scholarly journals Implementing the Health Early Warning System based on syndromic and event-based surveillance at the 2019 Hajj

2020 ◽  
Vol 26 (12) ◽  
pp. 1570-1575
Author(s):  
Kingsley Lezor Bieh ◽  
Anas Khan ◽  
Saber Yezli ◽  
Ahmed El Ganainy ◽  
Sari Asiri ◽  
...  
Keyword(s):  
Early Warning ◽  
Surveillance System ◽  
Disease Surveillance ◽  
Early Warning System ◽  
Situational Awareness ◽  
Warning System ◽  
Control Measures ◽  
Health Events ◽  
Disease Surveillance System ◽  
Event Based

Background: During the 2019 Hajj, the Ministry of Health in Saudi Arabia implemented for the first time a health early warning system for rapid detection and response to health threats. Aims: This study aimed to describe the early warning findings at the Hajj to highlight the pattern of health risks and the potential benefits of the disease surveillance system. Methods: Using syndromic surveillance and event-based surveillance data, the health early warning system generated automated alarms for public health events, triggered alerts for rapid epidemiological investigations and facilitated the monitoring of health events. Results: During the deployment period (4 July–31 August 2019), a total of 121 automated alarms were generated, of which 2 events (heat-related illnesses and injuries/trauma) were confirmed by the response teams. Conclusion: The surveillance system potentially improved the timeliness and situational awareness for health events, including non-infectious threats. In the context of the current COVID-19 pandemic, a health early warning system could enhance case detection and facilitate monitoring of the disease geographical spread and the effectiveness of control measures.

scholarly journals Early warning and rapid public health response to prevent COVID-19 outbreaks in long-term care facilities (LTCF) by monitoring SARS-CoV-2 RNA in LTCF site-specific sewage samples and assessment of antibodies response in this population: prospective study protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e052282
Author(s):  
Bonita E Lee ◽  
Christopher Sikora ◽  
Douglas Faulder ◽  
Eleanor Risling ◽  
Lorie A Little ◽  
...  
Keyword(s):  
Public Health ◽  
Early Warning ◽  
Early Warning System ◽  
Long Term Care ◽  
Warning System ◽  
Control Measures ◽  
Term Care ◽  
Site Specific ◽  
Care Facilities

IntroductionThe COVID-19 pandemic has an excessive impact on residents in long-term care facilities (LTCF), causing high morbidity and mortality. Early detection of presymptomatic and asymptomatic COVID-19 cases supports the timely implementation of effective outbreak control measures but repetitive screening of residents and staff incurs costs and discomfort. Administration of vaccines is key to controlling the pandemic but the robustness and longevity of the antibody response, correlation of neutralising antibodies with commercial antibody assays, and the efficacy of current vaccines for emerging COVID-19 variants require further study. We propose to monitor SARS-CoV-2 in site-specific sewage as an early warning system for COVID-19 in LTCF and to study the immune response of the staff and residents in LTCF to COVID-19 vaccines.Methods and analysisThe study includes two parts: (1) detection and quantification of SARS-CoV-2 in LTCF site-specific sewage samples using a molecular assay followed by notification of Public Health within 24 hours as an early warning system for appropriate outbreak investigation and control measures and cost–benefit analyses of the system and (2) testing for SARS-CoV-2 antibodies among staff and residents in LTCF at various time points before and after COVID-19 vaccination using commercial assays and neutralising antibody testing performed at a reference laboratory.Ethics and disseminationEthics approval was obtained from the University of Alberta Health Research Ethics Board with considerations to minimise risk and discomforts for the participants. Early recognition of a COVID-19 case in an LTCF might prevent further transmission in residents and staff. There was no direct benefit identified to the participants of the immunity study. Anticipated dissemination of information includes a summary report to the immunity study participants, sharing of study data with the scientific community through the Canadian COVID-19 Immunity Task Force, and prompt dissemination of study results in meeting abstracts and manuscripts in peer-reviewed journals.

scholarly journals SARS-CoV-2: fate in water environments and sewage surveillance as an early warning system

2021 ◽  
Author(s):  
Deepak Panchal ◽  
Purusottam Tripathy ◽  
Om Prakash ◽  
Abhishek Sharma ◽  
Sukdeb Pal
Keyword(s):  
Wastewater Treatment ◽  
Early Warning ◽  
Disease Surveillance ◽  
Early Warning System ◽  
Warning System ◽  
Quality Criteria ◽  
Well Being ◽  
Coliform Bacteria ◽  
Surveillance Systems ◽  
Water Quality Criteria

