Mobile Phone–based Syndromic Surveillance System, Papua New Guinea

Science.gov (United States)

Ropa, Berry; Randall, Heather; Dagina, Rosheila; Hurim, Samuel; Bieb, Sibauk; Datta, Siddhartha; Ramamurthy, Sundar; Mola, Glen; Zwi, Anthony B.; Ray, Pradeep; MacIntyre, C. Raina

2013-01-01

The health care system in Papua New Guinea is fragile, and surveillance systems infrequently meet international standards. To strengthen outbreak identification, health authorities piloted a mobile phone–based syndromic surveillance system and used established frameworks to evaluate whether the system was meeting objectives. Stakeholder experience was investigated by using standardized questionnaires and focus groups. Nine sites reported data that included 7 outbreaks and 92 cases of acute watery diarrhea. The new system was more timely (2.4 vs. 84 days), complete (70% vs. 40%), and sensitive (95% vs. 26%) than existing systems. The system was simple, stable, useful, and acceptable; however, feedback and subnational involvement were weak. A simple syndromic surveillance system implemented in a fragile state enabled more timely, complete, and sensitive data reporting for disease risk assessment. Feedback and provincial involvement require improvement. Use of mobile phone technology might improve the timeliness and efficiency of public health surveillance. PMID:24188144

[Surveillance Plan on Recent Outbreak of Measles and Rubella in Catalonia, Spain].

Science.gov (United States)

Jané, Mireia; Torner, Nuria; Vidal, Ma José

2015-01-01

Measles and rubella are two immuno-preventive illnesses. In Catalonia, since 1988 all children are given two doses of measles and rubella vaccine with high levels of vaccination coverage. The measles elimination programme has been carried out since 1990 in Catalonia. This programme includes achieving and keeping high immunization levels among population with high vaccination coverage, intense epidemiological surveillance and an immediate response to the appearance of a case or outbreak. In 2014, the measles incidence rate was 1.9 cases/ 100,000 inhabitants. There were 4 recent outbreaks in 2006, 2011, 2013 and 2014 that affected 381, 289, 31 and 124 people respectively. All outbreaks were triggered by an imported case. In 2011 and 2014 measles outbreaks, 6% and 5.5% of affected people were health care workers. All outbreaks presented a great variety of measles genotypes. Concerning rubella elimination programme, since 2002, 68 cases of postnatal rubella and 5 cases of congenital rubella were confirmed. Regarding measles and rubella surveillance and control, in addition to strengthen vaccination coverage, it is essential immediate notification, within the first 24 hours since suspicion and laboratory confirmation. In addition there is a need to enforce vaccination among health care workers as well as in other susceptible and unvaccinated people. It is recommended to vaccinate all people who were born after 1966 and who have not been vaccinated with two doses of trivalent measles-mumps-rubella vaccine. Furthermore, we have to emphasize that the progress concerning genotypes study allows identifying various imported cases from other European countries with active outbreaks, aspect that makes easier the surveillance of these illnesses.

measles case-based surveillance and outbreak response in nigeria

African Journals Online (AJOL)

of the existing national technical guideline on measles case- based surveillance and outbreak response in Nigeria in ... according to the revised national measles technical guideline9. However, with the strengthening of the ... involves immediate reporting and investigating any suspected case of measles by clinicians using ...

Automated real time constant-specificity surveillance for disease outbreaks

Directory of Open Access Journals (Sweden)

Brownstein John S

2007-06-01

Full Text Available Abstract Background For real time surveillance, detection of abnormal disease patterns is based on a difference between patterns observed, and those predicted by models of historical data. The usefulness of outbreak detection strategies depends on their specificity; the false alarm rate affects the interpretation of alarms. Results We evaluate the specificity of five traditional models: autoregressive, Serfling, trimmed seasonal, wavelet-based, and generalized linear. We apply each to 12 years of emergency department visits for respiratory infection syndromes at a pediatric hospital, finding that the specificity of the five models was almost always a non-constant function of the day of the week, month, and year of the study (p Conclusion Modeling the variance of visit patterns enables real-time detection with known, constant specificity at all times. With constant specificity, public health practitioners can better interpret the alarms and better evaluate the cost-effectiveness of surveillance systems.

The Nigerian health care system: Need for integrating adequate medical intelligence and surveillance systems

Directory of Open Access Journals (Sweden)

Menizibeya Osain Welcome

2011-01-01

Full Text Available Objectives : As an important element of national security, public health not only functions to provide adequate and timely medical care but also track, monitor, and control disease outbreak. The Nigerian health care had suffered several infectious disease outbreaks year after year. Hence, there is need to tackle the problem. This study aims to review the state of the Nigerian health care system and to provide possible recommendations to the worsening state of health care in the country. To give up-to-date recommendations for the Nigerian health care system, this study also aims at reviewing the dynamics of health care in the United States, Britain, and Europe with regards to methods of medical intelligence/surveillance. Materials and Methods : Databases were searched for relevant literatures using the following keywords: Nigerian health care, Nigerian health care system, and Nigerian primary health care system. Additional keywords used in the search were as follows: United States (OR Europe health care dynamics, Medical Intelligence, Medical Intelligence systems, Public health surveillance systems, Nigerian medical intelligence, Nigerian surveillance systems, and Nigerian health information system. Literatures were searched in scientific databases Pubmed and African Journals OnLine. Internet searches were based on Google and Search Nigeria. Results : Medical intelligence and surveillance represent a very useful component in the health care system and control diseases outbreak, bioattack, etc. There is increasing role of automated-based medical intelligence and surveillance systems, in addition to the traditional manual pattern of document retrieval in advanced medical setting such as those in western and European countries. Conclusion : The Nigerian health care system is poorly developed. No adequate and functional surveillance systems are developed. To achieve success in health care in this modern era, a system well grounded in routine

Integrating malaria surveillance with climate data for outbreak detection and forecasting: the EPIDEMIA system.

Science.gov (United States)

Merkord, Christopher L; Liu, Yi; Mihretie, Abere; Gebrehiwot, Teklehaymanot; Awoke, Worku; Bayabil, Estifanos; Henebry, Geoffrey M; Kassa, Gebeyaw T; Lake, Mastewal; Wimberly, Michael C

2017-02-23

Early indication of an emerging malaria epidemic can provide an opportunity for proactive interventions. Challenges to the identification of nascent malaria epidemics include obtaining recent epidemiological surveillance data, spatially and temporally harmonizing this information with timely data on environmental precursors, applying models for early detection and early warning, and communicating results to public health officials. Automated web-based informatics systems can provide a solution to these problems, but their implementation in real-world settings has been limited. The Epidemic Prognosis Incorporating Disease and Environmental Monitoring for Integrated Assessment (EPIDEMIA) computer system was designed and implemented to integrate disease surveillance with environmental monitoring in support of operational malaria forecasting in the Amhara region of Ethiopia. A co-design workshop was held with computer scientists, epidemiological modelers, and public health partners to develop an initial list of system requirements. Subsequent updates to the system were based on feedback obtained from system evaluation workshops and assessments conducted by a steering committee of users in the public health sector. The system integrated epidemiological data uploaded weekly by the Amhara Regional Health Bureau with remotely-sensed environmental data freely available from online archives. Environmental data were acquired and processed automatically by the EASTWeb software program. Additional software was developed to implement a public health interface for data upload and download, harmonize the epidemiological and environmental data into a unified database, automatically update time series forecasting models, and generate formatted reports. Reporting features included district-level control charts and maps summarizing epidemiological indicators of emerging malaria outbreaks, environmental risk factors, and forecasts of future malaria risk. Successful implementation and

Removing a barrier to computer-based outbreak and disease surveillance--the RODS Open Source Project.

Science.gov (United States)

Espino, Jeremy U; Wagner, M; Szczepaniak, C; Tsui, F C; Su, H; Olszewski, R; Liu, Z; Chapman, W; Zeng, X; Ma, L; Lu, Z; Dara, J

2004-09-24

Computer-based outbreak and disease surveillance requires high-quality software that is well-supported and affordable. Developing software in an open-source framework, which entails free distribution and use of software and continuous, community-based software development, can produce software with such characteristics, and can do so rapidly. The objective of the Real-Time Outbreak and Disease Surveillance (RODS) Open Source Project is to accelerate the deployment of computer-based outbreak and disease surveillance systems by writing software and catalyzing the formation of a community of users, developers, consultants, and scientists who support its use. The University of Pittsburgh seeded the Open Source Project by releasing the RODS software under the GNU General Public License. An infrastructure was created, consisting of a website, mailing lists for developers and users, designated software developers, and shared code-development tools. These resources are intended to encourage growth of the Open Source Project community. Progress is measured by assessing website usage, number of software downloads, number of inquiries, number of system deployments, and number of new features or modules added to the code base. During September--November 2003, users generated 5,370 page views of the project website, 59 software downloads, 20 inquiries, one new deployment, and addition of four features. Thus far, health departments and companies have been more interested in using the software as is than in customizing or developing new features. The RODS laboratory anticipates that after initial installation has been completed, health departments and companies will begin to customize the software and contribute their enhancements to the public code base.

Evaluation of Syndromic Surveillance Systems in 6 US State and Local Health Departments.

Science.gov (United States)

Thomas, Mathew J; Yoon, Paula W; Collins, James M; Davidson, Arthur J; Mac Kenzie, William R

Evaluating public health surveillance systems is critical to ensuring that conditions of public health importance are appropriately monitored. Our objectives were to qualitatively evaluate 6 state and local health departments that were early adopters of syndromic surveillance in order to (1) understand the characteristics and current uses, (2) identify the most and least useful syndromes to monitor, (3) gauge the utility for early warning and outbreak detection, and (4) assess how syndromic surveillance impacted their daily decision making. We adapted evaluation guidelines from the Centers for Disease Control and Prevention and gathered input from the Centers for Disease Control and Prevention subject matter experts in public health surveillance to develop a questionnaire. We interviewed staff members from a convenience sample of 6 local and state health departments with syndromic surveillance programs that had been in operation for more than 10 years. Three of the 6 interviewees provided an example of using syndromic surveillance to identify an outbreak (ie, cluster of foodborne illness in 1 jurisdiction) or detect a surge in cases for seasonal conditions (eg, influenza in 2 jurisdictions) prior to traditional, disease-specific systems. Although all interviewees noted that syndromic surveillance has not been routinely useful or efficient for early outbreak detection or case finding in their jurisdictions, all agreed that the information can be used to improve their understanding of dynamic disease control environments and conditions (eg, situational awareness) in their communities. In the jurisdictions studied, syndromic surveillance may be useful for monitoring the spread and intensity of large outbreaks of disease, especially influenza; enhancing public health awareness of mass gatherings and natural disasters; and assessing new, otherwise unmonitored conditions when real-time alternatives are unavailable. Future studies should explore opportunities to

The AFHSC-Division of GEIS Operations Predictive Surveillance Program: a multidisciplinary approach for the early detection and response to disease outbreaks.

Science.gov (United States)

Witt, Clara J; Richards, Allen L; Masuoka, Penny M; Foley, Desmond H; Buczak, Anna L; Musila, Lillian A; Richardson, Jason H; Colacicco-Mayhugh, Michelle G; Rueda, Leopoldo M; Klein, Terry A; Anyamba, Assaf; Small, Jennifer; Pavlin, Julie A; Fukuda, Mark M; Gaydos, Joel; Russell, Kevin L; Wilkerson, Richard C; Gibbons, Robert V; Jarman, Richard G; Myint, Khin S; Pendergast, Brian; Lewis, Sheri; Pinzon, Jorge E; Collins, Kathrine; Smith, Matthew; Pak, Edwin; Tucker, Compton; Linthicum, Kenneth; Myers, Todd; Mansour, Moustafa; Earhart, Ken; Kim, Heung Chul; Jiang, Ju; Schnabel, Dave; Clark, Jeffrey W; Sang, Rosemary C; Kioko, Elizabeth; Abuom, David C; Grieco, John P; Richards, Erin E; Tobias, Steven; Kasper, Matthew R; Montgomery, Joel M; Florin, Dave; Chretien, Jean-Paul; Philip, Trudy L

2011-03-04

The Armed Forces Health Surveillance Center, Division of Global Emerging Infections Surveillance and Response System Operations (AFHSC-GEIS) initiated a coordinated, multidisciplinary program to link data sets and information derived from eco-climatic remote sensing activities, ecologic niche modeling, arthropod vector, animal disease-host/reservoir, and human disease surveillance for febrile illnesses, into a predictive surveillance program that generates advisories and alerts on emerging infectious disease outbreaks. The program's ultimate goal is pro-active public health practice through pre-event preparedness, prevention and control, and response decision-making and prioritization. This multidisciplinary program is rooted in over 10 years experience in predictive surveillance for Rift Valley fever outbreaks in Eastern Africa. The AFHSC-GEIS Rift Valley fever project is based on the identification and use of disease-emergence critical detection points as reliable signals for increased outbreak risk. The AFHSC-GEIS predictive surveillance program has formalized the Rift Valley fever project into a structured template for extending predictive surveillance capability to other Department of Defense (DoD)-priority vector- and water-borne, and zoonotic diseases and geographic areas. These include leishmaniasis, malaria, and Crimea-Congo and other viral hemorrhagic fevers in Central Asia and Africa, dengue fever in Asia and the Americas, Japanese encephalitis (JE) and chikungunya fever in Asia, and rickettsial and other tick-borne infections in the U.S., Africa and Asia.

The AFHSC-Division of GEIS Operations Predictive Surveillance Program: a multidisciplinary approach for the early detection and response to disease outbreaks

Science.gov (United States)

2011-01-01

The Armed Forces Health Surveillance Center, Division of Global Emerging Infections Surveillance and Response System Operations (AFHSC-GEIS) initiated a coordinated, multidisciplinary program to link data sets and information derived from eco-climatic remote sensing activities, ecologic niche modeling, arthropod vector, animal disease-host/reservoir, and human disease surveillance for febrile illnesses, into a predictive surveillance program that generates advisories and alerts on emerging infectious disease outbreaks. The program’s ultimate goal is pro-active public health practice through pre-event preparedness, prevention and control, and response decision-making and prioritization. This multidisciplinary program is rooted in over 10 years experience in predictive surveillance for Rift Valley fever outbreaks in Eastern Africa. The AFHSC-GEIS Rift Valley fever project is based on the identification and use of disease-emergence critical detection points as reliable signals for increased outbreak risk. The AFHSC-GEIS predictive surveillance program has formalized the Rift Valley fever project into a structured template for extending predictive surveillance capability to other Department of Defense (DoD)-priority vector- and water-borne, and zoonotic diseases and geographic areas. These include leishmaniasis, malaria, and Crimea-Congo and other viral hemorrhagic fevers in Central Asia and Africa, dengue fever in Asia and the Americas, Japanese encephalitis (JE) and chikungunya fever in Asia, and rickettsial and other tick-borne infections in the U.S., Africa and Asia. PMID:21388561

Timeliness of Surveillance during Outbreak of Shiga Toxin–producing Escherichia coli Infection, Germany, 2011

OpenAIRE

Altmann, Mathias; Wadl, Maria; Altmann, Doris; Benzler, Justus; Eckmanns, Tim; Krause, Gérard; Spode, Anke; an der Heiden, Matthias

2011-01-01

In the context of a large outbreak of Shiga toxin–producing Escherichia coli O104:H4 in Germany, we quantified the timeliness of the German surveillance system for hemolytic uremic syndrome and Shiga toxin–producing E. coli notifiable diseases during 2003–2011. Although reporting occurred faster than required by law, potential for improvement exists at all levels of the information chain.

Testing a symptom-based surveillance system at high-profile gatherings as a preparatory measure for bioterrorism.

Science.gov (United States)

Osaka, K; Takahashi, H; Ohyama, T

2002-12-01

We tested symptom-based surveillance during the G8 conference in 2000 as a means of detecting outbreaks, including bio-terrorism attacks, promptly. Five categories of symptoms (skin and haemorrhagic, respiratory, gastrointestinal, neurological and unexplained) were adopted for the case definition of the surveillance. The surveillance began I week before the conference, and continued until 1 week after the conference ended. We could not detect any outbreaks during this surveillance. Compared to the existing diagnosis-based surveillance system, symptom-based surveillance has the advantages of timeliness and simplicity. However, poor specificity and difficulties in determining epidemic threshold were important limitations of this system. To increase the specificity of surveillance, it is essential to incorporate rapid laboratory diagnoses into the system.

Timeliness of Surveillance during Outbreak of Shiga Toxin–producing Escherichia coli Infection, Germany, 2011

Science.gov (United States)

Wadl, Maria; Altmann, Doris; Benzler, Justus; Eckmanns, Tim; Krause, Gérard; Spode, Anke; an der Heiden, Matthias

2011-01-01

In the context of a large outbreak of Shiga toxin–producing Escherichia coli O104:H4 in Germany, we quantified the timeliness of the German surveillance system for hemolytic uremic syndrome and Shiga toxin–producing E. coli notifiable diseases during 2003–2011. Although reporting occurred faster than required by law, potential for improvement exists at all levels of the information chain. PMID:22000368

Detecting Ebola with limited laboratory access in the Democratic Republic of Congo: evaluation of a clinical passive surveillance reporting system.

Science.gov (United States)

Ashbaugh, Hayley R; Kuang, Brandon; Gadoth, Adva; Alfonso, Vivian H; Mukadi, Patrick; Doshi, Reena H; Hoff, Nicole A; Sinai, Cyrus; Mossoko, Mathias; Kebela, Benoit Ilunga; Muyembe, Jean-Jacques; Wemakoy, Emile Okitolonda; Rimoin, Anne W

2017-09-01

Ebola virus disease (EVD) can be clinically severe and highly fatal, making surveillance efforts for early disease detection of paramount importance. In areas with limited access to laboratory testing, the Integrated Disease Surveillance and Response (IDSR) strategy in the Democratic Republic of Congo (DRC) may be a vital tool in improving outbreak response. Using DRC IDSR data from the nation's four EVD outbreak periods from 2007-2014, we assessed trends of Viral Hemorrhagic Fever (VHF) and EVD differential diagnoses reportable through IDSR. With official case counts from active surveillance of EVD outbreaks, we assessed accuracy of reporting through the IDSR passive surveillance system. Although the active and passive surveillance represent distinct sets of data, the two were correlated, suggesting that passive surveillance based only on clinical evaluation may be a useful predictor of true cases prior to laboratory confirmation. There were 438 suspect VHF cases reported through the IDSR system and 416 EVD cases officially recorded across the outbreaks examined. Although collected prior to official active surveillance cases, case reporting through the IDSR during the 2007, 2008 and 2012 outbreaks coincided with official EVD epidemic curves. Additionally, all outbreak areas experienced increases in suspected cases for both malaria and typhoid fever during EVD outbreaks, underscoring the importance of training health care workers in recognising EVD differential diagnoses and the potential for co-morbidities. © 2017 John Wiley & Sons Ltd.

Sharing experiences: towards an evidence based model of dengue surveillance and outbreak response in Latin America and Asia.

Science.gov (United States)

Badurdeen, Shiraz; Valladares, David Benitez; Farrar, Jeremy; Gozzer, Ernesto; Kroeger, Axel; Kuswara, Novia; Ranzinger, Silvia Runge; Tinh, Hien Tran; Leite, Priscila; Mahendradhata, Yodi; Skewes, Ronald; Verrall, Ayesha

2013-06-24

The increasing frequency and intensity of dengue outbreaks in endemic and non-endemic countries requires a rational, evidence based response. To this end, we aimed to collate the experiences of a number of affected countries, identify strengths and limitations in dengue surveillance, outbreak preparedness, detection and response and contribute towards the development of a model contingency plan adaptable to country needs. The study was undertaken in five Latin American (Brazil, Colombia, Dominican Republic, Mexico, Peru) and five in Asian countries (Indonesia, Malaysia, Maldives, Sri Lanka, Vietnam). A mixed-methods approach was used which included document analysis, key informant interviews, focus-group discussions, secondary data analysis and consensus building by an international dengue expert meeting organised by the World Health Organization, Special Program for Research and Training in Tropical Diseases (WHO-TDR). Country information on dengue is based on compulsory notification and reporting ("passive surveillance"), with laboratory confirmation (in all participating Latin American countries and some Asian countries) or by using a clinical syndromic definition. Seven countries additionally had sentinel sites with active dengue reporting, some also had virological surveillance. Six had agreed a formal definition of a dengue outbreak separate to seasonal variation in case numbers. Countries collected data on a range of warning signs that may identify outbreaks early, but none had developed a systematic approach to identifying and responding to the early stages of an outbreak. Outbreak response plans varied in quality, particularly regarding the early response. The surge capacity of hospitals with recent dengue outbreaks varied; those that could mobilise additional staff, beds, laboratory support and resources coped best in comparison to those improvising a coping strategy during the outbreak. Hospital outbreak management plans were present in 9

Automated real time constant-specificity surveillance for disease outbreaks.

Science.gov (United States)

Wieland, Shannon C; Brownstein, John S; Berger, Bonnie; Mandl, Kenneth D

2007-06-13

For real time surveillance, detection of abnormal disease patterns is based on a difference between patterns observed, and those predicted by models of historical data. The usefulness of outbreak detection strategies depends on their specificity; the false alarm rate affects the interpretation of alarms. We evaluate the specificity of five traditional models: autoregressive, Serfling, trimmed seasonal, wavelet-based, and generalized linear. We apply each to 12 years of emergency department visits for respiratory infection syndromes at a pediatric hospital, finding that the specificity of the five models was almost always a non-constant function of the day of the week, month, and year of the study (p accounting for not only the expected number of visits, but also the variance of the number of visits. The expectation-variance model achieves constant specificity on all three time scales, as well as earlier detection and improved sensitivity compared to traditional methods in most circumstances. Modeling the variance of visit patterns enables real-time detection with known, constant specificity at all times. With constant specificity, public health practitioners can better interpret the alarms and better evaluate the cost-effectiveness of surveillance systems.

Use of Surveillance Systems in Detection of a Ciguatera Fish Poisoning Outbreak - Orange County, Florida, 2014.

Science.gov (United States)

Klekamp, Benjamin G; Bodager, Dean; Matthews, Sarah D

2015-10-16

What is already known on this topic? Ciguatera fish poisoning (CFP), caused by the ingestion of predatory reef-dwelling fish harboring ciguatoxins is one of the most commonly reported fish-associated marine intoxications. Ciguatoxin retains toxicity regardless of freezing or cooking. Prompt treatment can reduce debilitating neurologic symptoms that are associated with CFP.What is added by this report? Syndromic surveillance systems in Florida identified six adults with CFP following consumption of black grouper. Five patients sought medical attention; health care providers did not make a diagnosis of CFP or report the cases to public health authorities, and none of the patients received treatment. Close collaboration among several investigating agencies allowed traceback efforts to link black grouper consumed by all patients to a common international distributor.What are the implications for public health practice? Syndromic surveillance systems capable of detecting CFP are essential public health tools to identify outbreaks and enhance investigations. Medical and public health practitioners should be educated to inquire about recent fish consumption when evaluating patients with clinically compatible signs and symptoms to allow for prompt treatment, and report suspected CFP cases to public health authorities to facilitate source-food traceback efforts. Public education on avoidance of consumption of relatively large predatory reef fish species known to be from ciguatoxic-endemic areas might reduce the risk for CFP.

Surveillance for waterborne disease and outbreaks associated with drinking water and water not intended for drinking--United States, 2005-2006.

Science.gov (United States)

Yoder, Jonathan; Roberts, Virginia; Craun, Gunther F; Hill, Vincent; Hicks, Lauri A; Alexander, Nicole T; Radke, Vince; Calderon, Rebecca L; Hlavsa, Michele C; Beach, Michael J; Roy, Sharon L

2008-09-12

Since 1971, CDC, the U.S. Environmental Protection Agency (EPA), and the Council of State and Territorial Epidemiologists have maintained a collaborative Waterborne Disease and Outbreak Surveillance System (WBDOSS) for collecting and reporting data related to occurrences and causes of waterborne-disease outbreaks (WBDOs) and cases of waterborne disease. This surveillance system is the primary source of data concerning the scope and effects of waterborne disease in the United States. Data presented summarize 28 WBDOs that occurred during January 2005--December 2006 and four previously unreported WBDOs that occurred during 1979--2002. The surveillance system includes data on WBDOs associated with recreational water, drinking water, water not intended for drinking (WNID) (excluding recreational water), and water use of unknown intent. Public health departments in the states, territories, localities, and Freely Associated States (FAS) (i.e., the Republic of the Marshall Islands, the Federated States of Micronesia, and the Republic of Palau, formerly parts of the U.S.-administered Trust Territory of the Pacific Islands) are primarily responsible for detecting and investigating WBDOs and voluntarily reporting them to CDC by a standard form. Only cases and outbreaks associated with drinking water, WNID (excluding recreational water), and water of unknown intent (WUI) are summarized in this report. Cases and outbreaks associated with recreational water are reported in a separate Surveillance Summary. Fourteen states reported 28 WBDOs that occurred during 2005--2006: a total of 20 were associated with drinking water, six were associated with WNID, and two were associated with WUI. The 20 drinking water-associated WBDOs caused illness among an estimated 612 persons and were linked to four deaths. Etiologic agents were identified in 18 (90.0%) of the drinking water-associated WBDOs. Among the 18 WBDOs with identified pathogens, 12 (66.7%) were associated with bacteria, three

Low-Cost National Media-Based Surveillance System for Public Health Events, Bangladesh

Science.gov (United States)

Ao, Trong T.; Rahman, Mahmudur; Haque, Farhana; Chakraborty, Apurba; Hossain, M. Jahangir; Haider, Sabbir; Alamgir, A.S.M.; Sobel, Jeremy; Luby, Stephen P.

2016-01-01

We assessed a media-based public health surveillance system in Bangladesh during 2010–2011. The system is a highly effective, low-cost, locally appropriate, and sustainable outbreak detection tool that could be used in other low-income, resource-poor settings to meet the capacity for surveillance outlined in the International Health Regulations 2005. PMID:26981877

Evaluation of outbreak detection performance using multi-stream syndromic surveillance for influenza-like illness in rural Hubei Province, China: a temporal simulation model based on healthcare-seeking behaviors.

Science.gov (United States)

Fan, Yunzhou; Wang, Ying; Jiang, Hongbo; Yang, Wenwen; Yu, Miao; Yan, Weirong; Diwan, Vinod K; Xu, Biao; Dong, Hengjin; Palm, Lars; Nie, Shaofa

2014-01-01

Syndromic surveillance promotes the early detection of diseases outbreaks. Although syndromic surveillance has increased in developing countries, performance on outbreak detection, particularly in cases of multi-stream surveillance, has scarcely been evaluated in rural areas. This study introduces a temporal simulation model based on healthcare-seeking behaviors to evaluate the performance of multi-stream syndromic surveillance for influenza-like illness. Data were obtained in six towns of rural Hubei Province, China, from April 2012 to June 2013. A Susceptible-Exposed-Infectious-Recovered model generated 27 scenarios of simulated influenza A (H1N1) outbreaks, which were converted into corresponding simulated syndromic datasets through the healthcare-behaviors model. We then superimposed converted syndromic datasets onto the baselines obtained to create the testing datasets. Outbreak performance of single-stream surveillance of clinic visit, frequency of over the counter drug purchases, school absenteeism, and multi-stream surveillance of their combinations were evaluated using receiver operating characteristic curves and activity monitoring operation curves. In the six towns examined, clinic visit surveillance and school absenteeism surveillance exhibited superior performances of outbreak detection than over the counter drug purchase frequency surveillance; the performance of multi-stream surveillance was preferable to signal-stream surveillance, particularly at low specificity (Sp performance of multi-stream surveillance.

Real-time whole-genome sequencing for routine typing, surveillance, and outbreak detection of verotoxigenic Escherichia coli.

OpenAIRE

Joensen, Katrine Grimstrup; Scheutz, Flemming; Lund, Ole; Hasman, Henrik; Kaas, Rolf Sommer; Nielsen, Eva M.; Aarestrup, Frank Møller

2014-01-01

Fast and accurate identification and typing of pathogens are essential for effective surveillance and outbreak detection. The current routine procedure is based on a variety of techniques, making the procedure laborious, time-consuming, and expensive. With whole-genome sequencing (WGS) becoming cheaper, it has huge potential in both diagnostics and routine surveillance. The aim of this study was to perform a real-time evaluation of WGS for routine typing and surveillance of verocytotoxin-prod...

Real-Time Whole-Genome Sequencing for Routine Typing, Surveillance, and Outbreak Detection of Verotoxigenic Escherichia coli

OpenAIRE

Joensen, Katrine Grimstrup; Scheutz, Flemming; Lund, Ole; Hasman, Henrik; Kaas, Rolf S.; Nielsen, Eva M.; Aarestrup, Frank M.

2014-01-01

Fast and accurate identification and typing of pathogens are essential for effective surveillance and outbreak detection. The current routine procedure is based on a variety of techniques, making the procedure laborious, time-consuming, and expensive. With whole-genome sequencing (WGS) becoming cheaper, it has huge potential in both diagnostics and routine surveillance. The aim of this study was to perform a real-time evaluation of WGS for routine typing and surveillance of verocytotoxin-prod...

Selection tool for foodborne norovirus outbreaks.

Science.gov (United States)

Verhoef, Linda P B; Kroneman, Annelies; van Duynhoven, Yvonne; Boshuizen, Hendriek; van Pelt, Wilfrid; Koopmans, Marion

2009-01-01

Detection of pathogens in the food chain is limited mainly to bacteria, and the globalization of the food industry enables international viral foodborne outbreaks to occur. Outbreaks from 2002 through 2006 recorded in a European norovirus surveillance database were investigated for virologic and epidemiologic indicators of food relatedness. The resulting validated multivariate logistic regression model comparing foodborne (n = 224) and person-to-person (n = 654) outbreaks was used to create a practical web-based tool that can be limited to epidemiologic parameters for nongenotyping countries. Non-genogroup-II.4 outbreaks, higher numbers of cases, and outbreaks in restaurants or households characterized (sensitivity = 0.80, specificity = 0.86) foodborne outbreaks and reduced the percentage of outbreaks requiring source-tracing to 31%. The selection tool enabled prospectively focused follow-up. Use of this tool is likely to improve data quality and strain typing in current surveillance systems, which is necessary for identification of potential international foodborne outbreaks.

Evaluation of outbreak detection performance using multi-stream syndromic surveillance for influenza-like illness in rural Hubei Province, China: a temporal simulation model based on healthcare-seeking behaviors.

Directory of Open Access Journals (Sweden)

Yunzhou Fan

Full Text Available BACKGROUND: Syndromic surveillance promotes the early detection of diseases outbreaks. Although syndromic surveillance has increased in developing countries, performance on outbreak detection, particularly in cases of multi-stream surveillance, has scarcely been evaluated in rural areas. OBJECTIVE: This study introduces a temporal simulation model based on healthcare-seeking behaviors to evaluate the performance of multi-stream syndromic surveillance for influenza-like illness. METHODS: Data were obtained in six towns of rural Hubei Province, China, from April 2012 to June 2013. A Susceptible-Exposed-Infectious-Recovered model generated 27 scenarios of simulated influenza A (H1N1 outbreaks, which were converted into corresponding simulated syndromic datasets through the healthcare-behaviors model. We then superimposed converted syndromic datasets onto the baselines obtained to create the testing datasets. Outbreak performance of single-stream surveillance of clinic visit, frequency of over the counter drug purchases, school absenteeism, and multi-stream surveillance of their combinations were evaluated using receiver operating characteristic curves and activity monitoring operation curves. RESULTS: In the six towns examined, clinic visit surveillance and school absenteeism surveillance exhibited superior performances of outbreak detection than over the counter drug purchase frequency surveillance; the performance of multi-stream surveillance was preferable to signal-stream surveillance, particularly at low specificity (Sp <90%. CONCLUSIONS: The temporal simulation model based on healthcare-seeking behaviors offers an accessible method for evaluating the performance of multi-stream surveillance.

Using Acute Flaccid Paralysis Surveillance as a Platform for Vaccine-Preventable Disease Surveillance.

Science.gov (United States)

Wassilak, Steven G F; Williams, Cheryl L; Murrill, Christopher S; Dahl, Benjamin A; Ohuabunwo, Chima; Tangermann, Rudolf H

2017-07-01

Surveillance for acute flaccid paralysis (AFP) is a fundamental cornerstone of the global polio eradication initiative (GPEI). Active surveillance (with visits to health facilities) is a critical strategy of AFP surveillance systems for highly sensitive and timely detection of cases. Because of the extensive resources devoted to AFP surveillance, multiple opportunities exist for additional diseases to be added using GPEI assets, particularly because there is generally 1 district officer responsible for all disease surveillance. For this reason, integrated surveillance has become a standard practice in many countries, ranging from adding surveillance for measles and rubella to integrated disease surveillance for outbreak-prone diseases (integrated disease surveillance and response). This report outlines the current level of disease surveillance integration in 3 countries (Nepal, India, and Nigeria) and proposes that resources continue for long-term maintenance in resource-poor countries of AFP surveillance as a platform for surveillance of vaccine-preventable diseases and other outbreak-prone diseases. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

Cost of dengue outbreaks: literature review and country case studies.

Science.gov (United States)

Stahl, Hans-Christian; Butenschoen, Vicki Marie; Tran, Hien Tinh; Gozzer, Ernesto; Skewes, Ronald; Mahendradhata, Yodi; Runge-Ranzinger, Silvia; Kroeger, Axel; Farlow, Andrew

2013-11-06

Dengue disease surveillance and vector surveillance are presumed to detect dengue outbreaks at an early stage and to save--through early response activities--resources, and reduce the social and economic impact of outbreaks on individuals, health systems and economies. The aim of this study is to unveil evidence on the cost of dengue outbreaks. Economic evidence on dengue outbreaks was gathered by conducting a literature review and collecting information on the costs of recent dengue outbreaks in 4 countries: Peru, Dominican Republic, Vietnam, and Indonesia. The literature review distinguished between costs of dengue illness including cost of dengue outbreaks, cost of interventions and cost-effectiveness of interventions. Seventeen publications on cost of dengue showed a large range of costs from 0.2 Million US$ in Venezuela to 135.2 Million US$ in Brazil. However, these figures were not standardized to make them comparable. Furthermore, dengue outbreak costs are calculated differently across the publications, and cost of dengue illness is used interchangeably with cost of dengue outbreaks. Only one paper from Australia analysed the resources saved through active dengue surveillance. Costs of vector control interventions have been reported in 4 studies, indicating that the costs of such interventions are lower than those of actual outbreaks. Nine papers focussed on the cost-effectiveness of dengue vaccines or dengue vector control; they do not provide any direct information on cost of dengue outbreaks, but their modelling methodologies could guide future research on cost-effectiveness of national surveillance systems.The country case studies--conducted in very different geographic and health system settings - unveiled rough estimates for 2011 outbreak costs of: 12 million US$ in Vietnam, 6.75 million US$ in Indonesia, 4.5 million US$ in Peru and 2.8 million US$ in Dominican Republic (all in 2012 US$). The proportions of the different cost components (vector control

Case study of early detection and intervention of infectious disease outbreaks in an institution using Nursery School Absenteeism Surveillance Systems (NSASSy) of the Public Health Center.

Science.gov (United States)

Matsumoto, Kayo; Hirayama, Chifumi; Sakuma, Yoko; Itoi, Yoichi; Sunadori, Asami; Kitamura, Junko; Nakahashi, Takeshi; Sugawara, Tamie; Ohkusa, Yasushi

2016-01-01

Objectives Detecting outbreaks early and then activating countermeasures based on such information is extremely important for infection control at childcare facilities. The Sumida ward began operating the Nursery School Absenteeism Surveillance System (NSASSy) in August 2013, and has since conducted real-time monitoring at nursery schools. The Public Health Center can detect outbreaks early and support appropriate intervention. This paper describes the experiences of Sumida Public Health Center related to early detection and intervention since the initiation of the system.Methods In this study, we investigated infectious disease outbreaks detected at 62 nursery schools in the Sumida ward, which were equipped with NSASSy from early November 2013 through late March 2015. We classified the information sources of the detected outbreak and responses of the public health center. The sources were (1) direct contact from some nursery schools, (2) messages from public officers with jurisdiction over nursery schools, (3) automatic detection by NSASSy, and (4) manual detection by public health center officers using NSASSy. The responses made by the health center were described and classified into 11 categories including verification of outbreak and advice for caregivers.Results The number of outbreaks detected by the aforementioned four information sources was zero, 25, 15, and 7 events, respectively, during the first 5 months after beginning NSASSy. These numbers became 5, 7, 53, and 25 events, respectively, during the subsequent 12 months. The number of outbreaks detected increased by 47% during the first 5 months, and by 87% in the following 12 months. The responses were primarily confirming the situation and offering advice to caregivers.Conclusion The Sumida Public Health Center ward could achieve early detection with automatic or manual detection of NSASSy. This system recently has become an important detection resource, and has contributed greatly to early

Surveillance for waterborne disease and outbreaks associated with recreational water use and other aquatic facility-associated health events--United States, 2005-2006.

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Yoder, Jonathan S; Hlavsa, Michele C; Craun, Gunther F; Hill, Vincent; Roberts, Virginia; Yu, Patricia A; Hicks, Lauri A; Alexander, Nicole T; Calderon, Rebecca L; Roy, Sharon L; Beach, Michael J

2008-09-12

Since 1971, CDC, the U.S. Environmental Protection Agency, and the Council of State and Territorial Epidemiologists have collaboratively maintained the Waterborne Disease and Outbreak Surveillance System for collecting and reporting data related to waterborne-disease outbreaks (WBDOs) associated with drinking water. In 1978, WBDOs associated with recreational water (natural and treated water) were added. This system is the primary source of data regarding the scope and effects of disease associated with recreational water in the United States. In addition, data are collected on individual cases of recreational water-associated illnesses and infections and health events occurring at aquatic facilities but not directly related to water exposure. Data presented summarize WBDOs and case reports associated with recreational water use that occurred during January 2005--December 2006 and previously unreported disease reports and outbreaks during 1978--2004. Public health departments in the states, territories, localities, and the Freely Associated States (i.e., the Republic of the Marshall Islands, the Federated States of Micronesia, and the Republic of Palau, formerly parts of the U.S.-administered Trust Territory of the Pacific Islands) have primary responsibility for detecting, investigating, and voluntarily reporting WBDOs to CDC. Although the surveillance system includes data for WBDOs and cases associated with drinking water, recreational water, and water not intended for drinking, only cases and outbreaks associated with recreational water and health events at aquatic facilities are summarized in this report. During 2005--2006, a total of 78 WBDOs associated with recreational water were reported by 31 states. Illness occurred in 4,412 persons, resulting in 116 hospitalizations and five deaths. The median outbreak size was 13 persons (range: 2--2,307 persons). Of the 78 WBDOs, 48 (61.5%) were outbreaks of gastroenteritis that resulted from infectious agents or

Epidemic Intelligence. Langmuir and the Birth of Disease Surveillance

OpenAIRE

Lyle Fearnley

2010-01-01

In the wake of the SARS and influenza epidemics of the past decade, one public health solution has become a refrain: surveillance systems for detection of disease outbreaks. This paper is an effort to understand how disease surveillance for outbreak detection gained such paramount rationality in contemporary public health. The epidemiologist Alexander Langmuir is well known as the creator of modern disease surveillance. But less well known is how he imagined disease surveillance as one part o...

Lessons learned by surveillance during the tail-end of the Ebola outbreak in Guinea, June-October 2015: a case series.

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Keïta, Mory; Conté, Fatoumata; Diallo, Boubacar; Lufwa, Dieudonné; Katomba, Jacques; Snacken, René; Pallawo, Raymond; Tolno, Aminata; Diallo, Amadou Bailo; Djingarey, Mamadou Harouna; Subissi, Lorenzo

2017-04-24

By the end of the 2013–2016 West African Ebola Virus Disease (EVD) outbreaks, a total of 3814 cases (probable and confirmed) and 2544 deaths were reported in Guinea. Clearly, surveillance activities aiming at stopping human-to-human transmission have been the breakthrough of EVD outbreak management, but their application has been at times easier said than done. This article presents five confirmed or probable EVD cases that arose in Conakry towards the end of the Guinea epidemic, which demonstrate flaws in surveillance and follow-up. For case 1, safe burial requirements were not followed. For cases 1 and 2, negative Polymerase Chain Reaction (PCR) results were interpreted as no infection. For the first case, the sample may have not been taken properly while for the second the disease was possibly at its early stage. Case 3 was stopped at a border health checkpoint and despite her high temperature she was allowed to continue the bus journey. For case 4, an oral swab sample was supposedly taken after death but could not be found for retrospective testing. Despite characteristic symptomatology, case 5 was not identified as a suspect case for as long as 3 weeks. In epidemic contexts, health systems must be able to track all samples of suspect cases and deaths, regardless of their laboratory results. Social mobilization in communities and training in health care facilities must be strengthened at the tail of an outbreak, to avoid the natural slackening of disease surveillance, in particular for long-lasting and deadly epidemics.

Epidemiological and Surveillance Response to Ebola Virus Disease Outbreak in Lofa County, Liberia (March-September, 2014); Lessons Learned.

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Kouadio, Koffi Isidore; Clement, Peter; Bolongei, Josephus; Tamba, Alpha; Gasasira, Alex Ntale; Warsame, Abdihamid; Okeibunor, Joseph Chukwudi; Ota, Martin Okechukwu; Tamba, Boima; Gumede, Nicksy; Shaba, Keith; Poy, Alain; Salla, Mbaye; Mihigo, Richard; Nshimirimana, Deo

2015-05-06

Ebola Virus Disease (EVD) outbreak was confirmed in Liberia on March 31st 2014. A response comprising of diverse expertise was mobilized and deployed to the country to contain transmission of Ebola and give relief to a people already impoverished from protracted civil war. This paper describes the epidemiological and surveillance response to the EVD outbreak in Lofa County in Liberia from March to September 2014. Five of the 6 districts of Lofa were affected. The most affected districts were Voinjama/Guardu Gbondi and Foya. By 26th September, 2014, a total of 619 cases, including 19.4% probable cases, 20.3% suspected cases and 44.2% confirmed cases were recorded by the Ebola Emergency Response Team (EERT) of Lofa County. Adults (20-50 years) were the most affected. Overall fatality rate was 53.3%.  Twenty two (22) cases were reported among the Health Care Workers with a fatality rate of 81.8%. Seventy eight percent (78%) of the contacts successfully completed 21 days follow-up while 134 (6.15%) that developed signs and symptoms of EVD were referred to the ETU in Foya. The contributions of the weak health systems as well as socio-cultural factors in fueling the epidemic are highlighted. Importantly, the lessons learnt including the positive impact of multi-sectorial and multidisciplinary and coordinated response led by the government and community.  Again, given that the spread of infectious disease can be considered a security threat every effort has to put in place to strengthen the health systems in developing countries including the International Health Regulation (IHR)'s core capacities. Key words:  Ebola virus disease, outbreak, epidemiology and surveillance, socio-cultural factors, health system, West Africa.

Cost of dengue outbreaks: literature review and country case studies

Science.gov (United States)

2013-01-01

Background Dengue disease surveillance and vector surveillance are presumed to detect dengue outbreaks at an early stage and to save – through early response activities – resources, and reduce the social and economic impact of outbreaks on individuals, health systems and economies. The aim of this study is to unveil evidence on the cost of dengue outbreaks. Methods Economic evidence on dengue outbreaks was gathered by conducting a literature review and collecting information on the costs of recent dengue outbreaks in 4 countries: Peru, Dominican Republic, Vietnam, and Indonesia. The literature review distinguished between costs of dengue illness including cost of dengue outbreaks, cost of interventions and cost-effectiveness of interventions. Results Seventeen publications on cost of dengue showed a large range of costs from 0.2 Million US$ in Venezuela to 135.2 Million US$ in Brazil. However, these figures were not standardized to make them comparable. Furthermore, dengue outbreak costs are calculated differently across the publications, and cost of dengue illness is used interchangeably with cost of dengue outbreaks. Only one paper from Australia analysed the resources saved through active dengue surveillance. Costs of vector control interventions have been reported in 4 studies, indicating that the costs of such interventions are lower than those of actual outbreaks. Nine papers focussed on the cost-effectiveness of dengue vaccines or dengue vector control; they do not provide any direct information on cost of dengue outbreaks, but their modelling methodologies could guide future research on cost-effectiveness of national surveillance systems. The country case studies – conducted in very different geographic and health system settings - unveiled rough estimates for 2011 outbreak costs of: 12 million US$ in Vietnam, 6.75 million US$ in Indonesia, 4.5 million US$ in Peru and 2.8 million US$ in Dominican Republic (all in 2012 US$). The proportions of the

Real-time monitoring of school absenteeism to enhance disease surveillance: a pilot study of a mobile electronic reporting system.

Science.gov (United States)

Lawpoolsri, Saranath; Khamsiriwatchara, Amnat; Liulark, Wongwat; Taweeseneepitch, Komchaluch; Sangvichean, Aumnuyphan; Thongprarong, Wiraporn; Kaewkungwal, Jaranit; Singhasivanon, Pratap

2014-05-12

School absenteeism is a common source of data used in syndromic surveillance, which can eventually be used for early outbreak detection. However, the absenteeism reporting system in most schools, especially in developing countries, relies on a paper-based method that limits its use for disease surveillance or outbreak detection. The objective of this study was to develop an electronic real-time reporting system on school absenteeism for syndromic surveillance. An electronic (Web-based) school absenteeism reporting system was developed to embed it within the normal routine process of absenteeism reporting. This electronic system allowed teachers to update students' attendance status via mobile tablets. The data from all classes and schools were then automatically sent to a centralized database for further analysis and presentation, and for monitoring temporal and spatial patterns of absent students. In addition, the system also had a disease investigation module, which provided a link between absenteeism data from schools and local health centers, to investigate causes of fever among sick students. The electronic school absenteeism reporting system was implemented in 7 primary schools in Bangkok, Thailand, with total participation of approximately 5000 students. During May-October 2012 (first semester), the percentage of absentees varied between 1% and 10%. The peak of school absenteeism (sick leave) was observed between July and September 2012, which coincided with the peak of dengue cases in children aged 6-12 years being reported to the disease surveillance system. The timeliness of a reporting system is a critical function in any surveillance system. Web-based application and mobile technology can potentially enhance the use of school absenteeism data for syndromic surveillance and outbreak detection. This study presents the factors that determine the implementation success of this reporting system.

Characteristics of wild polio virus outbreak investigation and response in Ethiopia in 2013-2014: implications for prevention of outbreaks due to importations.

