scholarly journals What did Syndromic Surveillance Show During London 2012? Lessons for Mass Gatherings

2015 ◽  
Vol 7 (1) ◽  
Author(s):  
Dan Todkill ◽  
Helen Hughes ◽  
Alex Elliot ◽  
Roger Morbey ◽  
Obaghe Edeghere ◽  
...  
Keyword(s):  
Public Health ◽  
General Practitioner ◽  
Syndromic Surveillance ◽  
Lessons Learned ◽  
Surveillance Systems ◽  
Mass Gathering ◽  
Daily Number ◽  
Mass Gatherings ◽  
London 2012 ◽  
The Impact

This paper investigates the impact of the London 2012 Olympic and Paralympic Games on syndromic surveillance systems coordinated by Public Health England. The Games had very little obvious impact on the daily number of ED attendances and general practitioner consultations both nationally, and within London. These results provide valuable lessons learned for future mass gathering events.

scholarly journals Coordinated Enhanced Surveillance with Healthcare Entities for Mass Gathering Events

2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Erin E. Austin
Keyword(s):  
Public Health ◽  
Syndromic Surveillance ◽  
Lessons Learned ◽  
Surveillance Systems ◽  
Mass Gathering ◽  
Functional Requirements ◽  
Specific Field ◽  
Mass Gatherings ◽  
Ed Visits ◽  
The U.S

ObjectiveTo describe the planning strategies and lessons learned by theVirginia Department of Health (VDH) when conducting enhancedsurveillance during mass gathering events and coordinating withhealthcare entities to distinguish event-related emergency department(ED) visits from community-related ED visits.IntroductionMass gatherings can result in morbidity and mortality fromcommunicable and non-communicable diseases, injury, andbioterrorism. Therefore, it is important to identify event-related visitsas opposed to community-related visits when conducting publichealth surveillance1. Previous mass gatherings in Virginia havedemonstrated the importance of implementing enhanced surveillanceto facilitate early detection of public health issues to allow for timelyresponse2.MethodsBetween June 2015 and September 2015, VDH coordinatedwith two healthcare entities representing six acute care hospitalsto conduct enhanced surveillance for the 2015 World Police andFire Games and 2015 Union Cycliste Internationale (UCI) RoadWorld Championships. VDH established initial communicationwith each healthcare entity between 1 week to 2 months before theevent start date to discuss functional requirements with technical,informatics, and clinical staff. Requirements included: 1) health careentity identifying gathering attendees during the ED registration, 2)capturing a standardized mass gathering indicator within the patient’selectronic health record (EHR), and 3) transmitting the gatheringindicator to VDH through existing electronic syndromic surveillancereporting processes. ED visit records with the gathering indicator wereanalyzed by VDH using the Virginia Electronic Surveillance Systemfor the Notification Community-based Epidemics (ESSENCE) andfindings were incorporated in daily VDH situational reports. Thissame methodology will be applied for the upcoming U.S. VicePresidential Debate in October 2016.ResultsThe duration of the two gatherings in 2015 ranged from 9 to 10 daysand the locations were categorized as urban. The population densityof the gathering location ranged from 1,950 to 2,889 populationper square mile. The estimated number of attendees ranged from45,000 to 400,000. Attendees were defined as having attended at leastone day of the mass gathering event. The mass gathering indicatorcaptured during the ED registration included the gathering acronymor a gathering specific field with a drop down menu containingtrue/false options. VDH utilized ESSENCE to identify 42 ED visits(0.5%) with the gathering acronym out of 8,768 total ED visits duringthe 2015 World Police and Fire Games and 60 ED visits (2.6%)with the gathering specific field out of 2,296 total visits during the2015 UCI Road World Championships. The results of the U.S. VicePresidential Debate in October 2016 are pending.ConclusionsIn 2015, VDH partnered with two healthcare entities to conductenhanced surveillance during two mass gatherings. Although VDHroutinely uses syndromic surveillance data to identify issues of publichealth concern, it has previously lacked the ability to identify EDvisits specific to mass gatherings. Prior to collaboration with VDH,the healthcare entities did not capture gathering-specific ED visitsusing their EHR systems. The two healthcare entities successfullymodified their business procedures and EHR system to capture andtransmit a gathering indicator for ED visits despite some challenges.These challenges include constraints with customization of theEHR and syndromic surveillance systems, lack of standardizedtraining among ED registration staff for interpreting and applyingthe gathering indicator, and limited functionality testing prior tothe event. Lessons learned from this coordinated effort are to: 1)initiate the planning phase and identification of requirements as earlyas possible to ensure they are well defined and understandable, 2)implement frequent communications with the healthcare entity,and 3) customize requirements for the specific gathering as muchas possible while balancing the burden and benefit to public healthand the healthcare entity. The coordinated enhanced surveillanceefforts provided both VDH and the healthcare entities with improvedsituational awareness and capacity building during mass gatheringevents. The strategies and lessons learned from these two events willbe applied to improve enhanced surveillance of public health issuesduring future mass gatherings, including the U.S. Vice PresidentialDebate in October 2016.

