scholarly journals NEDSS Base System (NBS): Electronic Data Exchange and Workflow Decision Support

2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Jennifer Ward ◽  
Christi Hildebrandt ◽  
Akshar Patel
Keyword(s):  
Public Health ◽  
Case Report ◽  
Data Integration ◽  
Surveillance System ◽  
Data Exchange ◽  
Case Reports ◽  
Use Cases ◽  
High Morbidity ◽  
Base System ◽  
Surveillance Systems

ObjectiveThe NEDSS Base System (NBS), an integrated disease surveillancesystem, implemented extensible functionality to support electronicdata exchange for multiple use cases and public health workflowmanagement of incoming messages and documents.IntroductionThe NBS is an integrated disease surveillance system deployedin 22 public health jurisdictions to support receipt, investigation,analysis and reporting, and data exchange for state reportableconditions. The NBS is governed by the Centers for Disease Controland Prevention (CDC) and state, local, and territorial users that makeup the NBS Community. In the early 2000’s, electronic laboratoryresults reporting (ELR) was implemented in an effort to improvetimeliness and completeness of disease reporting. As standards-basedelectronic health records (EHRs) are adopted and more surveillancedata become available, modern surveillance systems must consumeinformation in an automated way and provide more functionality toautomate key surveillance processes.MethodsMany use cases exist for exchanging data with an integrated publichealth surveillance system. These can include exchange of electroniccase and laboratory reports from healthcare, data sharing betweenpublic health entities, data migration from legacy systems, andongoing exchange with other public health systems (e.g. immunizationregistries). The NBS implemented an interface specification called thePublic Health Document Container (PHDC). PHDC is based on HL7version 3 Clinical Document Architecture (CDA). It allows import ofpatient (cases and contacts), investigation, treatment, interview, andlaboratory information into NBS. CDA was chosen as the buildingblock to facilitate data exchange with the healthcare community.Through use of data integration tools, incoming data can be mappedfrom any format to PHDC and imported into the system. Existingservices, such as patient, provider, and organization deduplicationare applied. To assist with management of incoming electronicdocuments, NBS implemented a functionality called WorkflowDecision Support (WDS). WDS uses configurable algorithms toautomatically process incoming documents (including case reports,laboratory reports, etc.) into the public health workflow. Users canchoose to mark an incoming document as reviewed or automaticallycreate an investigation and case notification message to CDC (fornationally notifiable conditions).ResultsThrough PHDC, NBS is able to receive data from healthcare usingnational standards, such as the HL7 Electronic Initial Case Report(eICR). Three NBS partners are currently collaborating to pilot eICRfunctionality. PHDC was successfully used to migrate large volumesof data from a legacy surveillance system into the NBS. Two NBSstates are using PHDC to implement ongoing data exchange betweenseparate surveillance systems within their jurisdiction. In several NBSjurisdictions, WDS is used to automatically create investigations andcase notifications for high-morbidity conditions such as gonorrheaand chlamydia. In other jurisdictions, WDS is used to assist withmanaging high volumes of Hepatitis B and C reports.ConclusionsCDA-based PHDC does require that public health have knowledgeof standards and data integration resources to transform incomingmessages to the PHDC interface; however, the flexibility providedby this approach ensures the system is able to respond to newand changing standards without system development. Additionalenhancements are needed to support data exchange with immunizationregistries. WDS functionality does reduce burden on public healthstaff, especially when dealing with high-volume diseases. Futurefunctionalities include the ability to define more criteria (such as ageor gender) to drive the actions taken on an incoming lab or case report.

scholarly journals Kidenga: Public engagement for detection and prevention of Aedes -borne viral diseases

2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Chris Schmidt ◽  
Alba Phippard ◽  
Jennifer M. Olsen ◽  
Kathy Wirt ◽  
Andrea Riviera ◽  
...  
Keyword(s):  
Public Health ◽  
Early Detection ◽  
Surveillance System ◽  
Control Strategies ◽  
Severe Disease ◽  
Health Department ◽  
High Morbidity ◽  
Surveillance Systems ◽  
Public Health Department ◽  
Local Public Health

