scholarly journals Integration of Multiple Surveillance Systems to Track COVID-19 in the U.S. Army Population

2021 ◽  
Author(s):  
Julianna Kebisek ◽  
Alexis Maule ◽  
Jacob Smith ◽  
Matthew Allman ◽  
Anthony Marquez ◽  
...  
Keyword(s):  
Public Health ◽  
Reporting System ◽  
Daily Basis ◽  
Severe Illness ◽  
Surveillance Systems ◽  
Military Population ◽  
Disease Reporting ◽  
Laboratory Test Results ◽  
Passive Surveillance System ◽  
Media Reports

ABSTRACT Introduction The coronavirus disease (COVID-19) pandemic presented unique challenges for surveillance of the military population, which include active component service members and their family members. Through integrating multiple Department of Defense surveillance systems, the Army Public Health Center can provide near real-time case counts to Army leadership on a daily basis. Materials and Methods The incidence of COVID-19 was tracked by incorporating data from the Disease Reporting System Internet, laboratory test results, Commanders’ Critical Incidence Reports, reports from the Centers for Disease Control and Prevention military liaison, and media reports. Cases were validated via a medical record review for all Army beneficiaries. Descriptive analyses were performed using Microsoft Excel and SAS 9.4 to measure demographic frequencies. Results In the first year of the pandemic from February 1, 2020 to February 28, 2021, a total of 96,315 COVID-19 cases were reported to the Disease Reporting System internet, the Army’s passive surveillance system, of which 95,429 (99%) were confirmed and 886 (1%) were probable. A total of 76 outbreak reports were submitted from 14 Army installations. The proportion of Army beneficiaries with severe illness was low: 2,271 (2.4%) individuals required hospitalization and 269 (0.3%) died. Installations in Texas reported the highest proportion of confirmed—not hospitalized cases (n = 19,246, 20.7%), confirmed—hospitalized cases (n = 1,037, 45.7%), and deaths (n = 137, 50.9%) as compared to other states with Army installations. Conclusions The pandemic has demonstrated the need for a robust public health enterprise with a focus on data collection, validation, and analysis, allowing leaders to make informed decisions that may impact the health of the Army.

scholarly journals Infectious Disease Reporting and Outbreak Management Improvement Project

2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Donald E. Brannen ◽  
Melissa Branum ◽  
Amy Schmitt
Keyword(s):  
Public Health ◽  
Surveillance System ◽  
Disease Surveillance ◽  
Reporting System ◽  
Median Number ◽  
Clinical Services ◽  
Disease Reporting ◽  
E Coli ◽  
Disease Surveillance System ◽  
The Impact