scholarly journals Using State and National Surveillance Systems during World Equestrian Games in NC

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Lana Deyneka ◽  
Zachary Faigen ◽  
Anne Hakenwerth ◽  
Nicole Lee ◽  
Amy Ising ◽  
...  
Keyword(s):  
Public Health ◽  
Syndromic Surveillance ◽  
Urgent Care ◽  
Poison Center ◽  
Surveillance Systems ◽  
Mass Gathering ◽  
Mass Gatherings ◽  
Epidemic Intelligence ◽  
Polk County ◽  
Ed Visits

ObjectiveTo describe surveillance activities and use of existing state (NC DETECT) and national (NSSP) syndromic surveillance systems during the International Federation for Equestrian Sports (FEI) World Equestrian Games (WEG), in Mill Spring, NC from September 11 to September 23, 2018MethodsNC DETECT collects statewide data from hospital emergency department (ED) visits and Carolinas Poison Center (CPC) calls. NC DETECT also collects data from select Urgent Care Centers (UCC) in the Charlotte area. CPC data are updated hourly, while ED data are updated twice a day. NC DETECT data were monitored daily for census (total ED visits), communicable disease syndromes, injury syndromes, and other occurrences of public health significance related to the event. The geographic areas monitored were Polk County (the location of the main event), the counties where the guests were lodging in the Western NC Region (Henderson, Transylvania, Buncombe, Rutherford, McDowell, and Cleveland), the Charlotte Metropolitan area, and statewide. Because of the large number of people from other states and countries who attended, ED surveillance was mainly conducted by hospitals so that visits were captured for all patients and not just NC residents. WEG dashboards containing ED data were created prior to the event using NC DETECT and NSSP ESSENCE systems, and were accessible to epidemiologists at the state level. NSSP syndrome queries were shared with the neighboring state (SC) public health agency. Surveillance began two weeks prior to the event to establish baseline levels for all ED visits for hospitals in Polk County and the Western NC Region. Surveillance occurred daily before the event, during the event, and for two weeks following the event to account for incubation periods of potential diseases.ResultsThe 2018 Equestrian games in Western NC were affected by heavy rain and heat. The weather led to low attendance and cancellation of a few competitions. During the observation period, ED admissions and most of the mass gathering related syndromes in both NC DETECT and NSSP systems were at baseline. ED admissions for motor vehicle collisions and dehydration syndromes were above baseline for 09/19 and 09/21/18 (Figures 3-4). CPC calls and UC admissions for selected UC centers in the Charlotte area were also monitored, and were at baseline.ConclusionsNC DETECT and NSSP Dashboards provided effective and timely surveillance for the WEG event to assist local public health in the rural NC area with epidemiologic investigations and appropriate response. NC DETECT’s CPC and UC data provided additional valuable information, and complemented ED surveillance during the mass gathering event. Syndromic surveillance became essential during WEG, as NC DPH deployment plans and resource availability changed when Hurricane Florence bore down on the region.References1. Joseph S. Lombardo, Carol A. Sniegoski, Wayne A. Loschen, Matthew Westercamp, Michael Wade, Shandy Dearth, and Guoyan Zhang Public Health Surveillance for Mass Gatherings Johns Hopkins APL Technical Digest , Volume 27, Number 4 (2008)2. Kaiser R, Coulombier D. Epidemic intelligence during mass gatherings. Euro Surveill. 2006;113. Ising A, Li M, Deyneka L, Vaughan-Batten H, Waller A. Improving syndromic surveillance for nonpower users: NC DETECT dashboards. Emerging Health Threats Journal 2011, 4: 11702 - DOI: 10.3402/ehtj.v4i0.11702 