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Tegegne, Ayesheshem Ademe; Braka, Fiona; Shebeshi, Meseret Eshetu; Aregay, Aron Kassahun; Beyene, Berhane; Mersha, Amare Mengistu; Ademe, Mohammed; Muhyadin, Abdulahi; Jima, Dadi; Wyessa, Abyot Bekele

2018-01-05

Ethiopia joined the Global Polio Eradication Initiative (GPEI) in 1996, and by the end of December 2001 circulation of indigenous Wild Polio Virus (WPV) had been interrupted. Nonetheless, the country experienced multiple importations during 2004-2008, and in 2013. We characterize the 2013 outbreak investigations and response activities, and document lessons learned. The data were pulled from different field investigation reports and from the national surveillance database for Acute Flaccid Paralysis (AFP). In 2013, a WPV1 outbreak was confirmed following importation in Dollo zone of the Somali region, which affected three Woredas (Warder, Geladi and Bokh). Between July 10, 2013, and January 5, 2014, there were 10 children paralyzed due to WPV1 infection. The majorities (7 of 10) were male and below 5 years of age, and 7 of 10 cases was not vaccinated, and 72% (92/129) of < 5 years of old children living in close proximity with WPV cases had zero doses of oral polio vaccine (OPV). The travel history of the cases showed that seven of the 10 cases had contact with someone who had traveled or had a travel history prior to the onset of paralysis. Underserved and inaccessibility of routine immunization service, suboptimal surveillance sensitivity, poor quality and inadequate supplemental immunization were the most crucial gaps identified during the outbreak investigations. Prior to the 2013 outbreak, Ethiopia experienced multiple imported polio outbreaks following the interruption of indigenous WPV in December 2001. The 2013 outbreak erupted due to massive population movement and was fueled by low population immunity as a result of low routine immunization and supplemental Immunization coverage and quality. In order to avert future outbreaks, it is critical that surveillance sensitivity be improved by establishing community-based surveillance systems and by assigning surveillance focal points at all level particularly in border areas. In addition, it is vital to set

Using health and demographic surveillance for the early detection of cholera outbreaks: analysis of community- and hospital-based data from Matlab, Bangladesh.

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Saulnier, Dell D; Persson, Lars-Åke; Streatfield, Peter Kim; Faruque, A S G; Rahman, Anisur

2016-01-01

Cholera outbreaks are a continuing problem in Bangladesh, and the timely detection of an outbreak is important for reducing morbidity and mortality. In Matlab, the ongoing Health and Demographic Surveillance System (HDSS) data records symptoms of diarrhea in children under the age of 5 years at the community level. Cholera surveillance in Matlab currently uses hospital-based data. The objective of this study is to determine whether increases in cholera in Matlab can be detected earlier by using HDSS diarrhea symptom data in a syndromic surveillance analysis, when compared to hospital admissions for cholera. HDSS diarrhea symptom data and hospital admissions for cholera in children under 5 years of age over a 2-year period were analyzed with the syndromic surveillance statistical program EARS (Early Aberration Reporting System). Dates when significant increases in either symptoms or cholera cases occurred were compared to one another. The analysis revealed that there were 43 days over 16 months when the cholera cases or diarrhea symptoms increased significantly. There were 8 months when both data sets detected days with significant increases. In 5 of the 8 months, increases in diarrheal symptoms occurred before increases of cholera cases. The increases in symptoms occurred between 1 and 15 days before the increases in cholera cases. The results suggest that the HDSS survey data may be able to detect an increase in cholera before an increase in hospital admissions is seen. However, there was no direct link between diarrheal symptom increases and cholera cases, and this, as well as other methodological weaknesses, should be taken into consideration.

Sharing experiences: towards an evidence based model of dengue surveillance and outbreak response in Latin America and Asia.

OpenAIRE

Badurdeen, Shiraz; Valladares, David; Farrar, Jeremy; Gozzer, Ernesto; Kroeger, Axel; Kuswara, Novia; Ranzinger, Silvia; Tinh, Hien; Leite, Priscila; Mahendradhata, Yodi; Skewes, Ronald; Verrall, Ayesha

2013-01-01

BACKGROUND\\ud The increasing frequency and intensity of dengue outbreaks in endemic and non-endemic countries requires a rational, evidence based response. To this end, we aimed to collate the experiences of a number of affected countries, identify strengths and limitations in dengue surveillance, outbreak preparedness, detection and response and contribute towards the development of a model contingency plan adaptable to country needs.\\ud \\ud METHODS\\ud The study was undertaken in five Latin ...

Leveraging social networking sites for disease surveillance and public sensing: the case of the 2013 avian influenza A(H7N9 outbreak in China

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Emma Xuxiao Zhang

2015-05-01

Full Text Available We conducted in-depth analysis on the use of a popular Chinese social networking and microblogging site, Sina Weibo, to monitor an avian influenza A(H7N9 outbreak in China and to assess the value of social networking sites in the surveillance of disease outbreaks that occur overseas. Two data sets were employed for our analysis: a line listing of confirmed cases obtained from conventional public health information channels and case information from Weibo posts. Our findings showed that the level of activity on Weibo corresponded with the number of new cases reported. In addition, the reporting of new cases on Weibo was significantly faster than those of conventional reporting sites and non-local news media. A qualitative review of the functions of Weibo also revealed that Weibo enabled timely monitoring of other outbreak-relevant information, provided access to additional crowd-sourced epidemiological information and was leveraged by the local government as an interactive platform for risk communication and monitoring public sentiment on the policy response. Our analysis demonstrated the potential for social networking sites to be used by public health agencies to enhance traditional communicable disease surveillance systems for the global surveillance of overseas public health threats. Social networking sites also can be used by governments for calibration of response policies and measures and for risk communication.

Leveraging social networking sites for disease surveillance and public sensing: the case of the 2013 avian influenza A(H7N9) outbreak in China.

Science.gov (United States)

Zhang, Emma Xuxiao; Yang, Yinping; Di Shang, Richard; Simons, Joseph John Pyne; Quek, Boon Kiat; Yin, Xiao Feng; See, Wanhan; Oh, Olivia Seen Huey; Nandar, Khine Sein Tun; Ling, Vivienne Ruo Yun; Chan, Pei Pei; Wang, Zhaoxia; Goh, Rick Siow Mong; James, Lyn; Tey, Jeannie Su Hui

2015-01-01

We conducted in-depth analysis on the use of a popular Chinese social networking and microblogging site, Sina Weibo, to monitor an avian influenza A(H7N9) outbreak in China and to assess the value of social networking sites in the surveillance of disease outbreaks that occur overseas. Two data sets were employed for our analysis: a line listing of confirmed cases obtained from conventional public health information channels and case information from Weibo posts. Our findings showed that the level of activity on Weibo corresponded with the number of new cases reported. In addition, the reporting of new cases on Weibo was significantly faster than those of conventional reporting sites and non-local news media. A qualitative review of the functions of Weibo also revealed that Weibo enabled timely monitoring of other outbreak-relevant information, provided access to additional crowd-sourced epidemiological information and was leveraged by the local government as an interactive platform for risk communication and monitoring public sentiment on the policy response. Our analysis demonstrated the potential for social networking sites to be used by public health agencies to enhance traditional communicable disease surveillance systems for the global surveillance of overseas public health threats. Social networking sites also can be used by governments for calibration of response policies and measures and for risk communication.

Building test data from real outbreaks for evaluating detection algorithms.

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Texier, Gaetan; Jackson, Michael L; Siwe, Leonel; Meynard, Jean-Baptiste; Deparis, Xavier; Chaudet, Herve

2017-01-01

Benchmarking surveillance systems requires realistic simulations of disease outbreaks. However, obtaining these data in sufficient quantity, with a realistic shape and covering a sufficient range of agents, size and duration, is known to be very difficult. The dataset of outbreak signals generated should reflect the likely distribution of authentic situations faced by the surveillance system, including very unlikely outbreak signals. We propose and evaluate a new approach based on the use of historical outbreak data to simulate tailored outbreak signals. The method relies on a homothetic transformation of the historical distribution followed by resampling processes (Binomial, Inverse Transform Sampling Method-ITSM, Metropolis-Hasting Random Walk, Metropolis-Hasting Independent, Gibbs Sampler, Hybrid Gibbs Sampler). We carried out an analysis to identify the most important input parameters for simulation quality and to evaluate performance for each of the resampling algorithms. Our analysis confirms the influence of the type of algorithm used and simulation parameters (i.e. days, number of cases, outbreak shape, overall scale factor) on the results. We show that, regardless of the outbreaks, algorithms and metrics chosen for the evaluation, simulation quality decreased with the increase in the number of days simulated and increased with the number of cases simulated. Simulating outbreaks with fewer cases than days of duration (i.e. overall scale factor less than 1) resulted in an important loss of information during the simulation. We found that Gibbs sampling with a shrinkage procedure provides a good balance between accuracy and data dependency. If dependency is of little importance, binomial and ITSM methods are accurate. Given the constraint of keeping the simulation within a range of plausible epidemiological curves faced by the surveillance system, our study confirms that our approach can be used to generate a large spectrum of outbreak signals.

Building test data from real outbreaks for evaluating detection algorithms.

Directory of Open Access Journals (Sweden)

Gaetan Texier

Full Text Available Benchmarking surveillance systems requires realistic simulations of disease outbreaks. However, obtaining these data in sufficient quantity, with a realistic shape and covering a sufficient range of agents, size and duration, is known to be very difficult. The dataset of outbreak signals generated should reflect the likely distribution of authentic situations faced by the surveillance system, including very unlikely outbreak signals. We propose and evaluate a new approach based on the use of historical outbreak data to simulate tailored outbreak signals. The method relies on a homothetic transformation of the historical distribution followed by resampling processes (Binomial, Inverse Transform Sampling Method-ITSM, Metropolis-Hasting Random Walk, Metropolis-Hasting Independent, Gibbs Sampler, Hybrid Gibbs Sampler. We carried out an analysis to identify the most important input parameters for simulation quality and to evaluate performance for each of the resampling algorithms. Our analysis confirms the influence of the type of algorithm used and simulation parameters (i.e. days, number of cases, outbreak shape, overall scale factor on the results. We show that, regardless of the outbreaks, algorithms and metrics chosen for the evaluation, simulation quality decreased with the increase in the number of days simulated and increased with the number of cases simulated. Simulating outbreaks with fewer cases than days of duration (i.e. overall scale factor less than 1 resulted in an important loss of information during the simulation. We found that Gibbs sampling with a shrinkage procedure provides a good balance between accuracy and data dependency. If dependency is of little importance, binomial and ITSM methods are accurate. Given the constraint of keeping the simulation within a range of plausible epidemiological curves faced by the surveillance system, our study confirms that our approach can be used to generate a large spectrum of outbreak

Summary of Notifiable Noninfectious Conditions and Disease Outbreaks: Surveillance Data Published Between April 1, 2016 and January 31, 2017 - United States.

Science.gov (United States)

Thomas, Kimberly; Jajosky, Ruth; Coates, Ralph J; Calvert, Geoffrey M; Dewey-Mattia, Daniel; Raymond, Jaime; Singh, Simple D

2017-08-11

The Summary of Notifiable Noninfectious Conditions and Disease Outbreaks: Surveillance Data Published Between April 1, 2016 and January 31, 2017 - United States, herein referred to as the Summary (Noninfectious), contains official statistics for nationally notifiable noninfectious conditions and disease outbreaks. This Summary (Noninfectious) is being published in the same volume of MMWR as the annual Summary of Notifiable Infectious Diseases and Conditions (1). Data on notifiable noninfectious conditions and disease outbreaks from prior years have been published previously (2,3).

Quantitative and qualitative assessment of the bovine abortion surveillance system in France.

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Bronner, Anne; Gay, Emilie; Fortané, Nicolas; Palussière, Mathilde; Hendrikx, Pascal; Hénaux, Viviane; Calavas, Didier

2015-06-01

Bovine abortion is the main clinical sign of bovine brucellosis, a disease of which France has been declared officially free since 2005. To ensure the early detection of any brucellosis outbreak, event-driven surveillance relies on the mandatory notification of bovine abortions and the brucellosis testing of aborting cows. However, the under-reporting of abortions appears frequent. Our objectives were to assess the aptitude of the bovine abortion surveillance system to detect each and every bovine abortion and to identify factors influencing the system's effectiveness. We evaluated five attributes defined by the U.S. Centers for Disease Control with a method suited to each attribute: (1) data quality was studied quantitatively and qualitatively, as this factor considerably influences data analysis and results; (2) sensitivity and representativeness were estimated using a unilist capture-recapture approach to quantify the surveillance system's effectiveness; (3) acceptability and simplicity were studied through qualitative interviews of actors in the field, given that the surveillance system relies heavily on abortion notifications by farmers and veterinarians. Our analysis showed that (1) data quality was generally satisfactory even though some errors might be due to actors' lack of awareness of the need to collect accurate data; (2) from 2006 to 2011, the mean annual sensitivity - i.e. the proportion of farmers who reported at least one abortion out of all those who detected such events - was around 34%, but was significantly higher in dairy than beef cattle herds (highlighting a lack of representativeness); (3) overall, the system's low sensitivity was related to its low acceptability and lack of simplicity. This study showed that, in contrast to policy-makers, most farmers and veterinarians perceived the risk of a brucellosis outbreak as negligible. They did not consider sporadic abortions as a suspected case of brucellosis and usually reported abortions only to

Optimizing the response to surveillance alerts in automated surveillance systems.

Science.gov (United States)

Izadi, Masoumeh; Buckeridge, David L

2011-02-28

Although much research effort has been directed toward refining algorithms for disease outbreak alerting, considerably less attention has been given to the response to alerts generated from statistical detection algorithms. Given the inherent inaccuracy in alerting, it is imperative to develop methods that help public health personnel identify optimal policies in response to alerts. This study evaluates the application of dynamic decision making models to the problem of responding to outbreak detection methods, using anthrax surveillance as an example. Adaptive optimization through approximate dynamic programming is used to generate a policy for decision making following outbreak detection. We investigate the degree to which the model can tolerate noise theoretically, in order to keep near optimal behavior. We also evaluate the policy from our model empirically and compare it with current approaches in routine public health practice for investigating alerts. Timeliness of outbreak confirmation and total costs associated with the decisions made are used as performance measures. Using our approach, on average, 80 per cent of outbreaks were confirmed prior to the fifth day of post-attack with considerably less cost compared to response strategies currently in use. Experimental results are also provided to illustrate the robustness of the adaptive optimization approach and to show the realization of the derived error bounds in practice. Copyright © 2011 John Wiley & Sons, Ltd.

Redefining syndromic surveillance

Directory of Open Access Journals (Sweden)

Rebecca Katz

2011-12-01

Full Text Available With growing concerns about international spread of disease and expanding use of early disease detection surveillance methods, the field of syndromic surveillance has received increased attention over the last decade. The purpose of this article is to clarify the various meanings that have been assigned to the term syndromic surveillance and to propose a refined categorization of the characteristics of these systems. Existing literature and conference proceedings were examined on syndromic surveillance from 1998 to 2010, focusing on low- and middle-income settings. Based on the 36 unique definitions of syndromic surveillance found in the literature, five commonly accepted principles of syndromic surveillance systems were identified, as well as two fundamental categories: specific and non-specific disease detection. Ultimately, the proposed categorization of syndromic surveillance distinguishes between systems that focus on detecting defined syndromes or outcomes of interest and those that aim to uncover non-specific trends that suggest an outbreak may be occurring. By providing an accurate and comprehensive picture of this field’s capabilities, and differentiating among system types, a unified understanding of the syndromic surveillance field can be developed, encouraging the adoption, investment in, and implementation of these systems in settings that need bolstered surveillance capacity, particularly low- and middle-income countries.

Ebola Outbreak Containment: Real-Time Task and Resource Coordination With SORMAS

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Cindy Perscheid

2018-04-01

Full Text Available Background: Since the beginning of the Ebola outbreak in West Africa in 2014, more than 11,000 people died. For outbreaks of infectious diseases like this, the rapid implementation of control measures is a crucial factor for containment. In West African countries, outbreak surveillance is a paper-based process with significant delays in forwarding outbreak information, which affects the ability to react adequately to situational changes. Our objective therefore was to develop a tool that improves data collection, situation assessment, and coordination of response measures in outbreak surveillance processes for a better containment.Methods: We have developed the Surveillance and Outbreak Response Management System (SORMAS based on findings from Nigeria's 2014 Ebola outbreak. We conducted a thorough requirements engineering and defined personas and processes. We also defined a data schema with specific variables to measure in outbreak situations. We designed our system to be a cloud application that consists of interfaces for both mobile devices and desktop computers to support all stakeholders in the process. In the field, health workers collect data on the outbreak situation via mobile applications and directly transmit it to control centers. At the control centers, health workers access SORMAS via desktop computers, receive instant updates on critical situations, react immediately on emergencies, and coordinate the implementation of control measures with SORMAS.Results: We have tested SORMAS in multiple workshops and a field study in July 2015. Results from workshops confirmed derived requirements and implemented features, but also led to further iterations on the systems regarding usability. Results from the field study are currently under assessment. General feedback showed high enthusiasm about the system and stressed its benefits for an effective outbreak containment of infectious diseases.Conclusions: SORMAS is a software tool to support

Real-Time Whole-Genome Sequencing for Routine Typing, Surveillance, and Outbreak Detection of Verotoxigenic Escherichia coli

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Scheutz, Flemming; Lund, Ole; Hasman, Henrik; Kaas, Rolf S.; Nielsen, Eva M.; Aarestrup, Frank M.

2014-01-01

Fast and accurate identification and typing of pathogens are essential for effective surveillance and outbreak detection. The current routine procedure is based on a variety of techniques, making the procedure laborious, time-consuming, and expensive. With whole-genome sequencing (WGS) becoming cheaper, it has huge potential in both diagnostics and routine surveillance. The aim of this study was to perform a real-time evaluation of WGS for routine typing and surveillance of verocytotoxin-producing Escherichia coli (VTEC). In Denmark, the Statens Serum Institut (SSI) routinely receives all suspected VTEC isolates. During a 7-week period in the fall of 2012, all incoming isolates were concurrently subjected to WGS using IonTorrent PGM. Real-time bioinformatics analysis was performed using web-tools (www.genomicepidemiology.org) for species determination, multilocus sequence type (MLST) typing, and determination of phylogenetic relationship, and a specific VirulenceFinder for detection of E. coli virulence genes was developed as part of this study. In total, 46 suspected VTEC isolates were characterized in parallel during the study. VirulenceFinder proved successful in detecting virulence genes included in routine typing, explicitly verocytotoxin 1 (vtx1), verocytotoxin 2 (vtx2), and intimin (eae), and also detected additional virulence genes. VirulenceFinder is also a robust method for assigning verocytotoxin (vtx) subtypes. A real-time clustering of isolates in agreement with the epidemiology was established from WGS, enabling discrimination between sporadic and outbreak isolates. Overall, WGS typing produced results faster and at a lower cost than the current routine. Therefore, WGS typing is a superior alternative to conventional typing strategies. This approach may also be applied to typing and surveillance of other pathogens. PMID:24574290

Real-time whole-genome sequencing for routine typing, surveillance, and outbreak detection of verotoxigenic Escherichia coli.

Science.gov (United States)

Joensen, Katrine Grimstrup; Scheutz, Flemming; Lund, Ole; Hasman, Henrik; Kaas, Rolf S; Nielsen, Eva M; Aarestrup, Frank M

2014-05-01

Fast and accurate identification and typing of pathogens are essential for effective surveillance and outbreak detection. The current routine procedure is based on a variety of techniques, making the procedure laborious, time-consuming, and expensive. With whole-genome sequencing (WGS) becoming cheaper, it has huge potential in both diagnostics and routine surveillance. The aim of this study was to perform a real-time evaluation of WGS for routine typing and surveillance of verocytotoxin-producing Escherichia coli (VTEC). In Denmark, the Statens Serum Institut (SSI) routinely receives all suspected VTEC isolates. During a 7-week period in the fall of 2012, all incoming isolates were concurrently subjected to WGS using IonTorrent PGM. Real-time bioinformatics analysis was performed using web-tools (www.genomicepidemiology.org) for species determination, multilocus sequence type (MLST) typing, and determination of phylogenetic relationship, and a specific VirulenceFinder for detection of E. coli virulence genes was developed as part of this study. In total, 46 suspected VTEC isolates were characterized in parallel during the study. VirulenceFinder proved successful in detecting virulence genes included in routine typing, explicitly verocytotoxin 1 (vtx1), verocytotoxin 2 (vtx2), and intimin (eae), and also detected additional virulence genes. VirulenceFinder is also a robust method for assigning verocytotoxin (vtx) subtypes. A real-time clustering of isolates in agreement with the epidemiology was established from WGS, enabling discrimination between sporadic and outbreak isolates. Overall, WGS typing produced results faster and at a lower cost than the current routine. Therefore, WGS typing is a superior alternative to conventional typing strategies. This approach may also be applied to typing and surveillance of other pathogens.

Prospective surveillance of multivariate spatial disease data

Science.gov (United States)

Corberán-Vallet, A

2012-01-01

Surveillance systems are often focused on more than one disease within a predefined area. On those occasions when outbreaks of disease are likely to be correlated, the use of multivariate surveillance techniques integrating information from multiple diseases allows us to improve the sensitivity and timeliness of outbreak detection. In this article, we present an extension of the surveillance conditional predictive ordinate to monitor multivariate spatial disease data. The proposed surveillance technique, which is defined for each small area and time period as the conditional predictive distribution of those counts of disease higher than expected given the data observed up to the previous time period, alerts us to both small areas of increased disease incidence and the diseases causing the alarm within each area. We investigate its performance within the framework of Bayesian hierarchical Poisson models using a simulation study. An application to diseases of the respiratory system in South Carolina is finally presented. PMID:22534429

A nationwide web-based automated system for early outbreak detection and rapid response in China

Directory of Open Access Journals (Sweden)

Yilan Liao

2011-03-01

Full Text Available Timely reporting, effective analyses and rapid distribution of surveillance data can assist in detecting the aberration of disease occurrence and further facilitate a timely response. In China, a new nationwide web-based automated system for outbreak detection and rapid response was developed in 2008. The China Infectious Disease Automated-alert and Response System (CIDARS was developed by the Chinese Center for Disease Control and Prevention based on the surveillance data from the existing electronic National Notifiable Infectious Diseases Reporting Information System (NIDRIS started in 2004. NIDRIS greatly improved the timeliness and completeness of data reporting with real time reporting information via the Internet. CIDARS further facilitates the data analysis, aberration detection, signal dissemination, signal response and information communication needed by public health departments across the country. In CIDARS, three aberration detection methods are used to detect the unusual occurrence of 28 notifiable infectious diseases at the county level and to transmit that information either in real-time or on a daily basis. The Internet, computers and mobile phones are used to accomplish rapid signal generation and dissemination, timely reporting and reviewing of the signal response results. CIDARS has been used nationwide since 2008; all Centers for Disease Control and Prevention (CDC in China at the county, prefecture, provincial and national levels are involved in the system. It assists with early outbreak detection at the local level and prompts reporting of unusual disease occurrences or potential outbreaks to CDCs throughout the country.

Strengthening foodborne diseases surveillance in the WHO African ...

African Journals Online (AJOL)

The new International Health Regulations (IHR) (2005) cover events of international importance including contaminated food and outbreaks of foodborne disease. The IHR (2005) and other international as well as regional agreements require Member States to strengthen surveillance systems including surveillance for ...

Descriptive review of tuberculosis surveillance systems across the circumpolar regions

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Annie-Claude Bourgeois

2016-04-01

Full Text Available Background: Tuberculosis is highly prevalent in many Arctic areas. Members of the International Circumpolar Surveillance Tuberculosis (ICS-TB Working Group collaborate to increase knowledge about tuberculosis in Arctic regions. Objective: To establish baseline knowledge of tuberculosis surveillance systems used by ICS-TB member jurisdictions. Design: Three questionnaires were developed to reflect the different surveillance levels (local, regional and national; all 3 were forwarded to the official representative of each of the 15 ICS-TB member jurisdictions in 2013. Respondents self-identified the level of surveillance conducted in their region and completed the applicable questionnaire. Information collected included surveillance system objectives, case definitions, data collection methodology, storage and dissemination. Results: Thirteen ICS-TB jurisdictions [Canada (Labrador, Northwest Territories, Nunavik, Nunavut, Yukon, Finland, Greenland, Norway, Sweden, Russian Federation (Arkhangelsk, Khanty-Mansiysk Autonomous Okrug, Yakutia (Sakha Republic, United States (Alaska] voluntarily completed the survey – representing 2 local, 7 regional and 4 national levels. Tuberculosis reporting is mandatory in all jurisdictions, and case definitions are comparable across regions. The common objectives across systems are to detect outbreaks, and inform the evaluation/planning of public health programmes and policies. All jurisdictions collect data on confirmed active tuberculosis cases and treatment outcomes; 11 collect contact tracing results. Faxing of standardized case reporting forms is the most common reporting method. Similar core data elements are collected; 8 regions report genotyping results. Data are stored using customized programmes (n=7 and commercial software (n=6. Nine jurisdictions provide monthly, bi-annual or annual reports to principally government and/or scientific/medical audiences. Conclusion: This review successfully establishes

Yellow Fever outbreak in Darfur, Sudan in October 2012; the initial outbreak investigation report

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Mohammed A. Soghaier

2013-10-01

Full Text Available Summary: Introduction: Sudan is subject to repeated outbreaks, including Viral Hemorrhagic Fever (VHF, which is considered to be a very serious illness. Yellow Fever (YF outbreaks in Sudan have been reported from the 1940s through 2005. In 2012, a new outbreak of YF occurred in the Darfur region. Objective: To identify the potential for an outbreak, to diagnose the disease and to be able to recognize its cause among the initial reported cases. Methodology: >This is a descriptive and investigative field study that applies standard communicable disease outbreak investigation steps. The study involved clinical, serological, entomological and environmental surveys. Results: The field investigation confirmed the outbreak and identified its cause to be YF. Conclusion: National surveillance systems should be strong enough to detect VHFs in a timely manner. Local health facilities should be prepared to promptly treat the initial cases because the case fatality ratios (CFRs are usually very high among the index cases. Keywords: Yellow Fever, Sudan, Darfur, VHFs, Soghaier

Yellow Fever outbreak in Darfur, Sudan in October 2012; the initial outbreak investigation report.

Science.gov (United States)

Soghaier, Mohammed A; Hagar, Ahmed; Abbas, Mohammed A; Elmangory, Mutasim M; Eltahir, Khalid M; Sall, Amadou A

2013-10-01

Sudan is subject to repeated outbreaks, including Viral Hemorrhagic Fever (VHF), which is considered to be a very serious illness. Yellow Fever (YF) outbreaks in Sudan have been reported from the 1940s through 2005. In 2012, a new outbreak of YF occurred in the Darfur region. To identify the potential for an outbreak, to diagnose the disease and to be able to recognize its cause among the initial reported cases. >This is a descriptive and investigative field study that applies standard communicable disease outbreak investigation steps. The study involved clinical, serological, entomological and environmental surveys. The field investigation confirmed the outbreak and identified its cause to be YF. National surveillance systems should be strong enough to detect VHFs in a timely manner. Local health facilities should be prepared to promptly treat the initial cases because the case fatality ratios (CFRs) are usually very high among the index cases. Copyright © 2013 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

Epidemic Intelligence. Langmuir and the Birth of Disease Surveillance

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Lyle Fearnley

2010-12-01

Full Text Available In the wake of the SARS and influenza epidemics of the past decade, one public health solution has become a refrain: surveillance systems for detection of disease outbreaks. This paper is an effort to understand how disease surveillance for outbreak detection gained such paramount rationality in contemporary public health. The epidemiologist Alexander Langmuir is well known as the creator of modern disease surveillance. But less well known is how he imagined disease surveillance as one part of what he called “epidemic intelligence.” Langmuir developed the practice of disease surveillance during an unprecedented moment in which the threat of biological warfare brought civil defense experts and epidemiologists together around a common problem. In this paper, I describe how Langmuir navigated this world, experimenting with new techniques and rationales of epidemic control. Ultimately, I argue, Langmuir′s experiments resulted in a set of techniques and infrastructures – a system of epidemic intelligence – that transformed the epidemic as an object of human art.

Comparing national infectious disease surveillance systems: China and the Netherlands.

Science.gov (United States)

Vlieg, Willemijn L; Fanoy, Ewout B; van Asten, Liselotte; Liu, Xiaobo; Yang, Jun; Pilot, Eva; Bijkerk, Paul; van der Hoek, Wim; Krafft, Thomas; van der Sande, Marianne A; Liu, Qi-Yong

2017-05-08

Risk assessment and early warning (RAEW) are essential components of any infectious disease surveillance system. In light of the International Health Regulations (IHR)(2005), this study compares the organisation of RAEW in China and the Netherlands. The respective approaches towards surveillance of arboviral disease and unexplained pneumonia were analysed to gain a better understanding of the RAEW mode of operation. This study may be used to explore options for further strengthening of global collaboration and timely detection and surveillance of infectious disease outbreaks. A qualitative study design was used, combining data retrieved from the literature and from semi-structured interviews with Chinese (5 national-level and 6 provincial-level) and Dutch (5 national-level) experts. The results show that some differences exist such as in the use of automated electronic components of the early warning system in China ('CIDARS'), compared to a more limited automated component in the Netherlands ('barometer'). Moreover, RAEW units in the Netherlands focus exclusively on infectious diseases, while China has a broader 'all hazard' approach (including for example chemical incidents). In the Netherlands, veterinary specialists take part at the RAEW meetings, to enable a structured exchange/assessment of zoonotic signals. Despite these differences, the main conclusion is that for the two infections studied, the early warning system in China and the Netherlands are remarkably similar considering their large differences in infectious disease history, population size and geographical setting. Our main recommendations are continued emphasis on international corporation that requires insight into national infectious disease surveillance systems, the usage of a One Health approach in infectious disease surveillance, and further exploration/strengthening of a combined syndromic and laboratory surveillance system.

Causes of Outbreaks Associated with Drinking Water in the United States from 1971 to 2006

Science.gov (United States)

Craun, Gunther F.; Brunkard, Joan M.; Yoder, Jonathan S.; Roberts, Virginia A.; Carpenter, Joe; Wade, Tim; Calderon, Rebecca L.; Roberts, Jacquelin M.; Beach, Michael J.; Roy, Sharon L.

2010-01-01

Summary: Since 1971, the CDC, EPA, and Council of State and Territorial Epidemiologists (CSTE) have maintained the collaborative national Waterborne Disease and Outbreak Surveillance System (WBDOSS) to document waterborne disease outbreaks (WBDOs) reported by local, state, and territorial health departments. WBDOs were recently reclassified to better characterize water system deficiencies and risk factors; data were analyzed for trends in outbreak occurrence, etiologies, and deficiencies during 1971 to 2006. A total of 833 WBDOs, 577,991 cases of illness, and 106 deaths were reported during 1971 to 2006. Trends of public health significance include (i) a decrease in the number of reported outbreaks over time and in the annual proportion of outbreaks reported in public water systems, (ii) an increase in the annual proportion of outbreaks reported in individual water systems and in the proportion of outbreaks associated with premise plumbing deficiencies in public water systems, (iii) no change in the annual proportion of outbreaks associated with distribution system deficiencies or the use of untreated and improperly treated groundwater in public water systems, and (iv) the increasing importance of Legionella since its inclusion in WBDOSS in 2001. Data from WBDOSS have helped inform public health and regulatory responses. Additional resources for waterborne disease surveillance and outbreak detection are essential to improve our ability to monitor, detect, and prevent waterborne disease in the United States. PMID:20610821

Designing and implementing an electronic dashboard for disease outbreaks response - Case study of the 2013-2014 Somalia Polio outbreak response dashboard.

Science.gov (United States)

Kamadjeu, Raoul; Gathenji, Caroline

2017-01-01

In April 2013, a case of wild polio virus (WPV) was detected in the Somalia capital Mogadishu. This inaugurated what is now referred to as the 2013-2014 Horn of Africa Polio outbreak with cases reported in Somalia, Kenya and Ethiopia. By the notification of the last polio case in August 2014, 223 cases of WPV had been reported in Somalia, Kenya and Ethiopia of which 199 in Somalia alone. The outbreak response required timely exchange of information between the outbreak response coordination unit (in Nairobi) and local staff located in multiple locations inside the country. The need to track and timely respond to information requests, to satisfy the information/data needs of polio partners and to track key outbreak response performance indicators dictated the need to urgently set up an online dashboard. The Somalia Polio Room dashboard provided a graphical display of the polio outbreak data to track progress and inform decision making. The system was designed using free and open sources components and seamlessly integrated existing polio surveillance data for real time monitoring of key outbreak response performance indicators. In this article, we describe the design and operation of an electronic dashboard for disease surveillance in an outbreak situation and used the lessons learned to propose key design considerations and functional requirements for online electronic dashboards for disease outbreak response.

Syndrome surveillance of fentanyl-laced heroin outbreaks: Utilization of EMS, Medical Examiner and Poison Center databases.

Science.gov (United States)

Moore, P Quincy; Weber, Joseph; Cina, Steven; Aks, Steven

2017-11-01

Describe surveillance data from three existing surveillance systems during an unexpected fentanyl outbreak in a large metropolitan area. We performed a retrospective analysis of three data sets: Chicago Fire Department EMS, Cook County Medical Examiner, and Illinois Poison Center. Each included data from January 1, 2015 through December 31, 2015. EMS data included all EMS responses in Chicago, Illinois, for suspected opioid overdose in which naloxone was administered and EMS personnel documented other criteria indicative of opioid overdose. Medical Examiner data included all deaths in Cook County, Illinois, related to heroin, fentanyl or both. Illinois Poison Center data included all calls in Chicago, Illinois, related to fentanyl, heroin, and other prescription opioids. Descriptive statistics using Microsoft Excel® were used to analyze the data and create figures. We identified a spike in opioid-related EMS responses during an 11-day period from September 30-October 10, 2015. Medical Examiner data showed an increase in both fentanyl and mixed fentanyl/heroin related deaths during the months of September and October, 2015 (375% and 550% above the median, respectively.) Illinois Poison Center data showed no significant increase in heroin, fentanyl, or other opioid-related calls during September and October 2015. Our data suggests that EMS data is an effective real-time surveillance mechanism for changes in the rate of opioid overdoses. Medical Examiner's data was found to be valuable for confirmation of EMS surveillance data and identification of specific intoxicants. Poison Center data did not correlate with EMS or Medical Examiner data. Copyright © 2017 Elsevier Inc. All rights reserved.

TOWARDS MODELING DISEASE OUTBREAK NOTIFICATION SYSTEMS

OpenAIRE

Farag Azzedin; Jaweed Yazdani,; Salahadin Adam; Mustafa Ghaleb

2014-01-01

Disease outbreak detection, monitoring and notification systems play an important role in assessing threats to public health since disease outbreaks are becoming increasingly common world-wide. There are several systems in use around the world, with coverage of national, international and global disease outbreaks. These systems use different taxonomies and classifications for the detection and prioritization of potential disease outbreaks. In this paper, we study and analyze th...

Developing new approaches for detecting and preventing Aedes aegypti population outbreaks: basis for surveillance, alert and control system

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Lêda Regis

2008-02-01

Full Text Available A new approach to dengue vector surveillance based on permanent egg-collection using a modified ovitrap and Bacillus thuringiensis israelensis(Bti was evaluated in different urban landscapes in Recife, Northeast Brazil. From April 2004 to April 2005, 13 egg-collection cycles of four weeks were carried out. Geo-referenced ovitraps containing grass infusion, Bti and three paddles were placed at fixed sampling stations distributed over five selected sites. Continuous egg-collections yielded more than four million eggs laid into 464 sentinel-ovitraps over one year. The overall positive ovitrap index was 98.5% (over 5,616 trap observations. The egg density index ranged from 100 to 2,500 eggs per trap-cycle, indicating a wide spread and high density of Aedes aegypti (Diptera: Culicidae breeding populations in all sites. Fluctuations in population density over time were observed, particularly a marked increase from January on, or later, according to site. Massive egg-collection carried out at one of the sites prevented such a population outbreak. At intra-site level, egg counts made it possible to identify spots where the vector population is consistently concentrated over the time, pinpointing areas that should be considered high priority for control activities. The results indicate that these could be promising strategies for detecting and preventing Ae. aegypti population outbreaks.

An assessment of public health surveillance of Zika virus infection and potentially associated outcomes in Latin America.

Science.gov (United States)

Bautista, Leonelo E; Herrera, Víctor M

2018-05-24

We evaluated whether outbreaks of Zika virus (ZIKV) infection, newborn microcephaly, and Guillain-Barré syndrome (GBS) in Latin America may be detected through current surveillance systems, and how cases detected through surveillance may increase health care burden. We estimated the sensitivity and specificity of surveillance case definitions using published data. We assumed a 10% ZIKV infection risk during a non-outbreak period and hypothetical increases in risk during an outbreak period. We used sensitivity and specificity estimates to correct for non-differential misclassification, and calculated a misclassification-corrected relative risk comparing both periods. To identify the smallest hypothetical increase in risk resulting in a detectable outbreak we compared the misclassification-corrected relative risk to the relative risk corresponding to the upper limit of the endemic channel (mean + 2 SD). We also estimated the proportion of false positive cases detected during the outbreak. We followed the same approach for microcephaly and GBS, but assumed the risk of ZIKV infection doubled during the outbreak, and ZIKV infection increased the risk of both diseases. ZIKV infection outbreaks were not detectable through non-serological surveillance. Outbreaks were detectable through serologic surveillance if infection risk increased by at least 10%, but more than 50% of all cases were false positive. Outbreaks of severe microcephaly were detected if ZIKV infection increased prevalence of this condition by at least 24.0 times. When ZIKV infection did not increase the prevalence of severe microcephaly, 34.7 to 82.5% of all cases were false positive, depending on diagnostic accuracy. GBS outbreaks were detected if ZIKV infection increased the GBS risk by at least seven times. For optimal GBS diagnosis accuracy, the proportion of false positive cases ranged from 29 to 54% and from 45 to 56% depending on the incidence of GBS mimics. Current surveillance systems have a

Dengue disease outbreak definitions are implicitly variable

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Oliver J. Brady

2015-06-01

Full Text Available Infectious diseases rarely exhibit simple dynamics. Outbreaks (defined as excess cases beyond response capabilities have the potential to cause a disproportionately high burden due to overwhelming health care systems. The recommendations of international policy guidelines and research agendas are based on a perceived standardised definition of an outbreak characterised by a prolonged, high-caseload, extra-seasonal surge. In this analysis we apply multiple candidate outbreak definitions to reported dengue case data from Brazil to test this assumption. The methods identify highly heterogeneous outbreak characteristics in terms of frequency, duration and case burden. All definitions identify outbreaks with characteristics that vary over time and space. Further, definitions differ in their timeliness of outbreak onset, and thus may be more or less suitable for early intervention. This raises concerns about the application of current outbreak guidelines for early warning/identification systems. It is clear that quantitatively defining the characteristics of an outbreak is an essential prerequisite for effective reactive response. More work is needed so that definitions of disease outbreaks can take into account the baseline capacities of treatment, surveillance and control. This is essential if outbreak guidelines are to be effective and generalisable across a range of epidemiologically different settings.

ISS--an electronic syndromic surveillance system for infectious disease in rural China.

Directory of Open Access Journals (Sweden)

Weirong Yan

Full Text Available BACKGROUND: Syndromic surveillance system has great advantages in promoting the early detection of epidemics and reducing the necessities of disease confirmation, and it is especially effective for surveillance in resource poor settings. However, most current syndromic surveillance systems are established in developed countries, and there are very few reports on the development of an electronic syndromic surveillance system in resource-constrained settings. OBJECTIVE: This study describes the design and pilot implementation of an electronic surveillance system (ISS for the early detection of infectious disease epidemics in rural China, complementing the conventional case report surveillance system. METHODS: ISS was developed based on an existing platform 'Crisis Information Sharing Platform' (CRISP, combining with modern communication and GIS technology. ISS has four interconnected functions: 1 work group and communication group; 2 data source and collection; 3 data visualization; and 4 outbreak detection and alerting. RESULTS: As of Jan. 31(st 2012, ISS has been installed and pilot tested for six months in four counties in rural China. 95 health facilities, 14 pharmacies and 24 primary schools participated in the pilot study, entering respectively 74,256, 79,701, and 2330 daily records into the central database. More than 90% of surveillance units at the study sites are able to send daily information into the system. In the paper, we also presented the pilot data from health facilities in the two counties, which showed the ISS system had the potential to identify the change of disease patterns at the community level. CONCLUSIONS: The ISS platform may facilitate the early detection of infectious disease epidemic as it provides near real-time syndromic data collection, interactive visualization, and automated aberration detection. However, several constraints and challenges were encountered during the pilot implementation of ISS in rural China.

Ebola Viral Hemorrhagic Disease Outbreak in West Africa- Lessons ...

African Journals Online (AJOL)

... to contain the Ebola epidemic. Key words: Ebola, viral hemorrhagic fever, West Africa, lessons, Uganda .... the corresponding surveillance systems for detecting priority diseases. ... A major outbreak of Yellow Fe- ver was reported in five ...

Syndromic Surveillance: Enhancing Detection of Disease Outbreaks in Urban China

NARCIS (Netherlands)

Pilot, E.; Schwarz, C.; Wang, L.; Krafft, T.; Wang, W.; Krafft, T.; Rosenberg, M.; Pilot, E.

2014-01-01

Recently a number of innovative surveillance approaches have been piloted or implemented in several parts of the country. Though Chinese cities have usually a sufficient health infrastructure that is included in the national surveillance system, the differences in treatment seeking behavior of a

Evaluating surveillance strategies for the early detection of low pathogenicity avian influenza infections.

Science.gov (United States)

Comin, Arianna; Stegeman, Arjan; Marangon, Stefano; Klinkenberg, Don

2012-01-01

In recent years, the early detection of low pathogenicity avian influenza (LPAI) viruses in poultry has become increasingly important, given their potential to mutate into highly pathogenic viruses. However, evaluations of LPAI surveillance have mainly focused on prevalence and not on the ability to act as an early warning system. We used a simulation model based on data from Italian LPAI epidemics in turkeys to evaluate different surveillance strategies in terms of their performance as early warning systems. The strategies differed in terms of sample size, sampling frequency, diagnostic tests, and whether or not active surveillance (i.e., routine laboratory testing of farms) was performed, and were also tested under different epidemiological scenarios. We compared surveillance strategies by simulating within-farm outbreaks. The output measures were the proportion of infected farms that are detected and the farm reproduction number (R(h)). The first one provides an indication of the sensitivity of the surveillance system to detect within-farm infections, whereas R(h) reflects the effectiveness of outbreak detection (i.e., if detection occurs soon enough to bring an epidemic under control). Increasing the sampling frequency was the most effective means of improving the timeliness of detection (i.e., it occurs earlier), whereas increasing the sample size increased the likelihood of detection. Surveillance was only effective in preventing an epidemic if actions were taken within two days of sampling. The strategies were not affected by the quality of the diagnostic test, although performing both serological and virological assays increased the sensitivity of active surveillance. Early detection of LPAI outbreaks in turkeys can be achieved by increasing the sampling frequency for active surveillance, though very frequent sampling may not be sustainable in the long term. We suggest that, when no LPAI virus is circulating yet and there is a low risk of virus introduction

Evaluating surveillance strategies for the early detection of low pathogenicity avian influenza infections.

Directory of Open Access Journals (Sweden)

Arianna Comin

Full Text Available In recent years, the early detection of low pathogenicity avian influenza (LPAI viruses in poultry has become increasingly important, given their potential to mutate into highly pathogenic viruses. However, evaluations of LPAI surveillance have mainly focused on prevalence and not on the ability to act as an early warning system. We used a simulation model based on data from Italian LPAI epidemics in turkeys to evaluate different surveillance strategies in terms of their performance as early warning systems. The strategies differed in terms of sample size, sampling frequency, diagnostic tests, and whether or not active surveillance (i.e., routine laboratory testing of farms was performed, and were also tested under different epidemiological scenarios. We compared surveillance strategies by simulating within-farm outbreaks. The output measures were the proportion of infected farms that are detected and the farm reproduction number (R(h. The first one provides an indication of the sensitivity of the surveillance system to detect within-farm infections, whereas R(h reflects the effectiveness of outbreak detection (i.e., if detection occurs soon enough to bring an epidemic under control. Increasing the sampling frequency was the most effective means of improving the timeliness of detection (i.e., it occurs earlier, whereas increasing the sample size increased the likelihood of detection. Surveillance was only effective in preventing an epidemic if actions were taken within two days of sampling. The strategies were not affected by the quality of the diagnostic test, although performing both serological and virological assays increased the sensitivity of active surveillance. Early detection of LPAI outbreaks in turkeys can be achieved by increasing the sampling frequency for active surveillance, though very frequent sampling may not be sustainable in the long term. We suggest that, when no LPAI virus is circulating yet and there is a low risk of virus

Syndromic surveillance system based on near real-time cattle mortality monitoring.

Science.gov (United States)

Torres, G; Ciaravino, V; Ascaso, S; Flores, V; Romero, L; Simón, F

2015-05-01

Early detection of an infectious disease incursion will minimize the impact of outbreaks in livestock. Syndromic surveillance based on the analysis of readily available data can enhance traditional surveillance systems and allow veterinary authorities to react in a timely manner. This study was based on monitoring the number of cattle carcasses sent for rendering in the veterinary unit of Talavera de la Reina (Spain). The aim was to develop a system to detect deviations from expected values which would signal unexpected health events. Historical weekly collected dead cattle (WCDC) time series stabilized by the Box-Cox transformation and adjusted by the minimum least squares method were used to build the univariate cycling regression model based on a Fourier transformation. Three different models, according to type of production system, were built to estimate the baseline expected number of WCDC. Two types of risk signals were generated: point risk signals when the observed value was greater than the upper 95% confidence interval of the expected baseline, and cumulative risk signals, generated by a modified cumulative sum algorithm, when the cumulative sums of reported deaths were above the cumulative sum of expected deaths. Data from 2011 were used to prospectively validate the model generating seven risk signals. None of them were correlated to infectious disease events but some coincided, in time, with very high climatic temperatures recorded in the region. The harvest effect was also observed during the first week of the study year. Establishing appropriate risk signal thresholds is a limiting factor of predictive models; it needs to be adjusted based on experience gained during the use of the models. To increase the sensitivity and specificity of the predictions epidemiological interpretation of non-specific risk signals should be complemented by other sources of information. The methodology developed in this study can enhance other existing early detection

Gastroenteritis outbreaks on cruise ships

DEFF Research Database (Denmark)

Mouchtouri, Varvara A; Verykouki, Eleni; Zamfir, Dumitru

2017-01-01

When an increased number of acute gastroenteritis (AG) cases is detected among tourists staying at the same accommodation, outbreak management plans must be activated in a timely manner to prevent large outbreaks. Syndromic surveillance data collected between 1 January 2010 and 31 December 2013...

Visual analytics of surveillance data on foodborne vibriosis, United States, 1973-2010.