ObjectiveImprove disease reporting and outbreak mangement.IntroductionSpecific communicable diseases have to be reported by law withina specific time period. In Ohio, prior to 2001, most of these diseasereports were on paper reports that were reported from providers tolocal health departments. In turn the Communicable Disease Nursemailed the hardcopies to the Ohio Department of Health (ODH).In 2001 the Ohio Disease Reporting System (ODRS) was rolled out toall local public health agencies in Ohio.1ODRS is Ohio’s portion ofthe National Electronic Disease Surveillance System. ODRS shouldnot be confused with syndromic surveillance systems that are fordetecting a disease outbreak before the disease itself is detected.2Chronic disease surveillance system data has been evaluated forlong term trends and potential enhancements.3However, the use ofcommunicable disease reports vary greatly.4 However, the exportdata has not routinely been used for quality improvement purposesof the disease reporting process itself. In December 2014, GreeneCounty Public Health (GCPH) begain a project to improve reportingof communicable diseases and the response to disease outbreaks.MethodsInitial efforts were to understand the current disease reportingprocess: Quantitative management techniques including creating alogic model and process map of the existing process, brainstormingand ranking of issues. The diseases selected to study included:Campylobacteriosis, Cryptosporidiosis, E. coli O157:H7 &shiga toxin-producing E. coli, Giardiasis, Influenza-associatedhospitalization, Legionnaires’ disease, Pertussis, Salmonellosis,and Shigellosis. The next steps included creating a data collectionand analysis plan. An updated process map was created and thepre- and post-process maps were compared to identify areas toimprove. The median number of days were compared before andafter improvements were implemented. Modeling of the impact ofthe process improvements on the median number of days reportedwas conducted. Estimation of the impact in healthy number of daysderived from the reduction in days to report (if any) were calculated.ResultsProcess improvements identified: Ensure all disease reportersuse digital reporting methods preferably starting with electroniclaboratory reporting directly to the online disease reporting system,with other methods such as direct web data entry into system, faxinglab reports, orsecure emailing reports, with no or little hard copy mailing;Centralize incoming email and fax reports (eliminating process steps);Standardize backup staffing procedures for disease reporting staff;Formalize incident command procedures under the authorized personin charge for every incident rather than distribute command betweenenvironmental and clinical services; and place communicable diseasereporting under that single authority rather than clinical services. Thedays to report diseases were reduced from a median of 2 to .5 days(p<.001). All the diseases were improved except for crytosporodiumdue to an outlier report two months late. The estimated societalhealthy days saved were valued at $52,779 in the first eight monthsafter implementation of the improvements.ConclusionsImprovements in disease reporting decreased the reporting timefrom over 2 days to less than 1 day on average. Estimated societalhealthy days saved by this project during the first 9 months was$52,779. Management of early command and control for outbreakresponse was improved.

scholarly journals High real-time reporting of domestic and wild animal diseases following rollout of mobile phone reporting system in Kenya

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0244119
Author(s):  
M. Kariuki Njenga ◽  
Naomi Kemunto ◽  
Samuel Kahariri ◽  
Lindsey Holmstrom ◽  
Harry Oyas ◽  
...  
Keyword(s):  
Mobile Phone ◽  
Open Source ◽  
Reporting System ◽  
Skin Diseases ◽  
Animal Health ◽  
Wild Animal ◽  
Sub Saharan Africa ◽  
Surveillance Systems ◽  
Animal Disease ◽  
Disease Reporting

Background To improve early detection of emerging infectious diseases in sub-Saharan Africa (SSA), many of them zoonotic, numerous electronic animal disease-reporting systems have been piloted but not implemented because of cost, lack of user friendliness, and data insecurity. In Kenya, we developed and rolled out an open-source mobile phone-based domestic and wild animal disease reporting system and collected data over two years to investigate its robustness and ability to track disease trends. Methods The Kenya Animal Biosurveillance System (KABS) application was built on the Java® platform, freely downloadable for android compatible mobile phones, and supported by web-based account management, form editing and data monitoring. The application was integrated into the surveillance systems of Kenya’s domestic and wild animal sectors by adopting their existing data collection tools, and targeting disease syndromes prioritized by national, regional and international animal and human health agencies. Smartphone-owning government and private domestic and wild animal health officers were recruited and trained on the application, and reports received and analyzed by Kenya Directorate of Veterinary Services. The KABS application performed automatic basic analyses (frequencies, spatial distribution), which were immediately relayed to reporting officers as feedback. Results Of 697 trained domestic animal officers, 662 (95%) downloaded the application, and >72% of them started reporting using the application within three months. Introduction of the application resulted in 2- to 14-fold increase in number of disease reports when compared to the previous year (relative risk = 14, CI 13.8–14.2, p<0.001), and reports were more widely distributed. Among domestic animals, food animals (cattle, sheep, goats, camels, and chicken) accounted for >90% of the reports, with respiratory, gastrointestinal and skin diseases constituting >85% of the reports. Herbivore wildlife (zebra, buffalo, elephant, giraffe, antelopes) accounted for >60% of the wildlife disease reports, followed by carnivores (lions, cheetah, hyenas, jackals, and wild dogs). Deaths, traumatic injuries, and skin diseases were most reported in wildlife. Conclusions This open-source system was user friendly and secure, ideal for rolling out in other countries in SSA to improve disease reporting and enhance preparedness for epidemics of zoonotic diseases.