An Observational Study Using English Syndromic Surveillance Data Collected During the 2012 London Olympics – What did Syndromic Surveillance Show and What Can We Learn for Future Mass-gathering Events?

2016 ◽  
Vol 31 (6) ◽  
pp. 628-634 ◽  
Author(s):  
Dan Todkill ◽  
Helen E. Hughes ◽  
Alex J. Elliot ◽  
Roger A. Morbey ◽  
Obaghe Edeghere ◽  
...  
Keyword(s):  
Public Health ◽  
Observational Study ◽  
Real Time ◽  
Syndromic Surveillance ◽  
Olympic Games ◽  
Surveillance Data ◽  
Surveillance Systems ◽  
Mass Gathering ◽  
Opening Ceremony ◽  
London 2012

AbstractIntroductionIn preparation for the London 2012 Olympic Games, existing syndromic surveillance systems operating in England were expanded to include daily general practitioner (GP) out-of-hours (OOH) contacts and emergency department (ED) attendances at sentinel sites (the GP OOH and ED syndromic surveillance systems: GPOOHS and EDSSS).Hypothesis/ProblemThe further development of syndromic surveillance systems in time for the London 2012 Olympic Games provided a unique opportunity to investigate the impact of a large mass-gathering event on public health and health services as monitored in near real-time by syndromic surveillance of GP OOH contacts and ED attendances. This can, in turn, aid the planning of future events.MethodsThe EDSSS and GPOOHS data for London and England from July 13 to August 26, 2012, and a similar period in 2013, were divided into three distinct time periods: pre-Olympic period (July 13-26, 2012); Olympic period (July 27 to August 12); and post-Olympic period (August 13-26, 2012). Time series of selected syndromic indicators in 2012 and 2013 were plotted, compared, and risk assessed by members of the Real-time Syndromic Surveillance Team (ReSST) in Public Health England (PHE). Student’s t test was used to test any identified changes in pattern of attendance.ResultsVery few differences were found between years or between the weeks which preceded and followed the Olympics. One significant exception was noted: a statistically significant increase (P value = .0003) in attendances for “chemicals, poisons, and overdoses, including alcohol” and “acute alcohol intoxication” were observed in London EDs coinciding with the timing of the Olympic opening ceremony (9:00 pm July 27, 2012 to 01:00 am July 28, 2012).ConclusionsSyndromic surveillance was able to provide near to real-time monitoring and could identify hourly changes in patterns of presentation during the London 2012 Olympic Games. Reassurance can be provided to planners of future mass-gathering events that there was no discernible impact in overall attendances to sentinel EDs or GP OOH services in the host country. The increase in attendances for alcohol-related causes during the opening ceremony, however, may provide an opportunity for future public health interventions.TodkillD, HughesHE, ElliotAJ, MorbeyRA, EdeghereO, HarcourtS, HughesT, EndericksT, McCloskeyB, CatchpoleM, IbbotsonS, SmithG. An observational study using English syndromic surveillance data collected during the 2012 London Olympics – what did syndromic surveillance show and what can we learn for future mass-gathering events?Prehosp Disaster Med. 2016;31(6):628–634.