Objective(1) Early detection ofAedes-borne arboviral disease; (2) improveddata onAe. aegyptiandAe. albopictusdistribution in the UnitedStates (U.S.); and (3) education of clinicians and the public.IntroductionZika, chikungunya, and dengue have surged in the Americas overthe past several years and pose serious health threats in regions of theU.S. whereAe. aegyptiandAe. albopictusmosquito vectors occur.Ae. aegyptihave been detected up to 6 months of the year or longer inparts of Arizona, Florida, and Texas where mosquito surveillance isregularly conducted. However, many areas in the U.S. lack basic dataon vector presence or absence. The Zika, dengue, and chikungunyaviruses range in pathogenicity, but all include asymptomatic or mildpresentations for which individuals may not seek care. Traditionalpassive surveillance systems rely on confirmatory laboratory testingand may not detect emergent disease until there is high morbidity in acommunity or severe disease presentation. Participatory surveillanceis an approach to disease detection that allows the public to directlyreport symptoms electronically and provides rapid visualization ofaggregated data to the user and public health agencies. Several suchsystems have been shown to be sensitive, accurate, and timelierthan traditional surveillance. We developed Kidenga, a mobilephone app and participatory surveillance system, to address someof the challenges in early detection of day-biting mosquitoes andAedes-borne arboviruses and to enhance dissemination of informationto at-risk communities.MethodsKidenga sends a weekly push notification prompting users toreport symptoms, travel history, and day-biting mosquito activity.If an individual reports through Kidenga that they or a family memberhave had symptoms consistent with Zika, dengue, or chikungunya,they receive an email with educational information about the diseases,prevention strategies, and treatment/testing information for clinicians.Upon registration, users can opt in to have additional follow-up viaemail. At any time, users may also view maps of aggregated userreports, confirmed case counts by county from public health partners(in pilot areas),Aedesdistribution maps, information about preventionand control strategies, and news on the diseases and vectors from acurated newsfeed. Users in select pilot areas may also receive pressreleases issued by their state or local public health department relatedto the diseases and their vectors. University of Arizona owns andmaintains the app and its data. Local and state health departmentsthat want more detailed information on user symptoms and mosquitoactivity may request and monitor the data at no cost. A marketingcampaign to recruit a broad user base is being implemented inArizona, Texas, and Florida.ResultsKidenga was developed with significant input from public healthstakeholders and launched in September 2016,accompanied byEnglish and Spanish radio public service announcements in selectArizona markets, press releases, and a social marketing campaign.A Spanish version of the app is under development. We willdescribe the results of user registration and survey submissions,challenges identified during development and deployment of thisnovel surveillance system, plans for data use and evaluation, andcollaborations with public health partners.ConclusionsThe utility of Kidenga as a surveillance system will depend onbroad and consistent participation among diverse user populations,particularly in low-risk areas; strategies to integrate health reports forhigh-risk populations who may not have smartphones; validation ofdata and development of sensitive and specific algorithms for takingpublic health action, and buy-in from public health departments touse the data and advocate for this novel surveillance tool. Kidenga’ssecondary function as an education tool onAedes-borne viruses is lessdependent upon a large user base and can be evaluated separately.Participatory surveillance systems that specifically monitorAedes-borne pathogens are relatively new, and the challenges associatedwith their early detection may differ from those of other diseases.

scholarly journals Evaluation of First Electronic Case Reports received in Illinois

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Stacey Hoferka
Keyword(s):  
Public Health ◽  
Case Report ◽  
Race And Ethnicity ◽  
Surveillance System ◽  
Disease Surveillance ◽  
Communicable Disease ◽  
Case Reports ◽  
Production Environment ◽  
Provider Group ◽  
Disease Surveillance System

