World Cup West Indies 2007 (ICC CWC WI 2007) in Western Jamaica.

The interpretation of aberrations detected by syndromic surveillance is critical for success, but poses challenges for local health departments who must conduct appropriate follow-up and confirm outbreaks. This paper describes the response of the Boston Public Health Commission (BPHC) to a cluster of emergency department (ED) visits in children detected by syndromic surveillance.

We explored the utility of tracking emergency department (ED) visits for febrile illness as a proxy for influenza surveillance, from both a local and a regional perspective.

To evaluate whether a rise or shift in severe morbidity and mortality by influenza can be detected with syndromic surveillance.

Although many syndromic surveillance (SS) systems have been developed and implemented, few have included response protocols to guide local health jurisdictions when alerts occur [1,2]. SS was first implemented in GA during the 2004 G-8 Summit. Six EDs in the Coastal Public Health District (PHD), 1 of 18 GA PHDs (Figure 1), conducted SS during that “national security special event.” Since that time, EDs in other PHDs have been actively recruited to participate in GA’s SS system. In GA, the PHD has the responsibility for monitoring SS data. Likewise, the PHD responds to alerts and initiates public health investigations and interventions; the state Division of Public Health (DPH) assists, if requested. To address these responsibilities, the Coastal PHD informally developed their own response practices.

Objective

To develop a template protocol to guide local response to syndromic surveillance alerts generated through analyses of emergency department (ED) visit data.

Syndromic surveillance may be suited for detection of emerging respiratory disease elevations that could pass undiagnosed. The syndromes under surveillance should then retrospectively reflect known respiratory pathogen activity. To validate this for respiratory syndromes we analyzed dutch medical registration data from 1999-2003 (national hospital discharge diagnoses and causes of death). We assume that syndromes with a good reflection of pathogen activity have the potential ability to reflect unexpected respiratory pathogen activity in prospective surveillance.

Objective

As a validation for syndromic surveillance we studied whether respiratory syndromes indeed reflect the activity of respiratory pathogens. Therefore we retrospectively estimated the temporal trend of two respiratory syndromes by the seasonal dynamics of common respiratory pathogens.

Disease surveillance provides essential information for control and response planning1. Emergency Room (ER) syndromic surveillance data can help to identify changes in disease incidence and affected group thereby providing valuable additional time for public health interventions1. The current study explored the relationship between ER syndromic surveillance data and influenza notification to the Houston Department of Health and Human services (HDHHS).

Measures aimed at controlling epidemics of infectious diseases critically benefit from early outbreak recognition [1]. SSS seek early detection by focusing on pre-diagnostic symptoms that by themselves may not alarm clinicians. We have previously determined the performance of various Case Detector (CD) algorithms at finding cases of influenza-like illness (ILI) recorded in the electronic medical record of the Veterans Administration (VA) health system. In this work, we measure the impact of using CDs of increasing sensitivity but decreasing specificity on the time it takes a VA-based SSS to identify a modeled community-wide influenza outbreak. Objective This work uses a mathematical model of a plausible influenza epidemic to test the influence of different case-detection algorithms on the performance of a real-world syndromic surveillance system (SSS).

Wetter and stormier weather is predicted in the UK as global temperatures rise. It is likely there will be increases in river and coastal flooding. The known short and medium term health effects of flooding are drowning, injury, acute asthma, skin rashes and outbreaks of gastrointestinal and respiratory disease. Longer term health effects of flooding are thought to be psychological stress and increased rates of mental illness. Reacher et al. conducted a retrospective study of illness in a population affected by flooding in Lewes, South-East England during 2000 [1]. They found a significant raised risk of earache (RR=2.2) and gastroenteritis (RR=1.7) for flooded households. More striking was the higher level of psychological distress experienced by these residents (RR=4.1), which may have also explained some of the excess physical illness.

Objective

This paper describes the results of prospective real time syndromic surveillance conducted during a national flooding incident during 2007 in the UK.