Developing a new syndromic surveillance system for the London 2012 Olympic and Paralympic Games

2012 ◽  
Vol 140 (12) ◽  
pp. 2152-2156 ◽  
Author(s):  
S. E. HARCOURT ◽  
J. FLETCHER ◽  
P. LOVERIDGE ◽  
A. BAINS ◽  
R. MORBEY ◽  
...  
Keyword(s):  
Public Health ◽  
General Practice ◽  
General Practitioner ◽  
Surveillance System ◽  
Syndromic Surveillance ◽  
Surveillance Systems ◽  
Syndromic Surveillance System ◽  
National System ◽  
London 2012 ◽  
Paralympic Games

SUMMARYSyndromic surveillance is vital for monitoring public health during mass gatherings. The London 2012 Olympic and Paralympic Games represents a major challenge to health protection services and community surveillance. In response to this challenge the Health Protection Agency has developed a new syndromic surveillance system that monitors daily general practitioner out-of-hours and unscheduled care attendances. This new national system will fill a gap identified in the existing general practice-based syndromic surveillance systems by providing surveillance capability of general practice activity during evenings/nights, over weekends and public holidays. The system will complement and supplement the existing tele-health phone line, general practitioner and emergency department syndromic surveillance systems. This new national system will contribute to improving public health reassurance, especially to meet the challenges of the London 2012 Olympic and Paralympic Games.

scholarly journals The COVID-19 pandemic: a new challenge for syndromic surveillance

2020 ◽  
Vol 148 ◽  
Author(s):  
Alex J. Elliot ◽  
Sally E. Harcourt ◽  
Helen E. Hughes ◽  
Paul Loveridge ◽  
Roger A. Morbey ◽  
...  
Keyword(s):  
Public Health ◽  
Health System ◽  
Syndromic Surveillance ◽  
Surveillance Data ◽  
Surveillance Systems ◽  
Clinical Coding ◽  
Public Health Response ◽  
Specific Symptom ◽  
Health And Social Care ◽  
The Impact

Abstract The COVID-19 pandemic is exerting major pressures on society, health and social care services and science. Understanding the progression and current impact of the pandemic is fundamental to planning, management and mitigation of future impact on the population. Surveillance is the core function of any public health system, and a multi-component surveillance system for COVID-19 is essential to understand the burden across the different strata of any health system and the population. Many countries and public health bodies utilise ‘syndromic surveillance’ (using real-time, often non-specific symptom/preliminary diagnosis information collected during routine healthcare provision) to supplement public health surveillance programmes. The current COVID-19 pandemic has revealed a series of unprecedented challenges to syndromic surveillance including: the impact of media reporting during early stages of the pandemic; changes in healthcare-seeking behaviour resulting from government guidance on social distancing and accessing healthcare services; and changes in clinical coding and patient management systems. These have impacted on the presentation of syndromic outputs, with changes in denominators creating challenges for the interpretation of surveillance data. Monitoring changes in healthcare utilisation is key to interpreting COVID-19 surveillance data, which can then be used to better understand the impact of the pandemic on the population. Syndromic surveillance systems have had to adapt to encompass these changes, whilst also innovating by taking opportunities to work with data providers to establish new data feeds and develop new COVID-19 indicators. These developments are supporting the current public health response to COVID-19, and will also be instrumental in the continued and future fight against the disease.

scholarly journals (A225) Lessons Learned at the Commonwealth Games: A Mass-Gathering Sporting Event in New Delhi, India

2011 ◽  
Vol 26 (S1) ◽  
pp. s61-s61
Author(s):  
A. Madan
Keyword(s):  
Public Health ◽  
Mass Casualty ◽  
Lessons Learned ◽  
Mitigation Strategies ◽  
New Delhi ◽  
Sporting Events ◽  
Mass Gathering ◽  
Outbreak Response ◽  
Mass Gatherings ◽  
Commonwealth Games

