scholarly journals Using Syndromic Surveillance Data to Monitor Endocarditis and Sepsis among Drug Users

2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Lana Deyneka ◽  
Anne Hakenewerth ◽  
Zachary Faigen ◽  
Amy Ising ◽  
Clifton Barnett
Keyword(s):  
Drug Use ◽  
Syndromic Surveillance ◽  
Drug Users ◽  
Situational Awareness ◽  
Temporal Trends ◽  
The United States ◽  
Case Definition ◽  
Accurate Information ◽  
Discharge Data ◽  
Syndromic Surveillance System

ObjectiveTo describe how the state syndromic surveillance system(NC DETECT) was used to initiate near real time surveillance forendocarditis, sepsis and skin infection among drug users.IntroductionRecreational drug use is a major problem in the United States andaround the world. Specifically, drug abuse results in heavy use ofemergency department (ED) services, and is a high financial burdento society and to the hospitals due to chronic ill health and multipleinjection drug use complications. Intravenous drug users are at highrisk of developing sepsis and endocarditis due to the use of a dirty orinfected needle that is either shared with someone else or re-used. Itcan also occur when a drug user repeatedly injects into an inflamedand infected site or due to the poor overall health of an injection druguser. The average cost of hospitalization for aortic valve replacementin USA is about $165,000, and in order for the valve replacement tobe successful, patients must abstain from using drugs.MethodsWe examined temporal trends of drug-related visits to hospitalEDs, as well as drug-related related ED admissions complicated withendocarditis, bacteremia and sepsis.ResultsThe trends in Endocarditis/Sepsis and drug-related relatedadmissions appear to echo overdose related ED admissions increase.Patients ED return visits and hospitalizations for the same problem arealso growing compare to the previous years. We will discuss the NCDETECT case definition used to monitor drug overdose/dependenceand infection, case definition transition from ICD-9 to ICD-10 codes,and will share surveillance analysis results.ConclusionsNC DETECT’s system flexibility has been important in rapidlyestablishing surveillance of infections among drug users. Near realtime analysis on hospital, county and state levels can be performedusing NC DETECT system reports to provide state officials, hospitalsand LHDs with situational awareness. Limitations: Syndromicsurveillance ED data contains less accurate information about thediagnosis codes, procedures, length of stay, and severity comparingto the hospital discharge data.

scholarly journals Use of Emergency Department Data to Monitor and Respond to an Increase in Opioid Overdoses in New Hampshire, 2011-2015

2017 ◽  
Vol 132 (1_suppl) ◽  
pp. 73S-79S ◽  
Author(s):  
Elizabeth R. Daly ◽  
Kenneth Dufault ◽  
David J. Swenson ◽  
Paul Lakevicius ◽  
Erin Metcalf ◽  
...  
Keyword(s):  
Public Health ◽  
Emergency Department ◽  
New Hampshire ◽  
Syndromic Surveillance ◽  
Situational Awareness ◽  
The United States ◽  
Chief Complaint ◽  
Public Health Response ◽  
Syndromic Surveillance System ◽  
Icd Codes

Objectives: Opioid-related overdoses and deaths in New Hampshire have increased substantially in recent years, similar to increases observed across the United States. We queried emergency department (ED) data in New Hampshire to monitor opioid-related ED encounters as part of the public health response to this health problem. Methods: We obtained data on opioid-related ED encounters for the period January 1, 2011, through December 31, 2015, from New Hampshire’s syndromic surveillance ED data system by querying for (1) chief complaint text related to the words “fentanyl,” “heroin,” “opiate,” and “opioid” and (2) opioid-related International Classification of Diseases ( ICD) codes. We then analyzed the data to calculate frequencies of opioid-related ED encounters by age, sex, residence, chief complaint text values, and ICD codes. Results: Opioid-related ED encounters increased by 70% during the study period, from 3300 in 2011 to 5603 in 2015; the largest increases occurred in adults aged 18-29 and in males. Of 20 994 total opioid-related ED visits, we identified 18 554 (88%) using ICD code alone, 690 (3%) using chief complaint text alone, and 1750 (8%) using both chief complaint text and ICD code. For those encounters identified by ICD code only, the corresponding chief complaint text included varied and nonspecific words, with the most common being “pain” (n = 3335, 18%), “overdose” (n = 1555, 8%), “suicidal” (n = 816, 4%), “drug” (n = 803, 4%), and “detox” (n = 750, 4%). Heroin-specific encounters increased by 827%, from 4% of opioid-related encounters in 2011 to 24% of encounters in 2015. Conclusions: Opioid-related ED encounters in New Hampshire increased substantially from 2011 to 2015. Data from New Hampshire’s ED syndromic surveillance system provided timely situational awareness to public health partners to support the overall response to the opioid epidemic.