ObjectiveComparison of content in eCR and ELR cases reportingReview technical challenges and strategies for data managementIntroductionCommunicable disease reporting from providers can be a time-consuming process that results in delayed or incomplete reporting of infectious diseases, limiting public health's ability to respond quickly to prevent or control disease. The recent development of an HL7 standard for automated Electronic initial case reports (eICR) represents an important advancement for public health surveillance. The Illinois Department of Public Health (IDPH) participated in a pilot with the Public Health Informatics Institute and an Illinois-based provider group to accept eICR reports for Gonorrhea and Chlamydia.MethodsThe provider group working with their EHR vendor submitted a batch of CT and GC reports directly to IDPH in September 2017 according to the published eICR standard. A summary of the provider and PHII work has been presented previously in the STI eCR Learning Community. The eICR reports received from the provider were compared to case report data in the communicable disease surveillance system, I-NEDSS. Data was extracted from I-NEDSS that included race and ethnicity, timing of specimen collection, result, ELR submission surveillance action and treatment.ResultsIDPH received a batch of 89 files containing 77 unique persons, with 54 chlamydia (CT), 13 Gonorrhea (GC) and 10 co-infected case reports. The communicable disease surveillance system had captured 76 (98.7%) of the persons reported in the pilot. Among those, an Electronic Laboratory Report (ELR) was received for 72 (95%) cases, on average within 1 day of the lab report date. Data in I-NEDSS had a completion of 45% for race and ethnicity compared to 99% for race and 92% for ethnicity in the eICR files. Information on treatment in the surveillance system was reported for 18 (24%) cases compared to 67 (87%) cases.ConclusionsThis pilot was the first submission of real patient data submitted using the eICR standard to IDPH. Data was more complete from provider eICR reports for key demographic of race and ethnicity and treatment. A comparison with the current surveillance system showed near complete and timely case capture from ELR data. Integrated reporting of both ELR and eICR can produce a more complete case report through automated submissions and potentially reduce burden of data collection on health department communicable disease investigators. As public health reporting moves in this direction, public health agencies will have some substantial tasks to correctly ingest, map and interpret the increased amounts of information that are contained in the eICR. Further, the advantages of case reporting will be dependent on automated processes within the communicable disease system to merge data and apply business rules to automatically process completed case reports for high volume diseases, such as STIs. This work will continue as providers are ready to submit reports from different vendor products from a near real-time production environment.

scholarly journals NBS: A Community-Based Approach to Developing an Integrated Surveillance System

2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Christi Hildebrandt ◽  
Jennifer Ward ◽  
Akshar Patel
Keyword(s):  
Public Health ◽  
Data Collection ◽  
Best Practices ◽  
Surveillance System ◽  
Disease Surveillance ◽  
Data Exchange ◽  
Inclusive Development ◽  
Base System ◽  
Open Communication ◽  
Community Based