scholarly journals Improving the Quality of Data Exchange Formats in the U.S. National Tuberculosis Surveillance System

2018 ◽  
Vol 10 (1) ◽  
Author(s):  
Wilfred Bonney ◽  
Sandy F Price ◽  
Roque Miramontes
Keyword(s):  
Public Health ◽  
Surveillance System ◽  
Surveillance Systems ◽  
Test Results ◽  
Snomed Ct ◽  
Quality Of Data ◽  
High Quality ◽  
Laboratory Test Results ◽  
National Tuberculosis

Objective: The objective of this presentation is to use a congruence of standardization protocols to effectively ensure that the quality of the data elements and exchange formats within the NTSS are optimal for users of the system.Introduction: Disease surveillance systems remain the best quality systems to rely on when standardized surveillance systems provide the best data to understand disease occurrence and trends. The United States National Tuberculosis Surveillance System (NTSS) contains reported tuberculosis (TB) cases provided by all 50 states, the District of Columbia (DC), New York City, Puerto Rico, and other U.S.-affiliated jurisdictions in the Pacific Ocean and Caribbean Sea [1]. However, the NTSS currently captures phenotypic drug susceptibility testing (DST) data and does not have the ability to collect the rapid molecular DST data generated by platforms such as Cepheid GeneXpert MTB/RIF, Hain MTBDRplus and MTBDRsl, Pyrosequencing, and Whole Genome Sequencing [2-6]. Moreover, the information exchanges within the NTSS (represented in HL7 v2.5.1 [7]) are missing critical segments for appropriately representing laboratory test results and data on microbiological specimens.Methods: The application of the standardization protocols involves: (a) the revision of the current Report of Verified Case of Tuberculosis (RCVT) form to include the collection of molecular DST data; (b) the enhancement of the TB Case Notification Message Mapping Guide (MMG) v2.03 [8] to include segments for appropriately reporting laboratory test results (i.e., using Logical Observation Identifiers Names and Codes (LOINC) as a recommended vocabulary) and microbiology related test results (i.e., using Systematized Nomenclature of Medicine -- Clinical Terms (SNOMED CT) as a recommended vocabulary); and (c) the standardization of the laboratory testing results generated by the variety of molecular DST platforms, reported to TB health departments through electronic laboratory results (ELR), using those same standardized LOINC and SNOMED CT vocabularies in HL7 v2.5.1 [7].Results: The application of the standardization protocols would optimize early detection and reporting of rifampin-resistant TB cases; provide a high-quality data-driven decision-making process by public health administrators on TB cases; and generate high-quality datasets to enhance reporting or analyses of TB surveillance data and drug resistance.Conclusions: This study demonstrates that it is possible to apply standardized protocols to improve the quality of data, specifications and exchange formats within the NTSS, thereby streamlining the seamless exchange of TB incident cases in an integrated public health environment supporting TB surveillance, informatics, and translational research.

scholarly journals Emergency department syndromic surveillance systems: a systematic review

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Helen E. Hughes ◽  
Obaghe Edeghere ◽  
Sarah J. O’Brien ◽  
Roberto Vivancos ◽  
Alex J. Elliot
Keyword(s):  
Public Health ◽  
Emergency Department ◽  
Disease Surveillance ◽  
Syndromic Surveillance ◽  
Best Practice ◽  
Public Health Practice ◽  
Healthcare Services ◽  
Urgent Care ◽  
Severe Illness ◽  
Surveillance Systems