scholarly journals Outbreak of ED visits related to the use of synthetic cannabinoids, Mayotte Island

2018 ◽  
Vol 10 (1) ◽  
Author(s):  
Pascal Vilain ◽  
Salamta Bah-Assoumani ◽  
Ali-Mohamed Youssouf ◽  
Laurent Filleul
Keyword(s):  
Public Health ◽  
Behavioral Disorders ◽  
Surveillance System ◽  
Syndromic Surveillance ◽  
Adverse Reactions ◽  
Health Agency ◽  
Case Definition ◽  
Syndromic Surveillance System ◽  
Ed Visits ◽  
Mental And Behavioral Disorders

ObjectiveTo confirm and to characterize the increase in emergency department (ED) visits related to the use of synthetic cannabinoids (SC)IntroductionOn October 2016, the Indian Ocean Regional Health Agency was alerted about an increase in ED visits related to adverse reactions associated with use of SC on Mayotte Island. In this context, an investigation based on a syndromic surveillance system was implemented by the regional unit of the French national public health agency.MethodsAn extraction of anonymized records routinely collected by the syndromic surveillance system (1) was carried out from January 1st, 2012 to October 30, 2016. ED visits related to the consumption of SC were identified from ICD-10 codes of the principal diagnostic according to two levels of confidence:- a probable case was defined as ED visit coded X69 (Intentional self-poisoning by and exposure to other and unspecified chemicals and noxious substances). This code has been implemented specifically by ED physicians since august 2015;- a suspect case was defined as ED visit coded: F11 (Mental and behavioral disorders due to use of opioids), F12 (Mental and behavioral disorders due to use of cannabinoids), F16 (Mental and behavioral disorders due to use of hallucinogens), F18 (Mental and behavioral disorders due to use of volatile solvents), F19 (Mental and behavioral disorders due to multiple drug use and use of other psychoactive substances).Based on these data, an epidemic curve and a descriptive analysis of ED visits were carried out.ResultsIn total, 146 ED visits related to adverse events associated with use of SC were registered from January 1st, 2012 to October 30, 2016. The epidemic curve shows two waves between 2015 and 2016 with a particularly high peak in August 2015 (Figure 1). In total, 49% (n=72/146) of these ED visits were probably related to adverse reactions associated to use SC and 51% (n=74/146) meet to the suspect case definition. On the surveillance period, men represented 84% of the patients (n=122) and median age (min – max) was 23 (8-62) years old. When the severity score variable was filled (n = 138), a vital emergency was reported for 4% (n = 5) of patients and 19% of patients were hospitalized.ConclusionsData from syndromic surveillance system allowed to confirm an increase in ED visits related to adverse reactions associated with use of SC in Mayotte Island. To our knowledge, it’s the first time that an outbreak related to use SC is described in the Ocean Indian areaThis phenomenon was particularly marked in 2015 with a peak of ED visits on August 2016.After this outbreak, the regional unit of the French national public health agency recommended the pursuit of the coding X69 in principal diagnosis with the following case definition: any patient with an adverse reaction attributed to synthetic cannabinoid use whether suspected by the medical team or declared by the patient himself or if the patient is in possession of the substance; and to raise awareness ED physicians to the notification of these poisonings to the Regional Addictive Surveillance Center.In conclusion, the young population, weakened by a precarious socio-economic situation, is a target for new synthetic drugs and a threat to public health. This emerging risk in Mayotte must be taken into account and must be actively monitored. In this context, collaborative work with the emergency services must continue in parallel with targeted prevention measures.References1. Vilain P, Maillard O, Raslan-Loubatie J, Abdou MA, Lernout T, Filleul L. Usefulness of Syndromic Surveillance for Early Outbreak Detection in Small Islands: The Case of Mayotte. Online Journal of Public Health Informatics. 2013;5(1):e149.