ObjectiveThe NEDSS Base System (NBS) is designed and developed usinginput from CDC programs, public health standards organizations,as well as its expansive user community. This community-basedapproach to development of an integrated surveillance system isdescribed.IntroductionThe NEDSS Base System (NBS) is a web-based, standards-driven, integrated disease surveillance system launched in 2001 andis currently in use in twenty-two public health jurisdictions. Over thepast fifteen years, the NBS has grown into a highly functional, modernapplication that supports: case management, electronic data exchange,metadata-driven data collection, workflow decision support, and ahost of other functionalities, all of which are defined and designedthrough a community-based approach.MethodsIn order to encourage open communication and collaborationacross and among the community, there is a well-publicized, long-standing communication plan in place. Further, tools such as an onlinecollaboration and support forum, NBSCentral, are made availableto any person who requests access. Also, the NBS source code isprovided in an open source package to anyone interested, alongwith each release, and a demonstration version of the applicationcan be accessed online by anyone to review the latest release of theapplication. All of these channels are in place to ensure there are waysfor all who have in interest in collaborating to easily participate.The NBS community regularly meets to provide input into furtherdevelopment of the system, as well as discuss topics affecting publichealth. As a community, members:■ Share best practices, tools, and lessons learned across jurisdictions■ Share innovative local approaches to disease surveillance andreporting■ Access NBSCentral for support and collaboration■ Participate in the change control and planning process for eachNBS release■ Work collaboratively with CDC to define high-level vision andpriorities■ Provide input to create community-defined requirements forsystem development■ Participate in weekly subject matter expert (SME) calls to discussdevelopment and best practices■ Have the opportunity to participate in beta testing for releases■ Attend a bi-weekly NBS User Group (NUG) call to discussthe system as well as reach out to colleagues to brainstorm creativesolutions to common problems in public health surveillanceAll meetings with stakeholders are recorded and shared withthe larger community to ensure full transparency and for historicalreference.ResultsThrough this inclusive development approach, the NBS hasevolved into a highly extensible, configurable system that can meetthat needs of twenty-two very different public health jurisdictions; thesystem can be implemented without the need for custom developmentin a relatively short timeframe due to the fact that it was designed tomeet the needs of many. Further, it has encouraged interoperabilityprojects, such as: piloting electronic case reporting use cases betweenNBS implementation sites and building and sharing electronic caseinvestigation forms for data collection using the NBS Page Buildermodule. All NBS sites use the same translation routes for electroniclab report, case report, and Nationally Notifiable Disease messageprocessing – embracing the build once, use many concept. Mostrecently, having this collaboration network in place made it very easyfor the NBS community to quickly adapt to the changing needs ofZika virus surveillance.ConclusionsIt does require clear definition of processes and communicationchannels, as well as regular update and transparency into the processfor community-based development to work. However, when theproper tools and processes are in place, the benefits of collaborationwith all key stakeholders are exponential when realized. Developingan application in this way has provided NBS users not only with amuch better, integrated surveillance system, but also a forum forunderstanding how other jurisdictions have solved similar issues; itprovides a springboard for sharing and building upon novel ideas andnew approaches in public health surveillance.

scholarly journals Evaluation of Measles Surveillance Systems in Ginnir District, Bale Zone, Southeast Ethiopia: A Concurrent Embedded Mixed Quantitative/Qualitative Study 

2020 ◽  
Author(s):  
Falaho Sani ◽  
Mohammed Hasen ◽  
Mohammed Seid ◽  
Nuriya Umer
Keyword(s):  
Public Health ◽  
Qualitative Study ◽  
Surveillance System ◽  
Public Health Surveillance ◽  
Health Surveillance ◽  
Health Facilities ◽  
Surveillance Data ◽  
Surveillance Systems ◽  
Southeast Ethiopia ◽  
Bale Zone

Abstract Background: Public health surveillance systems should be evaluated periodically to ensure that the problems of public health importance are being monitored efficiently and effectively. Despite the widespread measles outbreak in Ginnir district of Bale zone in 2019, evaluation of measles surveillance system has not been conducted. Therefore, we evaluated the performance of measles surveillance system and its key attributes in Ginnir district, Southeast Ethiopia.Methods: We conducted a concurrent embedded mixed quantitative/qualitative study in August 2019 among 15 health facilities/study units in Ginnir district. Health facilities are selected using lottery method. The qualitative study involved purposively selected 15 key informants. Data were collected using semi-structured questionnaire adapted from Centers for Disease Control and Prevention guidelines for evaluating public health surveillance systems through face-to-face interview and record review. The quantitative findings were analyzed using Microsoft Excel 2016 and summarized by frequency and proportion. The qualitative findings were narrated and summarized based on thematic areas to supplement the quantitative findings.Results: The structure of surveillance data flow was from the community to the respective upper level. Emergency preparedness and response plan was available only at the district level. Completeness of weekly report was 95%, while timeliness was 87%. No regular analysis and interpretations of surveillance data, and the supportive supervision and feedback system was weak. The participation and willingness of surveillance stakeholders in implementation of the system was good. The surveillance system was found to be useful, easy to implement, representative and can accommodate and adapt to changing conditions. Report documentation and quality of data was poor at lower level health facilities. Stability of the system has been challenged by shortage of budget and logistics, staff turnover and lack of update trainings.Conclusions: The surveillance system was acceptable, useful, simple, flexible and representative. Data quality, timeliness and stability of the system were attributes that require improvement. The overall performance of measles surveillance system in the district was poor. Hence, regular analysis of data, preparation and dissemination of epidemiological bulletin, capacity building and regular supervision and feedback are recommended to enhance performance of the system.