Abstract Background Syndromic surveillance provides public health intelligence to aid in early warning and monitoring of public health impacts (e.g. seasonal influenza), or reassurance when an impact has not occurred. Using information collected during routine patient care, syndromic surveillance can be based on signs/symptoms/preliminary diagnoses. This approach makes syndromic surveillance much timelier than surveillance requiring laboratory confirmed diagnoses. The provision of healthcare services and patient access to them varies globally. However, emergency departments (EDs) exist worldwide, providing unscheduled urgent care to people in acute need. This provision of care makes ED syndromic surveillance (EDSyS) a potentially valuable tool for public health surveillance internationally. The objective of this study was to identify and describe the key characteristics of EDSyS systems that have been established and used globally. Methods We systematically reviewed studies published in peer review journals and presented at International Society of Infectious Disease Surveillance conferences (up to and including 2017) to identify EDSyS systems which have been created and used for public health purposes. Search criteria developed to identify “emergency department” and “syndromic surveillance” were applied to NICE healthcare, Global Health and Scopus databases. Results In total, 559 studies were identified as eligible for inclusion in the review, comprising 136 journal articles and 423 conference abstracts/papers. From these studies we identified 115 EDSyS systems in 15 different countries/territories across North America, Europe, Asia and Australasia. Systems ranged from local surveillance based on a single ED, to comprehensive national systems. National EDSyS systems were identified in 8 countries/territories: 2 reported inclusion of ≥85% of ED visits nationally (France and Taiwan). Conclusions EDSyS provides a valuable tool for the identification and monitoring of trends in severe illness. Technological advances, particularly in the emergency care patient record, have enabled the evolution of EDSyS over time. EDSyS reporting has become closer to ‘real-time’, with automated, secure electronic extraction and analysis possible on a daily, or more frequent basis. The dissemination of methods employed and evidence of successful application to public health practice should be encouraged to support learning from best practice, enabling future improvement, harmonisation and collaboration between systems in future. Prospero number CRD42017069150.

Crowdsourcing Covid-19 signals in sub-Saharan Africa: Leveraging digital contributor networks for participatory surveillance of Covid-19 symptoms and deaths (Preprint)

2020 ◽  
Author(s):  
Ngozi A Erondu ◽  
Sagal A Ali ◽  
Mohamed Ali ◽  
Schadrac C Agbla
Keyword(s):  
Public Health ◽  
Sub Saharan Africa ◽  
Specific Information ◽  
Surveillance Systems ◽  
Health Seeking ◽  
African Countries ◽  
Cross Sectional Survey ◽  
Local Networks ◽  
The World ◽  
Sub Saharan

BACKGROUND In sub-Saharan Africa, underreporting of cases and deaths has been attributed to various factors including, weak disease surveillance, low health-seeking behaviour of flu like symptoms, and stigma of Covid-19. There is evidence that SARS-CoV-2 spread mimics transmission patterns of other countries across the world. Since the Covid-19 pandemic has changed the way research can be conducted and in light of restrictions on travel and risks to in-person data collection, innovative approaches to collecting data must be considered. Nearly 50% of Africa’s population is a unique mobile subscriber and it is one of the fastest growing smart-phone marketplaces in the world; hence, mobile phone platforms should be considered to monitor Covid-19 trends in the community. OBJECTIVE We demonstrate the use of digital contributor platforms to survey individuals about cases of flu-like symptoms and instances of unexplained deaths in Ethiopia, Kenya, Nigeria, Somalia, and Zimbabwe. METHODS Rapid cross-sectional survey of individuals with severe flu and pneumonia symptoms and unexplained deaths in Ethiopia, Kenya, Nigeria, Somalia and Zimbabwe RESULTS Using a non-health specific information platform, we found COVID-19 signals in five African countries, specifically: •Across countries, nearly half of the respondents (n=739) knew someone who had severe flu or pneumonia symptoms in recent months. •One in three respondents from Somalia and one in five from Zimbabwe respondents said they knew more than five people recently displaying flu and/or pneumonia symptoms. •In Somalia there were signals that a large number of people might be dying outside of health facilities, specifically in their homes or in IDP or refugee camps. CONCLUSIONS Existing digital contributor platforms with local networks are a non-traditional data source that can provide information from the community to supplement traditional government surveillance systems and academic surveys. We demonstrate that using these distributor networks to for community surveys can provide periodic information on rumours but could also be used to capture local sentiment to inform public health decision-making; for example, these insights could be useful to inform strategies to increase confidence in Covid19 vaccine. As Covid-19 continues to spread somewhat silently across sub-Saharan Africa, regional and national public health entities should consider expanding event-based surveillance sources to include these systems.