Abstract Coronavirus disease has emerged as one of the greatest threats to human well-being. Currently, the whole world is fighting against this pandemic that transmit either through exposure to virus laden respiratory or water droplets or by touching the virus contaminated surfaces. The viral load in feces of an infected patient varies according to the severity of the disease. Subsequent detection of viral genome (SARS-COV-2) in human feces and sewage systems is an emerging concern for public health. This also dictates to reinforce the existing sewage/wastewater treatment facilities. Rapid monitoring is the key to prevent and control the current mass transmission. Wastewater-Based Epidemiology (WBE) is a potential epidemiology tool that can act as a complementary approach for current infectious disease surveillance systems and an early warning system for disease outbreaks. In a developing country like India, inadequate wastewater treatment systems, low-operational facility and relaxed surface water quality criteria even in terms of fecal coliform bacteria are the major challenges for WBE. Herein, we review the occurrence, transmission, survival of SARS-CoV-2, disinfection and potential of sewage surveillance as an early warning system for COVID-19 spread. We also discuss the challenges of open-defecation practices affecting sewage-surveillance in real-time in densely populated developing countries like India.

scholarly journals Assessment of electronic disease early warning system for improved disease surveillance and outbreak response in Yemen

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Fekri Dureab ◽  
Kamran Ahmed ◽  
Claudia Beiersmann ◽  
Claire J. Standley ◽  
Ali Alwaleedi ◽  
...  
Keyword(s):  
Public Health ◽  
Data Quality ◽  
Early Warning ◽  
Predictive Value ◽  
Disease Surveillance ◽  
Early Warning System ◽  
Warning System ◽  
Health Facilities ◽  
Public Health Response ◽  
Attributes Data

Abstract Background Diseases Surveillance is a continuous process of data collection, analysis interpretation and dissemination of information for swift public health action. Recent advances in health informatics have led to the implementation of electronic tools to facilitate such critical disease surveillance processes. This study aimed to assess the performance of the national electronic Disease Early Warning System in Yemen (eDEWS) using system attributes: data quality, timeliness, stability, simplicity, predictive value positive, sensitivity, acceptability, flexibility, and representativeness, based on the Centres for Disease Control & Prevention (US CDC) standard indicators. Methods We performed a mixed methods study that occurred in two stages: first, the quantitative data was collected from weekly epidemiological bulletins from 2013 to 2017, all alerts of 2016, and annual eDEWS reports, and then the qualitative method using in-depth interviews was carried out in a convergent strategy. The CDC guideline used to describe the following system attributes: data quality (reporting, and completeness), timeliness, stability, simplicity, predictive value positive, sensitivity, acceptability, flexibility and representativeness. Results The finding of this assessment showed that eDEWS is a resilient and reliable system, and despite the conflict in Yemen, the system is still functioning and expanding. The response timeliness remains a challenge, since only 21% of all eDEWS alerts were verified within the first 24 h of detection in 2016. However, identified gaps did not affect the system’s ability to identify outbreaks in the current fragile situation. Findings show that eDEWS data is representative, since it covers the entire country. Although, eDEWS covers only 37% of all health facilities, this represents 83% of all functional health facilities in all 23 governorates and all 333 districts. Conclusion The quality and timeliness of responses are major challenges to eDEWS’ functionality, the eDEWS remains the only system that provides regular data on communicable diseases in Yemen. In particular, public health response timeliness needs improvement.

scholarly journals Evaluation and Extension of the Cusum Technique with an Application to Salmonella Surveillance

2002 ◽  
Vol 14 (3) ◽  
pp. 211-218 ◽  
Author(s):  
T. E. Carpenter
Keyword(s):  
Early Warning ◽  
Simulation Modeling ◽  
Surveillance System ◽  
Disease Surveillance ◽  
False Alarms ◽  
Laboratory System ◽  
Cumulative Sum ◽  
Diagnostic Laboratory ◽  
Disease Surveillance System ◽  
Using Data

The cumulative sum (cusum) technique was examined for its use in a disease surveillance system for detecting temporal clusters of events. Optimal technique parameters were derived for scenarios not previously considered. Simulation modeling produced results that evaluated deviations from predefined rate increases. The cusum technique was less prone to false alarms and more efficient at detecting large rate increases than previously reported. As demonstrated using data obtained from a Salmonella surveillance system operated by a state animal diagnostic laboratory system, the cusum technique could provide early warning of an epidemic problem.