scholarly journals Case ascertainment in active paediatric surveillance systems: a report from the British Paediatric Surveillance Unit Ascertainment Group

2019 ◽  
Vol 105 (1) ◽  
pp. 62-68
Author(s):  
Richard M Lynn ◽  
Richard Reading
Keyword(s):  
Public Health ◽  
Active Surveillance ◽  
Surveillance System ◽  
Primary Outcome ◽  
Case Finding ◽  
Surveillance Systems ◽  
Public Health Importance ◽  
Surveillance Studies ◽  
Study Team ◽  
Surveillance Unit

The British Paediatric Surveillance Unit (BPSU) conducts surveillance of rare paediatric conditions using active, or prospective, case finding. The reliability of estimates of incidence, which is the primary outcome of public health importance, depends on ascertainment being as near complete as possible. This paper reviews evidence of the completeness of ascertainment in recent surveillance studies run through the BPSU. Ascertainment varied between 49% and 94% depending on the study. These are upper estimates. This was the basis of a discussion on barriers and facilitators of ascertainment which we have separated into factors related to the condition, factors related to the study methods, factors related to the study team and factors related to the surveillance system infrastructure. This leads to a series of recommendations to ensure continuing high levels of ascertainment in active surveillance studies.

scholarly journals Use of Severity Indicators in a Public Health Surveillance System

2014 ◽  
Vol 6 (1) ◽  
Author(s):  
Rhonda A. Lizewski ◽  
Howard Burkom ◽  
Joseph Lombardo ◽  
Christopher Cuellar ◽  
Yevgeniy Elbert ◽  
...  
Keyword(s):  
Public Health ◽  
Surveillance System ◽  
Public Health Surveillance ◽  
Additional Data ◽  
Outpatient Setting ◽  
Health Surveillance ◽  
Surveillance Systems ◽  
Fusion Model ◽  
Community Based ◽  
Public Health Surveillance System

While other surveillance systems may only use death and admissions as severity indicators, these serious events may overshadow the more subtle severity signals based on appointment type, disposition from an outpatient setting, and whether that patient had to return for care if they their condition has not improved.  This abstract discusses how these additional data fields were utilized in a fusion model to improve the Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE).

scholarly journals Potential Early Identification of a Large Campylobacter Outbreak Using Alternative Surveillance Data Sources: Autoregressive Modelling and Spatiotemporal Clustering (Preprint)

2020 ◽  
Author(s):  
Mehnaz Adnan ◽  
Xiaoying Gao ◽  
Xiaohan Bai ◽  
Elizabeth Newbern ◽  
Jill Sherwood ◽  
...  
Keyword(s):  
Public Health ◽  
Surveillance System ◽  
Disease Surveillance ◽  
Case Reports ◽  
Surveillance Data ◽  
Data Sources ◽  
Google Trends ◽  
School Absenteeism ◽  
Disease Surveillance System ◽  
Spatiotemporal Clustering

BACKGROUND Over one-third of the population of Havelock North, New Zealand, approximately 5500 people, were estimated to have been affected by campylobacteriosis in a large waterborne outbreak. Cases reported through the notifiable disease surveillance system (notified case reports) are inevitably delayed by several days, resulting in slowed outbreak recognition and delayed control measures. Early outbreak detection and magnitude prediction are critical to outbreak control. It is therefore important to consider alternative surveillance data sources and evaluate their potential for recognizing outbreaks at the earliest possible time. OBJECTIVE The first objective of this study is to compare and validate the selection of alternative data sources (general practice consultations, consumer helpline, Google Trends, Twitter microblogs, and school absenteeism) for their temporal predictive strength for Campylobacter cases during the Havelock North outbreak. The second objective is to examine spatiotemporal clustering of data from alternative sources to assess the size and geographic extent of the outbreak and to support efforts to attribute its source. METHODS We combined measures derived from alternative data sources during the 2016 Havelock North campylobacteriosis outbreak with notified case report counts to predict suspected daily Campylobacter case counts up to 5 days before cases reported in the disease surveillance system. Spatiotemporal clustering of the data was analyzed using Local Moran’s I statistics to investigate the extent of the outbreak in both space and time within the affected area. RESULTS Models that combined consumer helpline data with autoregressive notified case counts had the best out-of-sample predictive accuracy for 1 and 2 days ahead of notified case reports. Models using Google Trends and Twitter typically performed the best 3 and 4 days before case notifications. Spatiotemporal clusters showed spikes in school absenteeism and consumer helpline inquiries that preceded the notified cases in the city primarily affected by the outbreak. CONCLUSIONS Alternative data sources can provide earlier indications of a large gastroenteritis outbreak compared with conventional case notifications. Spatiotemporal analysis can assist in refining the geographical focus of an outbreak and can potentially support public health source attribution efforts. Further work is required to assess the location of such surveillance data sources and methods in routine public health practice.

