scholarly journals Investigation and public health response to a COVID-19 outbreak in a rural resort community — Blaine County, Idaho, 2020

2021 ◽  
Author(s):  
Eileen M. Dunne ◽  
Tanis Maxwell ◽  
Christi Dawson-Skuza ◽  
Matthew Burns ◽  
Christopher Ball ◽  
...  
Keyword(s):  
Public Health ◽  
Rural Communities ◽  
Mitigation Strategies ◽  
Test Results ◽  
Public Health Response ◽  
Public Health Action ◽  
Central Public Health ◽  
South Central ◽  
Laboratory Test Results ◽  
Close Contacts

AbstractBlaine County, Idaho, a rural area with a renowned resort, experienced an outbreak of novel coronavirus disease (COVID-19). We undertook an epidemiologic investigation to describe the outbreak and guide public health action. Confirmed cases of COVID-19 were identified from reports of SARS-CoV-2-positive laboratory test results to South Central Public Health District.Information on symptoms, hospitalization, recent travel, healthcare worker status, and close contacts was obtained by medical record review and patient interviews. Viral sequence analysis was conducted on a subset of available specimens. During March 13–April 10, 2020, a total of 451 COVID-19 cases occurred among Blaine County residents (1,959 cases per 100,000 population). An additional 37 cases occurred in out-of-state residents. Among the 451 COVID-19 patients, the median age was 51 years (Interquartile range [IQR]: 37–63), 52 (11.5%) were hospitalized, and 5 (1.1%) died. The median duration between specimen collection and a positive laboratory result was 9 days (IQR: 4–10). Forty-four (9.8%) patients reported recent travel. Healthcare workers comprised 56 (12.4%) cases; 33 of whom worked at the only hospital in the county, leading to a 15-day disruption of hospital services. Of 562 close contacts monitored by public health authorities, 22 (3.9%) had laboratory-confirmed COVID-19 and an additional 29 (5.2%) experienced compatible symptoms. Sequencing results from 34 Idaho specimens supported epidemiologic findings indicating travel as a source of SARS-CoV-2, and identified multiple lineages among hospital workers. Community mitigation strategies included school and resort closure, stay-at-home orders, and restrictions on incoming travelers. COVID-19 outbreaks in rural communities can disrupt health services. Lack of local laboratory capacity led to long turnaround times for COVID-19 test results. Rural communities frequented by tourists should consider implementing restrictions on incoming travelers among other mitigation strategies to reduce COVID-19 transmission.

scholarly journals Investigation and public health response to a COVID-19 outbreak in a rural resort community—Blaine County, Idaho, 2020

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0250322
Author(s):  
Eileen M. Dunne ◽  
Tanis Maxwell ◽  
Christina Dawson-Skuza ◽  
Matthew Burns ◽  
Christopher Ball ◽  
...  
Keyword(s):  
Public Health ◽  
Rural Communities ◽  
Mitigation Strategies ◽  
Test Results ◽  
Public Health Response ◽  
Public Health Action ◽  
Illness Onset ◽  
South Central ◽  
Laboratory Test Results ◽  
Close Contacts

Blaine County, Idaho, a rural area with a renowned resort, experienced a COVID-19 outbreak early in the pandemic. We undertook an epidemiologic investigation to describe the outbreak and guide public health action. Confirmed cases of COVID-19 were identified from reports of SARS-CoV-2-positive laboratory test results to South Central Public Health District. Information on symptoms, hospitalization, recent travel, healthcare worker status, and close contacts was obtained by medical record review and patient interviews. Viral sequence analysis was conducted on a subset of available specimens. During March 13–April 10, 2020, a total of 451 COVID-19 cases among Blaine County residents (1,959 cases per 100,000 population) were reported, with earliest illness onset March 1. The median patient age was 51 years (interquartile range [IQR]: 37–63), 52 (11.5%) were hospitalized, and 5 (1.1%) died. The median duration between specimen collection and a positive laboratory result was 9 days (IQR: 4–10). Forty-four (9.8%) patients reported recent travel and an additional 37 cases occurred in out-of-state residents. Healthcare workers comprised 56 (12.4%) cases; 33 of whom worked at the only hospital in the county, leading to a 15-day disruption of hospital services. Among 562 close contacts monitored by public health authorities, laboratory-confirmed COVID-19 or compatible symptoms were identified in 51 (9.1%). Sequencing results from 34 specimens supported epidemiologic findings indicating travel as a source of SARS-CoV-2, and identified multiple lineages among hospital workers. Community mitigation strategies included school and resort closure, stay-at-home orders, and restrictions on incoming travelers. COVID-19 outbreaks in rural communities can disrupt health services. Lack of local laboratory capacity led to long turnaround times for COVID-19 test results. Rural communities frequented by tourists face unique challenges during the COVID-19 pandemic. Implementing restrictions on incoming travelers and other mitigation strategies helped reduce COVID-19 transmission early in the pandemic.