scholarly journals Host Diversity and Potential Transmission Pathways of SARS-CoV-2 at the Human-Animal Interface

Pathogens ◽  
2021 ◽  
Vol 10 (2) ◽  
pp. 180 ◽  
Author(s):  
Hayden D. Hedman ◽  
Eric Krawczyk ◽  
Yosra A. Helmy ◽  
Lixin Zhang ◽  
Csaba Varga
Keyword(s):  
Public Health ◽  
Close Contact ◽  
Natural Infection ◽  
Emerging Infectious Diseases ◽  
Reservoir Host ◽  
Host Susceptibility ◽  
Public Health Issue ◽  
Severe Illness ◽  
Host Diversity ◽  
Transmission Pathways

Emerging infectious diseases present great risks to public health. The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), causing coronavirus disease 2019 (COVID-19), has become an urgent public health issue of global concern. It is speculated that the virus first emerged through a zoonotic spillover. Basic research studies have suggested that bats are likely the ancestral reservoir host. Nonetheless, the evolutionary history and host susceptibility of SARS-CoV-2 remains unclear as a multitude of animals has been proposed as potential intermediate or dead-end hosts. SARS-CoV-2 has been isolated from domestic animals, both companion and livestock, as well as in captive wildlife that were in close contact with human COVID-19 cases. Currently, domestic mink is the only known animal that is susceptible to a natural infection, develop severe illness, and can also transmit SARS-CoV-2 to other minks and humans. To improve foundational knowledge of SARS-CoV-2, we are conducting a synthesis review of its host diversity and transmission pathways. To mitigate this COVID-19 pandemic, we strongly advocate for a systems-oriented scientific approach that comprehensively evaluates the transmission of SARS-CoV-2 at the human and animal interface.

Business intelligence tools to optimize the appropriateness of the diagnostic process for clinical and epidemiologic purposes in a multicenter veterinary pathology service

2021 ◽  
pp. 104063872110031
Author(s):  
Nicola Pozzato ◽  
Laura D’Este ◽  
Laura Gagliazzo ◽  
Marta Vascellari ◽  
Monia Cocchi ◽  
...  
Keyword(s):  
Business Intelligence ◽  
Reporting System ◽  
Animal Health ◽  
Final Diagnosis ◽  
Information Management System ◽  
Daily Basis ◽  
Diagnostic Process ◽  
Multifactorial Diseases ◽  
Specific Syndrome ◽  
Veterinary Pathology

Laboratory tests provide essential support to the veterinary practitioner, and their use has grown exponentially. This growth is the result of several factors, such as the eradication of historical diseases, the occurrence of multifactorial diseases, and the obligation to control endemic and epidemic diseases. However, the introduction of novel techniques is counterbalanced by economic constraints, and the establishment of evidence- and consensus-based guidelines is essential to support the pathologist. Therefore, we developed standardized protocols, categorized by species, type of production, age, and syndrome at the Istituto Zooprofilattico Sperimentale delle Venezie (IZSVe), a multicenter institution for animal health and food safety. We have 72 protocols in use for livestock, poultry, and pets, categorized as, for example, “bovine enteric calf”, “rabbit respiratory”, “broiler articular”. Each protocol consists of a panel of tests, divided into ‘mandatory’ and ‘ancillary’, to be selected by the pathologist in order to reach the final diagnosis. After autopsy, the case is categorized into a specific syndrome, subsequently referred to as a syndrome-specific panel of analyses. The activity of the laboratories is monitored through a web-based dynamic reporting system developed using a business intelligence product (QlikView) connected to the laboratory information management system (IZILAB). On a daily basis, reports become available at general, laboratory, and case levels, and are updated as needed. The reporting system highlights epidemiologic variations in the field and allows verification of compliance with the protocols within the organization. The diagnostic protocols are revised annually to increase system efficiency and to address stakeholder requests.

