scholarly journals Syndromic Surveillance of Emergency Department Visits for the 2015 Special Olympics

2016 ◽  
Vol 8 (1) ◽  
Author(s):  
Emily Kajita ◽  
Monica Z. Luarca ◽  
Choiyuk Chiang ◽  
Han Wu ◽  
Bessie Hwang

In the largest gathering of nations in Los Angeles' history, the 2015 Special Olympics (SO) welcomed approximately 6,500 athletes from 165 countries, as well as 30,000 volunteers and 500,000 spectators from July 25 to August 2, 2015. We describe how Los Angeles County's (LAC's) syndromic surveillance system was used to detect potential emerging health events congruent with SO games and pre-game events.

2017 ◽  
Vol 132 (1_suppl) ◽  
pp. 99S-105S ◽  
Author(s):  
Emily Kajita ◽  
Monica Z. Luarca ◽  
Han Wu ◽  
Bessie Hwang ◽  
Laurene Mascola

Introduction: Mass gatherings that attract a large international presence may cause or amplify point-source outbreaks of emerging infectious disease. The Los Angeles County Department of Public Health customized its syndromic surveillance system to detect increased syndrome-specific utilization of emergency departments (EDs) and other medical encounters coincident to the 2015 Special Olympics World Games. Materials and Methods: We queried live databases containing data on ED visits, California Poison Control System calls, and Los Angeles County coroner-investigated deaths for increases in daily counts from July 19 to August 6, 2015. We chose syndrome categories based on the potential for disease outbreaks common to international travel and dormitory settings, morbidity amplified by high temperatures, and bioterrorism threats inherent to mass gatherings. We performed line-list reviews and trend analyses of total, syndrome-specific, and region-specific daily counts, using cumulative sum-based signals. We also piloted a novel strategy of requesting that ED registrars proactively tag Special Olympics attendees in chief complaint data fields. Results: The syndromic surveillance system showed that the 2015 Special Olympics did not generate large-scale acute morbidities leading to detectable stress on local EDs. We recruited 10 hospitals for proactive patient tagging, from which 16 Special Olympics attendees were detected; these patients reported various symptoms, such as injury, vomiting, and syncope. Practice Implications: As an enhancement to traditional syndromic surveillance, proactive patient tagging can illuminate potential epidemiologic links among patients in challenging syndromic surveillance applications, such as mass gatherings. Syndromic surveillance has the potential to enhance ED patient polling and reporting of exposure, symptom, and other epidemiologic case definition criteria to public health agencies in near-real time.


2019 ◽  
Vol 29 (4) ◽  
pp. 621-625 ◽  
Author(s):  
G N Noel ◽  
A M Maghoo ◽  
F F Franke ◽  
G V Viudes ◽  
P M Minodier

Abstract Background Cannabis is illegal in France but, as in many countries, legalization is under debate. In the United States, an increase of emergency department (ED) visits related to cannabis exposure (CE) in infants and adults was reported. In France, a retrospective observational study also suggested an increase of CE in children under 6 years old. This study only included toddlers and the data sources used did not allow repeated analysis for monitoring. Methods Our study aimed to evaluate the trend in visits for CE in ED in patients younger than 27 years old in Southern France. A cross-sectional study using the Electronic Emergency Department Abstracts (EEDA) included in the national Syndromic Surveillance System. CE visits were defined using International Classification of Disease (ICD-10). Results From 2009 to 2014, 16 EDs consistently reported EEDA with <5% missing diagnosis code. Seven hundred and ninety seven patients were admitted for CE including 49 (4.1%) children under 8 years old. From 2009–11 to 2012–14, the rate of CE visits increased significantly across all age groups. The highest increase was in the 8–14 years old (+144%; 1.85–4.51, P < 0.001) and was also significant in children under 8 (0.53–1.06; P = 0.02). Among children under 8, hospitalization rate (75.5% vs. 16.8%; P < 0.001) and intensive care unit admissions (4.1% vs. 0.1%; P < 0.001) were higher compared with patients older than 8 years. Conclusion These trends occurred despite cannabis remaining illegal. EEDA could be useful for monitoring CE in EDs.


2014 ◽  
Vol 104 (1) ◽  
pp. e50-e56 ◽  
Author(s):  
Elisha L. Wilson ◽  
Joseph R. Egger ◽  
Kevin J. Konty ◽  
Marc Paladini ◽  
Don Weiss ◽  
...  