scholarly journals Ocorrência de Lesão Pulmonar Aguda relacionada à Transfusão em Hospital de Referência do Ceará: Relato de Caso / Occurrence of Transfusion-related Acute Lung Injury in a Reference Hospital of Ceará: Case Report

2021 ◽  
Vol 15 (58) ◽  
pp. 410-426
Author(s):  
Hermínia Moreira Coelho da Costa
Keyword(s):  
Acute Lung Injury ◽  
Case Report ◽  
Blood Transfusion ◽  
Lung Injury ◽  
Health Professionals ◽  
Case Reports ◽  
Ventilatory Support ◽  
Exploratory Laparotomy ◽  
High Morbidity ◽  
Reference Hospital

Lesão pulmonar aguda relacionada à transfusão (TRALI –Transfusion Related Acute Lung Injury) é uma complicação grave da transfusão sanguínea que cursa essencialmente com desconforto respiratório durante ou dentro de 6 horas depois de completada a transfusão. Apesar de ser considerada rara e a lesão pulmonar ser geralmente transitória, traz preocupação aos profissionais da área da saúde, visto que está associada à alta morbidade dos pacientes que necessitaram de suporte ventilatório, assim como a alta mortalidade. Sua incidência não está bem estabelecida, muito devido à falta de preparo para identificar os casos suspeitos. Assim, os relatos de casos ganham relevância tanto para contribuir que o diagnóstico desta patologia seja alcançado com mais facilidade quanto para estimular que os casos sejam notificados. O presente relato descreve a ocorrência de TRALI em paciente no segundo dia de pós-operatório de cesárea por pré- eclâmpsia e síndrome Hellp que evoluiu com suspeita de hemoperitônio sendo submetida a laparotomia exploratória (LE).---Transfusion related acute lung injury (TRALI) is a serious complication of blood transfusion that evolves mainly with respiratory distress during or within 6 hours after transfusion. Although considered rare and is usually transient lung injury, she brings concern to health professionals, as it is associated with high morbidity of patients requiring ventilatory support, as well as the high mortality. Its incidence is not well established, much due to lack of preparation to identify suspected cases. Thus, case reports gain relevance to contribute to the diagnosis of this condition is more easily achieved as to stimulate the cases are reported. This report describes the occurrence of TRALI in a patient on the second day after surgery by cesarean preeclampsia and HELLP syndrome who developed suspected hemoperitoneum and underwent exploratory laparotomy (LE).

scholarly journals Potential Early Identification of a Large Campylobacter Outbreak Using Alternative Surveillance Data Sources: Autoregressive Modelling and Spatiotemporal Clustering

10.2196/18281 ◽  
2020 ◽  
Vol 6 (3) ◽  
pp. e18281
Author(s):  
Mehnaz Adnan ◽  
Xiaoying Gao ◽  
Xiaohan Bai ◽  
Elizabeth Newbern ◽  
Jill Sherwood ◽  
...  
Keyword(s):  
Public Health ◽  
Surveillance System ◽  
Disease Surveillance ◽  
Case Reports ◽  
Surveillance Data ◽  
Data Sources ◽  
Google Trends ◽  
School Absenteeism ◽  
Disease Surveillance System ◽  
Spatiotemporal Clustering