Mass gatherings can be religious, political, socio-cultural, or sporting events, and vary in the form of processions, car races, conferences, fairs, etc. New Delhi hosted the 2010 Commonwealth Games, a mass gathering spread over a duration of 10 days with different venues and a high density of participants, spectators, security personnel, volunteers, and high-profile guests. Various organizations were involved in the planning and implementation of the games which called for a collaborative and coordinated effort to make the event a success. Security coverage was required for 23 sporting, 32 training, and seven non-sporting venues. Security arrangements were of utmost importance and required training, mobilization, and deployment of army, police, and other emergency workers, as well as establishing Standard Operating Procedures for responses to chemical, biological, radioactive, and nuclear events and availing specialized equipment. Areas of public health interventions in mass gathering include mass-casualty preparedness, disease surveillance and outbreak response, safety of water, food, and venues, health promotion, public health preparedness and response, pest and vector control, coordination and communication, healthcare facility capacity, and medical supplies. Methods adopted for the study included interviews with the stakeholders of the Commonwealth Games and use of secondary data to cite examples and support arguments. Existing knowledge must be documented and made available for use in planning for future mass gatherings. The size, duration, and interest of such events demands special attention toward preparedness and mitigation strategies to prevent or minimize the risk of ill health and maximizing the safety of people involved.

scholarly journals Using real-time syndromic surveillance to monitor the health effects of air pollution

2018 ◽  
Vol 10 (1) ◽  
Author(s):  
Sally Harcourt ◽  
Lydia Izon-Cooper ◽  
Felipe D. Colón-González ◽  
Roger Morbey ◽  
Gillian Smith ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Air Pollution ◽  
Syndromic Surveillance ◽  
Health Care Seeking ◽  
Surveillance Systems ◽  
Care Seeking ◽  
Health Care Seeking Behaviour ◽  
The Impact ◽  
Care Seeking Behaviour

ObjectiveTo explore the utility of syndromic surveillance systems for detecting and monitoring the impact of air pollution incidents on health-care seeking behaviour in England between 2012 and 2017.IntroductionThe negative effect of air pollution on human health is well documented illustrating increased risk of respiratory, cardiac and other health conditions. [1] Currently, during air pollution episodes Public Health England (PHE) syndromic surveillance systems [2] provide a near real-time analysis of the health impact of poor air quality. In England, syndromic surveillance has previously been used on an ad hoc basis to monitor health impact; this has usually happened during widespread national air pollution episodes where the air pollution index has reached ‘High’ or ‘Very High’ levels on the UK Daily Air Quality Index (DAQI). [3-5]We now aim to undertake a more systematic approach to understanding the utility of syndromic surveillance for monitoring the health impact of air pollution. This would improve our understanding of the sensitivity and specificity of syndromic surveillance systems for contributing to the public health response to acute air pollution incidents; form a baseline for future interventions; assess whether syndromic surveillance systems provide a useful tool for public health alerting; enable us to explore which pollutants drive changes in health-care seeking behaviour; and add to the knowledge base.MethodsThe systematic approach will involve accessing historical data for air pollution incidents and syndromic surveillance data over the period 2012-17 across England. We will use PM10, PM2.5, ozone, NO2 , SO2 and DAQI data to define air pollution periods, and historical syndromic surveillance system data for respiratory syndromes (asthma, difficulty breathing, wheeze, cough, bronchitis, sore throat and allergic rhinitis), cardiac (all cardiovascular and myocardial infarction) and eye irritation/conjunctivitis syndromes. We will use regression modelling and cross-correlation analyses to determine the effects of air pollution, weather and pollen upon these syndromes and thus provide evidence of the sensitivity of these systems. Historical data on additional environmental variables including temperature and precipitation, humidity and thunderstorm activity, pollen and fungal spores will be accounted for in the regression models, as well as data on influenza and respiratory syncytial virus (RSV) laboratory reports. We will include sub-national geographies and age/gender analyses in the study depending on the data availability and suitability.ResultsInitial results presented will include the preliminary descriptive epidemiology with a focus on asthma and the impact of air pollution incidents on health-care seeking behaviour using data from the PHE national syndromic surveillance systems.ConclusionsWe aim to demonstrate an innovative use of syndromic surveillance data to explore the impact of air pollution incidents on health-care seeking behaviour in England, in turn improving our understanding of the sensitivity and specificity of these systems for detecting the impact of air pollution incidents and to contribute to the knowledge base. This understanding will improve the public health response to future incidents.References1. World Health Organization (WHO). Preventing disease through healthy environments. Exposure to air pollution: A major public health concern. (http://www.who.int/ipcs/features/air_pollution.pdf). Accessed 28/09/20172. Public Health England. Syndromic surveillance: systems and analyses. (https://www.gov.uk/government/collections/syndromic-surveillance-systems-and-analyses). Accessed 20/09/20173. Department for Environment Food and Rural Affairs (Defra). Daily Air Quality Index (DAQI). (https://uk-air.defra.gov.uk/air-pollution/daqi). Accessed 28/06/20174. Smith GE, et al. Using real-time syndromic surveillance systems to help explore the acute impact of the air pollution incident of March/April 2014 in England. Environ Res 2015; 136: 500-504.5. Elliot AJ, et al. Monitoring the effect of air pollution episodes on health care consultations and ambulance call-outs in England during March/April 2014: A retrospective observational analysis. Environ Pollut 2016; 214: 903-911.