Science.gov (United States)

Sims, Jennifer N; Isokpehi, Raphael D; Cooper, Gabrielle A; Bass, Michael P; Brown, Shyretha D; St John, Alison L; Gulig, Paul A; Cohly, Hari H P

2011-01-01

Foodborne illnesses caused by microbial and chemical contaminants in food are a substantial health burden worldwide. In 2007, human vibriosis (non-cholera Vibrio infections) became a notifiable disease in the United States. In addition, Vibrio species are among the 31 major known pathogens transmitted through food in the United States. Diverse surveillance systems for foodborne pathogens also track outbreaks, illnesses, hospitalization and deaths due to non-cholera vibrios. Considering the recognition of vibriosis as a notifiable disease in the United States and the availability of diverse surveillance systems, there is a need for the development of easily deployed visualization and analysis approaches that can combine diverse data sources in an interactive manner. Current efforts to address this need are still limited. Visual analytics is an iterative process conducted via visual interfaces that involves collecting information, data preprocessing, knowledge representation, interaction, and decision making. We have utilized public domain outbreak and surveillance data sources covering 1973 to 2010, as well as visual analytics software to demonstrate integrated and interactive visualizations of data on foodborne outbreaks and surveillance of Vibrio species. Through the data visualization, we were able to identify unique patterns and/or novel relationships within and across datasets regarding (i) causative agent; (ii) foodborne outbreaks and illness per state; (iii) location of infection; (iv) vehicle (food) of infection; (v) anatomical site of isolation of Vibrio species; (vi) patients and complications of vibriosis; (vii) incidence of laboratory-confirmed vibriosis and V. parahaemolyticus outbreaks. The additional use of emerging visual analytics approaches for interaction with data on vibriosis, including non-foodborne related disease, can guide disease control and prevention as well as ongoing outbreak investigations.

A simulation study comparing aberration detection algorithms for syndromic surveillance

Directory of Open Access Journals (Sweden)

Painter Ian

2007-03-01

Full Text Available Abstract Background The usefulness of syndromic surveillance for early outbreak detection depends in part on effective statistical aberration detection. However, few published studies have compared different detection algorithms on identical data. In the largest simulation study conducted to date, we compared the performance of six aberration detection algorithms on simulated outbreaks superimposed on authentic syndromic surveillance data. Methods We compared three control-chart-based statistics, two exponential weighted moving averages, and a generalized linear model. We simulated 310 unique outbreak signals, and added these to actual daily counts of four syndromes monitored by Public Health – Seattle and King County's syndromic surveillance system. We compared the sensitivity of the six algorithms at detecting these simulated outbreaks at a fixed alert rate of 0.01. Results Stratified by baseline or by outbreak distribution, duration, or size, the generalized linear model was more sensitive than the other algorithms and detected 54% (95% CI = 52%–56% of the simulated epidemics when run at an alert rate of 0.01. However, all of the algorithms had poor sensitivity, particularly for outbreaks that did not begin with a surge of cases. Conclusion When tested on county-level data aggregated across age groups, these algorithms often did not perform well in detecting signals other than large, rapid increases in case counts relative to baseline levels.

Visual Analytics of Surveillance Data on Foodborne Vibriosis, United States, 1973–2010

Science.gov (United States)

Sims, Jennifer N.; Isokpehi, Raphael D.; Cooper, Gabrielle A.; Bass, Michael P.; Brown, Shyretha D.; St John, Alison L.; Gulig, Paul A.; Cohly, Hari H.P.

2011-01-01

Foodborne illnesses caused by microbial and chemical contaminants in food are a substantial health burden worldwide. In 2007, human vibriosis (non-cholera Vibrio infections) became a notifiable disease in the United States. In addition, Vibrio species are among the 31 major known pathogens transmitted through food in the United States. Diverse surveillance systems for foodborne pathogens also track outbreaks, illnesses, hospitalization and deaths due to non-cholera vibrios. Considering the recognition of vibriosis as a notifiable disease in the United States and the availability of diverse surveillance systems, there is a need for the development of easily deployed visualization and analysis approaches that can combine diverse data sources in an interactive manner. Current efforts to address this need are still limited. Visual analytics is an iterative process conducted via visual interfaces that involves collecting information, data preprocessing, knowledge representation, interaction, and decision making. We have utilized public domain outbreak and surveillance data sources covering 1973 to 2010, as well as visual analytics software to demonstrate integrated and interactive visualizations of data on foodborne outbreaks and surveillance of Vibrio species. Through the data visualization, we were able to identify unique patterns and/or novel relationships within and across datasets regarding (i) causative agent; (ii) foodborne outbreaks and illness per state; (iii) location of infection; (iv) vehicle (food) of infection; (v) anatomical site of isolation of Vibrio species; (vi) patients and complications of vibriosis; (vii) incidence of laboratory-confirmed vibriosis and V. parahaemolyticus outbreaks. The additional use of emerging visual analytics approaches for interaction with data on vibriosis, including non-foodborne related disease, can guide disease control and prevention as well as ongoing outbreak investigations. PMID:22174586

Human angiostrongyliasis outbreak in Dali, China.

Science.gov (United States)

Lv, Shan; Zhang, Yi; Chen, Shao-Rong; Wang, Li-Bo; Fang, Wen; Chen, Feng; Jiang, Jin-Yong; Li, Yuan-Lin; Du, Zun-Wei; Zhou, Xiao-Nong

2009-09-22

Several angiostrongyliasis outbreaks have been reported in recent years but the disease continues to be neglected in public health circles. We describe an outbreak in Dali, southwest China in order to highlight some key problems for the control of this helminth infection. All available medical records of suspected angiostrongyliasis patients visiting hospitals in Dali in the period 1 October 2007-31 March 2008 were reviewed, and tentative diagnoses of varying strengths were reached according to given sets of criteria. Snails collected from local markets, restaurants and natural habitats were also screened for the presence of Angiostrongylus cantonensis. A total of 33 patients met criteria for infection, and 11 among them were classified as clinically confirmed. An additional eight patients were identified through a surveillance system put in operation in response to the outbreak. The epidemic lasted for 8 months with its peak in February 2008. Of the 33 patients, 97.0% complained of severe headache. 84.8% patients had high eosinophil cell counts either in the peripheral blood or in cerebrospinal fluid (CSF). Three-quarters of the patients were treated with a combination of albendazole and corticosteroids, resulting in significantly improved overall conditions. Twenty-two patients reported the consumption of raw or undercooked snails prior to the onset of the symptoms, and approximately 1.0% of the Pomacea canaliculata snails on sale were found to be infected with A. cantonensis. The snails were also found in certain habitats around Dali but no parasites were detected in these populations. The import and sale of infected P. canaliculata is the likely trigger for this angiostrongyliasis outbreak. Awareness of angiostrongyliasis must be raised, and standardized diagnosis and treatment are needed in order to provide clinicians with a guide to address this disease. Health education campaigns could limit the risk, and a hospital-based surveillance system should be

Faster Detection of Poliomyelitis Outbreaks to Support Polio Eradication.

Science.gov (United States)

Blake, Isobel M; Chenoweth, Paul; Okayasu, Hiro; Donnelly, Christl A; Aylward, R Bruce; Grassly, Nicholas C

2016-03-01

As the global eradication of poliomyelitis approaches the final stages, prompt detection of new outbreaks is critical to enable a fast and effective outbreak response. Surveillance relies on reporting of acute flaccid paralysis (AFP) cases and laboratory confirmation through isolation of poliovirus from stool. However, delayed sample collection and testing can delay outbreak detection. We investigated whether weekly testing for clusters of AFP by location and time, using the Kulldorff scan statistic, could provide an early warning for outbreaks in 20 countries. A mixed-effects regression model was used to predict background rates of nonpolio AFP at the district level. In Tajikistan and Congo, testing for AFP clusters would have resulted in an outbreak warning 39 and 11 days, respectively, before official confirmation of large outbreaks. This method has relatively high specificity and could be integrated into the current polio information system to support rapid outbreak response activities.

Why do farmers and veterinarians not report all bovine abortions, as requested by the clinical brucellosis surveillance system in France?

OpenAIRE

Bronner, Anne; Hénaux, Viviane; Fortané, Nicolas; Hendrikx, Pascal; Calavas, Didier

2014-01-01

Background Since 2005, France has been officially free of brucellosis, an infectious disease that causes abortion in cattle and can be transmitted from cattle to humans. Recent animal and human cases have drawn attention to the need to prevent infection of humans and animals from any primary outbreaks. In order to detect any new outbreaks as soon as possible, a clinical surveillance system requires farmers and veterinarians to report each abortion and to test the aborting cow for brucello...

Avian Cholera emergence in Arctic-nesting northern Common Eiders: using community-based, participatory surveillance to delineate disease outbreak patterns and predict transmission risk

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Samuel A. Iverson

2016-12-01

Full Text Available Emerging infectious diseases are a growing concern in wildlife conservation. Documenting outbreak patterns and determining the ecological drivers of transmission risk are fundamental to predicting disease spread and assessing potential impacts on population viability. However, evaluating disease in wildlife populations requires expansive surveillance networks that often do not exist in remote and developing areas. Here, we describe the results of a community-based research initiative conducted in collaboration with indigenous harvesters, the Inuit, in response to a new series of Avian Cholera outbreaks affecting Common Eiders (Somateria mollissima and other comingling species in the Canadian Arctic. Avian Cholera is a virulent disease of birds caused by the bacterium Pasteurella multocida. Common Eiders are a valuable subsistence resource for Inuit, who hunt the birds for meat and visit breeding colonies during the summer to collect eggs and feather down for use in clothing and blankets. We compiled the observations of harvesters about the growing epidemic and with their assistance undertook field investigation of 131 colonies distributed over >1200 km of coastline in the affected region. Thirteen locations were identified where Avian Cholera outbreaks have occurred since 2004. Mortality rates ranged from 1% to 43% of the local breeding population at these locations. Using a species-habitat model (Maxent, we determined that the distribution of outbreak events has not been random within the study area and that colony size, vegetation cover, and a measure of host crowding in shared wetlands were significantly correlated to outbreak risk. In addition, outbreak locations have been spatially structured with respect to hypothesized introduction foci and clustered along the migration corridor linking Arctic breeding areas with wintering areas in Atlantic Canada. At present, Avian Cholera remains a localized threat to Common Eider populations in the

Management strategies of enterovirus D68 outbreaks: current perspectives

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Milhano N

2018-03-01

Full Text Available Natacha Milhano, Kaja Sverdrup Borge, Karoline Bragstad, Susanne G Dudman Domain for Environmental Health and Infectious Disease Control, Norwegian Institute of Public Health, Oslo, Norway Abstract: Following its discovery in California in 1962, enterovirus D68 (EV-D68 was reported only sporadically around the world. In August 2014, a marked increase of EV-D68 cases in young children with severe respiratory infections was reported in the USA and Canada and later in Europe and Asia. Some of these cases were also found to be associated with acute flaccid paralysis, which exacerbated public health concern, and has since triggered international efforts to strengthen both EV-D68 and acute flaccid paralysis surveillance systems. This review summarizes the current knowledge on EV-D68, offering an overview of EV-D68 epidemiology, clinical presentations, diagnostic methodologies, and treatment strategies, as well as surveillance and outbreak management. Keywords: enterovirus D68, AFP, diagnostics, treatment, surveillance, outbreak 

Inferring epidemic network topology from surveillance data.

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Xiang Wan

Full Text Available The transmission of infectious diseases can be affected by many or even hidden factors, making it difficult to accurately predict when and where outbreaks may emerge. One approach at the moment is to develop and deploy surveillance systems in an effort to detect outbreaks as timely as possible. This enables policy makers to modify and implement strategies for the control of the transmission. The accumulated surveillance data including temporal, spatial, clinical, and demographic information, can provide valuable information with which to infer the underlying epidemic networks. Such networks can be quite informative and insightful as they characterize how infectious diseases transmit from one location to another. The aim of this work is to develop a computational model that allows inferences to be made regarding epidemic network topology in heterogeneous populations. We apply our model on the surveillance data from the 2009 H1N1 pandemic in Hong Kong. The inferred epidemic network displays significant effect on the propagation of infectious diseases.

Global surveillance of emerging diseases: the ProMED-mail perspective

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John P. Woodall

2001-01-01

Full Text Available The Internet is changing the way global disease surveillance is conducted. Countries and international organizations are increasingly placing their outbreak reports on the Internet, which speeds up distribution and therefore prevention and control. The World Health Organization (WHO has recognized the value of nongovernmental organizations and the media in reporting outbreaks, which it then attempts to verify through its country offices. However, WHO and other official sources are constrained in their reporting by the need for bureaucratic clearance. ProMED-mail has no such constraints, and posts outbreak reports 7 days a week. It is moderated by infectious disease specialists who add relevant comments. Thus, ProMED-mail complements official sources and provides early warning of outbreaks. Its network is more than 20,000 people in over 150 countries, who place their computers and time at the network's disposal and report on outbreaks of which they have knowledge. Regions and countries could benefit from adopting the ProMED-mail approach to complement their own disease surveillance systems.

African Swine Fever in Uganda: Qualitative Evaluation of Three Surveillance Methods with Implications for Other Resource-Poor Settings.

Science.gov (United States)

Chenais, Erika; Sternberg-Lewerin, Susanna; Boqvist, Sofia; Emanuelson, Ulf; Aliro, Tonny; Tejler, Emma; Cocca, Giampaolo; Masembe, Charles; Ståhl, Karl

2015-01-01

Animal diseases impact negatively on households and on national economies. In low-income countries, this pertains especially to socio-economic effects on household level. To control animal diseases and mitigate their impact, it is necessary to understand the epidemiology of the disease in its local context. Such understanding, gained through disease surveillance, is often lacking in resource-poor settings. Alternative surveillance methods have been developed to overcome some of the hurdles obstructing surveillance. The objective of this study was to evaluate and qualitatively compare three methods for surveillance of acute infectious diseases using African swine fever in northern Uganda as an example. Report-driven outbreak investigations, participatory rural appraisals (PRAs), and a household survey using a smartphone application were evaluated. All three methods had good disease-detecting capacity, and each of them detected many more outbreaks compared to those reported to the World Organization for Animal Health during the same time period. Apparent mortality rates were similar for the three methods although highest for the report-driven outbreak investigations, followed by the PRAs, and then the household survey. The three methods have different characteristics and the method of choice will depend on the surveillance objective. The optimal situation might be achieved by a combination of the methods: outbreak detection via smartphone-based real-time surveillance, outbreak investigation for collection of biological samples, and a PRA for a better understanding of the epidemiology of the specific outbreak. All three methods require initial investments and continuous efforts. The sustainability of the surveillance system should, therefore, be carefully evaluated before making such investments.

Forecasting Zika Incidence in the 2016 Latin America Outbreak Combining Traditional Disease Surveillance with Search, Social Media, and News Report Data.

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Sarah F McGough

2017-01-01

Full Text Available Over 400,000 people across the Americas are thought to have been infected with Zika virus as a consequence of the 2015-2016 Latin American outbreak. Official government-led case count data in Latin America are typically delayed by several weeks, making it difficult to track the disease in a timely manner. Thus, timely disease tracking systems are needed to design and assess interventions to mitigate disease transmission.We combined information from Zika-related Google searches, Twitter microblogs, and the HealthMap digital surveillance system with historical Zika suspected case counts to track and predict estimates of suspected weekly Zika cases during the 2015-2016 Latin American outbreak, up to three weeks ahead of the publication of official case data. We evaluated the predictive power of these data and used a dynamic multivariable approach to retrospectively produce predictions of weekly suspected cases for five countries: Colombia, El Salvador, Honduras, Venezuela, and Martinique. Models that combined Google (and Twitter data where available with autoregressive information showed the best out-of-sample predictive accuracy for 1-week ahead predictions, whereas models that used only Google and Twitter typically performed best for 2- and 3-week ahead predictions.Given the significant delay in the release of official government-reported Zika case counts, we show that these Internet-based data streams can be used as timely and complementary ways to assess the dynamics of the outbreak.

A concept for routine emergency-care data-based syndromic surveillance in Europe.

Science.gov (United States)

Ziemann, A; Rosenkötter, N; Garcia-Castrillo Riesgo, L; Schrell, S; Kauhl, B; Vergeiner, G; Fischer, M; Lippert, F K; Krämer, A; Brand, H; Krafft, T

2014-11-01

We developed a syndromic surveillance (SyS) concept using emergency dispatch, ambulance and emergency-department data from different European countries. Based on an inventory of sub-national emergency data availability in 12 countries, we propose framework definitions for specific syndromes and a SyS system design. We tested the concept by retrospectively applying cumulative sum and spatio-temporal cluster analyses for the detection of local gastrointestinal outbreaks in four countries and comparing the results with notifiable disease reporting. Routine emergency data was available daily and electronically in 11 regions, following a common structure. We identified two gastrointestinal outbreaks in two countries; one was confirmed as a norovirus outbreak. We detected 1/147 notified outbreaks. Emergency-care data-based SyS can supplement local surveillance with near real-time information on gastrointestinal patients, especially in special circumstances, e.g. foreign tourists. It most likely cannot detect the majority of local gastrointestinal outbreaks with few, mild or dispersed cases.

Risk based surveillance for vector borne diseases

DEFF Research Database (Denmark)

Bødker, Rene

of samples and hence early detection of outbreaks. Models for vector borne diseases in Denmark have demonstrated dramatic variation in outbreak risk during the season and between years. The Danish VetMap project aims to make these risk based surveillance estimates available on the veterinarians smart phones...... in Northern Europe. This model approach may be used as a basis for risk based surveillance. In risk based surveillance limited resources for surveillance are targeted at geographical areas most at risk and only when the risk is high. This makes risk based surveillance a cost effective alternative...... sample to a diagnostic laboratory. Risk based surveillance models may reduce this delay. An important feature of risk based surveillance models is their ability to continuously communicate the level of risk to veterinarians and hence increase awareness when risk is high. This is essential for submission...

Assessing dengue outbreak areas using vector surveillance in north east district, Penang Island, Malaysia

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Ahmad Mohiddin

2015-11-01

Full Text Available Objective: To understand the efficacy of ovitrap surveillance and its implementation on monitoring reflection upon case occurrence in relation to climate variables. Methods: We used routinely setup ovitrap surveillance to monitor the mosquito populations in previous outbreak areas. Ovitraps were installed weekly at three localities that experienced high number of dengue cases (Flat Hamna, Kampung Sungai Gelugor and Kampung Tanjung Tokong from January 2010 to February 2011. Ovitraps and paddles were brought back to the laboratory and all of the water contents were poured into an enamel pan. Aged tap water was added into the enamel pan and eggs were allowed to hatch. The hatching larvae were counted after 3 days. The hatched larvae were identified at the 3rd instar larval stage. The ovitrap indices and mean number of larvae were analyzed using student t-test and One-way ANOVA. Spearmen’s rank correlation coefficient was used to determine the relation between meteorology variables and dengue fever cases. Results: Aedes albopictus was found as dominant species followed by Aedes aegypti recorded in all three study areas. Aedes aegypti preferred to breed outdoor with larvae collection, which was higher than indoor (72.37%. There was a positive correlation between the ovitrap index with the rainfall and humidity except in Kampung Tanjung Tokong. Our result also showed negative correlation between temperature and ovitrap index in all localities. Conclusions: This study provides useful data to be adapted in dengue vector management. It is very important to understand the fluctuation of vector population according to the seasonal activity, which can help us to improve our control programs. However, other factors might also contribute to the increment of dengue outbreak such as the number of available breeding sites, behavior of the vector against environmental factors and the cleanliness of the environment.

Mitigating measles outbreaks in West Africa post-Ebola.

Science.gov (United States)

Truelove, Shaun A; Moss, William J; Lessler, Justin

2015-01-01

The Ebola outbreak in 2014-2015 devastated the populations, economies and healthcare systems of Guinea, Liberia and Sierra Leone. With this devastation comes the impending threat of outbreaks of other infectious diseases like measles. Strategies for mitigating these risks must include both prevention, through vaccination, and case detection and management, focused on surveillance, diagnosis and appropriate clinical care and case management. With the high transmissibility of measles virus, small-scale reactive vaccinations will be essential to extinguish focal outbreaks, while national vaccination campaigns are needed to guarantee vaccination coverage targets are reached in the long term. Rapid and multifaceted strategies should carefully navigate challenges present in the wake of Ebola, while also taking advantage of current Ebola-related activities and international attention. Above all, resources and focus currently aimed at these countries must be utilized to build up the deficit in infrastructure and healthcare systems that contributed to the extent of the Ebola outbreak.

African swine fever in Uganda: qualitative evaluation of three surveillance methods with implications for other resource-poor settings

Directory of Open Access Journals (Sweden)

Erika eChenais

2015-10-01

Full Text Available Animal diseases impact negatively on households and on national economies. In low-income countries this pertains especially to socio-economic effects on household level. To control animal diseases and mitigate their impact, it is necessary to understand the epidemiology of the disease in its local context. Such understanding, gained through disease surveillance, is often lacking in resource-poor settings. Alternative surveillance methods have been developed to overcome some of the hurdles obstructing surveillance. The objective of this study was to evaluate and qualitatively compare three methods for surveillance of acute infectious diseases using African swine fever (ASF in northern Uganda as an example. Report-driven outbreak investigations, participatory rural appraisals (PRA, and a household survey using a smartphone application were evaluated. All three methods had good disease-detecting capacity, each of them detected many more outbreaks compared to those reported to the World Organization for Animal Health (OIE during the same time period. Apparent mortality rates were similar for the three methods although highest for the report-driven outbreak investigations, followed by the PRAs, and then the household survey. The three methods have different characteristics and the method of choice will depend on the surveillance objective. The optimal situation might be achieved by a combination of the methods: outbreak detection via smartphone-based real-time surveillance, outbreak investigation for collection of biological samples, and a PRA for a better understanding of the epidemiology of the specific outbreak. All three methods require initial investments and continuous efforts. The sustainability of the surveillance system should therefore be carefully evaluated before making such investments.

A cost-effectiveness analysis of three components of a syndromic surveillance system for the early warning of epidemics in rural China.

Science.gov (United States)

Ding, Yan; Sauerborn, Rainer; Xu, Biao; Shaofa, Nie; Yan, Weirong; Diwan, Vinod K; Dong, Hengjin

2015-11-14

Syndromic surveillance systems (SSSs) collect non-specific syndromes in early stages of disease outbreaks. This makes an SSS a promising tool for the early detection of epidemics. An Integrated Surveillance System in rural China (ISSC project), which added an SSS to the existing Chinese surveillance system for the early warning of epidemics, was implemented from April 2012 to March 2014 in Jiangxi and Hubei Provinces. This study aims to measure the costs and effectiveness of the three components of the SSS in the ISSC project. The central measures of the cost-effectiveness analysis of the three components of the syndromic surveillance system were: 1) the costs per reported event, respectively, at the health facilities, the primary schools and the pharmacies; and 2) the operating costs per surveillance unit per year, respectively, at the health facilities, the primary schools and the pharmacies. Effectiveness was expressed by reporting outputs which were numbers of reported events, numbers of raw signals, and numbers of verified signals. The reported events were tracked through an internal data base. Signal verification forms and epidemiological investigation reports were collected from local country centers for disease control and prevention. We adopted project managers' perspective for the cost analysis. Total costs included set-up costs (system development and training) and operating costs (data collection, quality control and signal verification). We used self-designed questionnaires to collect cost data and received, respectively, 369 and 477 facility and staff questionnaires through a cross-sectional survey with a purposive sampling following the ISSC project. All data were entered into Epidata 3.02 and exported to Stata for descriptive analysis. The number of daily reported events per unit was the highest at pharmacies, followed by health facilities and finally primary schools. Variances existed within the three groups and also between Jiangxi and Hubei

Establishing Ebola Virus Disease (EVD diagnostics using GeneXpert technology at a mobile laboratory in Liberia: Impact on outbreak response, case management and laboratory systems strengthening.

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Philomena Raftery

2018-01-01

Full Text Available The 2014-16 Ebola Virus Disease (EVD outbreak in West Africa highlighted the necessity for readily available, accurate and rapid diagnostics. The magnitude of the outbreak and the re-emergence of clusters of EVD cases following the declaration of interrupted transmission in Liberia, reinforced the need for sustained diagnostics to support surveillance and emergency preparedness. We describe implementation of the Xpert Ebola Assay, a rapid molecular diagnostic test run on the GeneXpert platform, at a mobile laboratory in Liberia and the subsequent impact on EVD outbreak response, case management and laboratory system strengthening. During the period of operation, site coordination, management and operational capacity was supported through a successful collaboration between Ministry of Health (MoH, World Health Organization (WHO and international partners. A team of Liberian laboratory technicians were trained to conduct EVD diagnostics and the laboratory had capacity to test 64-100 blood specimens per day. Establishment of the laboratory significantly increased the daily testing capacity for EVD in Liberia, from 180 to 250 specimens at a time when the effectiveness of the surveillance system was threatened by insufficient diagnostic capacity. During the 18 months of operation, the laboratory tested a total of 9,063 blood specimens, including 21 EVD positives from six confirmed cases during two outbreaks. Following clearance of the significant backlog of untested EVD specimens in November 2015, a new cluster of EVD cases was detected at the laboratory. Collaboration between surveillance and laboratory coordination teams during this and a later outbreak in March 2016, facilitated timely and targeted response interventions. Specimens taken from cases during both outbreaks were analysed at the laboratory with results informing clinical management of patients and discharge decisions. The GeneXpert platform is easy to use, has relatively low running

Establishing Ebola Virus Disease (EVD) diagnostics using GeneXpert technology at a mobile laboratory in Liberia: Impact on outbreak response, case management and laboratory systems strengthening.

Science.gov (United States)

Raftery, Philomena; Condell, Orla; Wasunna, Christine; Kpaka, Jonathan; Zwizwai, Ruth; Nuha, Mahmood; Fallah, Mosoka; Freeman, Maxwell; Harris, Victoria; Miller, Mark; Baller, April; Massaquoi, Moses; Katawera, Victoria; Saindon, John; Bemah, Philip; Hamblion, Esther; Castle, Evelyn; Williams, Desmond; Gasasira, Alex; Nyenswah, Tolbert

2018-01-01

The 2014-16 Ebola Virus Disease (EVD) outbreak in West Africa highlighted the necessity for readily available, accurate and rapid diagnostics. The magnitude of the outbreak and the re-emergence of clusters of EVD cases following the declaration of interrupted transmission in Liberia, reinforced the need for sustained diagnostics to support surveillance and emergency preparedness. We describe implementation of the Xpert Ebola Assay, a rapid molecular diagnostic test run on the GeneXpert platform, at a mobile laboratory in Liberia and the subsequent impact on EVD outbreak response, case management and laboratory system strengthening. During the period of operation, site coordination, management and operational capacity was supported through a successful collaboration between Ministry of Health (MoH), World Health Organization (WHO) and international partners. A team of Liberian laboratory technicians were trained to conduct EVD diagnostics and the laboratory had capacity to test 64-100 blood specimens per day. Establishment of the laboratory significantly increased the daily testing capacity for EVD in Liberia, from 180 to 250 specimens at a time when the effectiveness of the surveillance system was threatened by insufficient diagnostic capacity. During the 18 months of operation, the laboratory tested a total of 9,063 blood specimens, including 21 EVD positives from six confirmed cases during two outbreaks. Following clearance of the significant backlog of untested EVD specimens in November 2015, a new cluster of EVD cases was detected at the laboratory. Collaboration between surveillance and laboratory coordination teams during this and a later outbreak in March 2016, facilitated timely and targeted response interventions. Specimens taken from cases during both outbreaks were analysed at the laboratory with results informing clinical management of patients and discharge decisions. The GeneXpert platform is easy to use, has relatively low running costs and can be

Establishing Ebola Virus Disease (EVD) diagnostics using GeneXpert technology at a mobile laboratory in Liberia: Impact on outbreak response, case management and laboratory systems strengthening

Science.gov (United States)

Condell, Orla; Wasunna, Christine; Kpaka, Jonathan; Zwizwai, Ruth; Nuha, Mahmood; Fallah, Mosoka; Freeman, Maxwell; Harris, Victoria; Miller, Mark; Baller, April; Massaquoi, Moses; Katawera, Victoria; Saindon, John; Bemah, Philip; Hamblion, Esther; Castle, Evelyn; Williams, Desmond; Gasasira, Alex; Nyenswah, Tolbert

2018-01-01

The 2014–16 Ebola Virus Disease (EVD) outbreak in West Africa highlighted the necessity for readily available, accurate and rapid diagnostics. The magnitude of the outbreak and the re-emergence of clusters of EVD cases following the declaration of interrupted transmission in Liberia, reinforced the need for sustained diagnostics to support surveillance and emergency preparedness. We describe implementation of the Xpert Ebola Assay, a rapid molecular diagnostic test run on the GeneXpert platform, at a mobile laboratory in Liberia and the subsequent impact on EVD outbreak response, case management and laboratory system strengthening. During the period of operation, site coordination, management and operational capacity was supported through a successful collaboration between Ministry of Health (MoH), World Health Organization (WHO) and international partners. A team of Liberian laboratory technicians were trained to conduct EVD diagnostics and the laboratory had capacity to test 64–100 blood specimens per day. Establishment of the laboratory significantly increased the daily testing capacity for EVD in Liberia, from 180 to 250 specimens at a time when the effectiveness of the surveillance system was threatened by insufficient diagnostic capacity. During the 18 months of operation, the laboratory tested a total of 9,063 blood specimens, including 21 EVD positives from six confirmed cases during two outbreaks. Following clearance of the significant backlog of untested EVD specimens in November 2015, a new cluster of EVD cases was detected at the laboratory. Collaboration between surveillance and laboratory coordination teams during this and a later outbreak in March 2016, facilitated timely and targeted response interventions. Specimens taken from cases during both outbreaks were analysed at the laboratory with results informing clinical management of patients and discharge decisions. The GeneXpert platform is easy to use, has relatively low running costs and can

Diarrhea outbreaks in northeastern Brazil in 2013, according to media and health information systems - Surveillance of climate risk and health emergencies.

Science.gov (United States)

Rufino, Renata; Gracie, Renata; Sena, Aderita; de Freitas, Carlos Machado; Barcellos, Christovam

2016-03-01

This study has the objective of analyzing information about diarrhea outbreaks in Brazil's northeast in the year 2013. Information came from electronic media and from health information systems. A total of 33 news events related to diarrhea outbreaks were identified, some of them mentioning causes and aggravating factors. The analysis of spatial and temporal distribution of the news, admissions and deaths showed that more than 100,000 persons were affected and, according to the news analyzed, the most affected states were Alagoas and Pernambuco, with a greater extent in the months from May to July. The use of alternative sources of water such as ponds, wells, water trucks and household water reservoirs were identified as the most immediate causes of these outbreaks. However, other underlying factors such as precarious water supply systems in the semi-arid region, the exceptional conditions of drought, considered the worst in the last 60 years, as well as the capacity of the health sector to respond to a large number of cases, should be considered to recover the context in which these outbreaks are produced.

Time series modeling for syndromic surveillance

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Mandl Kenneth D

2003-01-01

Full Text Available Abstract Background Emergency department (ED based syndromic surveillance systems identify abnormally high visit rates that may be an early signal of a bioterrorist attack. For example, an anthrax outbreak might first be detectable as an unusual increase in the number of patients reporting to the ED with respiratory symptoms. Reliably identifying these abnormal visit patterns requires a good understanding of the normal patterns of healthcare usage. Unfortunately, systematic methods for determining the expected number of (ED visits on a particular day have not yet been well established. We present here a generalized methodology for developing models of expected ED visit rates. Methods Using time-series methods, we developed robust models of ED utilization for the purpose of defining expected visit rates. The models were based on nearly a decade of historical data at a major metropolitan academic, tertiary care pediatric emergency department. The historical data were fit using trimmed-mean seasonal models, and additional models were fit with autoregressive integrated moving average (ARIMA residuals to account for recent trends in the data. The detection capabilities of the model were tested with simulated outbreaks. Results Models were built both for overall visits and for respiratory-related visits, classified according to the chief complaint recorded at the beginning of each visit. The mean absolute percentage error of the ARIMA models was 9.37% for overall visits and 27.54% for respiratory visits. A simple detection system based on the ARIMA model of overall visits was able to detect 7-day-long simulated outbreaks of 30 visits per day with 100% sensitivity and 97% specificity. Sensitivity decreased with outbreak size, dropping to 94% for outbreaks of 20 visits per day, and 57% for 10 visits per day, all while maintaining a 97% benchmark specificity. Conclusions Time series methods applied to historical ED utilization data are an important tool

Lessons From the Implementation of Mo-Buzz, a Mobile Pandemic Surveillance System for Dengue.

Science.gov (United States)

Lwin, May Oo; Jayasundar, Karthikayen; Sheldenkar, Anita; Wijayamuni, Ruwan; Wimalaratne, Prasad; Ernst, Kacey C; Foo, Schubert

2017-10-02

Approximately 128 countries and 3.9 billion people are at risk of dengue infection. Incidence of dengue has increased over the past decades, becoming a growing public health concern for countries with populations that are increasingly susceptible to this vector-borne disease, such as Sri Lanka. Almost 55,150 dengue cases were reported in Sri Lanka in 2016, with more than 30.40% of cases (n=16,767) originating from Colombo, which struggles with an outdated manual paper-based dengue outbreak management system. Community education and outreach about dengue are also executed using paper-based media channels such as pamphlets and brochures. Yet, Sri Lanka is one of the countries with the most affordable rates of mobile services in the world, with penetration rates higher than most developing countries. To combat the issues of an exhausted dengue management system and to make use of new technology, in 2015, a mobile participatory system for dengue surveillance called Mo-Buzz was developed and launched in Colombo, Sri Lanka. This paper describes the system's components and uptake, along with other similar disease surveillance systems. We developed Mo-Buzz and tested its feasibility for dengue. Two versions of the app were developed. The first was for use by public health inspectors (PHIs) to digitize form filling and recording of site visit information, and track dengue outbreaks on a real-time dengue hotspot map using the global positioning system technology. The system also provides updated dengue infographics and educational materials for the PHIs to educate the general public. The second version of Mo-Buzz was created for use by the general public. This system uses dynamic mapping to help educate and inform the general public about potential outbreak regions and allow them to report dengue symptoms and post pictures of potential dengue mosquito-breeding sites, which are automatically sent to the health authorities. Targeted alerts can be sent to users depending on

Epidemiology of restaurant-associated foodborne disease outbreaks, United States, 1998-2013.

Science.gov (United States)

Angelo, K M; Nisler, A L; Hall, A J; Brown, L G; Gould, L H

2017-02-01

Although contamination of food can occur at any point from farm to table, restaurant food workers are a common source of foodborne illness. We describe the characteristics of restaurant-associated foodborne disease outbreaks and explore the role of food workers by analysing outbreaks associated with restaurants from 1998 to 2013 reported to the Centers for Disease Control and Prevention's Foodborne Disease Outbreak Surveillance System. We identified 9788 restaurant-associated outbreaks. The median annual number of outbreaks was 620 (interquartile range 618-629). In 3072 outbreaks with a single confirmed aetiology reported, norovirus caused the largest number of outbreaks (1425, 46%). Of outbreaks with a single food reported and a confirmed aetiology, fish (254 outbreaks, 34%) was most commonly implicated, and these outbreaks were commonly caused by scombroid toxin (219 outbreaks, 86% of fish outbreaks). Most outbreaks (79%) occurred at sit-down establishments. The most commonly reported contributing factors were those related to food handling and preparation practices in the restaurant (2955 outbreaks, 61%). Food workers contributed to 2415 (25%) outbreaks. Knowledge of the foods, aetiologies, and contributing factors that result in foodborne disease restaurant outbreaks can help guide efforts to prevent foodborne illness.

Surveillance of emerging diseases in cattle : Application to the Schmallenberg virus epidemic in the Netherlands

NARCIS (Netherlands)

Veldhuis, A.M.B.

2016-01-01

Animal health surveillance is an essential component to protect animal health, facilitate trade, and protect public health. Reliable surveillance systems are able to rapidly identify outbreaks of emerging animal diseases in previously free areas to enable the implementation of control measures. In

EpiContactTrace: an R-package for contact tracing during livestock disease outbreaks and for risk-based surveillance.

Science.gov (United States)

Nöremark, Maria; Widgren, Stefan

2014-03-17

During outbreak of livestock diseases, contact tracing can be an important part of disease control. Animal movements can also be of relevance for risk-based surveillance and sampling, i.e. both when assessing consequences of introduction or likelihood of introduction. In many countries, animal movement data are collected with one of the major objectives to enable contact tracing. However, often an analytical step is needed to retrieve appropriate information for contact tracing or surveillance. In this study, an open source tool was developed to structure livestock movement data to facilitate contact-tracing in real time during disease outbreaks and for input in risk-based surveillance and sampling. The tool, EpiContactTrace, was written in the R-language and uses the network parameters in-degree, out-degree, ingoing contact chain and outgoing contact chain (also called infection chain), which are relevant for forward and backward tracing respectively. The time-frames for backward and forward tracing can be specified independently and search can be done on one farm at a time or for all farms within the dataset. Different outputs are available; datasets with network measures, contacts visualised in a map and automatically generated reports for each farm either in HTML or PDF-format intended for the end-users, i.e. the veterinary authorities, regional disease control officers and field-veterinarians. EpiContactTrace is available as an R-package at the R-project website (http://cran.r-project.org/web/packages/EpiContactTrace/). We believe this tool can help in disease control since it rapidly can structure essential contact information from large datasets. The reproducible reports make this tool robust and independent of manual compilation of data. The open source makes it accessible and easily adaptable for different needs.

Human angiostrongyliasis outbreak in Dali, China.

Directory of Open Access Journals (Sweden)

Shan Lv

Full Text Available BACKGROUND: Several angiostrongyliasis outbreaks have been reported in recent years but the disease continues to be neglected in public health circles. We describe an outbreak in Dali, southwest China in order to highlight some key problems for the control of this helminth infection. METHODOLOGY/PRINCIPAL FINDINGS: All available medical records of suspected angiostrongyliasis patients visiting hospitals in Dali in the period 1 October 2007-31 March 2008 were reviewed, and tentative diagnoses of varying strengths were reached according to given sets of criteria. Snails collected from local markets, restaurants and natural habitats were also screened for the presence of Angiostrongylus cantonensis. A total of 33 patients met criteria for infection, and 11 among them were classified as clinically confirmed. An additional eight patients were identified through a surveillance system put in operation in response to the outbreak. The epidemic lasted for 8 months with its peak in February 2008. Of the 33 patients, 97.0% complained of severe headache. 84.8% patients had high eosinophil cell counts either in the peripheral blood or in cerebrospinal fluid (CSF. Three-quarters of the patients were treated with a combination of albendazole and corticosteroids, resulting in significantly improved overall conditions. Twenty-two patients reported the consumption of raw or undercooked snails prior to the onset of the symptoms, and approximately 1.0% of the Pomacea canaliculata snails on sale were found to be infected with A. cantonensis. The snails were also found in certain habitats around Dali but no parasites were detected in these populations. CONCLUSIONS/SIGNIFICANCE: The import and sale of infected P. canaliculata is the likely trigger for this angiostrongyliasis outbreak. Awareness of angiostrongyliasis must be raised, and standardized diagnosis and treatment are needed in order to provide clinicians with a guide to address this disease. Health education

Measles outbreak response decision-making under uncertainty: a retrospective analysis.

Science.gov (United States)

Fonnesbeck, Christopher J; Shea, Katriona; Carran, Spencer; Cassio de Moraes, Jose; Gregory, Christopher; Goodson, James L; Ferrari, Matthew J

2018-03-01

Resurgent outbreaks of vaccine-preventable diseases that have previously been controlled or eliminated have been observed in many settings. Reactive vaccination campaigns may successfully control outbreaks but must necessarily be implemented in the face of considerable uncertainty. Real-time surveillance may provide critical information about at-risk population and optimal vaccination targets, but may itself be limited by the specificity of disease confirmation. We propose an integrated modelling approach that synthesizes historical demographic and vaccination data with real-time outbreak surveillance via a dynamic transmission model and an age-specific disease confirmation model. We apply this framework to data from the 1996-1997 measles outbreak in São Paulo, Brazil. To simulate the information available to decision-makers, we truncated the surveillance data to what would have been available at 1 or 2 months prior to the realized interventions. We use the model, fitted to real-time observations, to evaluate the likelihood that candidate age-targeted interventions could control the outbreak. Using only data available prior to the interventions, we estimate that a significant excess of susceptible adults would prevent child-targeted campaigns from controlling the outbreak and that failing to account for age-specific confirmation rates would underestimate the importance of adult-targeted vaccination. © 2018 The Author(s).

Importance of Internet surveillance in public health emergency control and prevention: evidence from a digital epidemiologic study during avian influenza A H7N9 outbreaks.

Science.gov (United States)

Gu, Hua; Chen, Bin; Zhu, Honghong; Jiang, Tao; Wang, Xinyi; Chen, Lei; Jiang, Zhenggang; Zheng, Dawei; Jiang, Jianmin

2014-01-17

Outbreaks of human infection with a new avian influenza A H7N9 virus occurred in China in the spring of 2013. Control and prevention of a new human infectious disease outbreak can be strongly affected by public reaction and social impact through the Internet and social media. This study aimed to investigate the potential roles of Internet surveillance in control and prevention of the human H7N9 outbreaks. Official data for the human H7N9 outbreaks were collected via the China National Health and Family Planning Committee website from March 31 to April 24, 2013. We obtained daily posted and forwarded number of blogs for the keyword "H7N9" from Sina microblog website and a daily Baidu Attention Index (BAI) from Baidu website, which reflected public attention to the outbreak. Rumors identified and confirmed by the authorities were collected from Baidu search engine. Both daily posted and forwarded number and BAI for keyword H7N9 increased quickly during the first 3 days of the outbreaks and remained at a high level for 5 days. The total daily posted and forwarded number for H7N9 on Sina microblog peaked at 850,000 on April 3, from zero blogs before March 31, increasing to 97,726 on April 1 and to 370,607 on April 2, and remaining above 500,000 from April 5-8 before declining to 208,524 on April 12. The total daily BAI showed a similar pattern of change to the total daily posted and forwarded number over time from March 31 to April 12. When the outbreak locations spread, especially into other areas of the same province/city and the capital, Beijing, daily posted and forwarded number and BAI increased again to a peak at 368,500 and 116,911, respectively. The median daily BAI during the studied 25 days was significantly higher among the 7 provinces/cities with reported human H7N9 cases than the 2 provinces without any cases (Psocial media. The first 3 days of an epidemic is a critical period for the authorities to take appropriate action through Internet surveillance to

Surveillance for waterborne disease and outbreaks associated with drinking water and water not intended for drinking--United States, 2003-2004.

Science.gov (United States)

Liang, Jennifer L; Dziuban, Eric J; Craun, Gunther F; Hill, Vincent; Moore, Matthew R; Gelting, Richard J; Calderon, Rebecca L; Beach, Michael J; Roy, Sharon L

2006-12-22

Since 1971, CDC, the U.S. Environmental Protection Agency (EPA), and the Council of State and Territorial Epidemiologists have maintained a collaborative Waterborne Disease and Outbreaks Surveillance System for collecting and reporting data related to occurrences and causes of waterborne disease and outbreaks (WBDOs). This surveillance system is the primary source of data concerning the scope and effects of WBDOs in the United States. Data presented summarize 36 WBDOs that occurred during January 2003-December 2004 and nine previously unreported WBDOs that occurred during 1982-2002. The surveillance system includes data on WBDOs associated with drinking water, water not intended for drinking (excluding recreational water), and water of unknown intent. Public health departments in the states, territories, localities, and Freely Associated States (i.e., the Republic of the Marshall Islands, the Federated States of Micronesia, and the Republic of Palau, formerly parts of the U.S.-administered Trust Territory of the Pacific Islands) are primarily responsible for detecting and investigating WBDOs and voluntarily reporting them to CDC by using a standard form. During 2003-2004, a total of 36 WBDOs were reported by 19 states; 30 were associated with drinking water, three were associated with water not intended for drinking, and three were associated with water of unknown intent. The 30 drinking water-associated WBDOs caused illness among an estimated 2,760 persons and were linked to four deaths. Etiologic agents were identified in 25 (83.3%) of these WBDOs: 17 (68.0%) involved pathogens (i.e., 13 bacterial, one parasitic, one viral, one mixed bacterial/parasitic, and one mixed bacterial/parasitic/viral), and eight (32.0%) involved chemical/toxin poisonings. Gastroenteritis represented 67.7% of the illness related to drinking water-associated WBDOs; acute respiratory illness represented 25.8%, and dermatitis represented 6.5%. The classification of deficiencies contributing

A Simulation-Based Evaluation of Premovement Active Surveillance Protocol Options for the Managed Movement of Turkeys to Slaughter During an Outbreak of Highly Pathogenic Avian Influenza in the United States.

Science.gov (United States)

Todd Weaver, J; Malladi, Sasidhar; Bonney, Peter J; Patyk, Kelly A; Bergeron, Justin G; Middleton, Jamie L; Alexander, Catherine Y; Goldsmith, Timothy J; Halvorson, David A

2016-05-01

Risk management decisions associated with live poultry movement during a highly pathogenic avian influenza (HPAI) outbreak should be carefully considered. Live turkey movements may pose a risk for disease spread. On the other hand, interruptions in scheduled movements can disrupt business continuity. The Secure Turkey Supply (STS) Plan was developed through an industry-government-academic collaboration to address business continuity concerns that might arise during a HPAI outbreak. STS stakeholders proposed outbreak response measure options that were evaluated through risk assessment. The developed approach relies on 1) diagnostic testing of two pooled samples of swabs taken from dead turkeys immediately before movement via the influenza A matrix gene real-time reverse transcriptase polymerase chain reaction (rRT-PCR) test; 2) enhanced biosecurity measures in combination with a premovement isolation period (PMIP), restricting movement onto the premises for a few days before movement to slaughter; and 3) incorporation of a distance factor from known infected flocks such that exposure via local area spread is unlikely. Daily exposure likelihood estimates from spatial kernels from past HPAI outbreaks were coupled with simulation models of disease spread and active surveillance to evaluate active surveillance protocol options that differ with respect to the number of swabs per pooled sample and the timing of the tests in relation to movement. Simulation model results indicate that active surveillance testing, in combination with strict biosecurity, substantially increased HPAI virus detection probability. When distance from a known infected flock was considered, the overall combined likelihood of moving an infected, undetected turkey flock to slaughter was predicted to be lower at 3 and 5 km. The analysis of different active surveillance protocol options is designed to incorporate flexibility into HPAI emergency response plans.

Privacy Implications of Surveillance Systems

DEFF Research Database (Denmark)

Thommesen, Jacob; Andersen, Henning Boje

2009-01-01

This paper presents a model for assessing the privacy „cost‟ of a surveillance system. Surveillance systems collect and provide personal information or observations of people by means of surveillance technologies such as databases, video or location tracking. Such systems can be designed for vari......This paper presents a model for assessing the privacy „cost‟ of a surveillance system. Surveillance systems collect and provide personal information or observations of people by means of surveillance technologies such as databases, video or location tracking. Such systems can be designed...... for various purposes, even as a service for those being observed, but in any case they will to some degree invade their privacy. The model provided here can indicate how invasive any particular system may be – and be used to compare the invasiveness of different systems. Applying a functional approach......, the model is established by first considering the social function of privacy in everyday life, which in turn lets us determine which different domains will be considered as private, and finally identify the different types of privacy invasion. This underlying model (function – domain – invasion) then serves...