scholarly journals Coding of Electronic Laboratory Reports for Biosurveillance, Selected United States Hospitals, 2011

2015 ◽  
Vol 7 (2) ◽  
Author(s):  
Sanjaya Dhakal ◽  
Sherry L. Burrer ◽  
Carla A. Winston ◽  
Achintya Dey ◽  
Umed Ajani ◽  
...  
Keyword(s):  
Public Health ◽  
Laboratory Test ◽  
No Value ◽  
Laboratory Data ◽  
Test Results ◽  
Snomed Ct ◽  
Syndromic Surveillance System ◽  
Coding Systems ◽  
Surveillance And Response ◽  
Laboratory Test Results

ObjectiveElectronic laboratory reporting has been promoted as a public health priority. The Office of the U.S. National Coordinator for Health Information Technology has endorsed two coding systems: Logical Observation Identifiers Names and Codes (LOINC) for laboratory test orders and Systemized Nomenclature of Medicine-Clinical Terms (SNOMED CT) for test results.  Materials and MethodsWe examined LOINC and SNOMED CT code use in electronic laboratory data reported in 2011 by 63 non-federal hospitals to BioSense electronic syndromic surveillance system.  We analyzed the frequencies, characteristics, and code concepts of test orders and results.ResultsA total of 14,028,774 laboratory test orders or results were reported. No test orders used SNOMED CT codes. To describe test orders, 77% used a LOINC code, 17% had no value, and 6% had a non-informative value, “OTH”. Thirty-three percent (33%) of test results had missing or non-informative codes. For test results with at least one informative value, 91.8% had only LOINC codes, 0.7% had only SNOMED codes, and 7.4% had both. Of 108 SNOMED CT codes reported without LOINC codes, 45% could be matched to at least one LOINC code.ConclusionMissing or non-informative codes comprised almost a quarter of laboratory test orders and a third of test results reported to BioSense by non-federal hospitals. Use of LOINC codes for laboratory test results was more common than use of SNOMED CT. Complete and standardized coding could improve the usefulness of laboratory data for public health surveillance and response.

scholarly journals Bringing real-time geospatial precision to HIV incidence measurements via mobile phones (Preprint)

2018 ◽  
Author(s):  
Alain Placide Nsabimana ◽  
Bernard Uzabakiriho ◽  
Daniel M Kagabo ◽  
Jerome Nduwayo ◽  
Qinyouen Fu ◽  
...  
Keyword(s):  
Public Health ◽  
Mobile Phone ◽  
Real Time ◽  
Mobile Phones ◽  
Healthcare Workers ◽  
Lateral Flow ◽  
Rural Site ◽  
Test Results ◽  
Public Health Response ◽  
Hiv Test