scholarly journals Tracking HIV Post-Exposure Prophylaxis using Syndromic Surveillance in NYC Emergency Departments

2015 ◽  
Vol 7 (1) ◽  
Author(s):  
Stephanie Ngai ◽  
Zoe Edelstein ◽  
Julie Myers ◽  
Don Weiss
Keyword(s):  
New York ◽  
New York City ◽  
Emergency Departments ◽  
Syndromic Surveillance ◽  
The United States ◽  
Post Exposure Prophylaxis ◽  
Syndromic Surveillance System ◽  
Post Exposure ◽  
Threefold Increase ◽  
Exposure Prophylaxis

HIV post-exposure prophylaxis (PEP) prescriptions are not uniformly monitored in the United States. We developed a method to identify PEP-related visits in New York City emergency departments (EDs). Using ED data, we observed a threefold increase in PEP-related visits to NYC EDs from 2002-2013. 73% of PEP-related visits were among males, and 45% among adults ages 25-34 years. Incorporation of this method of PEP monitoring in the NYC syndromic surveillance system will be used to observe trends and inform HIV outreach efforts.

Monitoring Emergency Department Visits From Puerto Rico in the Aftermath of Hurricane Maria Using Syndromic Surveillance – New York City, 2017

2019 ◽  
Vol 14 (1) ◽  
pp. 44-48
Author(s):  
Priscilla W. Wong ◽  
Hilary B. Parton
Keyword(s):  
Emergency Department ◽  
New York ◽  
New York City ◽  
Puerto Rico ◽  
York City ◽  
Surveillance System ◽  
Syndromic Surveillance ◽  
Situational Awareness ◽  
Syndromic Surveillance System ◽  
Ed Visits

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.

scholarly journals A Qualitative View of Drug Use Behaviors of Mexican Male Injection Drug Users Deported from the United States

2011 ◽  
Vol 88 (1) ◽  
pp. 104-117 ◽  
Author(s):  
Victoria D. Ojeda ◽  
Angela M. Robertson ◽  
Sarah P. Hiller ◽  
Remedios Lozada ◽  
Wayne Cornelius ◽  
...  
Keyword(s):  
United States ◽  
Drug Use ◽  
Injection Drug Users ◽  
Drug Users ◽  
The United States ◽  
Injection Drug

scholarly journals Fast and Accurate Influenza Forecasting in the United States with Inferno

2021 ◽  
Author(s):  
Dave Osthus
Keyword(s):  
Situational Awareness ◽  
Model Development ◽  
Predictive Performance ◽  
The United States ◽  
Primary Objective ◽  
Forecasting Model ◽  
Accurate Information ◽  
Disease Forecasting ◽  
Minimal Impact ◽  
Forecasting Models

AbstractInfectious disease forecasting is an emerging field and has the potential to improve public health through anticipatory resource allocation, situational awareness, and mitigation planning. By way of exploring and operationalizing disease forecasting, the U.S. Centers for Disease Control and Prevention (CDC) has hosted FluSight since the 2013/14 flu season, an annual flu forecasting challenge. Since FluSight’s onset, forecasters have developed and improved forecasting models in an effort to provide more timely, reliable, and accurate information about the likely progression of the outbreak. While improving the predictive performance of these forecasting models is often the primary objective, it is also important for a forecasting model to run quickly, facilitating further model development, improvement, and scalability. In this vein I introduce Inferno, a fast and accurate flu forecasting model inspired by Dante, the top performing model in the 2018/19 FluSight challenge. When compared to all models that participated in FluSight 2018/19, Inferno would have placed 2nd in both the national and state challenges, behind only Dante. Inferno, however, runs in minutes and is trivially parallelizable, while Dante takes hours to run, representing a significant operational improvement with minimal impact to performance. A future consideration for forecasting competitions like FluSight will be how to encourage improvements to secondarily important properties of forecasting models, such as runtime, generalizability, and interpretability.