Background Over one-third of the population of Havelock North, New Zealand, approximately 5500 people, were estimated to have been affected by campylobacteriosis in a large waterborne outbreak. Cases reported through the notifiable disease surveillance system (notified case reports) are inevitably delayed by several days, resulting in slowed outbreak recognition and delayed control measures. Early outbreak detection and magnitude prediction are critical to outbreak control. It is therefore important to consider alternative surveillance data sources and evaluate their potential for recognizing outbreaks at the earliest possible time. Objective The first objective of this study is to compare and validate the selection of alternative data sources (general practice consultations, consumer helpline, Google Trends, Twitter microblogs, and school absenteeism) for their temporal predictive strength for Campylobacter cases during the Havelock North outbreak. The second objective is to examine spatiotemporal clustering of data from alternative sources to assess the size and geographic extent of the outbreak and to support efforts to attribute its source. Methods We combined measures derived from alternative data sources during the 2016 Havelock North campylobacteriosis outbreak with notified case report counts to predict suspected daily Campylobacter case counts up to 5 days before cases reported in the disease surveillance system. Spatiotemporal clustering of the data was analyzed using Local Moran’s I statistics to investigate the extent of the outbreak in both space and time within the affected area. Results Models that combined consumer helpline data with autoregressive notified case counts had the best out-of-sample predictive accuracy for 1 and 2 days ahead of notified case reports. Models using Google Trends and Twitter typically performed the best 3 and 4 days before case notifications. Spatiotemporal clusters showed spikes in school absenteeism and consumer helpline inquiries that preceded the notified cases in the city primarily affected by the outbreak. Conclusions Alternative data sources can provide earlier indications of a large gastroenteritis outbreak compared with conventional case notifications. Spatiotemporal analysis can assist in refining the geographical focus of an outbreak and can potentially support public health source attribution efforts. Further work is required to assess the location of such surveillance data sources and methods in routine public health practice.

Using Public Health Surveillance Data to Determine Hepatitis C Virus Exposure Among Live-Born Infants in Tennessee, 2013-2017

2021 ◽  
pp. 003335492110358
Author(s):  
Heather Wingate ◽  
Lindsey Sizemore ◽  
Jennifer Black ◽  
Zachary Heth ◽  
Pamela Talley ◽  
...  
Keyword(s):  
Public Health ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Surveillance System ◽  
Laboratory Data ◽  
Birth Certificate ◽  
Hcv Infection ◽  
Surveillance Data ◽  
Birth Certificates ◽  
Base System

Objective Maternal hepatitis C virus (HCV) infection reported on birth certificates has been shown to underestimate HCV infection. We sought to determine the usefulness of HCV surveillance data for (1) quantifying the number of HCV-positive reproductive-aged women with a live birth, (2) comparing maternal HCV surveillance data with reported HCV infection status on birth certificates, and (3) delineating past versus current maternal infection to identify true perinatal exposures. Methods We extracted data from January 1, 2013, through December 31, 2017, on birth certificate indication of HCV exposure from the Tennessee Birth Statistical File, and we ascertained indication of HCV exposure by using laboratory data from the Tennessee National Electronic Disease Surveillance System (NEDSS) Base System (NBS). We conducted a sensitivity analysis comparing birth certificate indication of HCV exposure with HCV laboratory data to determine whether true perinatal exposure had occurred. Results During the study period, 6731 mothers with live births in Tennessee reported having HCV infection during pregnancy: 3295 (49.0%) had both laboratory and birth certificate indication of HCV infection, 2130 (31.6%) had indication of HCV infection on the laboratory report only, and 1306 (19.4%) had indication of HCV infection on the birth certificate only. Conclusions Using data from a public health HCV surveillance system with birth certificate data may improve the identification of HCV-infected pregnant women and perinatally exposed infants. Surveillance systems that include complete reporting of all HCV RNA results can be used to distinguish past from present maternal HCV infection to focus limited public health resources on currently infected mothers and their exposed infants.

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