scholarly journals Spatiotemporal analysis of the first wave of COVID-19 hospitalisations in Birmingham, UK

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e050574
Author(s):  
Samuel I Watson ◽  
Peter J Diggle ◽  
Michael G Chipeta ◽  
Richard J Lilford
Keyword(s):  
Disease Control ◽  
Real Time ◽  
Surveillance System ◽  
Disease Surveillance ◽  
Temporal Correlation ◽  
Spatiotemporal Analysis ◽  
Control Measures ◽  
University Hospitals ◽  
Disease Surveillance System ◽  
Local Areas

ObjectivesTo evaluate the spatiotemporal distribution of the incidence of COVID-19 hospitalisations in Birmingham, UK during the first wave of the pandemic to support the design of public health disease control policies.DesignA geospatial statistical model was estimated as part of a real-time disease surveillance system to predict local daily incidence of COVID-19.ParticipantsAll hospitalisations for COVID-19 to University Hospitals Birmingham NHS Foundation Trust between 1 February 2020 and 30 September 2020.Outcome measuresPredictions of the incidence and cumulative incidence of COVID-19 hospitalisations in local areas, its weekly change and identification of predictive covariates.ResultsPeak hospitalisations occurred in the first and second weeks of April 2020 with significant variation in incidence and incidence rate ratios across the city. Population age, ethnicity and socioeconomic deprivation were strong predictors of local incidence. Hospitalisations demonstrated strong day of the week effects with fewer hospitalisations (10%–20% less) at the weekend. There was low temporal correlation in unexplained variance. By day 50 at the end of the first lockdown period, the top 2.5% of small areas had experienced five times as many cases per 10 000 population as the bottom 2.5%.ConclusionsLocal demographic factors were strong predictors of relative levels of incidence and can be used to target local areas for disease control measures. The real-time disease surveillance system provides a useful complement to other surveillance approaches by producing real-time, quantitative and probabilistic summaries of key outcomes at fine spatial resolution to inform disease control programmes.

scholarly journals Implementation Study of a 5-component Pediatric Early Warning System (PEWS) in an Emergency Department in British Columbia, Canada, to inform provincial scale up

2019 ◽  
Author(s):  
Theresa A McElroy ◽  
Erik N. Swartz ◽  
Kasra Hassani ◽  
Sina Waibel ◽  
Yasmin Tuff ◽  
...  
Keyword(s):  
Emergency Department ◽  
Early Warning ◽  
Early Warning System ◽  
Situational Awareness ◽  
Scale Up ◽  
Warning System ◽  
Implementation Fidelity ◽  
Pediatric Care ◽  
Communication Framework ◽  
Provincial Scale

Abstract Background: The rapid identification of deterioration in the pediatric population is complex, particularly in the emergency department (ED). A comprehensive multi-faceted Pediatric Early Warning System (PEWS) might maximize early recognition of clinical deterioration and provide a structured process for the reassessment and escalation of care. The objective of the study was to evaluate the implementation fidelity, effectiveness and utility of a 5-component PEWS implemented in the ED of an urban public general hospital in British Columbia, Canada, to guide provincial scale up. Methods: We used a before-and-after design to evaluate the implementation fidelity, effectiveness and utility of a 5-component PEWS (pediatric assessment flowsheet, PEWS score, situational awareness, escalation aid and communication framework). Sources of data included patient charts, surveys of direct care staff, and key-informant interviews. Data were analyzed using mixed-methods approaches. Results: The majority of charts had documented PEWS scores at triage (80%) and first bedside assessment (81.2%) indicating that the intervention was implemented with high fidelity. The intervention was effective in increasing vital signs documentation, both at first beside assessment (84% increase) and throughout the ED stay (>100% increase), in improving staff’s self-perceived knowledge and confidence in providing pediatric care, and self-reported communication between staff. Satisfaction levels were high with the PEWS scoring system, flowsheet, escalation aid, and to a lesser extent with the situational awareness tool and communication framework. Reasons for dissatisfaction included increased paperwork and incidence of false-positives. Overall, the majority of providers indicated that implementation of the PEWS system and completing a PEWS score at triage alongside the Canadian Triage and Acuity Scale (CTAS) added value to pediatric care in the ED. Results also suggest that the intervention is aligned with current practice in the ED.

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