The laboratory health system and its response to the Ebola virus disease outbreak in Liberia

Directory of Open Access Journals (Sweden)

Stephen B. Kennedy

2016-10-01

Full Text Available The laboratory system in Liberia has generally been fragmented and uncoordinatedAccordingly, the country’s Ministry of Health established the National Reference Laboratoryto strengthen and sustain laboratory services. However, diagnostic testing services were oftenlimited to clinical tests performed in health facilities, with the functionality of the NationaReference Laboratory restricted to performing testing services for a limited number ofepidemic-prone diseases. The lack of testing capacity in-country for Lassa fever and otherhaemorrhagic fevers affected the response of the country’s health system during the onset ofthe Ebola virus disease (EVD outbreak. Based on the experiences of the EVD outbreak, effortswere initiated to strengthen the laboratory system and infrastructure, enhance human resourcecapacity, and invest in diagnostic services and public health surveillance to inform admittancetreatment, and discharge decisions. In this article, we briefly describe the pre-EVD laboratorycapability in Liberia, and extensively explore the post-EVD strengthening initiatives to enhancecapacity, mobilise resources and coordinate disaster response with international partners torebuild the laboratory infrastructure in the country. Now that the EVD outbreak has endedadditional initiatives are needed to revise the laboratory strategic and operational plan forpost-EVD relevance, promote continual human resource capacity, institute accreditation andvalidation programmes, and coordinate the investment strategy to strengthen and sustain thepreparedness of the laboratory sector to mitigate future emerging and re-emerging infectiousdiseases.

Cholera Incidence and Mortality in Sub-Saharan African Sites during Multi-country Surveillance.

Science.gov (United States)

Sauvageot, Delphine; Njanpop-Lafourcade, Berthe-Marie; Akilimali, Laurent; Anne, Jean-Claude; Bidjada, Pawou; Bompangue, Didier; Bwire, Godfrey; Coulibaly, Daouda; Dengo-Baloi, Liliana; Dosso, Mireille; Orach, Christopher Garimoi; Inguane, Dorteia; Kagirita, Atek; Kacou-N'Douba, Adele; Keita, Sakoba; Kere Banla, Abiba; Kouame, Yao Jean-Pierre; Landoh, Dadja Essoya; Langa, Jose Paulo; Makumbi, Issa; Miwanda, Berthe; Malimbo, Muggaga; Mutombo, Guy; Mutombo, Annie; NGuetta, Emilienne Niamke; Saliou, Mamadou; Sarr, Veronique; Senga, Raphael Kakongo; Sory, Fode; Sema, Cynthia; Tante, Ouyi Valentin; Gessner, Bradford D; Mengel, Martin A

2016-05-01

Cholera burden in Africa remains unknown, often because of weak national surveillance systems. We analyzed data from the African Cholera Surveillance Network (www.africhol.org). During June 2011-December 2013, we conducted enhanced surveillance in seven zones and four outbreak sites in Togo, the Democratic Republic of Congo (DRC), Guinea, Uganda, Mozambique and Cote d'Ivoire. All health facilities treating cholera cases were included. Cholera incidences were calculated using culture-confirmed cholera cases and culture-confirmed cholera cases corrected for lack of culture testing usually due to overwhelmed health systems and imperfect test sensitivity. Of 13,377 reported suspected cases, 34% occurred in Conakry, Guinea, 47% in Goma, DRC, and 19% in the remaining sites. From 0-40% of suspected cases were aged under five years and from 0.3-86% had rice water stools. Within surveillance zones, 0-37% of suspected cases had confirmed cholera compared to 27-38% during outbreaks. Annual confirmed incidence per 10,000 population was cholera incidence, age distribution, clinical presentation, culture confirmation, and testing frequency. These results can help guide preventive activities, including vaccine use.

Legionnaires' Disease Outbreaks and Cooling Towers, New York City, New York, USA.

Science.gov (United States)

Fitzhenry, Robert; Weiss, Don; Cimini, Dan; Balter, Sharon; Boyd, Christopher; Alleyne, Lisa; Stewart, Renee; McIntosh, Natasha; Econome, Andrea; Lin, Ying; Rubinstein, Inessa; Passaretti, Teresa; Kidney, Anna; Lapierre, Pascal; Kass, Daniel; Varma, Jay K

2017-11-01

The incidence of Legionnaires' disease in the United States has been increasing since 2000. Outbreaks and clusters are associated with decorative, recreational, domestic, and industrial water systems, with the largest outbreaks being caused by cooling towers. Since 2006, 6 community-associated Legionnaires' disease outbreaks have occurred in New York City, resulting in 213 cases and 18 deaths. Three outbreaks occurred in 2015, including the largest on record (138 cases). Three outbreaks were linked to cooling towers by molecular comparison of human and environmental Legionella isolates, and the sources for the other 3 outbreaks were undetermined. The evolution of investigation methods and lessons learned from these outbreaks prompted enactment of a new comprehensive law governing the operation and maintenance of New York City cooling towers. Ongoing surveillance and program evaluation will determine if enforcement of the new cooling tower law reduces Legionnaires' disease incidence in New York City.

National laboratory-based surveillance system for antimicrobial resistance: a successful tool to support the control of antimicrobial resistance in the Netherlands.

Science.gov (United States)

Altorf-van der Kuil, Wieke; Schoffelen, Annelot F; de Greeff, Sabine C; Thijsen, Steven Ft; Alblas, H Jeroen; Notermans, Daan W; Vlek, Anne Lm; van der Sande, Marianne Ab; Leenstra, Tjalling

2017-11-01

An important cornerstone in the control of antimicrobial resistance (AMR) is a well-designed quantitative system for the surveillance of spread and temporal trends in AMR. Since 2008, the Dutch national AMR surveillance system, based on routine data from medical microbiological laboratories (MMLs), has developed into a successful tool to support the control of AMR in the Netherlands. It provides background information for policy making in public health and healthcare services, supports development of empirical antibiotic therapy guidelines and facilitates in-depth research. In addition, participation of the MMLs in the national AMR surveillance network has contributed to sharing of knowledge and quality improvement. A future improvement will be the implementation of a new semantic standard together with standardised data transfer, which will reduce errors in data handling and enable a more real-time surveillance. Furthermore, the scientific impact and the possibility of detecting outbreaks may be amplified by merging the AMR surveillance database with databases from selected pathogen-based surveillance programmes containing patient data and genotypic typing data.

Automated graphic image generation system for effective representation of infectious disease surveillance data.

Science.gov (United States)

Inoue, Masashi; Hasegawa, Shinsaku; Suyama, Akihiko; Meshitsuka, Shunsuke

2003-11-01

Infectious disease surveillance schemes have been established to detect infectious disease outbreak in the early stages, to identify the causative viral strains, and to rapidly assess related morbidity and mortality. To make a scheme function well, two things are required. Firstly, it must have sufficient sensitivity and be timely to guarantee as short a delay as possible from collection to redistribution of information. Secondly, it must provide a good representation of the results of the surveillance. To do this, we have developed a database system that can redistribute the information via the Internet. The feature of this system is to automatically generate the graphic images based on the numerical data stored in the database by using Hypertext Preprocessor (PHP) script and Graphics Drawing (GD) library. It dynamically displays the information as a map or bar chart as well as a numerical impression according to the real time demand of the users. This system will be a useful tool for medical personnel and researchers working on infectious disease problems and will save significant time in the redistribution of information.

A Platform for Crowdsourced Foodborne Illness Surveillance: Description of Users and Reports.

Science.gov (United States)

Quade, Patrick; Nsoesie, Elaine Okanyene

2017-07-05

Underreporting of foodborne illness makes foodborne disease burden estimation, timely outbreak detection, and evaluation of policies toward improving food safety challenging. The objective of this study was to present and evaluate Iwaspoisoned.com, an openly accessible Internet-based crowdsourcing platform that was launched in 2009 for the surveillance of foodborne illness. The goal of this system is to collect data that can be used to augment traditional approaches to foodborne disease surveillance. Individuals affected by a foodborne illness can use this system to report their symptoms and the suspected location (eg, restaurant, hotel, hospital) of infection. We present descriptive statistics of users and businesses and highlight three instances where reports of foodborne illness were submitted before the outbreaks were officially confirmed by the local departments of health. More than 49,000 reports of suspected foodborne illness have been submitted on Iwaspoisoned.com since its inception by individuals from 89 countries and every state in the United States. Approximately 95.51% (42,139/44,119) of complaints implicated restaurants as the source of illness. Furthermore, an estimated 67.55% (3118/4616) of users who responded to a demographic survey were between the ages of 18 and 34, and 60.14% (2776/4616) of the respondents were female. The platform is also currently used by health departments in 90% (45/50) of states in the US to supplement existing programs on foodborne illness reporting. Crowdsourced disease surveillance through systems such as Iwaspoisoned.com uses the influence and familiarity of social media to create an infrastructure for easy reporting and surveillance of suspected foodborne illness events. If combined with traditional surveillance approaches, these systems have the potential to lessen the problem of foodborne illness underreporting and aid in early detection and monitoring of foodborne disease outbreaks. ©Patrick Quade, Elaine Okanyene

Response to a large rotavirus outbreak on South Tarawa, Kiribati, 2013

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Teanibuaka Tabunga

2014-05-01

Full Text Available Introduction: In July 2013, during annual independence celebrations in Kiribati, staff at Tungaru Central Hospital on South Tarawa reported an increase in children presenting with severe diarrhoea. This report describes the outbreak investigation, findings and response. Method: After notification of the outbreak, all health facilities on South Tarawa began reporting cases of acute diarrhoea and/or vomiting through the early warning syndromic surveillance system on a daily basis. Community awareness was raised and the public was encouraged to present to a health facility if ill with acute gastroenteritis. Specimens were collected and sent for laboratory testing. Results: Between 10 and 24 July 2013, 1118 cases of gastroenteritis were reported; 103 were hospitalized and six died. The median age of cases was one year (range: 0–68 years; 93.4% were aged less than five years. Rotavirus was identified in 81% of specimens tested. The outbreak response included enhanced surveillance, community education, clinical training and changes to in-hospital patient management for infection control. Discussion: This outbreak was the largest diarrhoea outbreak in Kiribati in five years. Factors that may have contributed to the magnitude and severity of the outbreak included high household density, inadequate sanitation infrastructure and a mass gathering – all increasing the chance of transmission – as well as limited clinical response capacity. The current outbreak highlights the importance of clinical management to minimize severe dehydration and death. Rotavirus vaccination should be considered as an adjunct to other comprehensive enteric disease control measures as recommended by the World Health Organization.

Environmental health surveillance system; Kankyo hoken surveillance system

Energy Technology Data Exchange (ETDEWEB)

Ono, M. [National Inst. for Environmental Studies, Tsukuba (Japan)

1998-02-01

The Central Environmental Pollution Prevention Council pointed out the necessity to establish an environmental health surveillance system (hereinafter referred to as System) in its report `on the first type district specified by the Environmental Pollution Caused Health Damages Compensation Act,` issued in 1986. A study team, established in Environment Agency, has been discussing to establish System since 1986. This paper outlines System, and some of the pilot surveillance results. It is not aimed at elucidation of the cause-effect relationships between health and air pollution but at discovery of problems, in which the above relationships in a district population are monitored periodically and continuously from long-term and prospective viewpoints, in order to help take necessary measures in the early stage. System is now collecting the data of the chronic obstructive lung diseases on a nation-wide scale through health examinations of 3-year-old and preschool children and daily air pollution monitoring. 6 refs., 3 figs., 1 tab.

Survey of the perceptions of key stakeholders on the attributes of the South African Notifiable Diseases Surveillance System.

Science.gov (United States)

Benson, F G; Musekiwa, A; Blumberg, L; Rispel, L C

2016-10-25

An effective and efficient notifiable diseases surveillance system (NDSS) is essential for a rapid response to disease outbreaks, and the identification of priority diseases that may cause national, regional or public health emergencies of international concern (PHEICs). Regular assessments of country-based surveillance system are needed to enable countries to respond to outbreaks before they become PHEICs. As part of a broader evaluation of the NDSS in South Africa, the aim of the study was to determine the perceptions of key stakeholders on the national NDSS attributes of acceptability, flexibility, simplicity, timeliness and usefulness. During 2015, we conducted a nationally representative cross-sectional survey of communicable diseases coordinators and surveillance officers, as well as members of NDSS committees. Individuals with less than 1 year experience of the NDSS were excluded. Consenting participants completed a self-administered questionnaire. The questionnaire elicited information on demographic information and perceptions of the NDSS attributes. Data were analysed using descriptive statistics and the unconditional logistic regression model. Most stakeholders interviewed (53 %, 60/114) were involved in disease control and response. The median number of years of experience with the NDSS was 11 years (inter-quartile range (IQR): 5 to 20 years). Regarding the NDSS attributes, 25 % of the stakeholders perceived the system to be acceptable, 51 % to be flexible, 45 % to be timely, 61 % to be useful, and 74 % to be simple. Health management stakeholders perceived the system to be more useful and timely compared to the other stakeholders. Those with more years of experience were less likely to perceive the NDSS system as acceptable (OR 0.91, 95 % CI: 0.84-1.00, p = 0.041); those in disease detection were less likely to perceive it as timely (OR 0.10, 95 % CI: 0.01-0.96, p = 0.046) and those participating in National Outbreak Response Team were

Remote container monitoring and surveillance systems

International Nuclear Information System (INIS)

Resnik, W.M.; Kadner, S.P.

1995-01-01

Aquila Technologies Group is developing a monitoring and surveillance system to monitor containers of nuclear materials. The system will both visually and physically monitor the containers. The system is based on the combination of Aquila's Gemini All-Digital Surveillance System and on Aquila's AssetLAN trademark asset tracking technology. This paper discusses the Gemini Digital Surveillance system as well as AssetLAN technology. The Gemini architecture with emphasis on anti-tamper security features is also described. The importance of all-digital surveillance versus other surveillance methods is also discussed. AssetLAN trademark technology is described, emphasizing the ability to continually track containers (as assets) by location utilizing touch memory technology. Touch memory technology provides unique container identification, as well as the ability to store and retrieve digital information on the container. This information may relate to container maintenance, inspection schedules, and other information. Finally, this paper describes the combination of the Gemini system with AssetLAN technology, yielding a self contained, container monitoring and area/container surveillance system. Secure container fixture design considerations are discussed. Basic surveillance review functions are also discussed

Strengthening systems for communicable disease surveillance: creating a laboratory network in Rwanda

Directory of Open Access Journals (Sweden)

Ndihokubwayo Jean B

2011-06-01

Full Text Available Abstract Background The recent emergence of a novel strain of influenza virus with pandemic potential underscores the need for quality surveillance and laboratory services to contribute to the timely detection and confirmation of public health threats. To provide a framework for strengthening disease surveillance and response capacities in African countries, the World Health Organization Regional Headquarters for Africa (AFRO developed Integrated Disease Surveillance and Response (IDSR aimed at improving national surveillance and laboratory systems. IDSR emphasizes the linkage of information provided by public health laboratories to the selection of relevant, appropriate and effective public health responses to disease outbreaks. Methods We reviewed the development of Rwanda's National Reference Laboratory (NRL to understand essential structures involved in creating a national public health laboratory network. We reviewed documents describing the NRL's organization and record of test results, conducted site visits, and interviewed health staff in the Ministry of Health and in partner agencies. Findings were developed by organizing thematic categories and grouping examples within them. We purposefully sought to identify success factors as well as challenges inherent in developing a national public health laboratory system. Results Among the identified success factors were: a structured governing framework for public health surveillance; political commitment to promote leadership for stronger laboratory capacities in Rwanda; defined roles and responsibilities for each level; coordinated approaches between technical and funding partners; collaboration with external laboratories; and use of performance results in advocacy with national stakeholders. Major challenges involved general infrastructure, human resources, and budgetary constraints. Conclusions Rwanda's experience with collaborative partnerships contributed to creation of a functional

Cholera Incidence and Mortality in Sub-Saharan African Sites during Multi-country Surveillance.

Directory of Open Access Journals (Sweden)

Delphine Sauvageot

2016-05-01

Full Text Available Cholera burden in Africa remains unknown, often because of weak national surveillance systems. We analyzed data from the African Cholera Surveillance Network (www.africhol.org.During June 2011-December 2013, we conducted enhanced surveillance in seven zones and four outbreak sites in Togo, the Democratic Republic of Congo (DRC, Guinea, Uganda, Mozambique and Cote d'Ivoire. All health facilities treating cholera cases were included. Cholera incidences were calculated using culture-confirmed cholera cases and culture-confirmed cholera cases corrected for lack of culture testing usually due to overwhelmed health systems and imperfect test sensitivity. Of 13,377 reported suspected cases, 34% occurred in Conakry, Guinea, 47% in Goma, DRC, and 19% in the remaining sites. From 0-40% of suspected cases were aged under five years and from 0.3-86% had rice water stools. Within surveillance zones, 0-37% of suspected cases had confirmed cholera compared to 27-38% during outbreaks. Annual confirmed incidence per 10,000 population was <0.5 in surveillance zones, except Goma where it was 4.6. Goma and Conakry had corrected incidences of 20.2 and 5.8 respectively, while the other zones a median of 0.3. During outbreaks, corrected incidence varied from 2.6 to 13.0. Case fatality ratios ranged from 0-10% (median, 1% by country.Across different African epidemiological contexts, substantial variation occurred in cholera incidence, age distribution, clinical presentation, culture confirmation, and testing frequency. These results can help guide preventive activities, including vaccine use.

Environmental Monitoring and Surveillance of Rodents and Vectors for Francisella tularensis Following Outbreaks of Human Tularemia in Georgia.

Science.gov (United States)

Elashvili, Eka; Kracalik, Ian; Burjanadze, Irma; Datukishvili, Sophio; Chanturia, Gvantsa; Tsertsvadze, Nikoloz; Beridze, Levan; Shavishvili, Merab; Dzneladze, Archil; Grdzelidze, Marina; Imnadze, Paata; Pearson, Andrew; Blackburn, Jason K

2015-10-01

Tularemia is a re-emerging bacterial zoonosis, broadly distributed across the northern hemisphere. In Georgia, there is a history of human tularemia outbreaks dating back to the 1940s. In response to outbreaks, health officials initiated long-term field surveillance and environmental monitoring. The objective of our study was to obtain information from 57 years of field surveys to identify species that play a role in the occurrence Francisella tularensis subsp. holarctica in the environment in Georgia. We collected historical data on human outbreaks, field collections, population dynamics of the common vole (Microtus arvalis), and conducted surveys on small mammals and vectors from five regions in Georgia during 1956-2012. Bacterial isolation was conducted using standard culturing techniques, and isolation rates for species were obtained for a subset of years. We used a Spearman rank correlation to test for associations between the density of the common vole and isolation rates. From 1956 through 2012, there were four recorded outbreaks of human tularemia (362 cases). A total of 465 bacterial isolates of F. tularensis subsp. holarctica were obtained from 27 species and environmental samples. The number of isolations was highest in the common vole (M. arvalis; 149 isolates; 32%) and Dermacentor marginatus ticks (132 isolates; 28%); isolation rates ranged between 0-0.91% and 0-0.47%, respectively. Population dynamics of the common vole were not correlated with the isolation rate. Given the history of tularemia re-emergence in Georgia, continued field surveys and environmental monitoring may provide an early indication of outbreak risk in humans. In conclusion, our findings provide evidence of long-standing foci of F. tularensis subsp. holarctica that are likely maintained by the common vole-tick cycle.

Early warning and response system (EWARS) for dengue outbreaks: Recent advancements towards widespread applications in critical settings.

Science.gov (United States)

Hussain-Alkhateeb, Laith; Kroeger, Axel; Olliaro, Piero; Rocklöv, Joacim; Sewe, Maquins Odhiambo; Tejeda, Gustavo; Benitez, David; Gill, Balvinder; Hakim, S Lokman; Gomes Carvalho, Roberta; Bowman, Leigh; Petzold, Max

2018-01-01

Dengue outbreaks are increasing in frequency over space and time, affecting people's health and burdening resource-constrained health systems. The ability to detect early emerging outbreaks is key to mounting an effective response. The early warning and response system (EWARS) is a toolkit that provides countries with early-warning systems for efficient and cost-effective local responses. EWARS uses outbreak and alarm indicators to derive prediction models that can be used prospectively to predict a forthcoming dengue outbreak at district level. We report on the development of the EWARS tool, based on users' recommendations into a convenient, user-friendly and reliable software aided by a user's workbook and its field testing in 30 health districts in Brazil, Malaysia and Mexico. 34 Health officers from the 30 study districts who had used the original EWARS for 7 to 10 months responded to a questionnaire with mainly open-ended questions. Qualitative content analysis showed that participants were generally satisfied with the tool but preferred open-access vs. commercial software. EWARS users also stated that the geographical unit should be the district, while access to meteorological information should be improved. These recommendations were incorporated into the second-generation EWARS-R, using the free R software, combined with recent surveillance data and resulted in higher sensitivities and positive predictive values of alarm signals compared to the first-generation EWARS. Currently the use of satellite data for meteorological information is being tested and a dashboard is being developed to increase user-friendliness of the tool. The inclusion of other Aedes borne viral diseases is under discussion. EWARS is a pragmatic and useful tool for detecting imminent dengue outbreaks to trigger early response activities.

Laser surveillance system (LASSY)

International Nuclear Information System (INIS)

Boeck, H.

1991-09-01

Laser Surveillance System (LASSY) is a beam of laser light which scans a plane above the water or under-water in a spent-fuel pond. The system can detect different objects and estimates its coordinates and distance as well. LASSY can operate in stand-alone configuration or in combination with a video surveillance to trigger signal to a videorecorder. The recorded information on LASSY computer's disk comprises date, time, start and stop angle of detected alarm, the size of the disturbance indicated in number of deviated points and some other information. The information given by the laser system cannot be fully substituted by TV camera pictures since the scanning beam creates a horizontal surveillance plan. The engineered prototype laser system long-term field test has been carried out in Soluggia (Italy) and has shown its feasibility and reliability under the conditions of real spent fuel storage pond. The verification of the alarm table on the LASSY computer with the recorded video pictures of TV surveillance system confirmed that all alarm situations have been detected. 5 refs

National Outbreak Reporting System

Data.gov (United States)

U.S. Department of Health & Human Services — The National Outbreak Reporting System (NORS) is a web-based platform designed to support reporting to CDC by local, state, and territorial health departments in the...

Endoscope disinfection and its pitfalls - requirement for retrograde surveillance cultures

NARCIS (Netherlands)

Buss, A. J.; Been, M. H.; Borgers, R. P.; Stokroos, I.; Melchers, W. J. G.; Peters, F. T. M.; Limburg, A. J.; Degener, J. E.

Background and study aims: Several endoscopy-related outbreaks of infection have been reported in recent years. For early recognition of inadequate disinfection of endoscopes we designed a microbiological surveillance system to evaluate the efficacy of the cleaning and disinfection procedure, and to

Endoscope disinfection and its pitfalls--requirement for retrograde surveillance cultures.

NARCIS (Netherlands)

Buss, A.J.; Been, M.H.; Borgers, R.P.; Stokroos, I.; Melchers, W.J.G.; Peters, F.T.; Limburg, A.J.; Degener, J.E.

2008-01-01

BACKGROUND AND STUDY AIMS: Several endoscopy-related outbreaks of infection have been reported in recent years. For early recognition of inadequate disinfection of endoscopes we designed a microbiological surveillance system to evaluate the efficacy of the cleaning and disinfection procedure, and to

Study on Entomological Surveillance and its Significance during a Dengue Outbreak in the District of Tirunelveli in Tamil Nadu, India

Science.gov (United States)

Basker, Parasuraman; Kannan, Pichai; Porkaipandian, Rajagopal Thirugnanasambandam; Saravanan, Sivsankaran; Sridharan, Subramaniam; Kadhiresan, Mahaligam

2013-01-01

Objectives To study the significance of entomological surveillance, the house index (HI), container index (CI), and Breteau index (BI) were determined to estimate the degree of a major dengue outbreak in Tirunelveli, Tamil Nadu, India (Latitude: 8°42′N; Longitude: 77°42′E) in May 2012. Methods The HI, CI, and BI were determined in a primary health center (PHC) in the village of Maruthamputhur (Pappakudi taluk, Tirunelveli) by carrying out an antilarval (AL) work that involved door-to-door search for immature stages of Aedes spp. mosquitoes by trained field workers and volunteers. The work of field workers was evaluated by a junior and senior entomologist the following day. Results Before the AL work, the reported numbers of fever cases from Week 1 to 5 in Maruthamputhur were 211, 394, 244, 222, and 144 with two deaths. By contrast, after the AL work, these numbers were considerably reduced and there was no fever-related death (the HI was reduced from 48.2% to 1.6%, the CI from 28.6% to 0.4%, and the BI from 48.2 to 1.6). Conclusion Because no specific medicine and vaccines are available to treat dengue fever and dengue hemorrhagic fever, entomological surveillance and its significance can be used to halt the outbreak of dengue as shown in this study. PMID:24159547

Comparison of human and animal surveillance data for H5N1 influenza A in Egypt 2006-2011.

Directory of Open Access Journals (Sweden)

Peter M Rabinowitz

Full Text Available BACKGROUND: The majority of emerging infectious diseases are zoonotic (transmissible between animals and humans in origin, and therefore integrated surveillance of disease events in humans and animals has been recommended to support effective global response to disease emergence. While in the past decade there has been extensive global surveillance for highly pathogenic avian influenza (HPAI infection in both animals and humans, there have been few attempts to compare these data streams and evaluate the utility of such integration. METHODOLOGY: We compared reports of bird outbreaks of HPAI H5N1 in Egypt for 2006-2011 compiled by the World Organisation for Animal Health (OIE and the UN Food and Agriculture Organization (FAO EMPRESi reporting system with confirmed human H5N1 cases reported to the World Health Organization (WHO for Egypt during the same time period. PRINCIPAL FINDINGS: Both human cases and bird outbreaks showed a cyclic pattern for the country as a whole, and there was a statistically significant temporal correlation between the data streams. At the governorate level, the first outbreak in birds in a season usually but not always preceded the first human case, and the time lag between events varied widely, suggesting regional differences in zoonotic risk and/or surveillance effectiveness. In a multivariate risk model, lower temperature, lower urbanization, higher poultry density, and the recent occurrence of a bird outbreak were associated with increased risk of a human case of HPAI in the same governorate, although the positive predictive value of a bird outbreak was low. CONCLUSIONS: Integrating data streams of surveillance for human and animal cases of zoonotic disease holds promise for better prediction of disease risk and identification of environmental and regional factors that can affect risk. Such efforts can also point out gaps in human and animal surveillance systems and generate hypotheses regarding disease transmission.

A Classification System for Hospital-Based Infection Outbreaks

Directory of Open Access Journals (Sweden)

Paul S. Ganney

2010-01-01

Full Text Available Outbreaks of infection within semi-closed environments such as hospitals, whether inherent in the environment (such as Clostridium difficile (C.Diff or Methicillinresistant Staphylococcus aureus (MRSA or imported from the wider community (such as Norwalk-like viruses (NLVs, are difficult to manage. As part of our work on modelling such outbreaks, we have developed a classification system to describe the impact of a particular outbreak upon an organization. This classification system may then be used in comparing appropriate computer models to real outbreaks, as well as in comparing different real outbreaks in, for example, the comparison of differing management and containment techniques and strategies. Data from NLV outbreaks in the Hull and East Yorkshire Hospitals NHS Trust (the Trust over several previous years are analysed and classified, both for infection within staff (where the end of infection date may not be known and within patients (where it generally is known. A classification system consisting of seven elements is described, along with a goodness-of-fit method for comparing a new classification to previously known ones, for use in evaluating a simulation against history and thereby determining how ‘realistic’ (or otherwise it is.

A classification system for hospital-based infection outbreaks.

Science.gov (United States)

Ganney, Paul S; Madeo, Maurice; Phillips, Roger

2010-12-01

Outbreaks of infection within semi-closed environments such as hospitals, whether inherent in the environment (such as Clostridium difficile (C.Diff) or Methicillin-resistant Staphylococcus aureus (MRSA) or imported from the wider community (such as Norwalk-like viruses (NLVs)), are difficult to manage. As part of our work on modelling such outbreaks, we have developed a classification system to describe the impact of a particular outbreak upon an organization. This classification system may then be used in comparing appropriate computer models to real outbreaks, as well as in comparing different real outbreaks in, for example, the comparison of differing management and containment techniques and strategies. Data from NLV outbreaks in the Hull and East Yorkshire Hospitals NHS Trust (the Trust) over several previous years are analysed and classified, both for infection within staff (where the end of infection date may not be known) and within patients (where it generally is known). A classification system consisting of seven elements is described, along with a goodness-of-fit method for comparing a new classification to previously known ones, for use in evaluating a simulation against history and thereby determining how 'realistic' (or otherwise) it is.

Enhanced HIV-1 surveillance using molecular epidemiology to study and monitor HIV-1 outbreaks among intravenous drug users (IDUs) in Athens and Bucharest.

Science.gov (United States)

Paraskevis, Dimitrios; Paraschiv, Simona; Sypsa, Vana; Nikolopoulos, Georgios; Tsiara, Chryssa; Magiorkinis, Gkikas; Psichogiou, Mina; Flampouris, Andreas; Mardarescu, Mariana; Niculescu, Iulia; Batan, Ionelia; Malliori, Meni; Otelea, Dan; Hatzakis, Angelos

2015-10-01

A significant increase in HIV-1 diagnoses was reported among Injecting Drug Users (IDUs) in the Athens (17-fold) and Bucharest (9-fold) metropolitan areas starting 2011. Molecular analyses were conducted on HIV-1 sequences from IDUs comprising 51% and 20% of the diagnosed cases among IDUs during 2011-2013 for Greece and Romania, respectively. Phylodynamic analyses were performed using the newly developed birth-death serial skyline model which allows estimating of important epidemiological parameters, as implemented in BEAST programme. Most infections (>90%) occurred within four and three IDU local transmission networks in Athens and Bucharest, respectively. For all Romanian clusters, the viral strains originated from local circulating strains, whereas in Athens, the local strains seeded only two of the four sub-outbreaks. Birth-death skyline plots suggest a more explosive nature for sub-outbreaks in Bucharest than in Athens. In Athens, two sub-outbreaks had been controlled (Re1.0) and two had been controlled (Re<1.0). The lead times were shorter for the outbreak in Athens than in Bucharest. Enhanced molecular surveillance proved useful to gain information about the origin, causal pathways, dispersal patterns and transmission dynamics of the outbreaks that can be useful in a public health setting. Copyright © 2015 Elsevier B.V. All rights reserved.

Results from the fielding of the Bio-surveillance Analysis, Feedback, Evaluation and Response (B-SAFER) system in Albuquerque, New Mexico.

Science.gov (United States)

Forslund, David; Umland, Edith; Brillman, Judith C; Joyce, Ed; Froman, Philip; Burr, Tom; Judd, Stephen L; Picard, Richard; Wokoun, Doug; Joner, Mike; Sewell, C Mack

2003-01-01

Public health authorities need a surveillance system that is sensitive enough to detect a disease outbreak early to enable a proper response. In order to meet this challenge we have deployed a pilot component-based system in Albuquerque, NM as part of the National Biodefense Initiative (BDI). B-SAFER gathers routinely collected data from healthcare institutions to monitor disease events in the community. We describe initial results from the deployment of the system for the past 6 months

Cholera Incidence and Mortality in Sub-Saharan African Sites during Multi-country Surveillance

Science.gov (United States)

Sauvageot, Delphine; Njanpop-Lafourcade, Berthe-Marie; Akilimali, Laurent; Anne, Jean-Claude; Bidjada, Pawou; Bompangue, Didier; Bwire, Godfrey; Coulibaly, Daouda; Dengo-Baloi, Liliana; Dosso, Mireille; Orach, Christopher Garimoi; Inguane, Dorteia; Kagirita, Atek; Kacou-N’Douba, Adele; Keita, Sakoba; Kere Banla, Abiba; Kouame, Yao Jean-Pierre; Landoh, Dadja Essoya; Langa, Jose Paulo; Makumbi, Issa; Miwanda, Berthe; Malimbo, Muggaga; Mutombo, Guy; Mutombo, Annie; NGuetta, Emilienne Niamke; Saliou, Mamadou; Sarr, Veronique; Senga, Raphael Kakongo; Sory, Fode; Sema, Cynthia; Tante, Ouyi Valentin; Gessner, Bradford D.; Mengel, Martin A.

2016-01-01

Background Cholera burden in Africa remains unknown, often because of weak national surveillance systems. We analyzed data from the African Cholera Surveillance Network (www.africhol.org). Methods/ Principal findings During June 2011–December 2013, we conducted enhanced surveillance in seven zones and four outbreak sites in Togo, the Democratic Republic of Congo (DRC), Guinea, Uganda, Mozambique and Cote d’Ivoire. All health facilities treating cholera cases were included. Cholera incidences were calculated using culture-confirmed cholera cases and culture-confirmed cholera cases corrected for lack of culture testing usually due to overwhelmed health systems and imperfect test sensitivity. Of 13,377 reported suspected cases, 34% occurred in Conakry, Guinea, 47% in Goma, DRC, and 19% in the remaining sites. From 0–40% of suspected cases were aged under five years and from 0.3–86% had rice water stools. Within surveillance zones, 0–37% of suspected cases had confirmed cholera compared to 27–38% during outbreaks. Annual confirmed incidence per 10,000 population was Conakry had corrected incidences of 20.2 and 5.8 respectively, while the other zones a median of 0.3. During outbreaks, corrected incidence varied from 2.6 to 13.0. Case fatality ratios ranged from 0–10% (median, 1%) by country. Conclusions/Significance Across different African epidemiological contexts, substantial variation occurred in cholera incidence, age distribution, clinical presentation, culture confirmation, and testing frequency. These results can help guide preventive activities, including vaccine use. PMID:27186885

Phage typing or CRISPR typing for epidemiological surveillance of Salmonella Typhimurium?

Science.gov (United States)

Mohammed, Manal

2017-11-07

Salmonella Typhimurium is the most dominant Salmonella serovar around the world. It is associated with foodborne gastroenteritis outbreaks but has recently been associated with invasive illness and deaths. Characterization of S. Typhimurium is therefore very crucial for epidemiological surveillance. Phage typing has been used for decades for subtyping of S. Typhimurium to determine the epidemiological relation among isolates. Recent studies however have suggested that high throughput clustered regular interspaced short palindromic repeats (CRISPR) typing has the potential to replace phage typing. This study aimed to determine the efficacy of high-throughput CRISPR typing over conventional phage typing in epidemiological surveillance and outbreak investigation of S. Typhimurium. In silico analysis of whole genome sequences (WGS) of well-documented phage types of S. Typhimurium reveals the presence of different CRISPR type among strains belong to the same phage type. Furthermore, different phage types of S. Typhimurium share identical CRISPR type. Interestingly, identical spacers were detected among outbreak and non-outbreak associated DT8 strains of S. Typhimurium. Therefore, CRISPR typing is not useful for the epidemiological surveillance and outbreak investigation of S. Typhimurium and phage typing, until it is replaced by WGS, is still the gold standard method for epidemiological surveillance of S. Typhimurium.

Assessment of the response to cholera outbreaks in two districts in Ghana.

Science.gov (United States)

Ohene, Sally-Ann; Klenyuie, Wisdom; Sarpeh, Mark

2016-11-02

Despite recurring outbreaks of cholera in Ghana, very little has been reported on assessments of outbreak response activities undertaken in affected areas. This study assessed the response activities undertaken in two districts, Akatsi District in Volta Region and Komenda-Edina-Eguafo-Abirem (KEEA) Municipal in Central Region during the 2012 cholera epidemic in Ghana. We conducted a retrospective assessment of the events, strengths and weaknesses of the cholera outbreak response activities in the two districts making use of the WHO cholera evaluation tool. Information sources included surveillance and facility records, reports and interviews with relevant health personnel involved in the outbreak response from both district health directorates and health facilities. We collected data on age, sex, area of residence, date of reporting to health facility of cholera cases, district population data and information on the outbreak response activities and performed descriptive analyses of the outbreak data by person, time and place. The cholera outbreak in Akatsi was explosive with a high attack rate (AR) of 374/100,000 and case fatality rate (CFR) of 1.2 % while that in KEEA was on a relatively smaller scale AR of 23/100,000 but with a high case fatality rate of 18.8 %. For both districts, we identified multiple strengths in the response to the outbreak including timely notification of the district health officials which triggered prompt investigation of the suspected outbreak facilitating confirmation of cholera and initiation of public health response activities. Others were coordination of the activities by multi-sectoral committees, instituting water, sanitation and hygiene measures and appropriate case management at health facilities. We also found areas that needed improvement in both districts including incomplete surveillance data, sub-optimal community based surveillance considering the late reporting and the deaths in the community and the inadequate

Human temperatures for syndromic surveillance in the emergency department: data from the autumn wave of the 2009 swine flu (H1N1) pandemic and a seasonal influenza outbreak.

Science.gov (United States)

Bordonaro, Samantha F; McGillicuddy, Daniel C; Pompei, Francesco; Burmistrov, Dmitriy; Harding, Charles; Sanchez, Leon D

2016-03-09

The emergency department (ED) increasingly acts as a gateway to the evaluation and treatment of acute illnesses. Consequently, it has also become a key testing ground for systems that monitor and identify outbreaks of disease. Here, we describe a new technology that automatically collects body temperatures during triage. The technology was tested in an ED as an approach to monitoring diseases that cause fever, such as seasonal flu and some pandemics. Temporal artery thermometers that log temperature measurements were placed in a Boston ED and used for initial triage vital signs. Time-stamped measurements were collected from the thermometers to investigate the performance a real-time system would offer. The data were summarized in terms of rates of fever (temperatures ≥100.4 °F [≥38.0 °C]) and were qualitatively compared with regional disease surveillance programs in Massachusetts. From September 2009 through August 2011, 71,865 body temperatures were collected and included in our analysis, 2073 (2.6 %) of which were fevers. The period of study included the autumn-winter wave of the 2009-2010 H1N1 (swine flu) pandemic, during which the weekly incidence of fever reached a maximum of 5.6 %, as well as the 2010-2011 seasonal flu outbreak, during which the maximum weekly incidence of fever was 6.6 %. The periods of peak fever rates corresponded with the periods of regionally elevated flu activity. Temperature measurements were monitored at triage in the ED over a period of 2 years. The resulting data showed promise as a potential surveillance tool for febrile disease that could complement current disease surveillance systems. Because temperature can easily be measured by non-experts, it might also be suitable for monitoring febrile disease activity in schools, workplaces, and transportation hubs, where many traditional syndromic indicators are impractical. However, the system's validity and generalizability should be evaluated in additional years and

Ebola virus disease surveillance and response preparedness in northern Ghana

OpenAIRE

Adokiya, Martin N.; Awoonor-Williams, John K.

2016-01-01

Background: The recent Ebola virus disease (EVD) outbreak has been described as unprecedented in terms of morbidity, mortality, and geographical extension. It also revealed many weaknesses and inadequacies for disease surveillance and response systems in Africa due to underqualified staff, cultural beliefs, and lack of trust for the formal health care sector. In 2014, Ghana had high risk of importation of EVD cases.Objective: The objective of this study was to assess the EVD surveillance and ...

System specification for the integrated monitoring and surveillance system

International Nuclear Information System (INIS)

1997-09-01

This System Specification establishes the requirements for the Plutonium Focus Area (PFA) Integrated Monitoring and Surveillance System (IMSS). In this document, ''Integrated Monitoring and Surveillance System'' is used to describe the concept of integrated sensors, computers, personnel, and systems that perform the functions of sensing conditions, acquiring data, monitoring environmental safety and health, controlling and accounting for materials, monitoring material stability, monitoring container integrity, transferring data, and analyzing, reporting, and storing data. This concept encompasses systems (e.g. sensors, personnel, databases, etc.) that are already in place at the sites but may require modifications or additions to meet all identified surveillance requirements. The purpose of this System Specification is to provide Department of Energy (DOE) sites that store plutonium materials with a consolidation of all known requirements for the storage and surveillance of 3013 packages of stabilized plutonium metals and oxides. This compilation may be used (1) as a baseline for surveillance system design specifications where 3013 packages of stabilized plutonium metals and oxides will be stored and monitored; (2) as a checklist for evaluating existing surveillance systems to ensure that all requirements are met for the storage and surveillance of 3013 packages of stabilized plutonium metals and oxides; and (3) as a baseline for preparing procurement specifications tailored for site specific storage and surveillance of 3013 packages of stabilized plutonium metals and oxides

Post-tensioning system surveillance program

International Nuclear Information System (INIS)

Drew, G.E.

1979-01-01

Nuclear power plant containment structure post-tensioning system tendon surveillance program is described in detail. Data collected over three yearly post-tensioning system Surveillance Programs is presented and evaluated to correlate anticipated stress losses with actual losses. In addition corrosion protected system performance is analyzed

The use of a mobile laboratory unit in support of patient management and epidemiological surveillance during the 2005 Marburg Outbreak in Angola.

Directory of Open Access Journals (Sweden)

Allen Grolla

2011-05-01

Full Text Available BACKGROUND: Marburg virus (MARV, a zoonotic pathogen causing severe hemorrhagic fever in man, has emerged in Angola resulting in the largest outbreak of Marburg hemorrhagic fever (MHF with the highest case fatality rate to date. METHODOLOGY/PRINCIPAL FINDINGS: A mobile laboratory unit (MLU was deployed as part of the World Health Organization outbreak response. Utilizing quantitative real-time PCR assays, this laboratory provided specific MARV diagnostics in Uige, the epicentre of the outbreak. The MLU operated over a period of 88 days and tested 620 specimens from 388 individuals. Specimens included mainly oral swabs and EDTA blood. Following establishing on site, the MLU operation allowed a diagnostic response in <4 hours from sample receiving. Most cases were found among females in the child-bearing age and in children less than five years of age. The outbreak had a high number of paediatric cases and breastfeeding may have been a factor in MARV transmission as indicated by the epidemiology and MARV positive breast milk specimens. Oral swabs were a useful alternative specimen source to whole blood/serum allowing testing of patients in circumstances of resistance to invasive procedures but limited diagnostic testing to molecular approaches. There was a high concordance in test results between the MLU and the reference laboratory in Luanda operated by the US Centers for Disease Control and Prevention. CONCLUSIONS/SIGNIFICANCE: The MLU was an important outbreak response asset providing support in patient management and epidemiological surveillance. Field laboratory capacity should be expanded and made an essential part of any future outbreak investigation.

Early warning and response system (EWARS for dengue outbreaks: Recent advancements towards widespread applications in critical settings.

Directory of Open Access Journals (Sweden)

Laith Hussain-Alkhateeb

Full Text Available Dengue outbreaks are increasing in frequency over space and time, affecting people's health and burdening resource-constrained health systems. The ability to detect early emerging outbreaks is key to mounting an effective response. The early warning and response system (EWARS is a toolkit that provides countries with early-warning systems for efficient and cost-effective local responses. EWARS uses outbreak and alarm indicators to derive prediction models that can be used prospectively to predict a forthcoming dengue outbreak at district level.We report on the development of the EWARS tool, based on users' recommendations into a convenient, user-friendly and reliable software aided by a user's workbook and its field testing in 30 health districts in Brazil, Malaysia and Mexico.34 Health officers from the 30 study districts who had used the original EWARS for 7 to 10 months responded to a questionnaire with mainly open-ended questions. Qualitative content analysis showed that participants were generally satisfied with the tool but preferred open-access vs. commercial software. EWARS users also stated that the geographical unit should be the district, while access to meteorological information should be improved. These recommendations were incorporated into the second-generation EWARS-R, using the free R software, combined with recent surveillance data and resulted in higher sensitivities and positive predictive values of alarm signals compared to the first-generation EWARS. Currently the use of satellite data for meteorological information is being tested and a dashboard is being developed to increase user-friendliness of the tool. The inclusion of other Aedes borne viral diseases is under discussion.EWARS is a pragmatic and useful tool for detecting imminent dengue outbreaks to trigger early response activities.

An integrated national mortality surveillance system for death registration and mortality surveillance, China.

Science.gov (United States)

Liu, Shiwei; Wu, Xiaoling; Lopez, Alan D; Wang, Lijun; Cai, Yue; Page, Andrew; Yin, Peng; Liu, Yunning; Li, Yichong; Liu, Jiangmei; You, Jinling; Zhou, Maigeng

2016-01-01

In China, sample-based mortality surveillance systems, such as the Chinese Center for Disease Control and Prevention's disease surveillance points system and the Ministry of Health's vital registration system, have been used for decades to provide nationally representative data on health status for health-care decision-making and performance evaluation. However, neither system provided representative mortality and cause-of-death data at the provincial level to inform regional health service needs and policy priorities. Moreover, the systems overlapped to a considerable extent, thereby entailing a duplication of effort. In 2013, the Chinese Government combined these two systems into an integrated national mortality surveillance system to provide a provincially representative picture of total and cause-specific mortality and to accelerate the development of a comprehensive vital registration and mortality surveillance system for the whole country. This new system increased the surveillance population from 6 to 24% of the Chinese population. The number of surveillance points, each of which covered a district or county, increased from 161 to 605. To ensure representativeness at the provincial level, the 605 surveillance points were selected to cover China's 31 provinces using an iterative method involving multistage stratification that took into account the sociodemographic characteristics of the population. This paper describes the development and operation of the new national mortality surveillance system, which is expected to yield representative provincial estimates of mortality in China for the first time.

Measles outbreak investigation in Guji zone of Oromia Region, Ethiopia.

Science.gov (United States)

Belda, Ketema; Tegegne, Ayesheshem Ademe; Mersha, Amare Mengistu; Bayenessagne, Mekonnen Getahun; Hussein, Ibrahim; Bezabeh, Belay

2017-01-01

Despite the increase of immunization coverage (administrative) of measles in the country, there are widespread outbreaks of measles. In this respect, we investigated one of the outbreaks that occurred in hard to reach kebeles of Guji Zone, Oromia region, to identify the contributing factors that lead to the protracted outbreak of measles. We used a cross-sectional study design to investigate a measles outbreak in Guji zone, Oromia region. Data entry and analysis was performed using EPI-Info version 7.1.0.6 and MS-Microsoft Excel. In three months' time a total of 1059 suspected cases and two deaths were reported from 9 woredas affected by a measles outbreak in Guji zone. The cumulative attack rate of 81/100,000 population and case fatality ratio of 0.2% was recorded. Of these, 821 (77.5%) cases were measles vaccine. Although, all age groups were affected under five years old were more affected 495 (48%) than any other age groups. In response to the outbreak, an outbreak response immunization was organized at the 11th week of the epidemic, when the epidemic curve started to decline. 6 months to14 years old were targeted for outbreak response immunization and the overall coverage was 97 % (range: 90-103%). Case management with vitamin A supplementation, active case search, and health education was some of the activities carried out to curb the outbreak. We conclude that low routine immunization coverage in conjunction with low access to routine immunization in hard to reach areas, low community awareness in utilization of immunization service, inadequate cold chain management and delivery of a potent vaccine in hard to reach woredas/kebeles were likely contributed to the outbreak that's triggered a broad spread epidemic affecting mostly children without any vaccination. We also figured that the case-based surveillance lacks sensitivity and timely confirmation of the outbreak, which as a result outbreak response immunization were delayed. We recommend establishing

A Gastroenteritis Outbreak Caused by Noroviruses in Greece

Directory of Open Access Journals (Sweden)

Yiannis Alamanos

2011-08-01

Full Text Available In June 2006, an outbreak alert regarding cases of acute gastroenteritis in a region in North Eastern Greece (population 100,882 inhabitants, triggered investigations to guide control measures. The outbreak started the first days of June, and peaked in July. A descriptive epidemiological study, a virological characterization of the viral agent identified from cases as well as a phylogenetic analysis was performed. From June 5 to September 3, 2006 (weeks 23–44, 1,640 cases of gastroenteritis (45.2% male and 54.8% female, aged 3 months to 89 years were reported. The overall attack rate for the period was 16.3 cases/1,000 inhabitants. About 57% of cases observed were under the age of 15 years. Αnalysis of faecal samples identified Norovirus GII strains. Fifteen different Norovirus GII strains were recorded, presenting a homology of 94.8% (86–97% to GII strains obtained from GenBank. The long duration of the outbreak suggests an important role of person-to-person transmission, while the emergence of the outbreak was possibly due to contaminated potable water, although no viruses were detected in any tested water samples. This outbreak underscores the need for a national surveillance system for acute non-bacterial gastroenteritis outbreaks.