2017 ◽  
Vol 132 (1_suppl) ◽  
pp. 88S-94S ◽  
Author(s):  
S. Janet Kuramoto-Crawford ◽  
Erica L. Spies ◽  
John Davies-Cole

Objectives: Limited studies have examined the usefulness of syndromic surveillance to monitor emergency department (ED) visits involving suicidal ideation or attempt. The objectives of this study were to (1) examine whether syndromic surveillance of chief complaint data can detect suicide-related ED visits among adults and (2) assess the added value of using hospital ED data on discharge diagnoses to detect suicide-related visits. Methods: The study data came from the District of Columbia electronic syndromic surveillance system, which provides daily information on ED visits at 8 hospitals in Washington, DC. We detected suicide-related visits by searching for terms in the chief complaints and discharge diagnoses of 248 939 ED visits for which data were available for October 1, 2015, to September 30, 2016. We examined whether detection of suicide-related visits according to chief complaint data, discharge diagnosis data, or both varied by patient sex, age, or hospital. Results: The syndromic surveillance system detected 1540 suicide-related ED visits, 950 (62%) of which were detected through chief complaint data and 590 (38%) from discharge diagnosis data. The source of detection for suicide-related ED visits did not vary by patient sex or age. However, whether the suicide-related terms were mentioned in the chief complaint or discharge diagnosis differed across hospitals. Conclusions: ED syndromic surveillance systems based on chief complaint data alone would underestimate the number of suicide-related ED visits. Incorporating the discharge diagnosis into the case definition could help improve detection.


2019 ◽  
Vol 134 (2) ◽  
pp. 132-140 ◽  
Author(s):  
Grace E. Marx ◽  
Yushiuan Chen ◽  
Michele Askenazi ◽  
Bernadette A. Albanese

Objectives: In Colorado, legalization of recreational marijuana in 2014 increased public access to marijuana and might also have led to an increase in emergency department (ED) visits. We examined the validity of using syndromic surveillance data to detect marijuana-associated ED visits by comparing the performance of surveillance queries with physician-reviewed medical records. Methods: We developed queries of combinations of marijuana-specific International Classification of Diseases, Tenth Revision (ICD-10) diagnostic codes or keywords. We applied these queries to ED visit data submitted through the Electronic Surveillance System for the Early Notification of Community-Based Epidemics (ESSENCE) syndromic surveillance system at 3 hospitals during 2016-2017. One physician reviewed the medical records of ED visits identified by ≥1 query and calculated the positive predictive value (PPV) of each query. We defined cases of acute adverse effects of marijuana (AAEM) as determined by the ED provider’s clinical impression during the visit. Results: Of 44 942 total ED visits, ESSENCE queries detected 453 (1%) as potential AAEM cases; a review of 422 (93%) medical records identified 188 (45%) true AAEM cases. Queries using ICD-10 diagnostic codes or keywords in the triage note identified all true AAEM cases; PPV varied by hospital from 36% to 64%. Of the 188 true AAEM cases, 109 (58%) were among men and 178 (95%) reported intentional use of marijuana. Compared with noncases of AAEM, cases were significantly more likely to be among non-Colorado residents than among Colorado residents and were significantly more likely to report edible marijuana use rather than smoked marijuana use ( P < .001). Conclusions: ICD-10 diagnostic codes and triage note keyword queries in ESSENCE, validated by medical record review, can be used to track ED visits for AAEM.


Author(s):  
Christopher Sikora ◽  
Kerri Fournier ◽  
Hussain Usman ◽  
Angela Jacobs ◽  
Bryan Wicentowich ◽  
...  

2019 ◽  
Vol 14 (1) ◽  
pp. 44-48
Author(s):  
Priscilla W. Wong ◽  
Hilary B. Parton

ABSTRACTObjective:Syndromic surveillance has been useful for routine surveillance on a variety of health outcomes and for informing situational awareness during public health emergencies. Following the landfall of Hurricane Maria in 2017, the New York City (NYC) Department of Health and Mental Hygiene (DOHMH) implemented an enhanced syndromic surveillance system to characterize related emergency department (ED) visits.Methods:ED visits with any mention of specific key words (“Puerto,” “Rico,” “hurricane,” “Maria”) in the ED chief complaint or Puerto Rico patient home Zip Code were identified from the DOHMH syndromic surveillance system in the 8-week window leading up to and following landfall. Visit volume comparisons pre- and post-Hurricane Maria were performed using Fisher’s exact test.Results:Analyses identified an overall increase in NYC ED utilization relating to Puerto Rico following Hurricane Maria landfall. In particular, there was a small but significant increase in visits involving a medication refill or essential medical equipment. Visits for other outcomes, such as mental illness, also increased, but the differences were not statistically significant.Conclusions:Gaining this situational awareness of medical service use was informative following Hurricane Maria, and, following any natural disaster, the same surveillance methods could be easily established to aid an effective emergency response.


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