BACKGROUND Precise measurements of HIV incidences at community levels can help mount a more effective public health response, but the most reliable methods currently require labor-intensive population surveys. Novel mobile phone technologies are being tested for adherence to medical appointments and antiretroviral therapy, but using them to track HIV test results with automatically generated geospatial coordinates has not been widely tested. OBJECTIVE We customized a portable reader for interpreting the results of HIV lateral flow tests, and developed a mobile phone app to track HIV test results in urban and rural locations in Rwanda. The objective is to assess the feasibility of this technology to collect frontline HIV test results in real time and with geospatial context to help measure HIV incidences and improve epidemiological surveillance. METHODS 20 healthcare workers used the technology to track the test results of 2290 patients across three hospital sites (two urban sites in Kigali, and a rural site in the Western Province of Rwanda). Smartphones for less than $70 USD each were used. The mobile phone app to record HIV test results could take place without internet connectivity, with uploading of results to the cloud taking place later with internet. RESULTS 92% of HIV test results could be tracked in real time on an online dashboard with geographical resolution down to street resolution. Out of the 20 healthcare workers, 68% would recommend the lateral flow reader, and 100% would recommend the mobile phone app. CONCLUSIONS Mobile phones have the potential to simplify the input of HIV test results with geospatial context and in real time to improve public health surveillance of HIV.

scholarly journals COVID-19, Australia: Epidemiology Report 12: Reporting week ending 23:59 AEST 19 April 2020

2020 ◽  
Vol 44 ◽  
Author(s):  
Keyword(s):  
Public Health ◽  
Disease Transmission ◽  
Case Fatality ◽  
The United States ◽  
International Travel ◽  
World Health ◽  
Public Health Response ◽  
Public Health Action ◽  
Case Ascertainment ◽  
Overseas Travel

Confirmed cases in Australia notified up to 19 April 2020: notifications = 6,606; deaths = 69. The reduction in international travel and domestic movement, social distancing measures and public health action have likely slowed the spread of the disease. Notifications in Australia remain predominantly among people with recent overseas travel, with some locally-acquired cases being detected. Most locally-acquired cases can be linked back to a confirmed case, with a small portion unable to be epidemiologically linked. The distribution of overseas-acquired cases to locally-acquired cases varies by jurisdiction. The crude case fatality rate (CFR) in Australia remains low (1.0%) compared to the World Health Organization’s globally-reported rate (6.8%) and to other comparable high-income countries such as the United States of America (4.7%) and the United Kingdom (13.5%). The low CFR is likely reflective of high case ascertainment including detection of mild cases. High case ascertainment enables public health response and reduction of disease transmission. Internationally, cases continue to increase. The rates of increase have started to slow in several regions, although it is too soon to tell whether this trend will be sustained. Interpretation of international epidemiology should be conducted with caution as it differs from country to country depending not only on the disease dynamics, but also on differences in case detection, testing and implemented public health measures.

The Burden of Antimicrobial Resistant Infections in Wales: a population-level modelling analysis

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
H Wang ◽  
P P M Thomas
Keyword(s):  
Public Health ◽  
Relative Deprivation ◽  
Infection Type ◽  
Surveillance Data ◽  
Health Board ◽  
Local Health ◽  
Public Health Response ◽  
Public Health Action ◽  
Public Health Burden ◽  
Health Action

Abstract Background Antimicrobial Resistance (AMR) threatens the sustainability of an effective, global public health response to infectious disease. This study uses routine surveillance data to estimate the public health burden (PHB) of AMR infections in Wales for the period 2017-19, with further stratification by Age, Sex, local Health Board (HB) area and relative deprivation, to guide public health action. Methods Welsh AMR Surveillance data, collected as part of the European AMR Surveillance Network (EARS-Net), was collated for the period 2017-19. Adapting the methodology of the European Centres for Disease Control Burden of Communicable Diseases in Europe (BCoDE), we modelled the PHB of five types of antibiotic-resistant infection (invasive and non-invasive), and 7 pathogens which associated with AMR, using the Burden of Healthcare-Acquire Infection (BHAI) R package. Postcodes were used to assign patients' resident health board, as well as their relative socio-economic deprivation, using the Welsh Index of Multiple Deprivation (WIMD). Results Preliminary results (median estimation with 95% confidence interval (CI)) were calculated for: number of infections with AMRnumber of deaths attributable to AMRnumber of DALYs attributable to AMR Estimates were stratified by age; sex; HB; relative deprivation; and pathogen and infection type. Conclusions This is the first study of its kind to study the relationship between AMR incidence and relative deprivation. It offers a clear picture of the epidemiology of AMR within Wales to support public health action. Key messages Infections from AMR bacteria represent a major PHB in Wales, and the modelling PHB of AMR by socioeconomic group and local area can inform effective public health action. The results of this study are valuable for guiding public health action to address AMR at the national and international level.