Ebola Surveillance - Guinea, Liberia, and Sierra Leone.

Science.gov (United States)

McNamara, Lucy A; Schafer, Ilana J; Nolen, Leisha D; Gorina, Yelena; Redd, John T; Lo, Terrence; Ervin, Elizabeth; Henao, Olga; Dahl, Benjamin A; Morgan, Oliver; Hersey, Sara; Knust, Barbara

2016-07-08

Developing a surveillance system during a public health emergency is always challenging but is especially so in countries with limited public health infrastructure. Surveillance for Ebola virus disease (Ebola) in the West African countries heavily affected by Ebola (Guinea, Liberia, and Sierra Leone) faced numerous impediments, including insufficient numbers of trained staff, community reticence to report cases and contacts, limited information technology resources, limited telephone and Internet service, and overwhelming numbers of infected persons. Through the work of CDC and numerous partners, including the countries' ministries of health, the World Health Organization, and other government and nongovernment organizations, functional Ebola surveillance was established and maintained in these countries. CDC staff were heavily involved in implementing case-based surveillance systems, sustaining case surveillance and contact tracing, and interpreting surveillance data. In addition to helping the ministries of health and other partners understand and manage the epidemic, CDC's activities strengthened epidemiologic and data management capacity to improve routine surveillance in the countries affected, even after the Ebola epidemic ended, and enhanced local capacity to respond quickly to future public health emergencies. However, the many obstacles overcome during development of these Ebola surveillance systems highlight the need to have strong public health, surveillance, and information technology infrastructure in place before a public health emergency occurs. Intense, long-term focus on strengthening public health surveillance systems in developing countries, as described in the Global Health Security Agenda, is needed.The activities summarized in this report would not have been possible without collaboration with many U.S and international partners (http://www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/partners.html).

Cell Phone-Based System (Chaak) for Surveillance of Immatures of Dengue Virus Mosquito Vectors

Science.gov (United States)

LOZANO–FUENTES, SAUL; WEDYAN, FADI; HERNANDEZ–GARCIA, EDGAR; SADHU, DEVADATTA; GHOSH, SUDIPTO; BIEMAN, JAMES M.; TEP-CHEL, DIANA; GARCÍA–REJÓN, JULIÁN E.; EISEN, LARS

2014-01-01

Capture of surveillance data on mobile devices and rapid transfer of such data from these devices into an electronic database or data management and decision support systems promote timely data analyses and public health response during disease outbreaks. Mobile data capture is used increasingly for malaria surveillance and holds great promise for surveillance of other neglected tropical diseases. We focused on mosquito-borne dengue, with the primary aims of: 1) developing and field-testing a cell phone-based system (called Chaak) for capture of data relating to the surveillance of the mosquito immature stages, and 2) assessing, in the dengue endemic setting of Mérida, México, the cost-effectiveness of this new technology versus paper-based data collection. Chaak includes a desktop component, where a manager selects premises to be surveyed for mosquito immatures, and a cell phone component, where the surveyor receives the assigned tasks and captures the data. Data collected on the cell phone can be transferred to a central database through different modes of transmission, including near-real time where data are transferred immediately (e.g., over the Internet) or by first storing data on the cell phone for future transmission. Spatial data are handled in a novel, semantically driven, geographic information system. Compared with a pen-and-paper-based method, use of Chaak improved the accuracy and increased the speed of data transcription into an electronic database. The cost-effectiveness of using the Chaak system will depend largely on the up-front cost of purchasing cell phones and the recurring cost of data transfer over a cellular network. PMID:23926788

Analysis and Modeling of Influenza Outbreaks as Driven by Weather

Science.gov (United States)

Thrastarson, H. T.; Teixeira, J.; Serman, E. A.; Parekh, A.; Yeo, E.

2017-12-01

Seasonal influenza outbreaks are a major source of illness, mortality and economic burden worldwide. Attributing what drives the seasonality of the outbreaks is still an unsettled problem. But in temperate regions absolute humidity conditions are a strong candidate (Shaman et al., 2010) and some studies have associated temperature conditions with influenza outbreaks. We use humidity and temperature data from NASA's AIRS (Atmospheric Infra-Red Sounder) instrument as well as data for influenza incidence in the US and South Africa to explore the connection between weather and influenza seasonality at different spatial scales. We also incorporate influenza surveillance data, satellite data and humidity forecasts into a numerical epidemiological prediction system. Our results give support for the role of local weather conditions as drivers of the seasonality of influenza in temperate regions. This can have implications for public health efforts where forecasting of the timing and intensity of influenza outbreaks has a great potential role (e.g., aiding management and organization of vaccines, drugs and other resources).

Outbreaks of virulent diarrheagenic Escherichia coli - are we in control?

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Werber Dirk

2012-02-01

Full Text Available Abstract Shiga toxin-producing Escherichia coli (STEC are the most virulent diarrheagenic E. coli known to date. They can be spread with alarming ease via food as exemplified by a large sprout-borne outbreak of STEC O104:H4 in 2011 that was centered in northern Germany and affected several countries. Effective control of such outbreaks is an important public health task and necessitates early outbreak detection, fast identification of the outbreak vehicle and immediate removal of the suspected food from the market, flanked by consumer advice and measures to prevent secondary spread. In our view, opportunities to improve control of STEC outbreaks lie in early clinical suspicion for STEC infection, timely diagnosis of all STEC at the serotype-level and integrating molecular subtyping information into surveillance systems. Furthermore, conducting analytical studies that supplement patients' imperfect food history recall and performing, as an investigative element, product tracebacks, are pivotal but underutilized tools for successful epidemiologic identification of the suspected vehicle in foodborne outbreaks. As a corollary, these tools are amenable to tailor microbiological testing of suspected food. Please see related article: http://www.biomedcentral.com/1741-7015/10/12

Surveillance for Neisseria meningitidis Disease Activity and Transmission Using Information Technology.

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S Sohail Ahmed

Full Text Available While formal reporting, surveillance, and response structures remain essential to protecting public health, a new generation of freely accessible, online, and real-time informatics tools for disease tracking are expanding the ability to raise earlier public awareness of emerging disease threats. The rationale for this study is to test the hypothesis that the HealthMap informatics tools can complement epidemiological data captured by traditional surveillance monitoring systems for meningitis due to Neisseria meningitides (N. meningitides by highlighting severe transmissible disease activity and outbreaks in the United States.Annual analyses of N. meningitides disease alerts captured by HealthMap were compared to epidemiological data captured by the Centers for Disease Control's Active Bacterial Core surveillance (ABCs for N. meningitides. Morbidity and mortality case reports were measured annually from 2010 to 2013 (HealthMap and 2005 to 2012 (ABCs.HealthMap N. meningitides monitoring captured 80-90% of alerts as diagnosed N. meningitides, 5-20% of alerts as suspected cases, and 5-10% of alerts as related news articles. HealthMap disease alert activity for emerging disease threats related to N. meningitides were in agreement with patterns identified historically using traditional surveillance systems. HealthMap's strength lies in its ability to provide a cumulative "snapshot" of weak signals that allows for rapid dissemination of knowledge and earlier public awareness of potential outbreak status while formal testing and confirmation for specific serotypes is ongoing by public health authorities.The underreporting of disease cases in internet-based data streaming makes inadequate any comparison to epidemiological trends illustrated by the more comprehensive ABCs network published by the Centers for Disease Control. However, the expected delays in compiling confirmatory reports by traditional surveillance systems (at the time of writing, ABCs data

Laboratory-Based Surveillance and Molecular Characterization of Dengue Viruses in Taiwan, 2014.

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Chang, Shu-Fen; Yang, Cheng-Fen; Hsu, Tung-Chieh; Su, Chien-Ling; Lin, Chien-Chou; Shu, Pei-Yun

2016-04-01

We present the results of a laboratory-based surveillance of dengue in Taiwan in 2014. A total of 240 imported dengue cases were identified. The patients had arrived from 16 countries, and Malaysia, Indonesia, the Philippines, and China were the most frequent importing countries. Phylogenetic analyses showed that genotype I of dengue virus type 1 (DENV-1) and the cosmopolitan genotype of DENV-2 were the predominant DENV strains circulating in southeast Asia. The 2014 dengue epidemic was the largest ever to occur in Taiwan since World War II, and there were 15,492 laboratory-confirmed indigenous dengue cases. Phylogenetic analysis showed that the explosive dengue epidemic in southern Taiwan was caused by a DENV-1 strain of genotype I imported from Indonesia. There were several possible causes of this outbreak, including delayed notification of the outbreak, limited staff and resources for control measures, abnormal weather conditions, and a serious gas pipeline explosion in the dengue hot spot areas in Kaohsiung City. However, the results of this surveillance indicated that both active and passive surveillance systems should be strengthened so appropriate public health measures can be taken promptly to prevent large-scale dengue outbreaks. © The American Society of Tropical Medicine and Hygiene.

Emergency Medical Service (EMS) Data for Syndromic Surveillance in Andhra Pradesh, India

NARCIS (Netherlands)

Pilot, E.; Rao, R.; Jena, B.; Krafft, T.; Wang, W.; Krafft, T.; Rosenberg, M.; Pilot, E.

2014-01-01

Infectious disease outbreaks like H1N1 and more recently Ebola, have once more highlighted that health surveillance and early detection are critical core functions to improve the capacity, preparedness and responsiveness of the Indian public health system. The systematic use of routinely collected

Case Based Measles Surveillance in Pune: Evidence to Guide Current and Future Measles Control and Elimination Efforts in India

Science.gov (United States)

Bose, Anindya Sekhar; Jafari, Hamid; Sosler, Stephen; Narula, Arvinder Pal Singh; Kulkarni, V. M.; Ramamurty, Nalini; Oommen, John; Jadi, Ramesh S.; Banpel, R. V.; Henao-Restrepo, Ana Maria

2014-01-01

Background According to WHO estimates, 35% of global measles deaths in 2011 occurred in India. In 2013, India committed to a goal of measles elimination by 2020. Laboratory supported case based measles surveillance is an essential component of measles elimination strategies. Results from a case-based measles surveillance system in Pune district (November 2009 through December 2011) are reported here with wider implications for measles elimination efforts in India. Methods Standard protocols were followed for case identification, investigation and classification. Suspected measles cases were confirmed through serology (IgM) or epidemiological linkage or clinical presentation. Data regarding age, sex, vaccination status were collected and annualized incidence rates for measles and rubella cases calculated. Results Of the 1011 suspected measles cases reported to the surveillance system, 76% were confirmed measles, 6% were confirmed rubella, and 17% were non-measles, non-rubella cases. Of the confirmed measles cases, 95% were less than 15 years of age. Annual measles incidence rate was more than 250 per million persons and nearly half were associated with outbreaks. Thirty-nine per cent of the confirmed measles cases were vaccinated with one dose of measles vaccine (MCV1). Conclusion Surveillance demonstrated high measles incidence and frequent outbreaks in Pune where MCV1 coverage in infants was above 90%. Results indicate that even high coverage with a single dose of measles vaccine was insufficient to provide population protection and prevent measles outbreaks. An effective measles and rubella surveillance system provides essential information to plan, implement and evaluate measles immunization strategies and monitor progress towards measles elimination. PMID:25290339

Reliability demonstration of imaging surveillance systems

International Nuclear Information System (INIS)

Sheridan, T.F.; Henderson, J.T.; MacDiarmid, P.R.

1979-01-01

Security surveillance systems which employ closed circuit television are being deployed with increasing frequency for the protection of property and other valuable assets. A need exists to demonstrate the reliability of such systems before their installation to assure that the deployed systems will operate when needed with only the scheduled amount of maintenance and support costs. An approach to the reliability demonstration of imaging surveillance systems which employ closed circuit television is described. Failure definitions based on industry television standards and imaging alarm assessment criteria for surveillance systems are discussed. Test methods which allow 24 hour a day operation without the need for numerous test scenarios, test personnel and elaborate test facilities are presented. Existing reliability demonstration standards are shown to apply which obviate the need for elaborate statistical tests. The demonstration methods employed are shown to have applications in other types of imaging surveillance systems besides closed circuit television

Responding to a cVDPV1 outbreak in Ukraine: Implications, challenges and opportunities.

Science.gov (United States)

Khetsuriani, Nino; Perehinets, Ihor; Nitzan, Dorit; Popovic, Dragoslav; Moran, Thomas; Allahverdiyeva, Vusala; Huseynov, Shahin; Gavrilin, Eugene; Slobodianyk, Liudmyla; Izhyk, Olha; Sukhodolska, Anna; Hegazi, Sahar; Bulavinova, Katerina; Platov, Sergei; O'Connor, Patrick

2017-08-24

The European Region, certified polio-free in 2002, remains at risk of wild poliovirus reintroduction and emergence of circulating vaccine-derived polioviruses (cVDPV) until global polio eradication is achieved, as demonstrated by the cVDPV1 outbreak in Ukraine in 2015. We reviewed epidemiologic, clinical and virology data on cVDPV cases, surveillance and immunization coverage data, and reports of outbreak-related surveys, country missions, and expert group meetings. In Ukraine, 3-dose polio vaccine coverage declined from 91% in 2008 to 15% by mid-2015. In summer, 2015, two unrelated children from Zakarpattya province were paralyzed by a highly divergent cVDPV1. The isolates were 20 and 26 nucleotide divergent from prototype Sabin strain (with 18 identical mutations) consistent with their common origin and ∼2-year evolution. Outbreak response recommendations developed with international partner support included conducting three nationwide supplementary immunization activities (SIAs) with tOPV, strengthening surveillance and implementing communication interventions. SIAs were conducted during October 2015-February 2016 (officially reported coverage, round 1-64.4%, round 2-71.7%, and round 3-80.7%). Substantial challenges to outbreak response included lack of high-level support, resistance to OPV use, low perceived risk of polio, widespread vaccine hesitancy, anti-vaccine media environment, economic crisis and military conflict. Communication activities improved caregiver awareness of polio and confidence in vaccination. Surveillance was enhanced but did not consistently meet applicable performance standards. Post-outbreak assessments concluded that cVDPV1 transmission in Ukraine has likely stopped following the response, but significant gaps in population immunity and surveillance remained. Chronic under-vaccination in Ukraine resulted in the accumulation of children susceptible to polioviruses and created favorable conditions for VDPV1 emergence and circulation

Evaluation of the national Notifiable Diseases Surveillance System for dengue fever in Taiwan, 2010-2012.

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Caoimhe McKerr

2015-03-01

Full Text Available In Taiwan, around 1,500 cases of dengue fever are reported annually and incidence has been increasing over time. A national web-based Notifiable Diseases Surveillance System (NDSS has been in operation since 1997 to monitor incidence and trends and support case and outbreak management. We present the findings of an evaluation of the NDSS to ascertain the extent to which dengue fever surveillance objectives are being achieved.We extracted the NDSS data on all laboratory-confirmed dengue fever cases reported during 1 January 2010 to 31 December 2012 to assess and describe key system attributes based on the Centers for Disease Control and Prevention surveillance evaluation guidelines. The system's structure and processes were delineated and operational staff interviewed using a semi-structured questionnaire. Crude and age-adjusted incidence rates were calculated and key demographic variables were summarised to describe reporting activity. Data completeness and validity were described across several variables.Of 5,072 laboratory-confirmed dengue fever cases reported during 2010-2012, 4,740 (93% were reported during July to December. The system was judged to be simple due to its minimal reporting steps. Data collected on key variables were correctly formatted and usable in > 90% of cases, demonstrating good data completeness and validity. The information collected was considered relevant by users with high acceptability. Adherence to guidelines for 24-hour reporting was 99%. Of 720 cases (14% recorded as travel-related, 111 (15% had an onset >14 days after return, highlighting the potential for misclassification. Information on hospitalization was missing for 22% of cases. The calculated PVP was 43%.The NDSS for dengue fever surveillance is a robust, well maintained and acceptable system that supports the collection of complete and valid data needed to achieve the surveillance objectives. The simplicity of the system engenders compliance leading to

Can tail damage outbreaks in the pig be predicted by behavioural change?

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Larsen, Mona Lilian Vestbjerg; Andersen, Heidi Mai-Lis; Pedersen, Lene Juul

2016-03-01

Tail biting, resulting in outbreaks of tail damage in pigs, is a multifactorial welfare and economic problem which is usually partly prevented through tail docking. According to European Union legislation, tail docking is not allowed on a routine basis; thus there is a need for alternative preventive methods. One strategy is the surveillance of the pigs' behaviour for known preceding indicators of tail damage, which makes it possible to predict a tail damage outbreak and prevent it in proper time. This review discusses the existing literature on behavioural changes observed prior to a tail damage outbreak. Behaviours found to change prior to an outbreak include increased activity level, increased performance of enrichment object manipulation, and a changed proportion of tail posture with more tails between the legs. Monitoring these types of behaviours is also discussed for the purpose of developing an automatic warning system for tail damage outbreaks, with activity level showing promising results for being monitored automatically. Encouraging results have been found so far for the development of an automatic warning system; however, there is a need for further investigation and development, starting with the description of the temporal development of the predictive behaviour in relation to tail damage outbreaks. Copyright © 2016 Elsevier Ltd. All rights reserved.

Rise and fall of outbreak-specific clone inside endemic pulsotype of Salmonella 4,[5],12:i:-; insights from high-resolution molecular surveillance in Emilia-Romagna, Italy, 2012 to 2015.

Science.gov (United States)

Morganti, Marina; Bolzoni, Luca; Scaltriti, Erika; Casadei, Gabriele; Carra, Elena; Rossi, Laura; Gherardi, Paola; Faccini, Fabio; Arrigoni, Norma; Sacchi, Anna Rita; Delledonne, Marco; Pongolini, Stefano

2018-03-01

Background and aimEpidemiology of human non-typhoid salmonellosis is characterised by recurrent emergence of new clones of the pathogen over time. Some clonal lines of Salmonella have shaped epidemiology of the disease at global level, as happened for serotype Enteritidis or, more recently, for Salmonella 4,[5],12:i:-, a monophasic variant of serotype Typhimurium. The same clonal behaviour is recognisable at sub-serotype level where single outbreaks or more generalised epidemics are attributable to defined clones. The aim of this study was to understand the dynamics of a clone of Salmonella 4,[5],12:i:- over a 3-year period (2012-15) in a province of Northern Italy where the clone caused a large outbreak in 2013. Furthermore, the role of candidate outbreak sources was investigated and the accuracy of multilocus variable-number tandem repeat analysis (MLVA) was evaluated. Methods: we retrospectively investigated the outbreak through whole genome sequencing (WGS) and further monitored the outbreak clone for 2 years after its conclusion. Results: The study showed the transient nature of the clone in the population, possibly as a consequence of its occasional expansion in a food-processing facility. We demonstrated that important weaknesses characterise conventional typing methods applied to clonal pathogens such as Salmonella 4,[5],12:i:-, namely lack of accuracy for MLVA and inadequate resolution power for PFGE to be reliably used for clone tracking. Conclusions : The study provided evidence for the remarkable prevention potential of whole genome sequencing used as a routine tool in systems that integrate human, food and animal surveillance.

SCM: a practical tool to implement hospital-based syndromic surveillance.

Science.gov (United States)

Ye, Chuchu; Li, Zhongjie; Fu, Yifei; Lan, Yajia; Zhu, Weiping; Zhou, Dinglun; Zhang, Honglong; Lai, Shengjie; Buckeridge, David L; Sun, Qiao; Yang, Weizhong

2016-06-18

Syndromic surveillance has been widely used for the early warning of infectious disease outbreaks, especially in mass gatherings, but the collection of electronic data on symptoms in hospitals is one of the fundamental challenges that must be overcome during operating a syndromic surveillance system. The objective of our study is to describe and evaluate the implementation of a symptom-clicking-module (SCM) as a part of the enhanced hospital-based syndromic surveillance during the 41st World Exposition in Shanghai, China, 2010. The SCM, including 25 targeted symptoms, was embedded in the sentinels' Hospital Information Systems (HIS). The clinicians used SCM to record these information of all the visiting patients, and data were collated and transmitted automatically in daily batches. The symptoms were categorized into seven targeted syndromes using pre-defined criteria, and statistical algorithms were applied to detect temporal aberrations in the data series. SCM was deployed successfully in each sentinel hospital and was operated during the 184-day surveillance period. A total of 1,730,797 patient encounters were recorded by SCM, and 6.1 % (105,352 visits) met the criteria of the seven targeted syndromes. Acute respiratory and gastrointestinal syndromes were reported most frequently, accounted for 92.1 % of reports in all syndromes, and the aggregated time-series presented an obvious day-of-week variation over the study period. In total, 191 aberration signals were triggered, and none of them were identified as outbreaks after verification and field investigation. SCM has acted as a practical tool for recording symptoms in the hospital-based enhanced syndromic surveillance system during the 41st World Exposition in Shanghai, in the context of without a preexisting electronic tool to collect syndromic data in the HIS of the sentinel hospitals.

Investigation of a cholera outbreak in a tea garden of Sivasagar district of Assam

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Bhupendra Narayan Mahanta

2013-01-01

Full Text Available Background: In late May 2012, Bagjan division of Borbam tea estate, of Sivasagar district of Assam was affected by an outbreak of acute watery diarrhea, subsequently confirmed as Vibrio cholerae O1. Objectives: Our objective is to investigate and control the acute diarrheal disease outbreak in Sivasagar district of Assam. Materials and Methods: A physician-epidemiologist-led team did rapid outbreak investigation to confirm the outbreak and instituted treatment and control measures. Quantitative data collection was done using standard schedule and qualitative data by using key informant interview schedule. Results: Spot mapping of cases was done along the garden residential lines. About 120 suspected cases were line listed; with 1:1.23 male: female ratio. Ages ranged from 3 to 70 years (median - 40.5 years. Attack rate was 4.79% with one death; case fatality rate was 0.83%. Open air defecation was practiced by 94.6%. Rectal swabs were positive for V. cholerae O1 (Ogawa. All the piped water samples were class IV unsatisfactory for domestic use. Conclusions: There is a need to improve water and sanitation facility in the tea garden lines along with implementation of a strengthened disease surveillance system through integrated disease surveillance project covering all tea estates.

Epidemiology and Management of the 2013-16 West African Ebola Outbreak.

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Boisen, M L; Hartnett, J N; Goba, A; Vandi, M A; Grant, D S; Schieffelin, J S; Garry, R F; Branco, L M

2016-09-29

The 2013-16 West African Ebola outbreak is the largest, most geographically dispersed, and deadliest on record, with 28,616 suspected cases and 11,310 deaths recorded to date in Guinea, Liberia, and Sierra Leone. We provide a review of the epidemiology and management of the 2013-16 Ebola outbreak in West Africa aimed at stimulating reflection on lessons learned that may improve the response to the next international health crisis caused by a pathogen that emerges in a region of the world with a severely limited health care infrastructure. Surveillance efforts employing rapid and effective point-of-care diagnostics designed for environments that lack advanced laboratory infrastructure will greatly aid in early detection and containment efforts during future outbreaks. Introduction of effective therapeutics and vaccines against Ebola into the public health system and the biodefense armamentarium is of the highest priority if future outbreaks are to be adequately managed and contained in a timely manner.

Avian Influenza Risk Surveillance in North America with Online Media.

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Colin Robertson

Full Text Available The use of Internet-based sources of information for health surveillance applications has increased in recent years, as a greater share of social and media activity happens through online channels. The potential surveillance value in online sources of information about emergent health events include early warning, situational awareness, risk perception and evaluation of health messaging among others. The challenge in harnessing these sources of data is the vast number of potential sources to monitor and developing the tools to translate dynamic unstructured content into actionable information. In this paper we investigated the use of one social media outlet, Twitter, for surveillance of avian influenza risk in North America. We collected AI-related messages over a five-month period and compared these to official surveillance records of AI outbreaks. A fully automated data extraction and analysis pipeline was developed to acquire, structure, and analyze social media messages in an online context. Two methods of outbreak detection; a static threshold and a cumulative-sum dynamic threshold; based on a time series model of normal activity were evaluated for their ability to discern important time periods of AI-related messaging and media activity. Our findings show that peaks in activity were related to real-world events, with outbreaks in Nigeria, France and the USA receiving the most attention while those in China were less evident in the social media data. Topic models found themes related to specific AI events for the dynamic threshold method, while many for the static method were ambiguous. Further analyses of these data might focus on quantifying the bias in coverage and relation between outbreak characteristics and detectability in social media data. Finally, while the analyses here focused on broad themes and trends, there is likely additional value in developing methods for identifying low-frequency messages, operationalizing this

A local outbreak of dengue caused by an imported case in Dongguan China

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Peng Hong-Juan

2012-01-01

Full Text Available Abstract Background Dengue, a mosquito-borne febrile viral disease, is found in tropical and sub-tropical regions around the world. Since the first occurrence of dengue was confirmed in Guangdong, China in 1978, dengue outbreaks have been reported sequentially in different provinces in South China transmitted by.peridomestic Ae. albopictus mosquitoes, diplaying Ae. aegypti, a fully domestic vector that transmits dengue worldwide. Rapid and uncontrolled urbanization is a characteristic change in developing countries, which impacts greatly on vector habitat, human lifestyle and transmission dynamics on dengue epidemics. In September 2010, an outbreak of dengue was detected in Dongguan, a city in Guangdong province characterized by its fast urbanization. An investigation was initiated to identify the cause, to describe the epidemical characteristics of the outbreak, and to implement control measures to stop the outbreak. This is the first report of dengue outbreak in Dongguan, even though dengue cases were documented before in this city. Methods Epidemiological data were obtained from local Center of Disease Control and prevention (CDC. Laboratory tests such as real-time Reverse Transcription Polymerase Chain Reaction (RT-PCR, the virus cDNA sequencing, and Enzyme-Linked immunosorbent assay (ELISA were employed to identify the virus infection and molecular phylogenetic analysis was performed with MEGA5. The febrile cases were reported every day by the fever surveillance system. Vector control measures including insecticidal fogging and elimination of habitats of Ae. albopictus were used to control the dengue outbreak. Results The epidemiological studies results showed that this dengue outbreak was initiated by an imported case from Southeast Asia. The outbreak was characterized by 31 cases reported with an attack rate of 50.63 out of a population of 100,000. Ae. albopictus was the only vector species responsible for the outbreak. The virus c

Lessons from the Ebola Outbreak: Action Items for Emerging Infectious Disease Preparedness and Response.

Science.gov (United States)

Jacobsen, Kathryn H; Aguirre, A Alonso; Bailey, Charles L; Baranova, Ancha V; Crooks, Andrew T; Croitoru, Arie; Delamater, Paul L; Gupta, Jhumka; Kehn-Hall, Kylene; Narayanan, Aarthi; Pierobon, Mariaelena; Rowan, Katherine E; Schwebach, J Reid; Seshaiyer, Padmanabhan; Sklarew, Dann M; Stefanidis, Anthony; Agouris, Peggy

2016-03-01

As the Ebola outbreak in West Africa wanes, it is time for the international scientific community to reflect on how to improve the detection of and coordinated response to future epidemics. Our interdisciplinary team identified key lessons learned from the Ebola outbreak that can be clustered into three areas: environmental conditions related to early warning systems, host characteristics related to public health, and agent issues that can be addressed through the laboratory sciences. In particular, we need to increase zoonotic surveillance activities, implement more effective ecological health interventions, expand prediction modeling, support medical and public health systems in order to improve local and international responses to epidemics, improve risk communication, better understand the role of social media in outbreak awareness and response, produce better diagnostic tools, create better therapeutic medications, and design better vaccines. This list highlights research priorities and policy actions the global community can take now to be better prepared for future emerging infectious disease outbreaks that threaten global public health and security.

Incentives for reporting disease outbreaks.

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Ramanan Laxminarayan

Full Text Available BACKGROUND: Countries face conflicting incentives to report infectious disease outbreaks. Reports of outbreaks can prompt other countries to impose trade and travel restrictions, which has the potential to discourage reporting. However, reports can also bring medical assistance to contain the outbreak, including access to vaccines. METHODS: We compiled data on reports of meningococcal meningitis to the World Health Organization (WHO from 54 African countries between 1966 and 2002, a period is marked by two events: first, a large outbreak reported from many countries in 1987 associated with the Hajj that resulted in more stringent requirements for meningitis vaccination among pilgrims; and second, another large outbreak in Sub-Saharan Africa in 1996 that led to a new international mechanism to supply vaccines to countries reporting a meningitis outbreak. We used fixed-effects regression modeling to statistically estimate the effect of external forcing events on the number of countries reporting cases of meningitis to WHO. FINDINGS: We find that the Hajj vaccination requirements started in 1988 were associated with reduced reporting, especially among countries with relatively fewer cases reported between 1966 and 1979. After the vaccine provision mechanism was in place in 1996, reporting among countries that had previously not reported meningitis outbreaks increased. INTERPRETATION: These results indicate that countries may respond to changing incentives to report outbreaks when they can do so. In the long term, these incentives are likely to be more important than surveillance assistance in prompt reporting of outbreaks.

Pertussis outbreak in northwest Ireland, January - June 2010.

LENUS (Irish Health Repository)

Barret, A S

2010-09-02

We report a community pertussis outbreak that occurred in a small town located in the northwest of Ireland. Epidemiological investigations suggest that waning immunity and the absence of a booster dose during the second year of life could have contributed to the outbreak. The report also highlights the need to reinforce the surveillance of pertussis in Ireland and especially to improve the clinical and laboratory diagnosis of cases.

Pilot simulation study using meat inspection data for syndromic surveillance: use of whole carcass condemnation of adult cattle to assess the performance of several algorithms for outbreak detection.

Science.gov (United States)

Dupuy, C; Morignat, E; Dorea, F; Ducrot, C; Calavas, D; Gay, E

2015-09-01

The objective of this study was to assess the performance of several algorithms for outbreak detection based on weekly proportions of whole carcass condemnations. Data from one French slaughterhouse over the 2005-2009 period were used (177 098 slaughtered cattle, 0.97% of whole carcass condemnations). The method involved three steps: (i) preparation of an outbreak-free historical baseline over 5 years, (ii) simulation of over 100 years of baseline time series with injection of artificial outbreak signals with several shapes, durations and magnitudes, and (iii) assessment of the performance (sensitivity, specificity, outbreak detection precocity) of several algorithms to detect these artificial outbreak signals. The algorithms tested included the Shewart p chart, confidence interval of the negative binomial model, the exponentially weighted moving average (EWMA); and cumulative sum (CUSUM). The highest sensitivity was obtained using a negative binomial algorithm and the highest specificity with CUSUM or EWMA. EWMA sensitivity was too low to select this algorithm for efficient outbreak detection. CUSUM's performance was complementary to the negative binomial algorithm. The use of both algorithms on real data for a prospective investigation of the whole carcass condemnation rate as a syndromic surveillance indicator could be relevant. Shewart could also be a good option considering its high sensitivity and simplicity of implementation.

Using routinely reported tuberculosis genotyping and surveillance data to predict tuberculosis outbreaks.

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Sandy P Althomsons

Full Text Available We combined routinely reported tuberculosis (TB patient characteristics with genotyping data and measures of geospatial concentration to predict which small clusters (i.e., consisting of only 3 TB patients in the United States were most likely to become outbreaks of at least 6 TB cases. Of 146 clusters analyzed, 16 (11.0% grew into outbreaks. Clusters most likely to become outbreaks were those in which at least 1 of the first 3 patients reported homelessness or excess alcohol or illicit drug use or was incarcerated at the time of TB diagnosis and in which the cluster grew rapidly (i.e., the third case was diagnosed within 5.3 months of the first case. Of 17 clusters with these characteristics and therefore considered high risk, 9 (53% became outbreaks. This retrospective cohort analysis of clusters in the United States suggests that routinely reported data may identify small clusters that are likely to become outbreaks and which are therefore candidates for intensified contact investigations.

Establishing an emergency department syndromic surveillance system to support the London 2012 Olympic and Paralympic Games.

Science.gov (United States)

Elliot, Alex J; Hughes, Helen E; Hughes, Thomas C; Locker, Thomas E; Shannon, Tony; Heyworth, John; Wapling, Andy; Catchpole, Mike; Ibbotson, Sue; McCloskey, Brian; Smith, Gillian E

2012-12-01

The London 2012 Olympic and Paralympic Games is a mass gathering event that will present a major public health challenge. The Health Protection Agency, in collaboration with the College of Emergency Medicine, has established the Emergency Department Sentinel Syndromic Surveillance System (EDSSS) to support the public health surveillance requirements of the Games. This feasibility study assesses the usefulness of EDSSS in monitoring indicators of disease in the community. Daily counts of anonymised attendance data from six emergency departments across England were analysed by patient demographics (age, gender, partial postcode), triage coding and diagnosis codes. Generic and specific syndromic indicators were developed using aggregations of diagnosis codes recorded during each attendance. Over 339,000 attendances were recorded (26 July 2010 to 25 July 2011). The highest attendances recorded on weekdays between 10:00 and 11:00 and on weekends between 12:00 and 13:00. The mean daily attendance per emergency department was 257 (range 38-435). Syndromic indicators were developed including: respiratory, gastrointestinal, cardiac, acute respiratory infection, gastroenteritis and myocardial ischaemia. Respiratory and acute respiratory infection indicators peaked during December 2010, concomitant with national influenza activity, as monitored through other influenza surveillance systems. The EDSSS has been established to provide an enhanced surveillance system for the London 2012 Olympics. Further validation of the data will be required; however, the results from this initial descriptive study demonstrate the potential for identifying unusual and/or severe outbreaks of infectious disease, or other incidents with public health impact, within the community.

An automated, broad-based, near real-time public health surveillance system using presentations to hospital Emergency Departments in New South Wales, Australia

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Chiu Clayton

2005-12-01

Full Text Available Abstract Background In a climate of concern over bioterrorism threats and emergent diseases, public health authorities are trialling more timely surveillance systems. The 2003 Rugby World Cup (RWC provided an opportunity to test the viability of a near real-time syndromic surveillance system in metropolitan Sydney, Australia. We describe the development and early results of this largely automated system that used data routinely collected in Emergency Departments (EDs. Methods Twelve of 49 EDs in the Sydney metropolitan area automatically transmitted surveillance data from their existing information systems to a central database in near real-time. Information captured for each ED visit included patient demographic details, presenting problem and nursing assessment entered as free-text at triage time, physician-assigned provisional diagnosis codes, and status at departure from the ED. Both diagnoses from the EDs and triage text were used to assign syndrome categories. The text information was automatically classified into one or more of 26 syndrome categories using automated "naïve Bayes" text categorisation techniques. Automated processes were used to analyse both diagnosis and free text-based syndrome data and to produce web-based statistical summaries for daily review. An adjusted cumulative sum (cusum was used to assess the statistical significance of trends. Results During the RWC the system did not identify any major public health threats associated with the tournament, mass gatherings or the influx of visitors. This was consistent with evidence from other sources, although two known outbreaks were already in progress before the tournament. Limited baseline in early monitoring prevented the system from automatically identifying these ongoing outbreaks. Data capture was invisible to clinical staff in EDs and did not add to their workload. Conclusion We have demonstrated the feasibility and potential utility of syndromic surveillance using

Outbreak of Imipenemase-1-Producing Carbapenem-Resistant in an Intensive Care Unit

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Jin Young Lee

2017-02-01

Full Text Available Background Carbapenem-resistant Enterobacteriaceae (CRE with acquired metallo β-lactamase (MBL resistance have been increasingly reported worldwide and associated with significant mortality and morbidity. Here, an outbreak of genetically related strains of Klebsiella pneumoniae producing the imipenemase (IMP-1 MBL in a medical intensive care unit (MICU in Korea is reported. Methods Since isolating carbapenem-resistant K. pneumoniae (CRKP at the MICU of the hospital on August 10, 2011, surveillance cultures for CRE in 31 hospitalized patients were performed from August to September 2011. Carbapenem resistance was determined based on the disk diffusion method outlined in the Clinical and Laboratory Standards Institute guidelines. Polymerase chain reaction (PCR was performed for genes coding for β-lactamase. Associations among isolates were assessed via pulsed-field gel electrophoresis (PFGE. In addition, a surveillance study of environmental cultures and health-care workers (HCWs was conducted in the MICU during the same time frame. Results During the study period, non-duplicated CRKP specimens were discovered in four patients in the MICU, suggestive of an outbreak. On August 10, 2011, CRKP was isolated from the sputum of a 79-year-old male patient who was admitted to the MICU. A surveillance study to detect additional CRE carriers by rectal swab revealed an additional three CRKP isolates. PCR and sequencing of the four isolates identified the presence of the IMP-1 gene. In addition, PFGE showed that the four isolated strains were genetically related. CRE was not identified in specimens taken from the hands of HCWs or other environmental sources during surveillance following the outbreak. Transmission of the carbapenemase-producing Enterobacteriaceae strain was controlled by isolation of the patients and strict contact precautions. Conclusions This study shows that rapid and systemic detection of CRE and strict infection controls are important

Detecting and Responding to a Dengue Outbreak: Evaluation of Existing Strategies in Country Outbreak Response Planning

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Julia Harrington

2013-01-01

Full Text Available Background. Dengue outbreaks are occurring with increasing frequency and intensity. Evidence-based epidemic preparedness and effective response are now a matter of urgency. Therefore, we have analysed national and municipal dengue outbreak response plans. Methods. Thirteen country plans from Asia, Latin America and Australia, and one international plan were obtained from the World Health Organization. The information was transferred to a data analysis matrix where information was extracted according to predefined and emerging themes and analysed for scope, inconsistencies, omissions, and usefulness. Findings. Outbreak response planning currently has a considerable number of flaws. Outbreak governance was weak with a lack of clarity of stakeholder roles. Late timing of responses due to poor surveillance, a lack of combining routine data with additional alerts, and lack of triggers for initiating the response weakened the functionality of plans. Frequently an outbreak was not defined, and early response mechanisms based on alert signals were neglected. There was a distinct lack of consideration of contextual influences which can affect how an outbreak detection and response is managed. Conclusion. A model contingency plan for dengue outbreak prediction, detection, and response may help national disease control authorities to develop their own more detailed and functional context specific plans.

A foodborne outbreak of brucellosis at a police station cafeteria, Lima, Peru

NARCIS (Netherlands)

Román, Karina; Castillo, Rosa; Gilman, Robert H.; Calderón, Maritza; Vivar, Aldo; Céspedes, Manuel; Smits, Henk L.; Meléndez, Paolo; Gotuzzo, Eduardo; Guerra, Humberto; Maves, Ryan C.; Matthias, Michael A.; Vinetz, Joseph M.; Saito, Mayuko

2013-01-01

Brucella melitensis is highly infectious for humans and can be transmitted to humans in a number of epidemiological contexts. Within the context of an ongoing brucellosis surveillance project, an outbreak at a Peruvian police officer cafeteria was discovered, which led to active surveillance

Extensively drug-resistant Acinetobacter baumannii outbreak cross-transmitted in an intensive care unit and respiratory intensive care unit.

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Lei, Jin'e; Han, Shaoshan; Wu, Wenjing; Wang, Xue; Xu, Jiru; Han, Lei

2016-11-01

Extensively drug-resistant Acinetobacter baumannii (XDRAB) is a great threat in intensive care units (ICUs). The aim of this study was to describe an XDRAB outbreak which was cross-transmitted in the ICU and respiratory intensive care unit (RICU) in a tertiary care hospital from January-March 2013. Patient and environmental surveillances were performed. Isolates were tested for antimicrobial susceptibility. Genotypes were analyzed by multilocus sequence typing (MLST). A series of enhanced strategies were implemented to control the outbreak. A total of 11 patients were infected by XDRAB strains during this outbreak. Three patients in the ICU were found positive for XDRAB at the onset of the outbreak. Thereafter, infections were detected in 6 patients in the RICU, followed by reappearance of this strain in the ICU in 2 patients. All A baumannii strains isolated from patients and the environment were extensively drug resistant. MLST revealed them as ST368. After 3 rounds of environmental screening and cleaning, the laminar flow system connecting the ICU and RICU was found as the source of transmission. Successful control of this outbreak was achieved through multifaceted intervention measures. This study suggested the importance of thorough surveillance and disinfection of the environment, including concealed devices, in preventing the transmission of an outbreak. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

The value of information: Current challenges in surveillance implementation.

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Stärk, Katharina D C; Häsler, Barbara

2015-11-01

remains variable. Political and legal issues are also influential. A particular challenge exists during outbreaks when surveillance needs to be conducted under emergency conditions. Decision support systems can help make epidemiologically and economically sound choices amongst surveillance options. However, contingency planning is advisable so that pre-defined options allow for rapid decision making. Copyright © 2015 Elsevier B.V. All rights reserved.

Methodological challenges to multivariate syndromic surveillance: a case study using Swiss animal health data.

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Vial, Flavie; Wei, Wei; Held, Leonhard

2016-12-20

In an era of ubiquitous electronic collection of animal health data, multivariate surveillance systems (which concurrently monitor several data streams) should have a greater probability of detecting disease events than univariate systems. However, despite their limitations, univariate aberration detection algorithms are used in most active syndromic surveillance (SyS) systems because of their ease of application and interpretation. On the other hand, a stochastic modelling-based approach to multivariate surveillance offers more flexibility, allowing for the retention of historical outbreaks, for overdispersion and for non-stationarity. While such methods are not new, they are yet to be applied to animal health surveillance data. We applied an example of such stochastic model, Held and colleagues' two-component model, to two multivariate animal health datasets from Switzerland. In our first application, multivariate time series of the number of laboratories test requests were derived from Swiss animal diagnostic laboratories. We compare the performance of the two-component model to parallel monitoring using an improved Farrington algorithm and found both methods yield a satisfactorily low false alarm rate. However, the calibration test of the two-component model on the one-step ahead predictions proved satisfactory, making such an approach suitable for outbreak prediction. In our second application, the two-component model was applied to the multivariate time series of the number of cattle abortions and the number of test requests for bovine viral diarrhea (a disease that often results in abortions). We found that there is a two days lagged effect from the number of abortions to the number of test requests. We further compared the joint modelling and univariate modelling of the number of laboratory test requests time series. The joint modelling approach showed evidence of superiority in terms of forecasting abilities. Stochastic modelling approaches offer the

Performance of statistical process control methods for regional surgical site infection surveillance: a 10-year multicentre pilot study.

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Baker, Arthur W; Haridy, Salah; Salem, Joseph; Ilieş, Iulian; Ergai, Awatef O; Samareh, Aven; Andrianas, Nicholas; Benneyan, James C; Sexton, Daniel J; Anderson, Deverick J

2017-11-24

Traditional strategies for surveillance of surgical site infections (SSI) have multiple limitations, including delayed and incomplete outbreak detection. Statistical process control (SPC) methods address these deficiencies by combining longitudinal analysis with graphical presentation of data. We performed a pilot study within a large network of community hospitals to evaluate performance of SPC methods for detecting SSI outbreaks. We applied conventional Shewhart and exponentially weighted moving average (EWMA) SPC charts to 10 previously investigated SSI outbreaks that occurred from 2003 to 2013. We compared the results of SPC surveillance to the results of traditional SSI surveillance methods. Then, we analysed the performance of modified SPC charts constructed with different outbreak detection rules, EWMA smoothing factors and baseline SSI rate calculations. Conventional Shewhart and EWMA SPC charts both detected 8 of the 10 SSI outbreaks analysed, in each case prior to the date of traditional detection. Among detected outbreaks, conventional Shewhart chart detection occurred a median of 12 months prior to outbreak onset and 22 months prior to traditional detection. Conventional EWMA chart detection occurred a median of 7 months prior to outbreak onset and 14 months prior to traditional detection. Modified Shewhart and EWMA charts additionally detected several outbreaks earlier than conventional SPC charts. Shewhart and SPC charts had low false-positive rates when used to analyse separate control hospital SSI data. Our findings illustrate the potential usefulness and feasibility of real-time SPC surveillance of SSI to rapidly identify outbreaks and improve patient safety. Further study is needed to optimise SPC chart selection and calculation, statistical outbreak detection rules and the process for reacting to signals of potential outbreaks. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights

The link between the West African Ebola outbreak and health systems in Guinea, Liberia and Sierra Leone: a systematic review.

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Shoman, Haitham; Karafillakis, Emilie; Rawaf, Salman

2017-01-04

An Ebola outbreak started in December 2013 in Guinea and spread to Liberia and Sierra Leone in 2014. The health systems in place in the three countries lacked the infrastructure and the preparation to respond to the outbreak quickly and the World Health Organisation (WHO) declared a public health emergency of international concern on August 8 2014. The aim of this study was to determine the effects of health systems' organisation and performance on the West African Ebola outbreak in Guinea, Liberia and Sierra Leone and lessons learned. The WHO health system building blocks were used to evaluate the performance of the health systems in these countries. A systematic review of articles published from inception until July 2015 was conducted following the PRISMA guidelines. Electronic databases including Medline, Embase, Global Health, and the Cochrane library were searched for relevant literature. Grey literature was also searched through Google Scholar and Scopus. Articles were exported and selected based on a set of inclusion and exclusion criteria. Data was then extracted into a spreadsheet and a descriptive analysis was performed. Each study was critically appraised using the Crowe Critical Appraisal Tool. The review was supplemented with expert interviews where participants were identified from reference lists and using the snowball method. Thirteen articles were included in the study and six experts from different organisations were interviewed. Findings were analysed based on the WHO health system building blocks. Shortage of health workforce had an important effect on the control of Ebola but also suffered the most from the outbreak. This was followed by information and research, medical products and technologies, health financing and leadership and governance. Poor surveillance and lack of proper communication also contributed to the outbreak. Lack of available funds jeopardised payments and purchase of essential resources and medicines. Leadership and

Impact of the Legionella urinary antigen test on epidemiological trends in community outbreaks of legionellosis in Catalonia, Spain, 1990-2004.