scholarly journals Adoption of Public Health Readiness Guidelines for Meaningful Use

2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Eunice R. Santos ◽  
Wesley McNeely ◽  
Biru Yang ◽  
Raouf R. Arafat
Keyword(s):  
Public Health ◽  
Syndromic Surveillance ◽  
Gulf Coast ◽  
Meaningful Use ◽  
Health Department ◽  
Lessons Learned ◽  
Surveillance Systems ◽  
Syndromic Surveillance System ◽  
Related Data ◽  
Control And Prevention

ObjectiveTo describe the challenges and lessons learned for public healthand providers to successfully implement public health MeaningfulUse readiness guidelines and navigate from intent to submission ofproduction data while simultaneously upgrading surveillance systems.IntroductionThe Syndromic Surveillance Consortium of Southeast Texas(SSCSeT) consists of 13 stakeholders who represent 19 counties orjurisdictions in the Texas Gulf Coast region and receives health datafrom over 100 providers. The Houston Health Department (HHD)maintains and operates the syndromic surveillance system for the GulfCoast region since 2007. In preparation for Meaningful Use (MU) theHHD has adapted and implemented guidance and recommendationsfrom Centers for Disease Control and Prevention, Office of NationalCoordinator for Health Information Technology and others. HHDsgoal is to make it possible for providers meet MU specification byfacilitating the transmission of health related data for syndromicsurveillance. The timing of the transition into MU overlaps with thechange in syndromic surveillance systems.

scholarly journals Syndromic surveillance: two decades experience of sustainable systems – its people not just data!

2019 ◽  
Vol 147 ◽  
Author(s):  
Gillian E. Smith ◽  
Alex J. Elliot ◽  
Iain Lake ◽  
Obaghe Edeghere ◽  
Roger Morbey ◽  
...  
Keyword(s):  
Public Health ◽  
Real Time ◽  
Syndromic Surveillance ◽  
Situational Awareness ◽  
Clinical Signs ◽  
Added Value ◽  
Surveillance Systems ◽  
Public Health Action ◽  
Related Data ◽  
The Impact

AbstractSyndromic surveillance is a form of surveillance that generates information for public health action by collecting, analysing and interpreting routine health-related data on symptoms and clinical signs reported by patients and clinicians rather than being based on microbiologically or clinically confirmed cases. In England, a suite of national real-time syndromic surveillance systems (SSS) have been developed over the last 20 years, utilising data from a variety of health care settings (a telehealth triage system, general practice and emergency departments). The real-time systems in England have been used for early detection (e.g. seasonal influenza), for situational awareness (e.g. describing the size and demographics of the impact of a heatwave) and for reassurance of lack of impact on population health of mass gatherings (e.g. the London 2012 Olympic and Paralympic Games).We highlight the lessons learnt from running SSS, for nearly two decades, and propose questions and issues still to be addressed. We feel that syndromic surveillance is an example of the use of ‘big data’, but contend that the focus for sustainable and useful systems should be on the added value of such systems and the importance of people working together to maximise the value for the public health of syndromic surveillance services.

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