Surveillance Overview Julia Gunn Boston Public Health Commission.
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Transcript of Surveillance Overview Julia Gunn Boston Public Health Commission.
What is the range of responsibilities of a public health monitoring agency?Infectious DiseasesEnvironmental Issues
Chemical ExposuresCarbon Monoxide
Injuries Falls – Kids can’t fly Violence
Substance Abuse Overdoses
Chronic Diseases Asthma
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Pollen count Visits
Carbon Monoxide Violence: Penetrating Injuries
Heat Related Visits Asthma & Pollen Counts
Syndromic Data– Acute Care Visits– Boston EMS Calls– Poison Control Calls– Health Centers – Urgent Care Visit Volume– Sentinel sites (as needed)
Notifiable Diseases
Notifiable Illness or Exposure in–Research Laboratory Staff Using Select Agent or Other Priority Pathogens
Death Certificates
Inspectional Service Reports
Environmental Data– Weather– Pollen Counts– News Reports– Environmental
Detection Systems
BPHC
What evidence do you consider syndromic?
Syndromic Data– Acute Care Visits– Boston EMS Calls– Poison Control Calls– Health Centers – Urgent Care Visit Volume– Sentinel sites (as needed)
Chief Complaint Dictionary
Fever Respiratory Cough Hypoxia SOB Cold
chiles atelectasis
bringing up blood
color change apnea cold
chills brionchitis
coguh
color off
apneic episode
cold sx
cough+feverbrochiolitis
copugh cyancsisbreathing
difficulty cong
debrilebronchialitis
couch cyanotic breathing fast congesr
f v bronchiectasis cougdec o2 sat
breathing funny congest
faver bronchilitis
cough
decrease 02 stat breathing hard congested
Symptoms into Syndromes
GI
GI1 Nausea Vomiting Diarrhea
Abd pain Fever Dehydration Anorexia
GI2 Nausea Vomiting Diarrhea
Abd pain Fever Gyn/Pregnancy
GI3 Nausea Vomiting Diarrhea
Abd pain Fever Gyn/Pregnancy GU
GI4 Nausea Vomiting Diarrhea
Interpretation of signalsDoes it make epidemiologic sense?
Does it make clinical sense?
Does it pass the common sense test?
Information for signal characterizationDescriptive characteristics of the signal
How bigTrends
Historical patternsClustering
Space Demographics
Syndrome definitions Broad vs narrow
Chief complaintsOther biosurveillance dataLocal factors
Health care utilization patterns Weather Events
What is your connection to hospitals, private physicians, urgent care centers, government decision-makers, the public?Varies by federal, state, localVaries by situation
RoutinePublic Health Emergency
Varies by size and scopeLocal health department
Primary investigators of cases Surveillance Institute control measures Provide information for local response efforts Develop clinical guidance Media
Direct lines of communication with all agencies
How often are electronic systems used, by how much staff, which what training?Syndromic surveillance
EpidemiologistsReportable diseases
EpidemiologistsPublic Health Nurses
Limited formal training – Experience based
What cross-jurisdictional communication exists—how much of a problem is this?ISDS -Distribute
Foster collaborationInformal networkTrusted sourcesSharing of tools, codes
What role do analytic methods currently play, if any—how much more could it be, should it be?Current Status
Aberration detectionModels – disease transmission – not routinely
usedSilo
NeedsMultiple data streamsVaried needs by agenciesData to Information to ResponsePractical and functionalAdded value