scholarly journals First Local Transmission Cluster of COVID-19 in Malaysia: Public Health Response

2020 ◽  
Vol 8 (3) ◽  
pp. 124-130
Author(s):  
Noor Ani Ahmad ◽  
Chong Zhuo Lin ◽  
Sunita Abd Rahman ◽  
Muhammad Haikal bin Ghazali ◽  
Ezy Eriyani Nadzari ◽  
...  
Keyword(s):  
Public Health ◽  
Index Case ◽  
Contact Tracing ◽  
Public Health Response ◽  
Imported Case ◽  
Health Response ◽  
History Of ◽  
Local Transmission ◽  
Close Contacts ◽  
Inter State

Introduction: Rapid public health response is important in controlling the transmission of coronavirus disease 2019 (COVID-19). In this study, we described the public health response taken by the Ministry of Health of Malaysia in managing the first local transmission cluster of COVID-19 related to mass-gathering and inter-state traveling to celebrate a festival. Methods: We summarized strategies implemented by the Malaysia Crisis Preparedness and Response Centre (CPRC) in managing the first local transmission of COVID-19. We collected information related to the epidemiological investigation of this cluster and described the inter-state network in managing the outbreak. Results: This first local transmission of COVID-19 in Malaysia had a history of contact with her older brother, the index case, who was the first Malaysian imported case. Only two positive cases were detected out of 59 contacts traced from the index case. Close contacts with infected person/s, inter-state movement, and public/family gatherings were identified as the sources of transmission. A large number of contacts were traced from inter-state traveling, and family gatherings during the festive season, and health consultations and treatment. Conclusion: Close contacts from inter-state movement and public/family gatherings were identified as the source of transmission. Family or public gatherings during festivals or religious events should be prohibited or controlled in COVID-19 prevalent areas. A structured surveillance system with rapid contact tracing is significant in controlling the transmission of COVID-19 in the community.

scholarly journals The Association between Poor Glycemic Control in Diabetes Mellitus and Progression of COVID-19

2020 ◽  
Author(s):  
AliReza Estedlal ◽  
Marjan Jeddi ◽  
Seyed Taghi Heydari ◽  
Mohammad Hossein Dabbaghmanesh
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factor ◽  
Glycemic Control ◽  
Laboratory Test ◽  
Demographic Data ◽  
Elevated Serum ◽  
Diabetic Patients ◽  
Test Results ◽  
South Central ◽  
Laboratory Test Results

Abstract Background: Coronavirus disease 2019 (COVID-19) is a newly recognized disease whose rapid spread has resulted in a global pandemic. In this resepct, there are several comorbidities presumed to be associated with presentation of complications in COVID-19 such as diabetes mellitus (DM), hypertension (HTN), and cardiovascular diseases (CVDs). Therefore, this study aimed to explore whether DM was a risk factor influencing presentation, progression, and prognosis of COVID-19 or not.Methods: A total number of 447 patients with confirmed COVID-19 were selected from two centers for COVID-19 in the city of Shiraz, south-central Iran, from February 20 to April 29, 2020. Then, demographic data, medical history, signs and symptoms, laboratory test results, as well as chest computed tomography (CT) scan reports were collected and analyzed.Results: This study revealed that older age, HTN, and CVDs could be mostly seen in diabetic patients with COVID-19. In addition, such patients had prolonged hospital stay, lower oxygen (O2) saturation, and abnormal laboratory test results such as higher white blood cell (WBC) count, lower lymphocyte count, elevated serum tumor markers such as aspartate aminotransferase (AST), and abnormal kidney function.Conclusion: DM is an important risk factor for adverse endpoints in patients with COVID-19. In diabetic patients, proper consideration of clinical characteristics is thus of utmost importance. In addition, special clinical insight for disease prevention, good glycemic control during hospitalization, and efforts to develop a vaccine can help improve disease outcomes in this population.