scholarly journals Descriptive Epidemiology of Rescue-Related Fatal Drowning in Turkey

2021 ◽  
Vol 18 (12) ◽  
pp. 6613
Author(s):  
Ali Işın ◽  
Adnan Turgut ◽  
Amy E. Peden
Keyword(s):  
Public Health ◽  
Retrospective Study ◽  
Relative Risk ◽  
Confidence Interval ◽  
Descriptive Epidemiology ◽  
Death Registry ◽  
Public Health Threat ◽  
Reduction Strategies ◽  
Media Reports ◽  
Risk Reduction Strategies

Drowning is a public-health threat and a leading cause of injury-related death. In Turkey, drowning results in 900 fatalities annually, and the rate is rising. As data on rescue-related drowning are scarce, this retrospective study explores the epidemiology of fatal drowning among rescuers in Turkey. As there are no routinely collected death registry data on drowning in Turkey, data were sourced from media reports of incidents between 2015 and 2019. Rescuer fatalities were analysed by age, sex, activity prior to rescue, location, incident day of week and season, and place of death. Statistical analyses comprised X2 tests of significance (p < 0.05) and calculation of relative risk (95% confidence interval) using fatality rates. In total, 237 bystander rescuers drowned (90% male; 35% 15–24 years). In 33% of cases, the primary drowning victim (PDV) was successfully rescued, while in 46% of cases the rescue resulted in multiple drowning fatalities (mean = 2.29; range 1–5 rescuers). Rescues were more likely to be successful in saving the PDV if undertaken at the beach/sea (X2 = 29.147; p < 0.001), while swimming (X2 = 12.504; p = 0.001), or during summer (X2 = 8.223; p = 0.029). Risk of bystander rescue-related fatal drowning was twice as high on weekdays compared to on weekends (RR = 2.04; 95%CI: 1.56–2.67). While bystanders play an important role in reducing drowning, undertaking a rescue is not without risk and can lead to multiple drowning incidents. Training in rescue and resuscitation skills (especially the prioritization of non-contact rescues) coupled with increasing awareness of drowning risk, are risk-reduction strategies which should be explored in Turkey.

scholarly journals Media Reports as a Tool for Timely Monitoring of COVID-19–Related Deaths Among First Responders—United States, April 2020

2021 ◽  
pp. 003335492199917
Author(s):  
Kaitlin Kelly-Reif ◽  
Jessica L. Rinsky ◽  
Sophia K. Chiu ◽  
Sherry Burrer ◽  
Marie A. de Perio ◽  
...  
Keyword(s):  
Public Health ◽  
Law Enforcement ◽  
First Responders ◽  
High Sensitivity ◽  
Demographic Characteristics ◽  
Exposure Source ◽  
The Media ◽  
Media Reports ◽  
In Fire ◽  
Traditional Surveillance

We aimed to describe coronavirus disease 2019 (COVID-19) deaths among first responders early in the COVID-19 pandemic. We used media reports to gather timely information about COVID-19–related deaths among first responders during March 30–April 30, 2020, and evaluated the sensitivity of media scanning compared with traditional surveillance. We abstracted information about demographic characteristics, occupation, underlying conditions, and exposure source. Twelve of 19 US public health jurisdictions with data on reported deaths provided verification, and 7 jurisdictions reported whether additional deaths had occurred; we calculated the sensitivity of media scanning among these 7 jurisdictions. We identified 97 COVID-19–related first-responder deaths during the study period through media and jurisdiction reports. Participating jurisdictions reported 5 deaths not reported by the media. Sixty-six decedents worked in law enforcement, and 31 decedents worked in fire/emergency medical services. Media reports rarely noted underlying conditions. The media scan sensitivity was 88% (95% CI, 73%-96%) in the subset of 7 jurisdictions. Media reports demonstrated high sensitivity in documenting COVID-19–related deaths among first responders; however, information on risk factors was scarce. Routine collection of data on industry and occupation could improve understanding of COVID-19 morbidity and mortality among all workers.

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