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Alvarez, Josep; Domínguez, Angela; Sabrià, Miquel; Ruiz, Laura; Torner, Nuria; Cayla, Joan; Barrabeig, Irene; Sala, M Rosa; Godoy, Pere; Camps, Neus; Minguell, Sofia

2009-11-01

To describe the characteristics of community outbreaks of legionellosis in Catalonia, Spain from 1990 to 2004, to compare two time periods (1990-1996 and 1997-2004), and to assess the influence of outbreak characteristics on the case fatality rate (CFR). This is a descriptive analysis of the outbreaks detected by epidemiological surveillance units in Catalonia. Variables potentially related to the CFR were analyzed by logistic regression. Of the 118 outbreaks involving 690 patients (overall CFR 4.5%), the urinary antigen test (UAT) was used for first case diagnosis in 80.5%. The origin of the outbreak was identified as a cooling tower in 35.6%, as a water distribution system in a public building in 14.4%, and a water distribution system at other sites in 7.6%. Statistically significant differences were found in the CFR (12.2% vs. 3.9%; p=0.018) and detection of the first case by UAT (0.0% vs. 87.2%; pcases involved in outbreaks of legionellosis.

Risk factors for typhoid outbreak in Sungai Congkak Recreational Park, Selangor 2009.

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Anita, S; Amir, K M; Fadzilah, K; Ahamad, J; Noorhaida, U; Marina, K; Paid, M Y; Hanif, Z

2012-02-01

Typhoid fever continues to pose public health problems in Selangor where cases are found sporadically with occasional outbreaks reported. In February 2009, Hospital Tengku Ampuan Rahimah (HTAR) reported a cluster of typhoid fever among four children in the pediatric ward. We investigated the source of the outbreak, risk factors for the infection to propose control measures. We conducted a case-control study to identify the risk factors for the outbreak. A case was defined as a person with S. typhi isolated from blood, urine or stool and had visited Sungai Congkak recreational park on 27th January 2010. Controls were healthy household members of cases who have similar exposure but no isolation of S. typhi in blood, urine or stool. Cases were identified from routine surveillance system, medical record searching from the nearest clinic and contact tracing other than family members including food handlers and construction workers in the recreational park. Immediate control measures were initiated and followed up. Twelve (12) cases were identified from routine surveillance with 75 household controls. The Case-control study showed cases were 17 times more likely to be 12 years or younger (95% CI: 2.10, 137.86) and 13 times more likely to have ingested river water accidentally during swimming (95% CI: 3.07, 58.71). River water was found contaminated with sewage disposal from two public toilets which effluent grew salmonella spp. The typhoid outbreak in Sungai Congkak recreational park resulted from contaminated river water due to poor sanitation. Children who accidentally ingested river water were highly susceptible. Immediate closure and upgrading of public toilet has stopped the outbreak.

Reported waterborne outbreaks of gastrointestinal disease in Australia are predominantly associated with recreational exposure.

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Dale, Katie; Kirk, Martyn; Sinclair, Martha; Hall, Robert; Leder, Karin

2010-10-01

To examine the frequency and circumstances of reported waterborne outbreaks of gastroenteritis in Australia. Examination of data reported to OzFoodNet between 2001 and 2007. During these seven years, 6,515 gastroenteritis outbreaks were reported to OzFoodNet, most of which were classified as being transmitted person-to-person or from an unknown source. Fifty-four (0.83%) outbreaks were classified as either 'waterborne' or 'suspected waterborne', of which 78% (42/54) were attributed to recreational water and 19% (10/54) to drinking water. Of the drinking water outbreaks, implicated pathogens were found on all but one occasion and included Salmonella sp. (five outbreaks), Campylobacter jejuni (three outbreaks) and Giardia (one outbreak). There have been few waterborne outbreaks detected in Australia, and most of those reported have been associated with recreational exposure. However, there are difficulties in identifying and categorising gastroenteritis outbreaks, as well as in obtaining microbiological and epidemiological evidence, which can result in misclassification or underestimation of water-associated events. Gastroenteritis surveillance data show that, among reported water-associated gastroenteritis outbreaks in Australia, recreational exposure is currently more common than a drinking water source. However, ongoing surveillance for waterborne outbreaks is important, especially as drought conditions may necessitate replacement of conventional drinking water supplies with alternative water sources, which could incur potential for new health risks. © 2010 The Authors. Journal Compilation © 2010 Public Health Association of Australia.

Impact of two interventions on timeliness and data quality of an electronic disease surveillance system in a resource limited setting (Peru: a prospective evaluation

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Quispe Jose A

2009-03-01

Full Text Available Abstract Background A timely detection of outbreaks through surveillance is needed in order to prevent future pandemics. However, current surveillance systems may not be prepared to accomplish this goal, especially in resource limited settings. As data quality and timeliness are attributes that improve outbreak detection capacity, we assessed the effect of two interventions on such attributes in Alerta, an electronic disease surveillance system in the Peruvian Navy. Methods 40 Alerta reporting units (18 clinics and 22 ships were included in a 12-week prospective evaluation project. After a short refresher course on the notification process, units were randomly assigned to either a phone, visit or control group. Phone group sites were called three hours before the biweekly reporting deadline if they had not sent their report. Visit group sites received supervision visits on weeks 4 & 8, but no phone calls. The control group sites were not contacted by phone or visited. Timeliness and data quality were assessed by calculating the percentage of reports sent on time and percentage of errors per total number of reports, respectively. Results Timeliness improved in the phone group from 64.6% to 84% in clinics (+19.4 [95% CI, +10.3 to +28.6]; p Conclusion Regular phone reminders significantly improved timeliness of reports in clinics and ships, whereas supervision visits led to improved data quality only among clinics. Further investigations are needed to establish the cost-effectiveness and optimal use of each of these strategies.

Multi-site cholera surveillance within the African Cholera Surveillance Network shows endemicity in Mozambique, 2011-2015.

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Semá Baltazar, Cynthia; Langa, José Paulo; Dengo Baloi, Liliana; Wood, Richard; Ouedraogo, Issaka; Njanpop-Lafourcade, Berthe-Marie; Inguane, Dorteia; Elias Chitio, Jucunu; Mhlanga, Themba; Gujral, Lorna; D Gessner, Bradford; Munier, Aline; A Mengel, Martin

2017-10-01

Mozambique suffers recurrent annual cholera outbreaks especially during the rainy season between October to March. The African Cholera Surveillance Network (Africhol) was implemented in Mozambique in 2011 to generate accurate detailed surveillance data to support appropriate interventions for cholera control and prevention in the country. Africhol was implemented in enhanced surveillance zones located in the provinces of Sofala (Beira), Zambézia (District Mocuba), and Cabo Delgado (Pemba City). Data were also analyzed from the three outbreak areas that experienced the greatest number of cases during the time period under observation (in the districts of Cuamba, Montepuez, and Nampula). Rectal swabs were collected from suspected cases for identification of Vibrio cholerae, as well as clinical, behavioral, and socio-demographic variables. We analyzed factors associated with confirmed, hospitalized, and fatal cholera using multivariate logistic regression models. A total of 1,863 suspected cases and 23 deaths (case fatality ratio (CFR), 1.2%) were reported from October 2011 to December 2015. Among these suspected cases, 52.2% were tested of which 23.5% were positive for Vibrio cholerae O1 Ogawa. Risk factors independently associated with the occurrence of confirmed cholera were living in Nampula city district, the year 2014, human immunodeficiency virus infection, and the primary water source for drinking. Cholera was endemic in Mozambique during the study period with a high CFR and identifiable risk factors. The study reinforces the importance of continued cholera surveillance, including a strong laboratory component. The results enhanced our understanding of the need to target priority areas and at-risk populations for interventions including oral cholera vaccine (OCV) use, and assess the impact of prevention and control strategies. Our data were instrumental in informing integrated prevention and control efforts during major cholera outbreaks in recent years.

32 CFR 637.20 - Security surveillance systems.

Science.gov (United States)

2010-07-01

... 32 National Defense 4 2010-07-01 2010-07-01 true Security surveillance systems. 637.20 Section 637... ENFORCEMENT AND CRIMINAL INVESTIGATIONS MILITARY POLICE INVESTIGATION Investigations § 637.20 Security surveillance systems. Closed circuit video recording systems, to include those with an audio capability, may be...

Measuring costs of data collection at village clinics by village doctors for a syndromic surveillance system-a cross sectional survey from China.

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Ding, Yan; Fei, Yang; Xu, Biao; Yang, Jun; Yan, Weirong; Diwan, Vinod K; Sauerborn, Rainer; Dong, Hengjin

2015-07-25

Studies into the costs of syndromic surveillance systems are rare, especially for estimating the direct costs involved in implementing and maintaining these systems. An Integrated Surveillance System in rural China (ISSC project), with the aim of providing an early warning system for outbreaks, was implemented; village clinics were the main surveillance units. Village doctors expressed their willingness to join in the surveillance if a proper subsidy was provided. This study aims to measure the costs of data collection by village clinics to provide a reference regarding the subsidy level required for village clinics to participate in data collection. We conducted a cross-sectional survey with a village clinic questionnaire and a staff questionnaire using a purposive sampling strategy. We tracked reported events using the ISSC internal database. Cost data included staff time, and the annual depreciation and opportunity costs of computers. We measured the village doctors' time costs for data collection by multiplying the number of full time employment equivalents devoted to the surveillance by the village doctors' annual salaries and benefits, which equaled their net incomes. We estimated the depreciation and opportunity costs of computers by calculating the equivalent annual computer cost and then allocating this to the surveillance based on the percentage usage. The estimated total annual cost of collecting data was 1,423 Chinese Renminbi (RMB) in 2012 (P25 = 857, P75 = 3284), including 1,250 RMB (P25 = 656, P75 = 3000) staff time costs and 134 RMB (P25 = 101, P75 = 335) depreciation and opportunity costs of computers. The total costs of collecting data from the village clinics for the syndromic surveillance system was calculated to be low compared with the individual net income in County A.

Cryptosporidiosis outbreaks associated with recreational water use--five states, 2006.

Science.gov (United States)

2007-07-27

Cryptosporidiosis is a gastrointestinal illness caused by parasitic protozoa of the genus Cryptosporidium and can produce watery diarrhea lasting 1-3 weeks; one or two cases per 100,000 population are reported annually in the United States. Fecal-oral transmission of Cryptosporidium oocysts occurs through ingestion of contaminated drinking or recreational water, consumption of contaminated food, and contact with infected persons or animals (e.g., cattle or sheep). Unlike bacterial pathogens, Cryptosporidium oocysts are resistant to chlorine disinfection and can survive for days in treated recreational water venues (e.g., public and residential swimming pools and community and commercial water parks) despite adherence to recommended residual chlorine levels (1-3 ppm). For 2006, a total of 18 cryptosporidiosis outbreaks have been reported (as of July 24, 2007) to CDC's U.S. Waterborne Disease and Outbreak Surveillance System, compared with five outbreaks reported for 2003 and seven for 2004; data for 2005 and 2006 are not yet final. This report describes five laboratory-confirmed cryptosporidiosis outbreaks in 2006 that involved public recreational water use. The popularity of recreational water venues, the number and geographic distribution of recent cryptosporidiosis outbreaks, and the resistance of Cryptosporidium to chlorination suggest that treatment strategies for recreational water facilities need to be improved.

Outbreaks following wild poliovirus importations --- Europe, Africa, and Asia, January 2009-September 2010.

Science.gov (United States)

2010-11-05

The Global Polio Eradication Initiative (GPEI) began in 1988. By 2006, indigenous transmission of wild poliovirus (WPV) had been interrupted in all but four countries (Afghanistan, India, Nigeria, and Pakistan). However, outbreaks following WPV importations into previously polio-free countries remain an ongoing risk until polio is eradicated. The GPEI Strategic Plan for 2010-2012 set the following two goals for outbreak control: 1) end outbreaks occurring in 2009 by mid-2010 and 2) end outbreaks occurring during 2010 to mid-2012 within 6 months of confirmation. This report describes new outbreaks that have occurred in the World Health Organization (WHO) European Region and updates previous reports on the status of outbreaks in Africa and Asia. In 2010, the first WPV importation into the European Region since the region was declared polio-free in 2002 resulted in 476 confirmed cases: 458 in Tajikistan, 14 in Russia, three in Turkmenistan, and one in Kazakhstan. In Africa and Asia, 11 new importations into six countries were observed in 2010; 30 WPV importations that occurred during 2008-2009 resulted in 215 cases in 15 African countries during 2009-2010. An outbreak is considered interrupted if 6 months have elapsed since the latest confirmed case and surveillance performance indicators meet WHO standards. All 2009 outbreaks in Africa appear to have been interrupted, and 2010 outbreaks in three countries appear to have been interrupted. Maintaining high routine vaccination coverage and sensitive surveillance at all times and rapidly instituting additional immunization programs to control outbreaks are key to limiting and stopping the spread of WPV.

Disaster prevention surveillance system

International Nuclear Information System (INIS)

Nara, Satoru; Kamiya, Eisei

2001-01-01

Fuji Electric Co., Ltd. has supplied many management systems to nuclear reactor institution. 'The nuclear countermeasures-against-calamities special-measures' was enforced. A nuclear entrepreneur has devised the measure about expansion prevention and restoration of a calamity while it endeavors after prevention of generating of a nuclear calamity. Our company have supplied the 'disaster prevention surveillance system' to the Japan Atomic Energy Research Institute Tokai Research Establishment aiming at strengthening of the monitoring function at the time (after the accident) of the accident used as one of the above-mentioned measures. A 'disaster prevention surveillance system' can share the information on the accident spot in an on-site command place, an activity headquarters, and support organizations, when the serious accident happens. This system is composed of various sensors (temperature, pressure and radiation), cameras, computers and network. (author)

A large outbreak of shigellosis commencing in an internally displaced population, Papua New Guinea, 2013.

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Benny, Edwin; Mesere, Kelly; Pavlin, Boris I; Yakam, Logan; Ford, Rebecca; Yoannes, Mition; Kisa, Debbie; Abdad, Mohammad Y; Menda, Lincoln; Greenhill, Andrew R; Horwood, Paul F

2014-01-01

The objective of this study was to investigate a large outbreak of shigellosis in Papua New Guinea that began in a camp for internally displaced persons before spreading throughout the general community. Outbreak mitigation strategies were implemented in the affected area to curtail the spread of the disease. Data were collected from the surveillance system and analysed by time, place and person. Rectal swab samples were tested by standard culture methods and real-time polymerase chain reaction to determine the etiology of the outbreak. Laboratory analysis at two independent institutions established that the outbreak was caused by Shigella sp., with one strain further characterized as Shigella flexneri serotype 2. Approximately 1200 suspected cases of shigellosis were reported in a two-month period from two townships in Morobe Province, Papua New Guinea. The outbreak resulted in at least five deaths, all in young children. This outbreak of shigellosis highlights the threat of enteric diseases to vulnerable populations such as internally displaced persons in Papua New Guinea, as has been observed in other global settings.

A large outbreak of shigellosis commencing in an internally displaced population, Papua New Guinea, 2013

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Edwin Benny

2014-09-01

Full Text Available Objective: The objective of this study was to investigate a large outbreak of shigellosis in Papua New Guinea that began in a camp for internally displaced persons before spreading throughout the general community. Methods: Outbreak mitigation strategies were implemented in the affected area to curtail the spread of the disease. Data were collected from the surveillance system and analysed by time, place and person. Rectal swab samples were tested by standard culture methods and real-time polymerase chain reaction to determine the etiology of the outbreak. Results: Laboratory analysis at two independent institutions established that the outbreak was caused by Shigella sp., with one strain further characterized as Shigella flexneri serotype 2. Approximately 1200 suspected cases of shigellosis were reported in a two-month period from two townships in Morobe Province, Papua New Guinea. The outbreak resulted in at least five deaths, all in young children. Discussion: This outbreak of shigellosis highlights the threat of enteric diseases to vulnerable populations such as internally displaced persons in Papua New Guinea, as has been observed in other global settings.

A GIS-driven integrated real-time surveillance pilot system for national West Nile virus dead bird surveillance in Canada

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Aramini Jeff

2006-04-01

Full Text Available Abstract Background An extensive West Nile virus surveillance program of dead birds, mosquitoes, horses, and human infection has been launched as a result of West Nile virus first being reported in Canada in 2001. Some desktop and web GIS have been applied to West Nile virus dead bird surveillance. There have been urgent needs for a comprehensive GIS services and real-time surveillance. Results A pilot system was developed to integrate real-time surveillance, real-time GIS, and Open GIS technology in order to enhance West Nile virus dead bird surveillance in Canada. Driven and linked by the newly developed real-time web GIS technology, this integrated real-time surveillance system includes conventional real-time web-based surveillance components, integrated real-time GIS components, and integrated Open GIS components. The pilot system identified the major GIS functions and capacities that may be important to public health surveillance. The six web GIS clients provide a wide range of GIS tools for public health surveillance. The pilot system has been serving Canadian national West Nile virus dead bird surveillance since 2005 and is adaptable to serve other disease surveillance. Conclusion This pilot system has streamlined, enriched and enhanced national West Nile virus dead bird surveillance in Canada, improved productivity, and reduced operation cost. Its real-time GIS technology, static map technology, WMS integration, and its integration with non-GIS real-time surveillance system made this pilot system unique in surveillance and public health GIS.

Cholera public health surveillance in the Republic of Cameroon-opportunities and challenges.

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Ngwa, Moise Chi; Liang, Song; Mbam, Leonard Mbam; Mouhaman, Arabi; Teboh, Andrew; Brekmo, Kaousseri; Mevoula, Onana; Morris, John Glenn

2016-01-01

In Cameroon, cholera has periodically resurfaced since it was first reported in 1971. In 2003, Cameroon adapted the Integrated Disease Surveillance and Response (IDSR) strategy to strengthen surveillance in the country. This study was an in-depth description and assessment of the structure, core and support functions, and attributes of the current cholera surveillance system in Cameroon. It also discussed its strengths and challenges with hope that lessons learned could improve the system in Cameroon and in other countries in Africa implementing the IDSR strategy. Semi-structured key informant interviews, peer reviewed articles, and government record review were conducted in the Far North and Centre Regions of Cameroon. We used the matrix and conceptual framework from the World Health Organization (WHO) and Centers for Disease Control and Prevention, WHO Regional Office for Africa Technical Guidelines to frame the study. Site visits included the WHO country office, the ministry of public health (MoPH), two Regional Public Health Delegations (RPHDs), eight health districts (HDs) and health facilities (HFs) including two labs. Cholera surveillance is passive but turns active during outbreaks and follows a hierarchical structure. Cholera data are collected at HFs and sent to HDs where data are compiled and sent to the RPHD in paper format. RPHDs de-identify, digitalize, and send the data to the MoPH via internet and from there to the WHO. The case definition was officially changed in 2010 but the outdated definition was still in use in 2013. Nationally, there are 3 laboratories that have the ability to confirm cholera cases; the lack of laboratory capacity at HFs hampers case and outbreak confirmation. The absence of structured data analysis at the RPHD, HD, and HF further compounds the situation, making the goal of IDSR of data analysis and rapid response at the HD very challenging. Feedback is strongest at the central level (MoPH) and non-existent at the levels

Detección de un brote de hepatitis A en Ceuta a través del sistema de información microbiológica Detection of a hepatitis A outbreak in Ceuta [Spain] through a microbiological surveillance system

Directory of Open Access Journals (Sweden)

María Teresa Ortega-Maján

2008-08-01

Full Text Available Antecedentes: El Servicio de Vigilancia Epidemiológica de Ceuta comunicó al Centro Nacional de Epidemiología un aumento de casos de hepatitis A, detectado por el sistema de información microbiológica (SIM. Se investigó la posible existencia de un brote y se instauraron las medidas de control oportunas. Métodos: Se realizó un estudio descriptivo y otro de casos y controles. La información sociodemográfica, clínica y sobre factores de riesgo se obtuvo mediante un cuestionario cumplimentado por vía telefónica. Resultados: Se identificaron 19 casos. En el estudio univariante se encontró una asociación entre enfermar y el consumo de verduras crudas (odds ratio [OR] = 9,3; intervalo de confianza [IC] del 95%: 1,5-57,6 y de navajas (OR = 55; IC del 95%: 4,3-703,4. En el análisis multivariante sólo se mantuvo la asociación con el consumo de navajas (OR = 36,1; IC del 95%: 2,4-530,4. Ninguno de los 3 restaurantes inspeccionados disponía de control de facturas ni albaranes. Conclusiones: Se confirmó un brote de hepatitis A asociado al consumo de navajas en domicilios y restaurantes. El SIM fue la herramienta fundamental para su detección.Background: The Public Health Department of Ceuta informed the Spanish National Epidemiology Center of an increase in hepatitis A cases detected by the microbiological surveillance system. We conducted a study to confirm the outbreak and to initiate control measures. Methods: A descriptive study and a case-control study were performed. A standardized telephone questionnaire was used to collect information on demographic characteristics, symptoms, and risk factors. Results: Nineteen cases of hepatitis A were identified. Univariate analysis revealed an association between infection and eating raw vegetables (OR = 9.3; 95%CI: 1.5-57.6 or razor-shell (OR = 55; 95%CI: 4.3-703.4. In the logistic regression model, only razor-shell consumption remained a significant risk factor (OR = 36.1; 95%CI: 2

Laser surveillance system for spent fuel

International Nuclear Information System (INIS)

Fiarman, S.; Zucker, M.S.; Bieber, A.M. Jr.

1980-01-01

A laser surveillance system installed at spent fuel storage pools (SFSP's) will provide the safeguard inspector with specific knowledge of spent fuel movement that cannot be obtained with current surveillance systems. The laser system will allow for the division of the pool's spent fuel inventory into two populations - those assemblies which have been moved and those which haven't - which is essential for maximizing the efficiency and effectiveness of the inspection effort. We have designed, constructed, and tested a full size laser system operating in air and have used an array of 6 zircaloy BWR tubes to simulate an assembly. The reflective signal from the zircaloy rods is a strong function of position of the assembly, but in all cases is easily discernable from the reference scan of the background with no assembly. A design for a SFSP laser surveillance system incorporating laser ranging is discussed. 10 figures

Methods for molecular surveillance of influenza

OpenAIRE

Wang, Ruixue; Taubenberger, Jeffery K

2010-01-01

Molecular-based techniques for detecting influenza viruses have become an integral component of human and animal surveillance programs in the last two decades. The recent pandemic of the swine-origin influenza A virus (H1N1) and the continuing circulation of highly pathogenic avian influenza A virus (H5N1) further stress the need for rapid and accurate identification and subtyping of influenza viruses for surveillance, outbreak management, diagnosis and treatment. There has been remarkable pr...

Why do farmers and veterinarians not report all bovine abortions, as requested by the clinical brucellosis surveillance system in France?

Science.gov (United States)

Bronner, Anne; Hénaux, Viviane; Fortané, Nicolas; Hendrikx, Pascal; Calavas, Didier

2014-04-24

Since 2005, France has been officially free of brucellosis, an infectious disease that causes abortion in cattle and can be transmitted from cattle to humans. Recent animal and human cases have drawn attention to the need to prevent infection of humans and animals from any primary outbreaks. In order to detect any new outbreaks as soon as possible, a clinical surveillance system requires farmers and veterinarians to report each abortion and to test the aborting cow for brucellosis. However, under-reporting limits the sensitivity of this system. Our objective was to identify the barriers and motivations influencing field actors in their decision to report or not to report bovine abortions. We used a qualitative approach with semi-structured interviews of 12 cattle farmers and their eight veterinarians. Our analysis showed that four main themes influence the decision-making process of farmers and veterinarians: 1) the perceived risk of brucellosis and other abortive diseases; 2) the definition of a suspected case of brucellosis and other abortive diseases adopted by field actors, which is less sensitive than the mandatory definition; 3) the cost-benefit analysis conducted by actors, taking into account regulatory and health aspects, economic and financial losses, technical and practical factors; 4) the level of cooperation within the socio-technical network. We discussed how early detection may be improved by revising the definition of abortion, extending the time frame for notification and generalising the differential diagnosis of the causes of abortion. In contrast to quantitative approaches, qualitative studies can identify the factors (including unknown factors) influencing the decision-making process of field actors and reveal why they take those factors into consideration. Our qualitative study sheds light on the factors underlying the poor sensitivity of clinical brucellosis surveillance system for cattle in France, and suggests that early detection may be

Unattended digital video surveillance: A system prototype for EURATOM safeguards

International Nuclear Information System (INIS)

Chare, P.; Goerten, J.; Wagner, H.; Rodriguez, C.; Brown, J.E.

1994-01-01

Ever increasing capabilities in video and computer technology have changed the face of video surveillance. From yesterday's film and analog video tape-based systems, we now emerge into the digital era with surveillance systems capable of digital image processing, image analysis, decision control logic, and random data access features -- all of which provide greater versatility with the potential for increased effectiveness in video surveillance. Digital systems also offer other advantages such as the ability to ''compress'' data, providing increased storage capacities and the potential for allowing longer surveillance Periods. Remote surveillance and system to system communications are also a benefit that can be derived from digital surveillance systems. All of these features are extremely important in today's climate Of increasing safeguards activity and decreasing budgets -- Los Alamos National Laboratory's Safeguards Systems Group and the EURATOM Safeguards Directorate have teamed to design and implement a period surveillance system that will take advantage of the versatility of digital video for facility surveillance system that will take advantage of the versatility of digital video for facility surveillance and data review. In this Paper we will familiarize you with system components and features and report on progress in developmental areas such as image compression and region of interest processing

Multi-site cholera surveillance within the African Cholera Surveillance Network shows endemicity in Mozambique, 2011–2015

Science.gov (United States)

Langa, José Paulo; Dengo Baloi, Liliana; Wood, Richard; Ouedraogo, Issaka; Njanpop-Lafourcade, Berthe-Marie; Inguane, Dorteia; Elias Chitio, Jucunu; Mhlanga, Themba; Gujral, Lorna; D. Gessner, Bradford; Munier, Aline; A. Mengel, Martin

2017-01-01

Background Mozambique suffers recurrent annual cholera outbreaks especially during the rainy season between October to March. The African Cholera Surveillance Network (Africhol) was implemented in Mozambique in 2011 to generate accurate detailed surveillance data to support appropriate interventions for cholera control and prevention in the country. Methodology/Principal findings Africhol was implemented in enhanced surveillance zones located in the provinces of Sofala (Beira), Zambézia (District Mocuba), and Cabo Delgado (Pemba City). Data were also analyzed from the three outbreak areas that experienced the greatest number of cases during the time period under observation (in the districts of Cuamba, Montepuez, and Nampula). Rectal swabs were collected from suspected cases for identification of Vibrio cholerae, as well as clinical, behavioral, and socio-demographic variables. We analyzed factors associated with confirmed, hospitalized, and fatal cholera using multivariate logistic regression models. A total of 1,863 suspected cases and 23 deaths (case fatality ratio (CFR), 1.2%) were reported from October 2011 to December 2015. Among these suspected cases, 52.2% were tested of which 23.5% were positive for Vibrio cholerae O1 Ogawa. Risk factors independently associated with the occurrence of confirmed cholera were living in Nampula city district, the year 2014, human immunodeficiency virus infection, and the primary water source for drinking. Conclusions/Significance Cholera was endemic in Mozambique during the study period with a high CFR and identifiable risk factors. The study reinforces the importance of continued cholera surveillance, including a strong laboratory component. The results enhanced our understanding of the need to target priority areas and at-risk populations for interventions including oral cholera vaccine (OCV) use, and assess the impact of prevention and control strategies. Our data were instrumental in informing integrated prevention and

Syndromic surveillance using veterinary laboratory data: algorithm combination and customization of alerts.

Science.gov (United States)

Dórea, Fernanda C; McEwen, Beverly J; McNab, W Bruce; Sanchez, Javier; Revie, Crawford W

2013-01-01

Syndromic surveillance research has focused on two main themes: the search for data sources that can provide early disease detection; and the development of efficient algorithms that can detect potential outbreak signals. This work combines three algorithms that have demonstrated solid performance in detecting simulated outbreak signals of varying shapes in time series of laboratory submissions counts. These are: the Shewhart control charts designed to detect sudden spikes in counts; the EWMA control charts developed to detect slow increasing outbreaks; and the Holt-Winters exponential smoothing, which can explicitly account for temporal effects in the data stream monitored. A scoring system to detect and report alarms using these algorithms in a complementary way is proposed. The use of multiple algorithms in parallel resulted in increased system sensitivity. Specificity was decreased in simulated data, but the number of false alarms per year when the approach was applied to real data was considered manageable (between 1 and 3 per year for each of ten syndromic groups monitored). The automated implementation of this approach, including a method for on-line filtering of potential outbreak signals is described. The developed system provides high sensitivity for detection of potential outbreak signals while also providing robustness and flexibility in establishing what signals constitute an alarm. This flexibility allows an analyst to customize the system for different syndromes.

Comparing effectiveness of regional and circular intervention zones in case of a foot-and-mouth disease outbreak

DEFF Research Database (Denmark)

Christiansen, Lasse Engbo; Dickey, Bradley F; Carpenter, Tim E

In case of a foot-and-mouth disease (FMD) or other exotic disease outbreak, surveillance zones and infected areas are conventionally created as circles with their centroids at the known infected premises. Given the availability of geographic information systems (GIS), it is no longer difficult...... model originally applied to a 3-county area in California and the available information about the state’s livestock demographics to compare these two control strategies. The comparisons included the simulated duration of outbreaks, number of herds and animals affected, and manpower issues...

[Epidemiologic surveillance of dengue fever in the French army from 1996 to 1999].

Science.gov (United States)

Meynard, J B; Ollivier-Gay, L; Deparis, X; Durand, J P; Michel, R; Pages, F; Matton, T; Boutin, J P; Tolou, H; Merouze, F; Baudon, D

2001-01-01

Dengue fever is a widespread disease that can occur outside tropical areas. Several thousand French military personnel are exposed to this infectious risk each year and exposure is expected to rise with the creation of a professional army and the increasing number of foreign missions. As a result, dengue fever has become a major priority for the Armed Services Health Corps (ASHC). A system of epidemiological surveillance based on the active participation of all military physicians has been designed by the ASHC to collect and analyze all data relevant to cases of dengue fever involving French military personnel stationed overseas or at home. The purpose of this study is to present data compiled for the period from 1996 to 1999. Analysis of these data demonstrated that the incidence of dengue fever peaked in 1997 due to epidemic outbreaks occurring in French Polynesia and Martinique. In response to these outbreaks control measures were adapted especially in regard to vector control. This study shows that the system of surveillance implemented by the ASHC is an effective but still perfectible tool.

Optimizing surveillance for livestock disease spreading through animal movements

Science.gov (United States)

Bajardi, Paolo; Barrat, Alain; Savini, Lara; Colizza, Vittoria

2012-01-01

The spatial propagation of many livestock infectious diseases critically depends on the animal movements among premises; so the knowledge of movement data may help us to detect, manage and control an outbreak. The identification of robust spreading features of the system is however hampered by the temporal dimension characterizing population interactions through movements. Traditional centrality measures do not provide relevant information as results strongly fluctuate in time and outbreak properties heavily depend on geotemporal initial conditions. By focusing on the case study of cattle displacements in Italy, we aim at characterizing livestock epidemics in terms of robust features useful for planning and control, to deal with temporal fluctuations, sensitivity to initial conditions and missing information during an outbreak. Through spatial disease simulations, we detect spreading paths that are stable across different initial conditions, allowing the clustering of the seeds and reducing the epidemic variability. Paths also allow us to identify premises, called sentinels, having a large probability of being infected and providing critical information on the outbreak origin, as encoded in the clusters. This novel procedure provides a general framework that can be applied to specific diseases, for aiding risk assessment analysis and informing the design of optimal surveillance systems. PMID:22728387

Surveillance of tularaemia in Kosovo, 2001 to 2010.

Science.gov (United States)

Grunow, R; Kalaveshi, A; Kühn, A; Mulliqi-Osmani, G; Ramadani, N

2012-07-12

Tularaemia, caused by Francisella tularensis, had not been registered in Kosovo before an outbreak in 1999 and 2000. A national surveillance system has been implemented in Kosovo since 2000 to monitor a number of diseases, including tularaemia. Antibody detection in human sera was used for laboratory diagnosis of tularaemia and F. tularensis lipopolysaccharide antigen was used as a marker of infection. The purpose of this study is to describe the incidence of tularaemia in Kosovo after the 1999-00 outbreak. In 2001 and 2002, a second outbreak occurred, with 327 serologically confirmed cases. From 2001 to 2010, 25-327 cases were registered per year, giving a mean annual incidence of 5.2 per 100,000 population. The most likely sources of infection were contaminated drinking water and food. The dominant clinical manifestations were the glandular (79%) and ulcero-glandular (21%) forms. By 2010, the disease had spread throughout Kosovo. Presumably as a result of war and subsequent environmental disruption, mass population displacement and breakdown of sanitation and hygiene, the two major outbreaks of tularaemia resulted in the establishment of an active endemic area of tularaemia in Kosovo.

Analytical report of the 2016 dengue outbreak in Córdoba city, Argentina

Directory of Open Access Journals (Sweden)

Camilo Rotela

2017-11-01

Full Text Available After elimination of the Aedes aegypti vector in South America in the 1960s, dengue outbreaks started to reoccur during the 1990s; strongly in Argentina since 1998. In 2016, Córdoba City had the largest dengue outbreak in its history. In this article we report this outbreak including spatio-temporal analysis of cases and vectors in the city. A total of 653 dengue cases were recorded by the laboratory-based dengue surveillance system and georeferenced by their residential addresses. Case maps were generated from the epidemiological week 1 (beginning of January to week 19 (mid-May. Dengue outbreak temporal evolution was analysed globally and three specific, high-incidence zones were detected using Knox analysis to characterising its spatio-temporal attributes. Field and remotely sensed data were collected and analysed in real time and a vector presence map based on the MaxEnt approach was generated to define hotspots, towards which the pesticide- based strategy was then targeted. The recorded pattern of cases evolution within the community suggests that dengue control measures should be improved.

Large Human Outbreak of West Nile Virus Infection in North-Eastern Italy in 2012

Directory of Open Access Journals (Sweden)

Luisa Barzon

2013-11-01

Full Text Available Human cases of West Nile virus (WNV disease have been reported in Italy since 2008. So far, most cases have been identified in north-eastern Italy, where, in 2012, the largest outbreak of WNV infection ever recorded in Italy occurred. Most cases of the 2012 outbreak were identified in the Veneto region, where a special surveillance plan for West Nile fever was in place. In this outbreak, 25 cases of West Nile neuroinvasive disease and 17 cases of fever were confirmed. In addition, 14 WNV RNA-positive blood donors were identified by screening of blood and organ donations and two cases of asymptomatic infection were diagnosed by active surveillance of subjects at risk of WNV exposure. Two cases of death due to WNND were reported. Molecular testing demonstrated the presence of WNV lineage 1 in all WNV RNA-positive patients and, in 15 cases, infection by the novel Livenza strain was ascertained. Surveillance in other Italian regions notified one case of neuroinvasive disease in the south of Italy and two cases in Sardinia. Integrated surveillance for WNV infection remains a public health priority in Italy and vector control activities have been strengthened in areas of WNV circulation.

Using Google Trends for influenza surveillance in South China.

Science.gov (United States)

Kang, Min; Zhong, Haojie; He, Jianfeng; Rutherford, Shannon; Yang, Fen

2013-01-01

Google Flu Trends was developed to estimate influenza activity in many countries; however there is currently no Google Flu Trends or other Internet search data used for influenza surveillance in China. Influenza surveillance data from 2008 through 2011 were obtained from provincial CDC influenza-like illness and virological surveillance systems of Guangdong, a province in south China. Internet search data were downloaded from the website of Google Trends. Pearson's correlation coefficients with 95% confidence intervals (95% CI) were calculated to compare surveillance data and internet search trends. The correlation between CDC ILI surveillance and CDC virus surveillance was 0.56 (95% CI: 0.43, 0.66). The strongest correlation was between the Google Trends term of Fever and ILI surveillance with a correlation coefficient of 0.73 (95% CI: 0.66, 0.79). When compared with influenza virological surveillance, the Google Trends term of Influenza A had the strongest correlation with a correlation coefficient of 0.64 (95% CI: 0.43, 0.79) in the 2009 H1N1 influenza pandemic period. This study shows that Google Trends in Chinese can be used as a complementary source of data for influenza surveillance in south China. More research in the future should develop new models using search trends in Chinese language to estimate local disease activity and detect early signals of outbreaks.

Pneumonia outbreaks in calves and finishers.

Science.gov (United States)

2016-03-19

Pneumonia in calves and finishers. Ovarian tumour in a calf . Abortion associated with bovine herpesvirus 1 in a suckler herd. Parasitic gastroenteritis causing illthrift and death in sheep. Outbreaks of acute fasciolosis in sheep. These are among matters discussed in the disease surveillance report for December 2015 from SAC Consulting: Veterinary Services (SAC C VS). British Veterinary Association.

Risk analysis of a video-surveillance system

NARCIS (Netherlands)

Rothkrantz, L.; Lefter, I.

2011-01-01

The paper describes a surveillance system of cameras installed at lamppost of a military area. The surveillance system has been designed to detect unwanted visitors or suspicious behaviors. The area is composed of streets, building blocks and surrounded by gates and water. The video recordings are

Secure Video Surveillance System (SVSS) for unannounced safeguards inspections

International Nuclear Information System (INIS)

Galdoz, Erwin G.; Pinkalla, Mark

2010-01-01

The Secure Video Surveillance System (SVSS) is a collaborative effort between the U.S. Department of Energy (DOE), Sandia National Laboratories (SNL), and the Brazilian-Argentine Agency for Accounting and Control of Nuclear Materials (ABACC). The joint project addresses specific requirements of redundant surveillance systems installed in two South American nuclear facilities as a tool to support unannounced inspections conducted by ABACC and the International Atomic Energy Agency (IAEA). The surveillance covers the critical time (as much as a few hours) between the notification of an inspection and the access of inspectors to the location in facility where surveillance equipment is installed. ABACC and the IAEA currently use the EURATOM Multiple Optical Surveillance System (EMOSS). This outdated system is no longer available or supported by the manufacturer. The current EMOSS system has met the project objective; however, the lack of available replacement parts and system support has made this system unsustainable and has increased the risk of an inoperable system. A new system that utilizes current technology and is maintainable is required to replace the aging EMOSS system. ABACC intends to replace one of the existing ABACC EMOSS systems by the Secure Video Surveillance System. SVSS utilizes commercial off-the shelf (COTS) technologies for all individual components. Sandia National Laboratories supported the system design for SVSS to meet Safeguards requirements, i.e. tamper indication, data authentication, etc. The SVSS consists of two video surveillance cameras linked securely to a data collection unit. The collection unit is capable of retaining historical surveillance data for at least three hours with picture intervals as short as 1sec. Images in .jpg format are available to inspectors using various software review tools. SNL has delivered two SVSS systems for test and evaluation at the ABACC Safeguards Laboratory. An additional 'proto-type' system remains

Evaluation of HIV Surveillance System in Rivers State, Nigeria ...

African Journals Online (AJOL)

Background: Rivers State has been reported to have the highest HIV prevalence of all the thirty-six states in Nigeria. HIV surveillance system generates information for timely and appropriate public health action. Evaluation of the surveillance system is vital in ensuring that the purpose of the surveillance system is being met.

Unattended video surveillance systems for international safeguards

International Nuclear Information System (INIS)

Johnson, C.S.

1979-01-01

The use of unattended video surveillance systems places some unique requirements on the systems and their hardware. The systems have the traditional requirements of video imaging, video storage, and video playback but also have some special requirements such as tamper safing. The technology available to meet these requirements and how it is being applied to unattended video surveillance systems are discussed in this paper

Large outbreak caused by methicillin resistant Staphylococcus pseudintermedius ST71 in a Finnish Veterinary Teaching Hospital--from outbreak control to outbreak prevention.

Directory of Open Access Journals (Sweden)

Thomas Grönthal

Full Text Available INTRODUCTION: The purpose of this study was to describe a nosocomial outbreak caused by methicillin resistant Staphylococcus pseudintermedius (MRSP ST71 SCCmec II-III in dogs and cats at the Veterinary Teaching Hospital of the University of Helsinki in November 2010 - January 2012, and to determine the risk factors for acquiring MRSP. In addition, measures to control the outbreak and current policy for MRSP prevention are presented. METHODS: Data of patients were collected from the hospital patient record software. MRSP surveillance data were acquired from the laboratory information system. Risk factors for MRSP acquisition were analyzed from 55 cases and 213 controls using multivariable logistic regression in a case-control study design. Forty-seven MRSP isolates were analyzed by pulsed field gel electrophoresis and three were further analyzed with multi-locus sequence and SCCmec typing. RESULTS: Sixty-three MRSP cases were identified, including 27 infections. MRSPs from the cases shared a specific multi-drug resistant antibiogram and PFGE-pattern indicated clonal spread. Four risk factors were identified; skin lesion (OR = 6.2; CI95% 2.3-17.0, P = 0.0003, antimicrobial treatment (OR = 3.8, CI95% 1.0-13.9, P = 0.0442, cumulative number of days in the intensive care unit (OR = 1.3, CI95% 1.1-1.6, P = 0.0007 or in the surgery ward (OR = 1.1, CI95% 1.0-1.3, P = 0.0401. Tracing and screening of contact patients, enhanced hand hygiene, cohorting and barrier nursing, as well as cleaning and disinfection were used to control the outbreak. To avoid future outbreaks and spread of MRSP a search-and-isolate policy was implemented. Currently nearly all new MRSP findings are detected in screening targeted to risk patients on admission. CONCLUSION: Multidrug resistant MRSP is capable of causing a large outbreak difficult to control. Skin lesions, antimicrobial treatment and prolonged hospital stay increase the probability of acquiring MRSP. Rigorous control

Internet-based surveillance systems for monitoring emerging infectious diseases.

Science.gov (United States)

Milinovich, Gabriel J; Williams, Gail M; Clements, Archie C A; Hu, Wenbiao

2014-02-01

Emerging infectious diseases present a complex challenge to public health officials and governments; these challenges have been compounded by rapidly shifting patterns of human behaviour and globalisation. The increase in emerging infectious diseases has led to calls for new technologies and approaches for detection, tracking, reporting, and response. Internet-based surveillance systems offer a novel and developing means of monitoring conditions of public health concern, including emerging infectious diseases. We review studies that have exploited internet use and search trends to monitor two such diseases: influenza and dengue. Internet-based surveillance systems have good congruence with traditional surveillance approaches. Additionally, internet-based approaches are logistically and economically appealing. However, they do not have the capacity to replace traditional surveillance systems; they should not be viewed as an alternative, but rather an extension. Future research should focus on using data generated through internet-based surveillance and response systems to bolster the capacity of traditional surveillance systems for emerging infectious diseases. Copyright © 2014 Elsevier Ltd. All rights reserved.

Laser surveillance system (LASSY)

International Nuclear Information System (INIS)

Boeck, H.; Hammer, J.

1988-01-01

The development progress during the reporting period 1988 of the laser surveillance system of spent fuel pools is summarized. The present engineered system comes close to a final version for field application as all technical questions have been solved in 1988. 14 figs., 1 tab. (Author)

Integrated Disease Surveillance in India: Way Forward

OpenAIRE

Deepak K. Raut; Anil K. Bhola

2014-01-01

Integrated Disease Surveillance Project (IDSP) with 9 years of its implementation in India has given a positive impetus to integration of surveillance functions primarily for epidemic prone diseases and decentralized symptoms--‐based detection of early warning signals of outbreaks at primary health care level. This review is based on systematic literature review through PubMed and Google Scholar databases and published reports of the IDSP from 2005-2013. It attempts to describe the progr...

Integrated Disease Surveillance in India: Way Forward

OpenAIRE

Deepak K. Raut

2014-01-01

Integrated Disease Surveillance Project (IDSP) with 9 years of its implementation in India has given a positive impetus to integration of surveillance functions primarily for epidemic prone diseases and decentralized symptoms-based detection of early warning signals of outbreaks at primary health care level. This review is based on systematic literature review through PubMed and Google Scholar databases and published reports of the IDSP from 2005-2013. It attempts to describe the progress ...

Building-level analyses to prospectively detect influenza outbreaks in long-term care facilities: New York City, 2013-2014.

Science.gov (United States)

Levin-Rector, Alison; Nivin, Beth; Yeung, Alice; Fine, Annie D; Greene, Sharon K

2015-08-01

Timely outbreak detection is necessary to successfully control influenza in long-term care facilities (LTCFs) and other institutions. To supplement nosocomial outbreak reports, calls from infection control staff, and active laboratory surveillance, the New York City (NYC) Department of Health and Mental Hygiene implemented an automated building-level analysis to proactively identify LTCFs with laboratory-confirmed influenza activity. Geocoded addresses of LTCFs in NYC were compared with geocoded residential addresses for all case-patients with laboratory-confirmed influenza reported through passive surveillance. An automated daily analysis used the geocoded building identification number, approximate text matching, and key-word searches to identify influenza in residents of LTCFs for review and follow-up by surveillance coordinators. Our aim was to determine whether the building analysis improved prospective outbreak detection during the 2013-2014 influenza season. Of 119 outbreaks identified in LTCFs, 109 (92%) were ever detected by the building analysis, and 55 (46%) were first detected by the building analysis. Of the 5,953 LTCF staff and residents who received antiviral prophylaxis during the 2013-2014 season, 929 (16%) were at LTCFs where outbreaks were initially detected by the building analysis. A novel building-level analysis improved influenza outbreak identification in LTCFs in NYC, prompting timely infection control measures. Copyright © 2015 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Intelligent video surveillance systems and technology

CERN Document Server

Ma, Yunqian

2009-01-01

From the streets of London to subway stations in New York City, hundreds of thousands of surveillance cameras ubiquitously collect hundreds of thousands of videos, often running 24/7. How can such vast volumes of video data be stored, analyzed, indexed, and searched? How can advanced video analysis and systems autonomously recognize people and detect targeted activities real-time? Collating and presenting the latest information Intelligent Video Surveillance: Systems and Technology explores these issues, from fundamentals principle to algorithmic design and system implementation.An Integrated

Wallops Ship Surveillance System

Science.gov (United States)

Smith, Donna C.

2011-01-01

Approved as a Wallops control center backup system, the Wallops Ship Surveillance Software is a day-of-launch risk analysis tool for spaceport activities. The system calculates impact probabilities and displays ship locations relative to boundary lines. It enables rapid analysis of possible flight paths to preclude the need to cancel launches and allow execution of launches in a timely manner. Its design is based on low-cost, large-customer- base elements including personal computers, the Windows operating system, C/C++ object-oriented software, and network interfaces. In conformance with the NASA software safety standard, the system is designed to ensure that it does not falsely report a safe-for-launch condition. To improve the current ship surveillance method, the system is designed to prevent delay of launch under a safe-for-launch condition. A single workstation is designated the controller of the official ship information and the official risk analysis. Copies of this information are shared with other networked workstations. The program design is divided into five subsystems areas: 1. Communication Link -- threads that control the networking of workstations; 2. Contact List -- a thread that controls a list of protected item (ocean vessel) information; 3. Hazard List -- threads that control a list of hazardous item (debris) information and associated risk calculation information; 4. Display -- threads that control operator inputs and screen display outputs; and 5. Archive -- a thread that controls archive file read and write access. Currently, most of the hazard list thread and parts of other threads are being reused as part of a new ship surveillance system, under the SureTrak project.