scholarly journals Validation of ICD-10 codes for identifying cases of chlamydia and gonorrhea

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
B E Dixon ◽  
Y A Ho ◽  
A A Broyles ◽  
A Wiensch ◽  
J N Arno
Keyword(s):  
Public Health ◽  
Laboratory Test ◽  
Health Systems ◽  
Administrative Data ◽  
Laboratory Testing ◽  
Test Results ◽  
Predictive Values ◽  
Laboratory Test Results ◽  
Icd 10 ◽  
Disease Specific

Abstract Background Public health researchers seek to use administrative health data captured in digital health systems to examine outcomes for individuals with sexually transmitted infections (STIs). Yet the International Classification of Diseases, Tenth Revision (ICD-10) codes used to identify cases of chlamydia and gonorrhea have not been validated. Objective We sought to assess the validity of using ICD-10 codes to identify cases of chlamydia and gonorrhea. Methods We utilized data from electronic health records gathered from private and public health systems from 1 October, 2015 to 31 December, 2016. Patients were included if they were aged 13-44 and received either 1) laboratory testing for chlamydia or gonorrhea or 2) an ICD-10 diagnosis of chlamydia, gonorrhea, or an unspecified STI. To validate ICD-10 codes, we calculated positive and negative predictive values, sensitivity, and specificity based on the presence of a laboratory test result, or any STI laboratory test results in case of unspecified STI. We further examined the timing of clinical diagnosis relative to laboratory testing. Results A total of 238,876 individuals (16.0% of population) were either tested for chlamydia or gonorrhea, or diagnosed with an ICD-10 code of interest, during the study period. For cases in which a patient was diagnosed with chlamydia or gonorrhea, 82% and 78% of cases were confirmed, respectively. The positive predictive values for chlamydia, gonorrhea, and unspecified STI ICD-10 codes were 87.6%, 85.0%, and 32.0%, respectively. Negative predictive values were high (>92%). Sensitivity for chlamydia diagnostic codes was 10.6% and gonorrhea was 9.7%. Specificity was 99.9% for both chlamydia and gonorrhea. Conclusions Disease specific ICD-10 codes accurately identify cases of chlamydia and gonorrhea. However, low sensitivities suggest that most gonorrhea and chlamydia cases could not be identified in administrative data alone without laboratory test results. Key messages Disease specific ICD-10-CM codes accurately identify cases of chlamydia and gonorrhea. Low sensitivities suggest that most gonorrhea and chlamydia cases could not be identified in administrative data alone without laboratory test results.

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 Outbreak of Neisseria meningitidis capsular group W among scouts returning from the World Scout Jamboree, Japan, 2015

2016 ◽  
Vol 21 (45) ◽  
Author(s):  
Alison Smith-Palmer ◽  
Ken Oates ◽  
Diana Webster ◽  
Sarah Taylor ◽  
Kevin J Scott ◽  
...  
Keyword(s):  
Public Health ◽  
Meningococcal Disease ◽  
Molecular Testing ◽  
Timely Manner ◽  
Public Health Action ◽  
The Public ◽  
The World ◽  
Health Action ◽  
Collaboration And Communication ◽  
Close Contacts

The 23rd World Scout Jamboree was held in Japan from 28 July to 8 August 2015 and was attended by over 33,000 scouts from 162 countries. An outbreak of invasive meningococcal disease capsular group W was investigated among participants, with four confirmed cases identified in Scotland, who were all associated with one particular scout unit, and two confirmed cases in Sweden; molecular testing showed the same strain to be responsible for illness in both countries. The report describes the public health action taken to prevent further cases and the different decisions reached with respect to how wide to extend the offer of chemoprophylaxis in the two countries; in Scotland, chemoprophylaxis was offered to the unit of 40 participants to which the four cases belonged and to other close contacts of cases, while in Sweden chemoprophylaxis was offered to all those returning from the Jamboree. The report also describes the international collaboration and communication required to investigate and manage such multinational outbreaks in a timely manner.

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