AIDS and IV Drug Use among Ethnic Minorities

1989 ◽  
Vol 19 (1) ◽  
pp. 27-37 ◽  
Author(s):  
John L. Peterson ◽  
Roger Bakeman
Keyword(s):  
United States ◽  
Drug Use ◽  
Drug Users ◽  
The United States ◽  
Sexual Partners ◽  
Minority Populations ◽  
Aids Virus ◽  
Acquired Immunodeficiency ◽  
Immunodeficiency Syndrome ◽  
Iv Drug Use

Blacks and Hispanics have a higher prevalence and incidence of cases of Acquired Immunodeficiency Syndrome (AIDS) associated with intravenous (IV) drug use than do whites. Further transmission of the AIDS virus to sexual partners of IV drug users increases the possibility of a secondary epidemic of AIDS, especially among non-white females. This report presents data on differences in IV drug cases of AIDS among white and non-white IV drug users in the United States, offers possible explanations for differences in transmission patterns, and suggests the implications of these differences for the prevention of further transmission of the AIDS virus among minority populations.

Public Health in the Field and the Emergency Operations Center: Methods for Implementing Real-Time Onsite Syndromic Surveillance at Large Public Events

2013 ◽  
Vol 7 (5) ◽  
pp. 467-474 ◽  
Author(s):  
Kristen Pogreba-Brown ◽  
Kyle McKeown ◽  
Sarah Santana ◽  
Alisa Diggs ◽  
Jennifer Stewart ◽  
...  
Keyword(s):  
Public Health ◽  
Syndromic Surveillance ◽  
Prediction Models ◽  
Health Department ◽  
The United States ◽  
Study Data ◽  
Public Health Response ◽  
Syndromic Surveillance System ◽  
Patient Reports ◽  
Public Events

AbstractObjectiveTo develop an onsite syndromic surveillance system for the early detection of public health emergencies and outbreaks at large public events.MethodsAs the third largest public health jurisdiction in the United States, Maricopa County Department of Public Health has worked with academic and first-response partners to create an event-targeted syndromic surveillance (EVENTSS) system. This system complements long-standing traditional emergency department-based surveillance and provides public health agencies with rapid reporting of possible clusters of illness.ResultsAt 6 high profile events, 164 patient reports were collected. Gastrointestinal and neurological syndromes were most commonly reported, followed by multisyndromic reports. Neurological symptoms were significantly increased during hot weather events. The interview rate was 2 to 7 interviews per 50 000 people per hour, depending on the ambient temperature.DiscussionStudy data allowed an estimation of baseline values of illness occurring at large public events. As more data are collected, prediction models can be built to determine threshold levels for public health response.ConclusionsEVENTSS was conducted largely by volunteer public health graduate students, increasing the response capacity for the health department. Onsite epidemiology staff could make informed decisions and take actions quickly in the event of a public health emergency. (Disaster Med Public Health Preparedness. 2013;0:1–8)

scholarly journals Increase in emergency department visits related to cannabis reported using syndromic surveillance system

2019 ◽  
Vol 29 (4) ◽  
pp. 621-625 ◽  
Author(s):  
G N Noel ◽  
A M Maghoo ◽  
F F Franke ◽  
G V Viudes ◽  
P M Minodier
Keyword(s):  
Emergency Department ◽  
Surveillance System ◽  
Syndromic Surveillance ◽  
Age Groups ◽  
The United States ◽  
Cross Sectional Study ◽  
Emergency Department Visits ◽  
Cross Sectional ◽  
Syndromic Surveillance System ◽  
Icd 10

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.

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