Identification and control of a poliomyelitis outbreak in Xinjiang, China.

Science.gov (United States)

Luo, Hui-Ming; Zhang, Yong; Wang, Xin-Qi; Yu, Wen-Zhou; Wen, Ning; Yan, Dong-Mei; Wang, Hua-Qing; Wushouer, Fuerhati; Wang, Hai-Bo; Xu, Ai-Qiang; Zheng, Jing-Shan; Li, De-Xin; Cui, Hui; Wang, Jian-Ping; Zhu, Shuang-Li; Feng, Zi-Jian; Cui, Fu-Qiang; Ning, Jing; Hao, Li-Xin; Fan, Chun-Xiang; Ning, Gui-Jun; Yu, Hong-Jie; Wang, Shi-Wen; Liu, Da-Wei; Wang, Dong-Yan; Fu, Jian-Ping; Gou, Ai-li; Zhang, Guo-Min; Huang, Guo-Hong; Chen, Yuan-Sheng; Mi, Sha-Sha; Liu, Yan-Min; Yin, Da-Peng; Zhu, Hui; Fan, Xin-Chun; Li, Xin-Lan; Ji, Yi-Xin; Li, Ke-Li; Tang, Hai-Shu; Xu, Wen-Bo; Wang, Yu; Yang, Wei-Zhong

2013-11-21

The last case of infection with wild-type poliovirus indigenous to China was reported in 1994, and China was certified as a poliomyelitis-free region in 2000. In 2011, an outbreak of infection with imported wild-type poliovirus occurred in the province of Xinjiang. We conducted an investigation to guide the response to the outbreak, performed sequence analysis of the poliovirus type 1 capsid protein VP1 to determine the source, and carried out serologic and coverage surveys to assess the risk of viral propagation. Surveillance for acute flaccid paralysis was intensified to enhance case ascertainment. Between July 3 and October 9, 2011, investigators identified 21 cases of infection with wild-type poliovirus and 23 clinically compatible cases in southern Xinjiang. Wild-type poliovirus type 1 was isolated from 14 of 673 contacts of patients with acute flaccid paralysis (2.1%) and from 13 of 491 healthy persons who were not in contact with affected persons (2.6%). Sequence analysis implicated an imported wild-type poliovirus that originated in Pakistan as the cause of the outbreak. A public health emergency was declared in Xinjiang after the outbreak was confirmed. Surveillance for acute flaccid paralysis was enhanced, with daily reporting from all public and private hospitals. Five rounds of vaccination with live, attenuated oral poliovirus vaccine (OPV) were conducted among children and adults, and 43 million doses of OPV were administered. Trivalent OPV was used in three rounds, and monovalent OPV type 1 was used in two rounds. The outbreak was stopped 1.5 months after laboratory confirmation of the index case. The 2011 outbreak in China showed that poliomyelitis-free countries remain at risk for outbreaks while the poliovirus circulates anywhere in the world. Global eradication of poliomyelitis will benefit all countries, even those that are currently free of poliomyelitis.

Large Outbreak Caused by Methicillin Resistant Staphylococcus pseudintermedius ST71 in a Finnish Veterinary Teaching Hospital – From Outbreak Control to Outbreak Prevention

Science.gov (United States)

Grönthal, Thomas; Moodley, Arshnee; Nykäsenoja, Suvi; Junnila, Jouni; Guardabassi, Luca; Thomson, Katariina; Rantala, Merja

2014-01-01

Introduction The purpose of this study was to describe a nosocomial outbreak caused by methicillin resistant Staphylococcus pseudintermedius (MRSP) ST71 SCCmec II-III in dogs and cats at the Veterinary Teaching Hospital of the University of Helsinki in November 2010 – January 2012, and to determine the risk factors for acquiring MRSP. In addition, measures to control the outbreak and current policy for MRSP prevention are presented. Methods Data of patients were collected from the hospital patient record software. MRSP surveillance data were acquired from the laboratory information system. Risk factors for MRSP acquisition were analyzed from 55 cases and 213 controls using multivariable logistic regression in a case-control study design. Forty-seven MRSP isolates were analyzed by pulsed field gel electrophoresis and three were further analyzed with multi-locus sequence and SCCmec typing. Results Sixty-three MRSP cases were identified, including 27 infections. MRSPs from the cases shared a specific multi-drug resistant antibiogram and PFGE-pattern indicated clonal spread. Four risk factors were identified; skin lesion (OR = 6.2; CI95% 2.3–17.0, P = 0.0003), antimicrobial treatment (OR = 3.8, CI95% 1.0–13.9, P = 0.0442), cumulative number of days in the intensive care unit (OR = 1.3, CI95% 1.1–1.6, P = 0.0007) or in the surgery ward (OR = 1.1, CI95% 1.0–1.3, P = 0.0401). Tracing and screening of contact patients, enhanced hand hygiene, cohorting and barrier nursing, as well as cleaning and disinfection were used to control the outbreak. To avoid future outbreaks and spread of MRSP a search-and-isolate policy was implemented. Currently nearly all new MRSP findings are detected in screening targeted to risk patients on admission. Conclusion Multidrug resistant MRSP is capable of causing a large outbreak difficult to control. Skin lesions, antimicrobial treatment and prolonged hospital stay increase the probability of acquiring

Economic costs of outbreaks of acute viral gastroenteritis due to norovirus in Catalonia (Spain), 2010-2011.

Science.gov (United States)

Navas, Encarna; Torner, Nuria; Broner, Sonia; Godoy, Pere; Martínez, Ana; Bartolomé, Rosa; Domínguez, Angela

2015-10-01

To determine the direct and indirect costs of outbreaks of acute viral gastroenteritis (AVG) due to norovirus in closed institutions (hospitals, social health centers or nursing homes) and the community in Catalonia in 2010-11. Information on outbreaks were gathered from the reports made by epidemiological surveillance units. Direct costs (medical visits, hospital stays, drug treatment, sample processing, transport, diagnostic tests, monitoring and control of the outbreaks investigated) and indirect costs (lost productivity due to work absenteeism, caregivers time and working hours lost due to medical visits) were calculated. Twenty-seven outbreaks affecting 816 people in closed institutions and 74 outbreaks affecting 1,940 people in the community were detected. The direct and indirect costs of outbreaks were € 131,997.36 (€ 4,888.79 per outbreak) in closed institutions and € 260,557.16 (€ 3,521.04 per outbreak) in community outbreaks. The cost per case was € 161.76 in outbreaks in closed institutions and € 134.31 in community outbreaks. The main costs were surveillance unit monitoring (€ 116,652.93), laboratory diagnoses (€ 119,950.95), transport of samples (€ 69,970.90), medical visits (€ 25,250.50) and hospitalization (€ 13,400.00). The cost of outbreaks of acute viral gastroenteritis due to norovirus obtained in this study was influenced by the number of people affected and the severity of the outbreak, which determined hospitalizations and work absenteeism. Urgent reporting of outbreaks would allow the implementation of control measures that could reduce the numbers affected and the duration of the illness and thus the costs derived from them.

Human resources for health: lessons from the cholera outbreak in Papua New Guinea.

Science.gov (United States)

Rosewell, Alexander; Bieb, Sibauk; Clark, Geoff; Miller, Geoff; MacIntyre, Raina; Zwi, Anthony

2013-01-01

Papua New Guinea is striving to achieve the minimum core requirements under the International Health Regulations in surveillance and outbreak response, and has experienced challenges in the availability and distribution of health professionals. Since mid-2009, a large cholera outbreak spread across lowland regions of the country and has been associated with more than 15 500 notifications at a case fatality ratio of 3.2%. The outbreak placed significant pressure on clinical and public health services. We describe some of the challenges to cholera preparedness and response in this human resource-limited setting, the strategies used to ensure effective cholera management and lessons learnt. Cholera task forces were useful to establish a clear system of leadership and accountability for cholera outbreak response and ensure efficiencies in each technical area. Cholera outbreak preparedness and response was strongest when human resource and health systems functioned well before the outbreak. Communication relied on coordination of existing networks and methods for empowering local leaders and villagers to modify behaviours of the population. In line with the national health emergencies plan, the successes of human resource strategies during the cholera outbreak should be built upon through emergency exercises, especially in non-affected provinces. Population needs for all public health professionals involved in health emergency preparedness and response should be mapped, and planning should be implemented to increase the numbers in relevant areas. Human resource planning should be integrated with health emergency planning. It is essential to maintain and strengthen the human resource capacities and experiences gained during the cholera outbreak to ensure a more effective response to the next health emergency.

Can tail damage outbreaks in the pig be predicted by behavioural change?

DEFF Research Database (Denmark)

Larsen, Mona Lilian Vestbjerg; Andersen, Heidi Mai-Lis; Pedersen, Lene Juul

2016-01-01

preventive methods. One strategy is the surveillance of the pigs' behaviour for known preceding indicators of tail damage, which makes it possible to predict a tail damage outbreak and prevent it in proper time. This review discusses the existing literature on behavioural changes observed prior to a tail...... damage outbreak. Behaviours found to change prior to an outbreak include increased activity level, increased performance of enrichment object manipulation, and a changed proportion of tail posture with more tails between the legs. Monitoring these types of behaviours is also discussed for the purpose......, starting with the description of the temporal development of the predictive behaviour in relation to tail damage outbreaks...

A comprehensive review on intelligent surveillance systems

Directory of Open Access Journals (Sweden)

Sutrisno Warsono Ibrahim

2016-05-01

Full Text Available Intelligent surveillance system (ISS has received growing attention due to the increasing demand on security and safety. ISS is able to automatically analyze image, video, audio or other type of surveillance data without or with limited human intervention. The recent developments in sensor devices, computer vision, and machine learning have an important role in enabling such intelligent system. This paper aims to provide general overview of intelligent surveillance system and discuss some possible sensor modalities and their fusion scenarios such as visible camera (CCTV, infrared camera, thermal camera and radar. This paper also discusses main processing steps in ISS: background-foreground segmentation, object detection and classification, tracking, and behavioral analysis.

An international point source outbreak of typhoid fever: a European collaborative investigation*

Science.gov (United States)

Stanwell-Smith, R. E.; Ward, L. R.

1986-01-01

A point source outbreak of Salmonella typhi, degraded Vi-strain 22, affecting 32 British visitors to Kos, Greece, in 1983 was attributed by a case—control study to the consumption of a salad at one hotel. This represents the first major outbreak of typhoid fever in which a salad has been identified as the vehicle. The source of the infection was probably a carrier in the hotel staff. The investigation demonstrates the importance of national surveillance, international cooperation, and epidemiological methods in the investigation and control of major outbreaks of infection. PMID:3488842

[Hospital hygiene - outbreak management of nosocomial infections].

Science.gov (United States)

Kerwat, Klaus; Wulf, Hinnerk

2012-04-01

According to §6, section 3 of the German Protection against Infections Act [Infektionsschutzgesetz (IfSG)] an outbreak is defined as the occurrence in large numbers of nosocomial infections for which an epidemiological relationship is probable or can be assumed. About 2-10% of nosocomial infections in hospitals (about 5% in intensive care wards) occur within the framework of an outbreak. The heaped occurrence of nosocomial infections can be declared according to the prescribed surveillance of nosocomial infections (§23 IfSG) when, in the course of this assessment, a statistically significant increase in the rate of infections becomes apparent. On the other hand, the occurrence of an outbreak can also be recognized through the vigilance of all involved personnel and a general sensibilization towards this subject. The names of patients involved in outbreaks need not be reported to the responsible health authorities. As a consequence of the report the health authorities become involved in the investigation to determine the cause and its elimination, and to provide support and advice. The outbreak management should be oriented on the respective recommendations of the Robert Koch Institute. © Georg Thieme Verlag Stuttgart · New York.

Listeriosis Outbreaks in British Columbia, Canada, Caused by Soft Ripened Cheese Contaminated from Environmental Sources

Science.gov (United States)

Wilcott, Lynn; Naus, Monika

2015-01-01

Soft ripened cheese (SRC) caused over 130 foodborne illnesses in British Columbia (BC), Canada, during two separate listeriosis outbreaks. Multiple agencies investigated the events that lead to cheese contamination with Listeria monocytogenes (L.m.), an environmentally ubiquitous foodborne pathogen. In both outbreaks pasteurized milk and the pasteurization process were ruled out as sources of contamination. In outbreak A, environmental transmission of L.m. likely occurred from farm animals to personnel to culture solutions used during cheese production. In outbreak B, birds were identified as likely contaminating the dairy plant's water supply and cheese during the curd-washing step. Issues noted during outbreak A included the risks of operating a dairy plant in a farm environment, potential for transfer of L.m. from the farm environment to the plant via shared toilet facilities, failure to clean and sanitize culture spray bottles, and cross-contamination during cheese aging. L.m. contamination in outbreak B was traced to wild swallows defecating in the plant's open cistern water reservoir and a multibarrier failure in the water disinfection system. These outbreaks led to enhanced inspection and surveillance of cheese plants, test and release programs for all SRC manufactured in BC, improvements in plant design and prevention programs, and reduced listeriosis incidence. PMID:25918702

Listeriosis Outbreaks in British Columbia, Canada, Caused by Soft Ripened Cheese Contaminated from Environmental Sources

Directory of Open Access Journals (Sweden)

Lorraine McIntyre

2015-01-01

Full Text Available Soft ripened cheese (SRC caused over 130 foodborne illnesses in British Columbia (BC, Canada, during two separate listeriosis outbreaks. Multiple agencies investigated the events that lead to cheese contamination with Listeria monocytogenes (L.m., an environmentally ubiquitous foodborne pathogen. In both outbreaks pasteurized milk and the pasteurization process were ruled out as sources of contamination. In outbreak A, environmental transmission of L.m. likely occurred from farm animals to personnel to culture solutions used during cheese production. In outbreak B, birds were identified as likely contaminating the dairy plant’s water supply and cheese during the curd-washing step. Issues noted during outbreak A included the risks of operating a dairy plant in a farm environment, potential for transfer of L.m. from the farm environment to the plant via shared toilet facilities, failure to clean and sanitize culture spray bottles, and cross-contamination during cheese aging. L.m. contamination in outbreak B was traced to wild swallows defecating in the plant’s open cistern water reservoir and a multibarrier failure in the water disinfection system. These outbreaks led to enhanced inspection and surveillance of cheese plants, test and release programs for all SRC manufactured in BC, improvements in plant design and prevention programs, and reduced listeriosis incidence.

Surveillance of avian influenza in the Caribbean through the Caribbean Animal Health Network: surveillance tools and epidemiologic studies.

Science.gov (United States)

Lefrançois, T; Hendrikx, P; Ehrhardt, N; Millien, M; Gomez, L; Gouyet, L; Gaidet, N; Gerbier, G; Vachiéry, N; Petitclerc, F; Carasco-Lacombe, C; Pinarello, V; Ahoussou, S; Levesque, A; Gongora, H V; Trotman, M

2010-03-01

The Caribbean region is considered to be at risk for avian influenza (AI) due to a large backyard poultry system, an important commercial poultry production system, the presence of migratory birds, and disparities in the surveillance systems. The Caribbean Animal Health Network (CaribVET) has developed tools to implement AI surveillance in the region with the goals to have 1) a regionally harmonized surveillance protocol and specific web pages for AI surveillance on www.caribvet.net, and 2) an active and passive surveillance for AI in domestic and wild birds. A diagnostic network for the Caribbean, including technology transfer and AI virus molecular diagnostic capability in Guadeloupe (real-time reverse transcription-polymerase chain reaction for the AI virus matrix gene), was developed. Between 2006 and 2009, 627 samples from four Caribbean countries were tested for three circumstances: importation purposes, following a clinical suspicion of AI, or through an active survey of wild birds (mainly waders) during the southward and northward migration periods in Guadeloupe. None of the samples tested were positive, suggesting a limited role of these species in the AI virus ecology in the Caribbean. Following low pathogenic H5N2 outbreaks in the Dominican Republic in 2007, a questionnaire was developed to collect data for a risk analysis of AI spread in the region through fighting cocks. The infection pathway of the Martinique commercial poultry sector by AI, through introduction of infected cocks, was designed, and recommendations were provided to the Caribbean Veterinary Services to improve cock movement control and biosecurity measures. The CaribVET and its organization allowed interaction between diagnostic and surveillance tools on the one hand and epidemiologic studies on the other, both of them developed in congruence with regional strategies. Together, these CaribVET activities contribute to strengthening surveillance of avian influenza virus (AIV) in the

Ebola viral hemorrhagic disease outbreak in West Africa- lessons from Uganda.

Science.gov (United States)

Mbonye, Anthony K; Wamala, Joseph F; Nanyunja, Miriam; Opio, Alex; Makumbi, Issa; Aceng, Jane Ruth

2014-09-01

There has been a rapid spread of Ebola Viral Hemorrhagic disease in Guinea, Liberia and Sierra Leone since March 2014. Since this is the first time of a major Ebola outbreak in West Africa; it is possible there is lack of understanding of the epidemic in the communities, lack of experience among the health workers to manage the cases and limited capacities for rapid response. The main objective of this article is to share Uganda's experience in controlling similar Ebola outbreaks and to suggest some lessons that could inform the control of the Ebola outbreak in West Africa. The article is based on published papers, reports of previous Ebola outbreaks, response plans and experiences of individuals who have participated in the control of Ebola epidemics in Uganda. Lessons learnt: The success in the control of Ebola epidemics in Uganda has been due to high political support, effective coordination through national and district task forces. In addition there has been active surveillance, strong community mobilization using village health teams and other community resources persons, an efficient laboratory system that has capacity to provide timely results. These have coupled with effective case management and infection control and the involvement of development partners who commit resources with shared responsibility. Several factors have contributed to the successful quick containment of Ebola outbreaks in Uganda. West African countries experiencing Ebola outbreaks could draw some lessons from the Uganda experience and adapt them to contain the Ebola epidemic.

The Global Public Health Intelligence Network and early warning outbreak detection: a Canadian contribution to global public health.

Science.gov (United States)

Mykhalovskiy, Eric; Weir, Lorna

2006-01-01

The recent SARS epidemic has renewed widespread concerns about the global transmission of infectious diseases. In this commentary, we explore novel approaches to global infectious disease surveillance through a focus on an important Canadian contribution to the area--the Global Public Health Intelligence Network (GPHIN). GPHIN is a cutting-edge initiative that draws on the capacity of the Internet and newly available 24/7 global news coverage of health events to create a unique form of early warning outbreak detection. This commentary outlines the operation and development of GPHIN and compares it to ProMED-mail, another Internet-based approach to global health surveillance. We argue that GPHIN has created an important shift in the relationship of public health and news information. By exiting the pyramid of official reporting, GPHIN has created a new monitoring technique that has disrupted national boundaries of outbreak notification, while creating new possibilities for global outbreak response. By incorporating news within the emerging apparatus of global infectious disease surveillance, GPHIN has effectively responded to the global media's challenge to official country reporting of outbreak and enhanced the effectiveness and credibility of international public health.

Electronic Integrated Disease Surveillance System and Pathogen Asset Control System

Directory of Open Access Journals (Sweden)

Tom G. Wahl

2012-06-01

Full Text Available Electronic Integrated Disease Surveillance System (EIDSS has been used to strengthen and support monitoring and prevention of dangerous diseases within One Health concept by integrating veterinary and human surveillance, passive and active approaches, case-based records including disease-specific clinical data based on standardised case definitions and aggregated data, laboratory data including sample tracking linked to each case and event with test results and epidemiological investigations. Information was collected and shared in secure way by different means: through the distributed nodes which are continuously synchronised amongst each other, through the web service, through the handheld devices. Electronic Integrated Disease Surveillance System provided near real time information flow that has been then disseminated to the appropriate organisations in a timely manner. It has been used for comprehensive analysis and visualisation capabilities including real time mapping of case events as these unfold enhancing decision making. Electronic Integrated Disease Surveillance System facilitated countries to comply with the IHR 2005 requirements through a data transfer module reporting diseases electronically to the World Health Organisation (WHO data center as well as establish authorised data exchange with other electronic system using Open Architecture approach. Pathogen Asset Control System (PACS has been used for accounting, management and control of biological agent stocks. Information on samples and strains of any kind throughout their entire lifecycle has been tracked in a comprehensive and flexible solution PACS. Both systems have been used in a combination and individually. Electronic Integrated Disease Surveillance System and PACS are currently deployed in the Republics of Kazakhstan, Georgia and Azerbaijan as a part of the Cooperative Biological Engagement Program (CBEP sponsored by the US Defense Threat Reduction Agency (DTRA.

Electronic integrated disease surveillance system and pathogen asset control system.

Science.gov (United States)

Wahl, Tom G; Burdakov, Aleksey V; Oukharov, Andrey O; Zhilokov, Azamat K

2012-06-20

Electronic Integrated Disease Surveillance System (EIDSS) has been used to strengthen and support monitoring and prevention of dangerous diseases within One Health concept by integrating veterinary and human surveillance, passive and active approaches, case-based records including disease-specific clinical data based on standardised case definitions and aggregated data, laboratory data including sample tracking linked to each case and event with test results and epidemiological investigations. Information was collected and shared in secure way by different means: through the distributed nodes which are continuously synchronised amongst each other, through the web service, through the handheld devices. Electronic Integrated Disease Surveillance System provided near real time information flow that has been then disseminated to the appropriate organisations in a timely manner. It has been used for comprehensive analysis and visualisation capabilities including real time mapping of case events as these unfold enhancing decision making. Electronic Integrated Disease Surveillance System facilitated countries to comply with the IHR 2005 requirements through a data transfer module reporting diseases electronically to the World Health Organisation (WHO) data center as well as establish authorised data exchange with other electronic system using Open Architecture approach. Pathogen Asset Control System (PACS) has been used for accounting, management and control of biological agent stocks. Information on samples and strains of any kind throughout their entire lifecycle has been tracked in a comprehensive and flexible solution PACS.Both systems have been used in a combination and individually. Electronic Integrated Disease Surveillance System and PACS are currently deployed in the Republics of Kazakhstan, Georgia and Azerbaijan as a part of the Cooperative Biological Engagement Program (CBEP) sponsored by the US Defense Threat Reduction Agency (DTRA).

Information Systems to Support Surveillance for Malaria Elimination

Science.gov (United States)

Ohrt, Colin; Roberts, Kathryn W.; Sturrock, Hugh J. W.; Wegbreit, Jennifer; Lee, Bruce Y.; Gosling, Roly D.

2015-01-01

Robust and responsive surveillance systems are critical for malaria elimination. The ideal information system that supports malaria elimination includes: rapid and complete case reporting, incorporation of related data, such as census or health survey information, central data storage and management, automated and expert data analysis, and customized outputs and feedback that lead to timely and targeted responses. Spatial information enhances such a system, ensuring cases are tracked and mapped over time. Data sharing and coordination across borders are vital and new technologies can improve data speed, accuracy, and quality. Parts of this ideal information system exist and are in use, but have yet to be linked together coherently. Malaria elimination programs should support the implementation and refinement of information systems to support surveillance and response and ensure political and financial commitment to maintain the systems and the human resources needed to run them. National malaria programs should strive to improve the access and utility of these information systems and establish cross-border data sharing mechanisms through the use of standard indicators for malaria surveillance. Ultimately, investment in the information technologies that support a timely and targeted surveillance and response system is essential for malaria elimination. PMID:26013378

Polio and Measles Down the Drain: Environmental Enterovirus Surveillance in the Netherlands, 2005 to 2015.

Science.gov (United States)

Benschop, Kimberley S M; van der Avoort, Harrie G; Jusic, Edin; Vennema, Harry; van Binnendijk, Rob; Duizer, Erwin

2017-07-01

Polioviruses (PVs) are members of the genus Enterovirus In the Netherlands, the exclusion of PV circulation is based on clinical enterovirus (EV) surveillance (CEVS) of EV-positive cases and routine environmental EV surveillance (EEVS) conducted on sewage samples collected in the region of the Netherlands where vaccination coverage is low due to religious reasons. We compared the EEVS data to those of the CEVS to gain insight into the relevance of EEVS for poliovirus and nonpolio enterovirus surveillance. Following the polio outbreak in Syria, EEVS was performed at the primary refugee center in Ter Apel in the Netherlands, and data were compared to those of CEVS and EEVS. Furthermore, we assessed the feasibility of poliovirus detection by EEVS using measles virus detection in sewage during a measles outbreak as a proxy. Two Sabin-like PVs were found in routine EEVS, 11 Sabin-like PVs were detected in the CEVS, and one Sabin-like PV was found in the Ter Apel sewage. We observed significant differences between the three programs regarding which EVs were found. In 6 sewage samples collected during the measles outbreak in 2013, measles virus RNA was detected in regions where measles cases were identified. In conclusion, we detected PVs, nonpolio EVs, and measles virus in sewage and showed that environmental surveillance is useful for poliovirus detection in the Netherlands, where live oral poliovirus vaccine is not used and communities with lower vaccination coverage exist. EEVS led to the detection of EV types not seen in the CEVS, showing that EEVS is complementary to CEVS. IMPORTANCE We show that environmental enterovirus surveillance complements clinical enterovirus surveillance for poliovirus detection, or exclusion, and for nonpolio enterovirus surveillance. Even in the presence of adequate surveillance, only a very limited number of Sabin-like poliovirus strains were detected in a 10-year period, and no signs of transmission of oral polio vaccine (OPV) strains

The 2011 outbreak of African horse sickness in the African horse sickness controlled area in South Africa

Directory of Open Access Journals (Sweden)

John D. Grewar

2013-11-01

Full Text Available African horse sickness (AHS is a controlled animal disease in South Africa, and as a result of the high mortality rates experienced, outbreaks in the AHS controlled area in the Western Cape Province have a significant impact on affected properties as well as on the exportation of live horses from the AHS free zone in metropolitan Cape Town. An outbreak of AHS serotype 1 occurred in the surveillance zone of the AHS controlled area of the Western Cape during the summer of 2011. The epicentre of the outbreak was the town of Mamre in the magisterial district of Malmesbury and the outbreak was confined to a defined containment zone within this area by movement control of all equids and a blanket vaccination campaign. A total of 73 cases of AHS were confirmed during this outbreak, which included four confirmed subclinical cases. The morbidity rate for the outbreak was 16%with a mortality rate of 14%and a case fatality rate of 88%. Outbreak disease surveillance relied on agent identification using polymerase chain reaction (PCR-based assays, which is novel for an AHS outbreak in South Africa. The source of this outbreak was never confirmed although it is believed to be associated with the illegal movement of an infected animal into the Mamre area. This detailed description of the outbreak provides a sound scientific basis to assist decision making in future AHS outbreaks in the AHS controlled area of South Africa and in countries where AHS is an exotic or emerging disease.

Laser surveillance system for spent fuel

International Nuclear Information System (INIS)

Fiarman, S.; Zucker, M.S.; Bieber, A.M. Jr.

1980-01-01

A laser surveillance system installed at spent fuel storage pools will provide the safeguard inspector with specific knowledge of spent fuel movement that cannot be obtained with current surveillance systems. The laser system will allow for the division of the pool's spent fuel inventory into two populations - those assemblies which have been moved and those which haven't - which is essential for maximizing the efficiency and effectiveness of the inspection effort. We have designed, constructed, and tested a laser system and have used it with a simulated BWR assembly. The reflected signal from the zircaloy rods depends on the position of the assembly, but in all cases is easily discernable from the reference scan of background with no assembly

Multimodal surveillance sensors, algorithms, and systems

CERN Document Server

Zhu, Zhigang

2007-01-01

From front-end sensors to systems and environmental issues, this practical resource guides you through the many facets of multimodal surveillance. The book examines thermal, vibration, video, and audio sensors in a broad context of civilian and military applications. This cutting-edge volume provides an in-depth treatment of data fusion algorithms that takes you to the core of multimodal surveillance, biometrics, and sentient computing. The book discusses such people and activity topics as tracking people and vehicles and identifying individuals by their speech.Systems designers benefit from d

Global Avian Influenza Surveillance in Wild Birds: A Strategy to Capture Viral Diversity

Science.gov (United States)

Machalaba, Catherine C.; Elwood, Sarah E.; Forcella, Simona; Smith, Kristine M.; Hamilton, Keith; Jebara, Karim B.; Swayne, David E.; Webby, Richard J.; Mumford, Elizabeth; Mazet, Jonna A.K.; Gaidet, Nicolas; Daszak, Peter

2015-01-01

Wild birds play a major role in the evolution, maintenance, and spread of avian influenza viruses. However, surveillance for these viruses in wild birds is sporadic, geographically biased, and often limited to the last outbreak virus. To identify opportunities to optimize wild bird surveillance for understanding viral diversity, we reviewed responses to a World Organisation for Animal Health–administered survey, government reports to this organization, articles on Web of Knowledge, and the Influenza Research Database. At least 119 countries conducted avian influenza virus surveillance in wild birds during 2008–2013, but coordination and standardization was lacking among surveillance efforts, and most focused on limited subsets of influenza viruses. Given high financial and public health burdens of recent avian influenza outbreaks, we call for sustained, cost-effective investments in locations with high avian influenza diversity in wild birds and efforts to promote standardized sampling, testing, and reporting methods, including full-genome sequencing and sharing of isolates with the scientific community. PMID:25811221

What caused the 2012 dengue outbreak in Pucallpa, Peru? A socio-ecological autopsy.

Science.gov (United States)

Charette, Margot; Berrang-Ford, Lea; Llanos-Cuentas, Elmer Alejandro; Cárcamo, César; Kulkarni, Manisha

2017-02-01

Dengue is highly endemic in Peru, with increases in transmission particularly since vector re-infestation of the country in the 1980s. Pucallpa, the second largest city in the Peruvian Amazon, experienced a large outbreak in 2012 that caused more than 10,000 cases and 13 deaths. To date, there has been limited research on dengue in the Peruvian Amazon outside of Iquitos, and no published review or critical analysis of the 2012 Pucallpa dengue outbreak. This study describes the incidence, surveillance, and control of dengue in Ucayali to understand the factors that contributed to the 2012 Pucallpa outbreak. We employed a socio-ecological autopsy approach to consider distal and proximal contributing factors, drawing on existing literature and interviews with key personnel involved in dengue control, surveillance and treatment in Ucayali. Spatio-temporal analysis showed that relative risk of dengue was higher in the northern districts of Calleria (RR = 2.18), Manantay (RR = 1.49) and Yarinacocha (RR = 1.25) compared to all other districts between 2004 and 2014. The seasonal occurrence of the 2012 outbreak is consistent with typical seasonal patterns for dengue incidence in the region. Our assessment suggests that the outbreak was proximally triggered by the introduction of a new virus serotype (DENV-2 Asian/America) to the region. Increased travel, rapid urbanization, and inadequate water management facilitated the potential for virus spread and transmission, both within Pucallpa and regionally. These triggers occurred within the context of failures in surveillance and control programming, including underfunded and ad hoc vector control. These findings have implications for future prevention and control of dengue in Ucayali as new diseases such as chikungunya and Zika threaten the region. Copyright © 2016 Elsevier Ltd. All rights reserved.

Lineage-Specific Real-Time RT-PCR for Yellow Fever Virus Outbreak Surveillance, Brazil.

Science.gov (United States)

Fischer, Carlo; Torres, Maria C; Patel, Pranav; Moreira-Soto, Andres; Gould, Ernest A; Charrel, Rémi N; de Lamballerie, Xavier; Nogueira, Rita Maria Ribeiro; Sequeira, Patricia C; Rodrigues, Cintia D S; Kümmerer, Beate M; Drosten, Christian; Landt, Olfert; Bispo de Filippis, Ana Maria; Drexler, Jan Felix

2017-11-01

The current yellow fever outbreak in Brazil prompted widespread yellow fever virus (YFV) vaccination campaigns, imposing a responsibility to distinguish between vaccine- and wild-type YFV-associated disease. We developed novel multiplex real-time reverse transcription PCRs that differentiate between vaccine and American wild-type YFV. We validated these highly specific and sensitive assays in an outbreak setting.

Lineage-Specific Real-Time RT-PCR for Yellow Fever Virus Outbreak Surveillance, Brazil

OpenAIRE

Fischer, Carlo; Torres, Maria C.; Patel, Pranav; Moreira-Soto, Andres; Gould, Ernest A.; Charrel, Rémi N.; de Lamballerie, Xavier; Nogueira, Rita Maria Ribeiro; Sequeira, Patricia C.; Rodrigues, Cintia D.S.; Kümmerer, Beate M.; Drosten, Christian; Landt, Olfert; Bispo de Filippis, Ana Maria; Drexler, Jan Felix

2017-01-01

The current yellow fever outbreak in Brazil prompted widespread yellow fever virus (YFV) vaccination campaigns, imposing a responsibility to distinguish between vaccine- and wild-type YFV-associated disease. We developed novel multiplex real-time reverse transcription PCRs that differentiate between vaccine and American wild-type YFV. We validated these highly specific and sensitive assays in an outbreak setting.

Evaluation of HIV Surveillance System in Rivers State, Nigeria ...

African Journals Online (AJOL)

Sony Computer (Iby)

HIV surveillance system generates information for timely and appropriate ..... active type of surveillance.14 Nonetheless, it requires training, supervision and motivation ... very effectively.14 The introduction of reward-system could be included.

Ebola virus disease surveillance and response preparedness in northern Ghana

Directory of Open Access Journals (Sweden)

Martin N. Adokiya

2016-05-01

Full Text Available Background: The recent Ebola virus disease (EVD outbreak has been described as unprecedented in terms of morbidity, mortality, and geographical extension. It also revealed many weaknesses and inadequacies for disease surveillance and response systems in Africa due to underqualified staff, cultural beliefs, and lack of trust for the formal health care sector. In 2014, Ghana had high risk of importation of EVD cases. Objective: The objective of this study was to assess the EVD surveillance and response system in northern Ghana. Design: This was an observational study conducted among 47 health workers (district directors, medical, disease control, and laboratory officers in all 13 districts of the Upper East Region representing public, mission, and private health services. A semi-structured questionnaire with focus on core and support functions (e.g. detection, confirmation was administered to the informants. Their responses were recorded according to specific themes. In addition, 34 weekly Integrated Disease Surveillance and Response reports (August 2014 to March 2015 were collated from each district. Results: In 2014 and 2015, a total of 10 suspected Ebola cases were clinically diagnosed from four districts. Out of the suspected cases, eight died and the cause of death was unexplained. All the 10 suspected cases were reported, none was confirmed. The informants had knowledge on EVD surveillance and data reporting. However, there were gaps such as delayed reporting, low quality protective equipment (e.g. gloves, aprons, inadequate staff, and lack of laboratory capacity. The majority (38/47 of the respondents were not satisfied with EVD surveillance system and response preparedness due to lack of infrared thermometers, ineffective screening, and lack of isolation centres. Conclusion: EVD surveillance and response preparedness is insufficient and the epidemic is a wake-up call for early detection and response preparedness. Ebola surveillance remains

Sonoma Persistent Surveillance System

Energy Technology Data Exchange (ETDEWEB)

Pennington, D M

2006-03-24

Sonoma offers the first cost-effective, broad-area, high-resolution, real-time motion imagery system for surveillance applications. Sonoma is unique in its ability to provide continuous, real-time video imagery of an area the size of a small city with resolutions sufficient to track 8,000 moving objects in the field of view. At higher resolutions and over smaller areas, Sonoma can even track the movement of individual people. The visual impact of the data available from Sonoma is already causing a paradigm shift in the architecture and operation of other surveillance systems. Sonoma is expected to cost just one-tenth the price of comparably sized sensor systems. Cameras mounted on an airborne platform constantly monitor an area, feeding data to the ground for real-time analysis. Sonoma was designed to provide real-time data for actionable intelligence in situations such as monitoring traffic, special events, border security, and harbors. If a Sonoma system had been available in the aftermath of the Katrina and Rita hurricanes, emergency responders would have had real-time information on roads, water levels, and traffic conditions, perhaps saving many lives.

Dengue data and surveillance in Tanzania: a systematic literature review.

Science.gov (United States)

Ward, Tara; Samuel, Moody; Maoz, Dorit; Runge-Ranzinger, Silvia; Boyce, Ross; Toledo, Joao; Velayudhan, Raman; Horstick, Olaf

2017-08-01

Although there is evidence that dengue virus is circulating in Tanzania, the country lacks a dengue surveillance system. Consequently, the true estimate of dengue seroprevalence, as well as the incidence in the population, the frequency and magnitude of outbreaks is unknown. This study therefore sought to systematically review available dengue data from Tanzania. The systematic review was conducted and reported using the PRISMA tool. Five databases (PubMed, Embase, Web of Science, WHOLIS and Google Scholar) were searched for articles using various keywords on the illness, data and geographical location. Identified articles were assessed for inclusion based on predefined eligibility criteria. Data were extracted from included articles, analysed and reported. Based on the 10 seroprevalence studies in defined populations with estimates of acute confirmed infections that were included in the review, the estimated seroprevalence of past dengue infection in Tanzania ranged from 50.6% in a health facility-based study to 11% in a population-based study. Acute confirmed infections of dengue were estimated to be as high as 38.2% of suspected cases. Only one study reported on an outbreak. It is evident that dengue needs to become part of regular disease surveillance in Tanzania. Control measures need to be instituted with a focus on building human resource capacity and integrating dengue control measures in ongoing health programmes, for both preventive and curative interventions. Systematic reviews are valuable in assessing health issues when surveillance data are not available. © 2017 John Wiley & Sons Ltd.

Typhoid fever acquired in the United States, 1999-2010: epidemiology, microbiology, and use of a space-time scan statistic for outbreak detection.

Science.gov (United States)

Imanishi, M; Newton, A E; Vieira, A R; Gonzalez-Aviles, G; Kendall Scott, M E; Manikonda, K; Maxwell, T N; Halpin, J L; Freeman, M M; Medalla, F; Ayers, T L; Derado, G; Mahon, B E; Mintz, E D

2015-08-01

Although rare, typhoid fever cases acquired in the United States continue to be reported. Detection and investigation of outbreaks in these domestically acquired cases offer opportunities to identify chronic carriers. We searched surveillance and laboratory databases for domestically acquired typhoid fever cases, used a space-time scan statistic to identify clusters, and classified clusters as outbreaks or non-outbreaks. From 1999 to 2010, domestically acquired cases accounted for 18% of 3373 reported typhoid fever cases; their isolates were less often multidrug-resistant (2% vs. 15%) compared to isolates from travel-associated cases. We identified 28 outbreaks and two possible outbreaks within 45 space-time clusters of ⩾2 domestically acquired cases, including three outbreaks involving ⩾2 molecular subtypes. The approach detected seven of the ten outbreaks published in the literature or reported to CDC. Although this approach did not definitively identify any previously unrecognized outbreaks, it showed the potential to detect outbreaks of typhoid fever that may escape detection by routine analysis of surveillance data. Sixteen outbreaks had been linked to a carrier. Every case of typhoid fever acquired in a non-endemic country warrants thorough investigation. Space-time scan statistics, together with shoe-leather epidemiology and molecular subtyping, may improve outbreak detection.

Survey of Clostridium difficile infection surveillance systems in Europe, 2011.

Science.gov (United States)

Kola, Axel; Wiuff, Camilla; Akerlund, Thomas; van Benthem, Birgit H; Coignard, Bruno; Lyytikäinen, Outi; Weitzel-Kage, Doris; Suetens, Carl; Wilcox, Mark H; Kuijper, Ed J; Gastmeier, Petra

2016-07-21

To develop a European surveillance protocol for Clostridium difficile infection (CDI), existing national CDI surveillance systems were assessed in 2011. A web-based electronic form was provided for all national coordinators of the European CDI Surveillance Network (ECDIS-Net). Of 35 national coordinators approached, 33 from 31 European countries replied. Surveillance of CDI was in place in 14 of the 31 countries, comprising 18 different nationwide systems. Three of 14 countries with CDI surveillance used public health notification of cases as the route of reporting, and in another three, reporting was limited to public health notification of cases of severe CDI. The CDI definitions published by the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) and the European Centre for Disease Prevention and Control (ECDC) were widely used, but there were differing definitions to distinguish between community- and healthcare-associated cases. All CDI surveillance systems except one reported annual national CDI rates (calculated as number of cases per patient-days). Only four surveillance systems regularly integrated microbiological data (typing and susceptibility testing results). Surveillance methods varied considerably between countries, which emphasises the need for a harmonised European protocol to allow consistent monitoring of the CDI epidemiology at European level. The results of this survey were used to develop a harmonised EU-wide hospital-based CDI surveillance protocol. This article is copyright of The Authors, 2016.

Sharing Data for Global Infectious Disease Surveillance and Outbreak Detection

DEFF Research Database (Denmark)

Aarestrup, Frank Møller; Koopmans, Marion G.

2016-01-01

Rapid global sharing and comparison of epidemiological and genomic data on infectious diseases would enable more rapid and efficient global outbreak control and tracking of diseases. Several barriers for global sharing exist but, in our opinion, the presumed magnitude of the problems appears larger...

Information systems to support surveillance for malaria elimination.

Science.gov (United States)

Ohrt, Colin; Roberts, Kathryn W; Sturrock, Hugh J W; Wegbreit, Jennifer; Lee, Bruce Y; Gosling, Roly D

2015-07-01

Robust and responsive surveillance systems are critical for malaria elimination. The ideal information system that supports malaria elimination includes: rapid and complete case reporting, incorporation of related data, such as census or health survey information, central data storage and management, automated and expert data analysis, and customized outputs and feedback that lead to timely and targeted responses. Spatial information enhances such a system, ensuring cases are tracked and mapped over time. Data sharing and coordination across borders are vital and new technologies can improve data speed, accuracy, and quality. Parts of this ideal information system exist and are in use, but have yet to be linked together coherently. Malaria elimination programs should support the implementation and refinement of information systems to support surveillance and response and ensure political and financial commitment to maintain the systems and the human resources needed to run them. National malaria programs should strive to improve the access and utility of these information systems and establish cross-border data sharing mechanisms through the use of standard indicators for malaria surveillance. Ultimately, investment in the information technologies that support a timely and targeted surveillance and response system is essential for malaria elimination. © The American Society of Tropical Medicine and Hygiene.

The multi-camera optical surveillance system (MOS)

International Nuclear Information System (INIS)

Otto, P.; Wagner, H.; Richter, B.; Gaertner, K.J.; Laszlo, G.; Neumann, G.

1991-01-01

The transition from film camera to video surveillance systems, in particular the implementation of high capacity multi-camera video systems, results in a large increase in the amount of recorded scenes. Consequently, there is a substantial increase in the manpower requirements for review. Moreover, modern microprocessor controlled equipment facilitates the collection of additional data associated with each scene. Both the scene and the annotated information have to be evaluated by the inspector. The design of video surveillance systems for safeguards necessarily has to account for both appropriate recording and reviewing techniques. An aspect of principal importance is that the video information is stored on tape. Under the German Support Programme to the Agency a technical concept has been developed which aims at optimizing the capabilities of a multi-camera optical surveillance (MOS) system including the reviewing technique. This concept is presented in the following paper including a discussion of reviewing and reliability

Youth Risk Behavior Surveillance System

Science.gov (United States)

... Youth Risk Behavior Surveillance System (YRBSS) monitors six types of health-risk behaviors that contribute to the leading causes of death and disability among youth and adults, including— Behaviors that contribute ...

Outbreaks of Acute Gastroenteritis Transmitted by Person-to-Person Contact, Environmental Contamination, and Unknown Modes of Transmission--United States, 2009-2013.

Science.gov (United States)

Wikswo, Mary E; Kambhampati, Anita; Shioda, Kayoko; Walsh, Kelly A; Bowen, Anna; Hall, Aron J

2015-12-11

-term-care facilities (n = 4,894). In contrast, 59% (n = 143) of shigellosis outbreaks, 36% (n = 30) of salmonellosis outbreaks, and 32% (n = 84) of other or multiple etiology outbreaks were identified in child care facilities. NORS is the first U.S. surveillance system that provides national data on AGE outbreaks spread through person-to-person contact, environmental contamination, and unknown modes of transmission. The increase in reporting rates during 2009-2013 indicates that reporting to NORS improved notably in the 5 years since its inception. Norovirus is the most commonly reported cause of these outbreaks and, on the basis of epidemiologic data, might account for a substantial proportion of outbreaks without a reported etiology. During 2009-2013, norovirus accounted for most deaths and health care visits in AGE outbreaks spread through person-to-person contact, environmental contamination, and unknown modes of transmission. Recommendations for prevention and control of AGE outbreaks transmitted through person-to-person contact, environmental contamination, and unknown modes of transmission depend primarily on appropriate hand hygiene, environmental disinfection, and isolation of ill persons. NORS surveillance data can help identify priority targets for the development of future control strategies, including hygiene interventions and vaccines, and help monitor the frequency and severity of AGE outbreaks in the United States. Ongoing study of these AGE outbreaks can provide a better understanding of certain pathogens and their modes of transmission. For example, certain reported outbreak etiologies (e.g., Salmonella) are considered primarily foodborne pathogens but can be transmitted through multiple routes. Similarly, further examination of outbreaks of unknown etiology could help identify barriers to making an etiologic determination, to analyze clinical and epidemiologic clues suggestive of a probable etiology, and to discover new and emerging etiologic agents. Outbreak

A Study of 279 General Outbreaks of Gastrointestinal Infection in the North-East Region of England

Science.gov (United States)

Tebbutt, Grahame M.; Wilson, Deborah; Holtby, Ian

2009-01-01

All outbreaks of infectious intestinal disease reported to the authorities were entered on a computer database with outbreak control teams being established to investigate larger or more significant incidents. The outbreak database and, when set up, the notes of outbreak team meetings were examined for the 279 outbreaks reported in a three-year period (2003–2005). Faeces specimens submitted as part of an outbreak were examined for microbial pathogens and the results cross-matched to the outbreak number. Almost half of the general outbreaks reported (137) occurred in long-term care facilities for the elderly, 51 outbreaks were recorded in hospitals and 31 occurred in the wider community. In 76 outbreaks no specimen was logged. A microbial cause was confirmed in about one-third of outbreaks, with noroviruses being the most common (19%). Salmonellas accounted for 12 of the 21 community outbreaks linked to social events and all were foodborne. Suggestions for improving notification and surveillance are discussed. PMID:19440398

An Autonomous Mobile Robotic System for Surveillance of Indoor Environments

Directory of Open Access Journals (Sweden)

Donato Di Paola

2010-02-01

Full Text Available The development of intelligent surveillance systems is an active research area. In this context, mobile and multi-functional robots are generally adopted as means to reduce the environment structuring and the number of devices needed to cover a given area. Nevertheless, the number of different sensors mounted on the robot, and the number of complex tasks related to exploration, monitoring, and surveillance make the design of the overall system extremely challenging. In this paper, we present our autonomous mobile robot for surveillance of indoor environments. We propose a system able to handle autonomously general-purpose tasks and complex surveillance issues simultaneously. It is shown that the proposed robotic surveillance scheme successfully addresses a number of basic problems related to environment mapping, localization and autonomous navigation, as well as surveillance tasks, like scene processing to detect abandoned or removed objects and people detection and following. The feasibility of the approach is demonstrated through experimental tests using a multisensor platform equipped with a monocular camera, a laser scanner, and an RFID device. Real world applications of the proposed system include surveillance of wide areas (e.g. airports and museums and buildings, and monitoring of safety equipment.

An Autonomous Mobile Robotic System for Surveillance of Indoor Environments

Directory of Open Access Journals (Sweden)

Donato Di Paola

2010-03-01

Full Text Available The development of intelligent surveillance systems is an active research area. In this context, mobile and multi-functional robots are generally adopted as means to reduce the environment structuring and the number of devices needed to cover a given area. Nevertheless, the number of different sensors mounted on the robot, and the number of complex tasks related to exploration, monitoring, and surveillance make the design of the overall system extremely challenging. In this paper, we present our autonomous mobile robot for surveillance of indoor environments. We propose a system able to handle autonomously general-purpose tasks and complex surveillance issues simultaneously. It is shown that the proposed robotic surveillance scheme successfully addresses a number of basic problems related to environment mapping, localization and autonomous navigation, as well as surveillance tasks, like scene processing to detect abandoned or removed objects and people detection and following. The feasibility of the approach is demonstrated through experimental tests using a multisensor platform equipped with a monocular camera, a laser scanner, and an RFID device. Real world applications of the proposed system include surveillance of wide areas (e.g. airports and museums and buildings, and monitoring of safety equipment.

Constructing rigorous and broad biosurveillance networks for detecting emerging zoonotic outbreaks.

Directory of Open Access Journals (Sweden)

Mac Brown

Full Text Available Determining optimal surveillance networks for an emerging pathogen is difficult since it is not known beforehand what the characteristics of a pathogen will be or where it will emerge. The resources for surveillance of infectious diseases in animals and wildlife are often limited and mathematical modeling can play a supporting role in examining a wide range of scenarios of pathogen spread. We demonstrate how a hierarchy of mathematical and statistical tools can be used in surveillance planning help guide successful surveillance and mitigation policies for a wide range of zoonotic pathogens. The model forecasts can help clarify the complexities of potential scenarios, and optimize biosurveillance programs for rapidly detecting infectious diseases. Using the highly pathogenic zoonotic H5N1 avian influenza 2006-2007 epidemic in Nigeria as an example, we determined the risk for infection for localized areas in an outbreak and designed biosurveillance stations that are effective for different pathogen strains and a range of possible outbreak locations. We created a general multi-scale, multi-host stochastic SEIR epidemiological network model, with both short and long-range movement, to simulate the spread of an infectious disease through Nigerian human, poultry, backyard duck, and wild bird populations. We chose parameter ranges specific to avian influenza (but not to a particular strain and used a Latin hypercube sample experimental design to investigate epidemic predictions in a thousand simulations. We ranked the risk of local regions by the number of times they became infected in the ensemble of simulations. These spatial statistics were then complied into a potential risk map of infection. Finally, we validated the results with a known outbreak, using spatial analysis of all the simulation runs to show the progression matched closely with the observed location of the farms infected in the 2006-2007 epidemic.

Typhoid fever acquired in the United States, 1999–2010: epidemiology, microbiology, and use of a space–time scan statistic for outbreak detection

Science.gov (United States)

IMANISHI, M.; NEWTON, A. E.; VIEIRA, A. R.; GONZALEZ-AVILES, G.; KENDALL SCOTT, M. E.; MANIKONDA, K.; MAXWELL, T. N.; HALPIN, J. L.; FREEMAN, M. M.; MEDALLA, F.; AYERS, T. L.; DERADO, G.; MAHON, B. E.; MINTZ, E. D.

2016-01-01

SUMMARY Although rare, typhoid fever cases acquired in the United States continue to be reported. Detection and investigation of outbreaks in these domestically acquired cases offer opportunities to identify chronic carriers. We searched surveillance and laboratory databases for domestically acquired typhoid fever cases, used a space–time scan statistic to identify clusters, and classified clusters as outbreaks or non-outbreaks. From 1999 to 2010, domestically acquired cases accounted for 18% of 3373 reported typhoid fever cases; their isolates were less often multidrug-resistant (2% vs. 15%) compared to isolates from travel-associated cases. We identified 28 outbreaks and two possible outbreaks within 45 space–time clusters of ⩾2 domestically acquired cases, including three outbreaks involving ⩾2 molecular subtypes. The approach detected seven of the ten outbreaks published in the literature or reported to CDC. Although this approach did not definitively identify any previously unrecognized outbreaks, it showed the potential to detect outbreaks of typhoid fever that may escape detection by routine analysis of surveillance data. Sixteen outbreaks had been linked to a carrier. Every case of typhoid fever acquired in a non-endemic country warrants thorough investigation. Space–time scan statistics, together with shoe-leather epidemiology and molecular subtyping, may improve outbreak detection. PMID:25427666

A comprehensive database of the geographic spread of past human Ebola outbreaks.

Science.gov (United States)

Mylne, Adrian; Brady, Oliver J; Huang, Zhi; Pigott, David M; Golding, Nick; Kraemer, Moritz U G; Hay, Simon I

2014-01-01

Ebola is a zoonotic filovirus that has the potential to cause outbreaks of variable magnitude in human populations. This database collates our existing knowledge of all known human outbreaks of Ebola for the first time by extracting details of their suspected zoonotic origin and subsequent human-to-human spread from a range of published and non-published sources. In total, 22 unique Ebola outbreaks were identified, composed of 117 unique geographic transmission clusters. Details of the index case and geographic spread of secondary and imported cases were recorded as well as summaries of patient numbers and case fatality rates. A brief text summary describing suspected routes and means of spread for each outbreak was also included. While we cannot yet include the ongoing Guinea and DRC outbreaks until they are over, these data and compiled maps can be used to gain an improved understanding of the initial spread of past Ebola outbreaks and help evaluate surveillance and control guidelines for limiting the spread of future epidemics.

Molecular Investigation into a Malaria Outbreak in Cusco, Peru: Plasmodium falciparum BV1 Lineage is Linked to a Second Outbreak in Recent Times

Science.gov (United States)

Okoth, Sheila Akinyi; Chenet, Stella M.; Arrospide, Nancy; Gutierrez, Sonia; Cabezas, Cesar; Matta, Jose Antonio; Udhayakumar, Venkatachalam

2016-01-01

In November 2013, a Plasmodium falciparum malaria outbreak of 11 cases occurred in Cusco, southern Peru, where falciparum malaria had not been reported since 1946. Although initial microscopic diagnosis reported only Plasmodium vivax infection in each of the specimens, subsequent examination by the national reference laboratory confirmed P. falciparum infection in all samples. Molecular typing of four available isolates revealed identity as the B-variant (BV1) strain that was responsible for a malaria outbreak in Tumbes, northern Peru, between 2010 and 2012. The P. falciparum BV1 strain is multidrug resistant, can escape detection by PfHRP2-based rapid diagnostic tests, and has contributed to two malaria outbreaks in Peru. This investigation highlights the importance of accurate species diagnosis given the potential for P. falciparum to be reintroduced to regions where it may have been absent. Similar molecular epidemiological investigations can track the probable source(s) of outbreak parasite strains for malaria surveillance and control purposes. PMID:26483121

Services oriented architectures and rapid deployment of ad-hoc health surveillance systems: lessons from Katrina relief efforts.

Science.gov (United States)

Mirhaji, Parsa; Casscells, S Ward; Srinivasan, Arunkumar; Kunapareddy, Narendra; Byrne, Sean; Richards, David Mark; Arafat, Raouf

2006-01-01

During the Hurricane Katrina relief efforts, a new city was born overnight within the City of Houston to provide accommodation and health services for thousands of evacuees deprived of food, rest, medical attention, and sanitation. The hurricane victims had been exposed to flood water, toxic materials, physical injury, and mental stress. This scenario was an invitation for a variety of public health hazards, primarily infectious disease outbreaks. Early detection and monitoring of morbidity and mortality among evacuees due to unattended health conditions was an urgent priority and called for deployment of real-time surveillance to collect and analyze data at the scene, and to enable and guide appropriate response and planning activities. The University of Texas Health Science Center at Houston (UTHSC) and the Houston Department of Health and Human Services (HDHHS) deployed an ad hoc surveillance system overnight by leveraging Internet-based technologies and Services Oriented Architecture (SOA). The system was post-coordinated through the orchestration of Web Services such as information integration, natural language processing, syndromic case finding, and online analytical processing (OLAP). Here we will report the use of Internet-based and distributed architectures in providing timely, novel, and customizable solutions on demand for unprecedented events such as natural disasters.

Outbreak of Bacillus cereus infections in a neonatal intensive care unit traced to balloons used in manual ventilation.

Science.gov (United States)

Van Der Zwet, W C; Parlevliet, G A; Savelkoul, P H; Stoof, J; Kaiser, A M; Van Furth, A M; Vandenbroucke-Grauls, C M

2000-11-01

In 1998, an outbreak of systemic infections caused by Bacillus cereus occurred in the Neonatal Intensive Care Unit of the University Hospital Vrije Universiteit, Amsterdam, The Netherlands. Three neonates developed sepsis with positive blood cultures. One neonate died, and the other two neonates recovered. An environmental survey, a prospective surveillance study of neonates, and a case control study were performed, in combination with molecular typing, in order to identify potential sources and transmission routes of infection. Genotypic fingerprinting by amplified-fragment length polymorphism (AFLP) showed that the three infections were caused by a single clonal type of B. cereus. The same strain was found in trachea aspirate specimens of 35 other neonates. The case control study showed mechanical ventilation with a Sensormedics ventilation machine to be a risk factor for colonization and/or infection (odds ratio, 9.8; 95% confidence interval, 1.1 to 88.2). Prospective surveillance showed that colonization with B. cereus occurred exclusively in the respiratory tract of mechanically ventilated neonates. The epidemic strain of B. cereus was found on the hands of nursing staff and in balloons used for manual ventilation. Sterilization of these balloons ended the outbreak. We conclude that B. cereus can cause outbreaks of severe opportunistic infection in neonates. Typing by AFLP proved very useful in the identification of the outbreak and in the analysis of strains recovered from the environment to trace the cause of the epidemic.

Perspectives on West Africa Ebola Virus Disease Outbreak, 2013-2016.

Science.gov (United States)

Spengler, Jessica R; Ervin, Elizabeth D; Towner, Jonathan S; Rollin, Pierre E; Nichol, Stuart T

2016-06-01

The variety of factors that contributed to the initial undetected spread of Ebola virus disease in West Africa during 2013-2016 and the difficulty controlling the outbreak once the etiology was identified highlight priorities for disease prevention, detection, and response. These factors include occurrence in a region recovering from civil instability and lacking experience with Ebola response; inadequate surveillance, recognition of suspected cases, and Ebola diagnosis; mobile populations and extensive urban transmission; and the community's insufficient general understanding about the disease. The magnitude of the outbreak was not attributable to a substantial change of the virus. Continued efforts during the outbreak and in preparation for future outbreak response should involve identifying the reservoir, improving in-country detection and response capacity, conducting survivor studies and supporting survivors, engaging in culturally appropriate public education and risk communication, building productive interagency relationships, and continuing support for basic research.

A novel response to an outbreak of infectious syphilis in Christchurch, New Zealand.

Science.gov (United States)

Coughlan, Edward; Young, Heather; Parkes, Catherine; Coshall, Maureen; Dickson, Nigel; Psutka, Rebecca; Saxton, Peter; Pink, Ramon; Adams, Katharine

2015-04-01

During 2012, Christchurch experienced a dramatic increase in cases of infectious syphilis among men who have sex with men. This was accompanied by some novel trends; notably, the acquisition of infection in a younger age group, with local sexual contacts, commonly via the use of social media. This study is a report on an approach to case identification and public health communication as a component of a multifaceted outbreak response. Enhanced syphilis surveillance data on public health responses to outbreaks of sexually transmissible infections was collated and reviewed, alongside clinical records and literature. Reported outbreak response methods were adapted for the Christchurch cohort. A Facebook page was created to raise awareness of infectious syphilis, the importance of screening and where to get tested. Twenty-six males were diagnosed with infectious syphilis in 2012, an increase from previous years, of which 22 reported only male sexual contact. High use of social media used to find potential sexual contacts was reported. Enhanced syphilis surveillance characterised in detail an infectious syphilis outbreak in Christchurch. Index cases were identified, contact tracing mapping was used to identify transmission networks and social media was also used to educate the risk group. There was a decrease in infectious syphilis presentations, with no cases in the last 3 months of 2012.

Systèmes de surveillance de la fièvre jaune en Afrique : rôle des centres OMS et place de la surveillance entomologique

OpenAIRE

Thonnon, J.; Mathiot, C.; Fontenille, Didier

1998-01-01

WHO Collaborating Centers, or (by default) designated national laboratories, intervene at two levels in the surveillance of yellow fever : (1) upstream, through knowledge and analysis of risk factors linked to vectors and populations, including : collection of entomological data (surveillance of the sylvatic cycle, Kédougou, Senegal), measuring the risk of an outbreak in urban areas (quantity of larvae of #Aedes aegypti$), measuring the national immunity to yellow fever among human population...

Polio eradication initiative in Africa: influence on other infectious disease surveillance development

Directory of Open Access Journals (Sweden)

Cochi Stephen

2002-12-01

Full Text Available Abstract Background The World Health Organization (WHO and partners are collaborating to eradicate poliomyelitis. To monitor progress, countries perform surveillance for acute flaccid paralysis (AFP. The WHO African Regional Office (WHO-AFRO and the U.S Centers for Disease Control and Prevention are also involved in strengthening infectious disease surveillance and response in Africa. We assessed whether polio-eradication initiative resources are used in the surveillance for and response to other infectious diseases in Africa. Methods During October 1999-March 2000, we developed and administered a survey questionnaire to at least one key informant from the 38 countries that regularly report on polio activities to WHO. The key informants included WHO-AFRO staff assigned to the countries and Ministry of Health personnel. Results We obtained responses from 32 (84% of the 38 countries. Thirty-one (97% of the 32 countries had designated surveillance officers for AFP surveillance, and 25 (78% used the AFP resources for the surveillance and response to other infectious diseases. In 28 (87% countries, AFP program staff combined detection for AFP and other infectious diseases. Fourteen countries (44% had used the AFP laboratory specimen transportation system to transport specimens to confirm other infectious disease outbreaks. The majority of the countries that performed AFP surveillance adequately (i.e., non polio AFP rate = 1/100,000 children aged Conclusions Despite concerns regarding the targeted nature of AFP surveillance, it is partially integrated into existing surveillance and response systems in multiple African countries. Resources provided for polio eradication should be used to improve surveillance for and response to other priority infectious diseases in Africa.

The impact of meteorology on the occurrence of waterborne outbreaks of vero cytotoxin-producing Escherichia coli (VTEC): a logistic regression approach.

Science.gov (United States)

O'Dwyer, Jean; Morris Downes, Margaret; Adley, Catherine C

2016-02-01

This study analyses the relationship between meteorological phenomena and outbreaks of waterborne-transmitted vero cytotoxin-producing Escherichia coli (VTEC) in the Republic of Ireland over an 8-year period (2005-2012). Data pertaining to the notification of waterborne VTEC outbreaks were extracted from the Computerised Infectious Disease Reporting system, which is administered through the national Health Protection Surveillance Centre as part of the Health Service Executive. Rainfall and temperature data were obtained from the national meteorological office and categorised as cumulative rainfall, heavy rainfall events in the previous 7 days, and mean temperature. Regression analysis was performed using logistic regression (LR) analysis. The LR model was significant (p < 0.001), with all independent variables: cumulative rainfall, heavy rainfall and mean temperature making a statistically significant contribution to the model. The study has found that rainfall, particularly heavy rainfall in the preceding 7 days of an outbreak, is a strong statistical indicator of a waterborne outbreak and that temperature also impacts waterborne VTEC outbreak occurrence.

Evaluating the use of cell phone messaging for community Ebola syndromic surveillance in high risked settings in Southern Sierra Leone.

Science.gov (United States)

Jia, Kangbai; Mohamed, Koroma

2015-09-01

Most underdeveloped countries do not meet core disease outbreak surveillance because of the lack of human resources, laboratory and infrastructural facilities. The use of cell phone technology for disease outbreak syndromic surveillance is a new phenomenon in Sierra Leone despite its successes in other developing countries like Sri Lanka. In this study we set to evaluate the effectiveness of using cell phone technology for Ebola hemorrhagic fever syndromic surveillance in a high risked community in Sierra Leone. This study evaluated the effectiveness of using cell phone messaging (text and calls) for community Ebola hemorrhagic fever syndromic surveillance in high risked community in southern Sierra Leone. All cell phone syndromic surveillance data used for this study was reported as cell phone alert messages-texts and voice calls; by the Moyamba District Health Management Team for both Ebola hemorrhagic fever suspect and mortalities. We conducted a longitudinal data analysis of the monthly cumulative confirmed Ebola hemorrhagic fever cases and mortalities collected by both the traditional sentinel and community cell phone syndromic surveillance from August 2014 to October 2014. A total of 129 and 49 Ebola hemorrhagic fever suspect and confirmed cases respectively were recorded using the community Ebola syndromic surveillance cell phone alert system by the Moyamba District Health Management Team in October 2014. The average number of Ebola hemorrhagic fever suspects and confirmed cases for October 2014 were 4.16 (Std.dev 3.76) and 1.58 (Std.dev 1.43) respectively. Thirty-four percent (n=76) of the community Ebola syndromic surveillance cell phone alerts that were followed-up within 24 hours reported Ebola hemorrhagic fever suspect cases while 65.92% (n=147) reported mortality. Our study suggests some form of underreporting by the traditional sentinel Ebola hemorrhagic fever disease surveillance system in Moyamba District southern Sierra Leone for August

Spatio-temporal analysis of Salmonella surveillance data in Thailand

DEFF Research Database (Denmark)

Coutinho Calado Domingues, Ana Rita; Vieira, Antonio; Hendriksen, Rene S.

2014-01-01

This study evaluates the usefulness of spatio-temporal statistical tools to detect outbreaks using routine surveillance data where limited epidemiological information is available. A dataset from 2002 to 2007 containing information regarding date, origin, source and serotype of 29 586 Salmonella ...

An Assessment of Information Exchange Practices, Challenges, and Opportunities to Support US Disease Surveillance in 3 States.

Science.gov (United States)

Garcia, Macarena C; Garrett, Nedra Y; Singletary, Vivian; Brown, Sheereen; Hennessy-Burt, Tamara; Haney, Gillian; Link, Kimberly; Tripp, Jennifer; Mac Kenzie, William R; Yoon, Paula

2017-12-07

State and local public health agencies collect and use surveillance data to identify outbreaks, track cases, investigate causes, and implement measures to protect the public-s health through various surveillance systems and data exchange practices. The purpose of this assessment was to better understand current practices at state and local public health agencies for collecting, managing, processing, reporting, and exchanging notifiable disease surveillance information. Over an 18-month period (January 2014-June 2015), we evaluated the process of data exchange between surveillance systems, reporting burdens, and challenges within 3 states (California, Idaho, and Massachusetts) that were using 3 different reporting systems. All 3 states use a combination of paper-based and electronic information systems for managing and exchanging data on reportable conditions within the state. The flow of data from local jurisdictions to the state health departments varies considerably. When state and local information systems are not interoperable, manual duplicative data entry and other work-arounds are often required. The results of the assessment show the complexity of disease reporting at the state and local levels and the multiple systems, processes, and resources engaged in preparing, processing, and transmitting data that limit interoperability and decrease efficiency. Through this structured assessment, the Centers for Disease Control and Prevention (CDC) has a better understanding of the complexities for surveillance of using commercial off-the-shelf data systems (California and Massachusetts), and CDC-developed National Electronic Disease Surveillance System Base System. More efficient data exchange and use of data will help facilitate interoperability between National Notifiable Diseases Surveillance Systems.

Toward unsupervised outbreak detection through visual perception of new patterns

Directory of Open Access Journals (Sweden)

Lévy Pierre P

2009-06-01

Full Text Available Abstract Background Statistical algorithms are routinely used to detect outbreaks of well-defined syndromes, such as influenza-like illness. These methods cannot be applied to the detection of emerging diseases for which no preexisting information is available. This paper presents a method aimed at facilitating the detection of outbreaks, when there is no a priori knowledge of the clinical presentation of cases. Methods The method uses a visual representation of the symptoms and diseases coded during a patient consultation according to the International Classification of Primary Care 2nd version (ICPC-2. The surveillance data are transformed into color-coded cells, ranging from white to red, reflecting the increasing frequency of observed signs. They are placed in a graphic reference frame mimicking body anatomy. Simple visual observation of color-change patterns over time, concerning a single code or a combination of codes, enables detection in the setting of interest. Results The method is demonstrated through retrospective analyses of two data sets: description of the patients referred to the hospital by their general practitioners (GPs participating in the French Sentinel Network and description of patients directly consulting at a hospital emergency department (HED. Informative image color-change alert patterns emerged in both cases: the health consequences of the August 2003 heat wave were visualized with GPs' data (but passed unnoticed with conventional surveillance systems, and the flu epidemics, which are routinely detected by standard statistical techniques, were recognized visually with HED data. Conclusion Using human visual pattern-recognition capacities to detect the onset of unexpected health events implies a convenient image representation of epidemiological surveillance and well-trained "epidemiology watchers". Once these two conditions are met, one could imagine that the epidemiology watchers could signal epidemiological alerts

SCORPIO - VVER core surveillance system

International Nuclear Information System (INIS)

Zalesky, K.; Svarny, J.; Novak, L.; Rosol, J.; Horanes, A.

1997-01-01

The Halden Project has developed the core surveillance system SCORPIO which has two parallel modes of operation: the Core Follow Mode and the Predictive Mode. The main motivation behind the development of SCORPIO is to make a practical tool for reactor operators which can increase the quality and quantity of information presented on core status and dynamic behavior. This can first of all improve plant safety as undesired core conditions are detected and prevented. Secondly, more flexible and efficient plant operation is made possible. So far the system has only been implemented on western PWRs but the basic concept is applicable to a wide range of reactor including WWERs. The main differences between WWERs and typical western PWRs with respect to core surveillance requirements are outlined. The development of a WWER version of SCORPIO was initiated in cooperation with the Nuclear Research Institute at Rez and industry partners in the Czech Republic. The first system will be installed at the Dukovany NPP. (author)

Exploratory space-time analysis of reported dengue cases during an outbreak in Florida, Puerto Rico, 1991-1992.

Science.gov (United States)

Morrison, A C; Getis, A; Santiago, M; Rigau-Perez, J G; Reiter, P

1998-03-01

The spatial and temporal distributions of dengue cases reported during a 1991-1992 outbreak in Florida, Puerto Rico (population = 8,689), were studied by using a Geographic Information System. A total of 377 dengue cases were identified from a laboratory-based dengue surveillance system and georeferenced by their residential addresses on digital zoning and U.S. Geological Survey topographic maps. Weekly case maps were generated for the period between June and December 1991, when 94.2% of the dengue cases were reported. The temporal evolution of the epidemic was rapid, affecting a wide geographic area within seven weeks of the first reported cases of the season. Dengue cases were reported in 217 houses; of these 56 (25.8%) had between two and six reported cases. K-function analysis was used to characterize the spatial clustering patterns for all reported dengue cases (laboratory-positive and indeterminate) and laboratory-positive cases alone, while the Barton and David and Knox tests were used to characterize spatio-temporal attributes of dengue cases reported during the 1991-1992 outbreak. For both sets of data significant case clustering was identified within individual households over short periods of time (three days or less), but in general, the cases had spatial pattern characteristics much like the population pattern as a whole. The rapid temporal and spatial progress of the disease within the community suggests that control measures should be applied to the entire municipality, rather than to the areas immediately surrounding houses of reported cases. The potential for incorporating Geographic Information System technologies into a dengue surveillance system and the limitations of using surveillance data for spatial studies are discussed.

Revising rates of asymptomatic Zika virus infection based on sentinel surveillance data from French Overseas Territories

Directory of Open Access Journals (Sweden)

Lorenzo Subissi

2017-12-01

Full Text Available French Polynesia and the French Territories of the Americas (FTAs have experienced outbreaks of Zika virus (ZIKV infection. These territories used similar sentinel syndromic surveillance to follow the epidemics. However, the surveillance system only takes into account consulting patients diagnosed with ZIKV disease, while non-consulting cases, as well as asymptomatic cases, are not taken into account. In the French territories under study, the ratio of consulting to non-consulting patients was found to likely be as low as 1/3 to 1/4, and rough estimates of the ZIKV asymptomatic infections indicated a lower rate than previously reported (i.e., not more than half. Keywords: Zika virus, Sentinel surveillance, Asymptomatic infections, Pacific islands, Caribbean region, Vector-borne infections

How to select a proper early warning threshold to detect infectious disease outbreaks based on the China infectious disease automated alert and response system (CIDARS).

Science.gov (United States)

Wang, Ruiping; Jiang, Yonggen; Michael, Engelgau; Zhao, Genming

2017-06-12

China Centre for Diseases Control and Prevention (CDC) developed the China Infectious Disease Automated Alert and Response System (CIDARS) in 2005. The CIDARS was used to strengthen infectious disease surveillance and aid in the early warning of outbreak. The CIDARS has been integrated into the routine outbreak monitoring efforts of the CDC at all levels in China. Early warning threshold is crucial for outbreak detection in the CIDARS, but CDCs at all level are currently using thresholds recommended by the China CDC, and these recommended thresholds have recognized limitations. Our study therefore seeks to explore an operational method to select the proper early warning threshold according to the epidemic features of local infectious diseases. The data used in this study were extracted from the web-based Nationwide Notifiable Infectious Diseases Reporting Information System (NIDRIS), and data for infectious disease cases were organized by calendar week (1-52) and year (2009-2015) in Excel format; Px was calculated using a percentile-based moving window (moving window [5 week*5 year], x), where x represents one of 12 centiles (0.40, 0.45, 0.50….0.95). Outbreak signals for the 12 Px were calculated using the moving percentile method (MPM) based on data from the CIDARS. When the outbreak signals generated by the 'mean + 2SD' gold standard were in line with a Px generated outbreak signal for each week during the year of 2014, this Px was then defined as the proper threshold for the infectious disease. Finally, the performance of new selected thresholds for each infectious disease was evaluated by simulated outbreak signals based on 2015 data. Six infectious diseases were selected in this study (chickenpox, mumps, hand foot and mouth diseases (HFMD), scarlet fever, influenza and rubella). Proper thresholds for chickenpox (P75), mumps (P80), influenza (P75), rubella (P45), HFMD (P75), and scarlet fever (P80) were identified. The selected proper thresholds for these

Second Generation of HIV Surveillance System: A Pattern for Iran

OpenAIRE

Nematollahi, M; Khalesi, N; Moghaddasi, H; Askarian, M

2012-01-01

Background For the purpose of minimizing the HIV/AIDS epidemic effects, one of the programs is the promotion of scientific methods and setting of the suitable surveillance systems. The present research was conducted to design the HIV/AIDS surveillance system in Iran applying WHO recommendations and the experience of some countries. Methods In 2009, based on the country's requirements, the HIV/AIDS surveillance system was proposed and designed for Iran. The Delphi technique was utilized to fin...

Molecular characterization of AI viruses from poultry and wild bird surveillance in Denmark

DEFF Research Database (Denmark)

Larsen, Lars Erik; Krog, Jesper Schak; Madsen, Jesper J.

Infection with avian influenza virus (AIV) in poultry may cause devastating disease although the same virus may not cause disease in wild birds. Since AI viruses can be exchanged between poultry and wild birds, surveillance in wild birds provides important knowledge for control of disease...... in poultry. AIV’s from the Danish wild bird active surveillance were characterized, focusing on viruses from 2012, and from outbreaks of AI in poultry in Denmark. The matrix (M) gene from more than 50 viruses of different subtypes and the hemagglutinin (HA) gene from more than 30 subtype H5 low pathogenic...... viruses were sequenced and compared by alignment and phylogenetic analyses. The aim was to evaluate: the origin of viruses from outbreaks of AI in Danish poultry, the design of active surveillance in Denmark, and the suitability of the molecular diagnostic RT-PCR tests employed. All M-genes from Danish...

Botulinum Neurotoxin Detection Methods for Public Health Response and Surveillance

Directory of Open Access Journals (Sweden)

Nagarajan Thirunavukkarasu

2018-06-01

Full Text Available Botulism outbreak due to consumption of food contaminated with botulinum neurotoxins (BoNTs is a public health emergency. The threat of bioterrorism through deliberate distribution in food sources and/or aerosolization of BoNTs raises global public health and security concerns due to the potential for high mortality and morbidity. Rapid and reliable detection methods are necessary to support clinical diagnosis and surveillance for identifying the source of contamination, performing epidemiological analysis of the outbreak, preventing and responding to botulism outbreaks. This review considers the applicability of various BoNT detection methods and examines their fitness-for-purpose in safeguarding the public health and security goals.

National surveillance and control costs for highly pathogenic avian influenza H5N1 in poultry: A benefit-cost assessment for a developing economy, Nigeria.

Science.gov (United States)

Fasanmi, Olubunmi G; Kehinde, Olugbenga O; Laleye, Agnes T; Ekong, Bassey; Ahmed, Syed S U; Fasina, Folorunso O

2018-06-13

We conducted benefit-cost analysis of outbreak and surveillance costs for HPAI H5N1in poultry in Nigeria. Poultry's death directly cost US$ 939,734.0 due to outbreaks. The integrated disease surveillance and response originally created for comprehensive surveillance and laboratory investigation of human diseases was adapted for HPAI H5N1 in poultry. Input data were obtained from the field, government documents and repositories and peer-reviewed publications. Actual/forecasted bird numbers lost were integrated into a financial model and estimates of losses were calculated. Costs of surveillance as alternative intervention were determined based on previous outbreak control costs and outputs were generated in SurvCost® with sensitivity analyses for different scenarios. Uncontrolled outbreaks will lead to loss of over US$ 2.2 billion annually in Nigeria with 47.8% of the losses coming from eggs. The annual cost of all animal related health activities was cost was 96.2% of the total surveillance and response costs, and 31.0% of the HPAI surveillance cost was spent on personnel with 3.8% as capital cost. Cost-wisely, routine monitoring and surveillance for HPAI are 68 times more cost effective than to do nothing. Assuming that successful control and eradication of HPAI H5N1 is partially attributable to H5N1 surveillance and response, a quarter or half of the success will result in 17 or 34 times more benefits. Although animal surveillance and response activities for avian influenza appeared expensive, their implementation are economically cost beneficial for developing countries. Copyright © 2018 Elsevier Ltd. All rights reserved.

Lessons learned during active epidemiological surveillance of Ebola ...

African Journals Online (AJOL)

Objective: To review epidemiological surveillance approaches used during Ebola and Marburg hemorrhagic fever epidemics in Africa in the past fifteen years. Overall, 26 hemorrhagic epidemic outbreaks have been registered in 12 countries; 18 caused by the Ebola virus and eight by the Marburg virus. About 2551 cases ...

Immunization Documentation Practices and Vaccine-Preventable Disease Surveillance Capacity among Institutions of Higher Education in Indiana

Science.gov (United States)

Stevens, Taryn; Golwalkar, Mugdha

2018-01-01

ABSTRACTObjective: Complete and accurate documentation of immunization records and surveillance of disease transmission are critical to the public health response to outbreaks of communicable disease in institutions of higher education (IHEs). This study aims to describe immunization documentation practices and disease surveillance capacity among…

The national web-based outbreak rapid alert system in Norway: eight years of experience, 2006-2013.

Science.gov (United States)

Guzman-Herrador, B; Vold, L; Berg, T; Berglund, T M; Heier, B; Kapperud, G; Lange, H; Nygård, K

2016-01-01

In 2005, the Norwegian Institute of Public Health established a web-based outbreak rapid alert system called Vesuv. The system is used for mandatory outbreak alerts from municipal medical officers, healthcare institutions, and food safety authorities. As of 2013, 1426 outbreaks have been reported, involving 32913 cases. More than half of the outbreaks occurred in healthcare institutions (759 outbreaks, 53·2%). A total of 474 (33·2%) outbreaks were associated with food or drinking water. The web-based rapid alert system has proved to be a helpful tool by enhancing reporting and enabling rapid and efficient information sharing between different authorities at both the local and national levels. It is also an important tool for event-based reporting, as required by the International Health Regulations (IHR) 2005. Collecting information from all the outbreak alerts and reports in a national database is also useful for analysing trends, such as occurrence of certain microorganisms, places or sources of infection, or route of transmission. This can facilitate the identification of specific areas where more general preventive measures are needed.

An outbreak of Burkholderia cepacia complex in the paediatric unit of a tertiary care hospital.

Science.gov (United States)

Mali, Swapna; Dash, Lona; Gautam, Vikas; Shastri, Jayanthi; Kumar, Sunil

2017-01-01

Burkholderia cepacia complex (Bcc) has emerged as a serious nosocomial pathogen worldwide especially in patients with indwelling catheters and cystic fibrosis. Bcc is a common contaminant of pharmaceutical products. We describe an outbreak of Bcc bacteraemia amongst children admitted in Paediatric Intensive Care Unit (PICU) and paediatric ward at a tertiary care hospital, Mumbai, in Western India. Blood culture samples from paediatric patients yielded growth of non-fermenting, oxidase positive, motile, Gram negative bacilli (NFGNB) (76/909) over a period of 8 months. Based on conventional biochemical tests and antimicrobial susceptibility testing, these isolates were provisionally identified as Bcc. The increased, repeated and continued isolation of Bcc alerted the possibility of an outbreak confined to PICU and paediatric ward. Active surveillance was undertaken to trace the source and contain the outbreak. Isolates were subjected to recA polymerase chain reaction (PCR) and Expanded multilocus sequence typing (EMLST). Surveillance revealed the presence of Bcc on the upper surface of rubber stopper of sealed multidose amikacin vials. Isolates from blood culture and rubber stoppers were confirmed as Bcc by recA PCR. EMLST revealed that these isolates shared an identical novel sequence type 824 proving clonality. Timely interventions instituted led to control of the outbreak. This study highlights the importance of identification and molecular characterization of Bcc to establish its role in infection and outbreak.

[Practical lessons from the risk management of an outbreak of acute gastroenteritis in a public school].

Science.gov (United States)

Morillo-García, Aurea; Sillero-Sánchez, Rocío; Aldana-Espinal, Josefa María; Nieto-Cervera, Pilar

2005-01-01

We present our reflections on the management of an acute gastroenteritis outbreak in a public school, which caused a public health crisis, and the conclusions drawn from this experience. The methodology of strengths, weaknesses, opportunities, and threats (SWOT) analysis was used. This article describes the epidemiology of the incident and the policy decisions made, but focuses on operational aspects of outbreak management. The experience of the outbreak control team, liaison with other organizations, and data management are discussed. The difficulties encountered by the outbreak team related to delay in declaring in the outbreak, lack of training in some of the entities involved, and incorrect use of the surveillance circuits. Current protocols and specific action plans for the management of outbreaks should be improved through self-evaluation and updating of resources and knowledge.

Web-based infectious disease surveillance systems and public health perspectives: a systematic review

Directory of Open Access Journals (Sweden)

Jihye Choi

2016-12-01

Full Text Available Abstract Background Emerging and re-emerging infectious diseases are a significant public health concern, and early detection and immediate response is crucial for disease control. These challenges have led to the need for new approaches and technologies to reinforce the capacity of traditional surveillance systems for detecting emerging infectious diseases. In the last few years, the availability of novel web-based data sources has contributed substantially to infectious disease surveillance. This study explores the burgeoning field of web-based infectious disease surveillance systems by examining their current status, importance, and potential challenges. Methods A systematic review framework was applied to the search, screening, and analysis of web-based infectious disease surveillance systems. We searched PubMed, Web of Science, and Embase databases to extensively review the English literature published between 2000 and 2015. Eleven surveillance systems were chosen for evaluation according to their high frequency of application. Relevant terms, including newly coined terms, development and classification of the surveillance systems, and various characteristics associated with the systems were studied. Results Based on a detailed and informative review of the 11 web-based infectious disease surveillance systems, it was evident that these systems exhibited clear strengths, as compared to traditional surveillance systems, but with some limitations yet to be overcome. The major strengths of the newly emerging surveillance systems are that they are intuitive, adaptable, low-cost, and operated in real-time, all of which are necessary features of an effective public health tool. The most apparent potential challenges of the web-based systems are those of inaccurate interpretation and prediction of health status, and privacy issues, based on an individual’s internet activity. Conclusion Despite being in a nascent stage with further modification

Outbreaks of listeriosis associated with deli meats and cheese: an overview

Directory of Open Access Journals (Sweden)

Dele Raheem

2016-07-01

Full Text Available Microbial pollution of foods by undesirable microorganisms is a global food safety issue. One of such undesirable microorganism is the psychrotrophic, pathogenic specie of Listeria—Listeria monocytogenes that survives at low temperature. The source of contamination of this microbe into foods can be many including the food processing facilities due to improper sanitation procedures. The review of the literature on this important topic shows there are increasing concerns as regards contamination from Listeria in foods leading to many cases of listeriosis disease and food recalls. Ready-to-eat products, such as delicatessen (deli meats and soft cheeses have repeatedly been identified by foodborne disease control programs as sources of outbreaks and products that put humans at risk for listeriosis. Although, most listeriosis cases tend to be sporadic in occurrence, outbreaks do occur frequently. Due to the global phenomenon of outbreaks associated with Listeria in deli meats and cheese, it requires an urgent attention from national and international authorities through rigorous procedures for its identification, surveillance procedures that can bring more awareness to the general public. There is also a need for more reports on the cases of Listeria particularly in developing countries, the standardization of identification procedures, and an improvement on national control programs by adequate surveillance.

A comprehensive database of the geographic spread of past human Ebola outbreaks

Science.gov (United States)

Mylne, Adrian; Brady, Oliver J.; Huang, Zhi; Pigott, David M.; Golding, Nick; Kraemer, Moritz U.G.; Hay, Simon I.

2014-01-01

Ebola is a zoonotic filovirus that has the potential to cause outbreaks of variable magnitude in human populations. This database collates our existing knowledge of all known human outbreaks of Ebola for the first time by extracting details of their suspected zoonotic origin and subsequent human-to-human spread from a range of published and non-published sources. In total, 22 unique Ebola outbreaks were identified, composed of 117 unique geographic transmission clusters. Details of the index case and geographic spread of secondary and imported cases were recorded as well as summaries of patient numbers and case fatality rates. A brief text summary describing suspected routes and means of spread for each outbreak was also included. While we cannot yet include the ongoing Guinea and DRC outbreaks until they are over, these data and compiled maps can be used to gain an improved understanding of the initial spread of past Ebola outbreaks and help evaluate surveillance and control guidelines for limiting the spread of future epidemics. PMID:25984346

Levels of alarm thresholds of meningitis outbreaks in Hamadan Province, west of Iran.

Science.gov (United States)

Faryadres, Mohammad; Karami, Manoochehr; Moghimbeigi, Abbas; Esmailnasab, Nader; Pazhouhi, Khabat

2015-01-01

Few studies have focused on syndromic data to determine levels of alarm thresholds to detection of meningitis outbreaks. The purpose of this study was to determine threshold levels of meningitis outbreak in Hamadan Province, west of Iran. Data on both confirmed and suspected cases of meningitis (fever and neurological symptom) form 21 March 2010 to 20 March 2012 were used in Hamadan Province, Iran. Alarm threshold levels of meningitis outbreak were determined using four different methods including absolute values or standard method, relative increase, statistical cutoff points and upper control limit of exponentially weighted moving average (EWMA) algorithm. Among 723 reported cases, 41 were diagnosed to have meningitis. Standard level of alarm thresholds for meningitis outbreak was determined as incidence of 5/100000 persons. Increasing 1.5 to two times in reported cases of suspected meningitis per week was known as the threshold levels according to relative increase method. An occurrence four cases of suspected meningitis per week that equals to 90th percentile was chosen as alarm thresholds by statistical cut off point method. The corresponding value according to EWMA algorithm was 2.57 i.e. three cases. Policy makers and staff of syndromic surveillance systems are highly recommended to apply the above different methods to determine the levels of alarm threshold.

Tuberculosis genotyping information management system: enhancing tuberculosis surveillance in the United States.

Science.gov (United States)

Ghosh, Smita; Moonan, Patrick K; Cowan, Lauren; Grant, Juliana; Kammerer, Steve; Navin, Thomas R

2012-06-01

Molecular characterization of Mycobacterium tuberculosis complex isolates (genotyping) can be used by public health programs to more readily identify tuberculosis (TB) transmission. The Centers for Disease Control and Prevention's National Tuberculosis Genotyping Service has offered M. tuberculosis genotyping for every culture-confirmed case in the United States since 2004. The TB Genotyping Information Management System (TB GIMS), launched in March 2010, is a secure online database containing genotype results linked with case characteristics from the national TB registry for state and local TB programs to access, manage and analyze these data. As of September 2011, TB GIMS contains genotype results for 89% of all culture-positive TB cases for 2010. Over 400 users can generate local and national reports and maps using TB GIMS. Automated alerts on geospatially concentrated cases with matching genotypes that may represent outbreaks are also generated by TB GIMS. TB genotyping results are available to enhance national TB surveillance and apply genotyping results to conduct TB control activities in the United States. Published by Elsevier B.V.

Outbreak of H3N2 influenza at a US military base in Djibouti during the H1N1 pandemic of 2009.

Science.gov (United States)

Cosby, Michael T; Pimentel, Guillermo; Nevin, Remington L; Fouad Ahmed, Salwa; Klena, John D; Amir, Ehab; Younan, Mary; Browning, Robert; Sebeny, Peter J

2013-01-01

Influenza pandemics have significant operational impact on deployed military personnel working in areas throughout the world. The US Department of Defense global influenza-like illness (ILI) surveillance network serves an important role in establishing baseline trends and can be leveraged to respond to outbreaks of respiratory illness. We identified and characterized an operationally unique outbreak of H3N2 influenza at Camp Lemonnier, Djibouti occurring simultaneously with the H1N1 pandemic of 2009 [A(H1N1)pdm09]. Enhanced surveillance for ILI was conducted at Camp Lemonnier in response to local reports of a possible outbreak during the A(H1N1)pdm09 pandemic. Samples were collected from consenting patients presenting with ILI (utilizing a modified case definition) and who completed a case report form. Samples were cultured and analyzed using standard real-time reverse transcriptase PCR (rt-RT-PCR) methodology and sequenced genetic material was phylogenetically compared to other published strains. rt-RT-PCR and DNA sequencing revealed that 25 (78%) of the 32 clinical samples collected were seasonal H3N2 and only 2 (6%) were A(H1N1)pdm09 influenza. The highest incidence of H3N2 occurred during the month of May and 80% of these were active duty military personnel. Phylogenetic analysis revealed that sequenced H3N2 strains were genetically similar to 2009 strains from the United States of America, Australia, and South east Asia. This outbreak highlights challenges in the investigation of influenza among deployed military populations and corroborates the public health importance of maintaining surveillance systems for ILI that can be enhanced locally when needed.

Investigation of an outbreak of acute respiratory disease in Côte D ...

African Journals Online (AJOL)

Materials and Methods: To investigate the outbreak, we conducted active surveillance in the community and reviewed health registries. Persons meeting the case definition were asked to provide nasopharyngeal specimens. On the basis of clinical and epidemiological information, specimens were tested using conventional ...

International outbreak investigation of Salmonella Heidelberg associated with in-flight catering.

Science.gov (United States)

Rebolledo, J; Garvey, P; Ryan, A; O'Donnell, J; Cormican, M; Jackson, S; Cloak, F; Cullen, L; Swaan, C M; Schimmer, B; Appels, R W; Nygard, K; Finley, R; Sreenivasan, N; Lenglet, A; Gossner, C; McKeown, P

2014-04-01

Rapid and wide dispersal of passengers after flights makes investigation of flight-related outbreaks challenging. An outbreak of Salmonella Heidelberg was identified in a group of Irish travellers returning from Tanzania. Additional international cases sharing the same flight were identified. Our aim was to determine the source and potential vehicles of infection. Case-finding utilized information exchange using experts' communication networks and national surveillance systems. Demographic, clinical and food history information was collected. Twenty-five additional cases were identified from Ireland, The Netherlands, Norway, USA and Canada. We conducted a case-control study which indicated a significant association between illness and consumption of milk tart (OR 10.2) and an egg dish (OR 6) served on-board the flight. No food consumed before the flight was associated with illness. Cases from countries other than Ireland provided supplementary information that facilitated the identification of likely vehicles of infection. Timely, committed international collaboration is vital in such investigations.

International outbreak investigation of Salmonella Heidelberg associated with in-flight catering.

LENUS (Irish Health Repository)

Rebolledo, J

2013-07-26

SUMMARY Rapid and wide dispersal of passengers after flights makes investigation of flight-related outbreaks challenging. An outbreak of Salmonella Heidelberg was identified in a group of Irish travellers returning from Tanzania. Additional international cases sharing the same flight were identified. Our aim was to determine the source and potential vehicles of infection. Case-finding utilized information exchange using experts\\' communication networks and national surveillance systems. Demographic, clinical and food history information was collected. Twenty-five additional cases were identified from Ireland, The Netherlands, Norway, USA and Canada. We conducted a case-control study which indicated a significant association between illness and consumption of milk tart (OR 10·2) and an egg dish (OR 6) served on-board the flight. No food consumed before the flight was associated with illness. Cases from countries other than Ireland provided supplementary information that facilitated the identification of likely vehicles of infection. Timely, committed international collaboration is vital in such investigations.

Surveillance System for Infectious Diseases of Pets, Santiago, Chile

Science.gov (United States)

López, Javier; Abarca, Katia; Valenzuela, Berta; Lorca, Lilia; Olea, Andrea; Aguilera, Ximena

2009-01-01

Pet diseases may pose risks to human health but are rarely included in surveillance systems. A pilot surveillance system of pet infectious diseases in Santiago, Chile, found that 4 canine and 3 feline diseases accounted for 90.1% and 98.4% of notifications, respectively. Data also suggested association between poverty and pet diseases. PMID:19861073

Human and entomological surveillance of West Nile fever, dengue and chikungunya in Veneto Region, Italy, 2010-2012.

Science.gov (United States)

Gobbi, Federico; Capelli, Gioia; Angheben, Andrea; Giobbia, Mario; Conforto, Mario; Franzetti, Marzia; Cattelan, Anna Maria; Raise, Enzo; Rovere, Pierangelo; Mulatti, Paolo; Montarsi, Fabrizio; Drago, Andrea; Barzon, Luisa; Napoletano, Giuseppina; Zanella, Francesca; Pozza, Francesca; Russo, Francesca; Rosi, Paolo; Palù, Giorgio; Bisoffi, Zeno

2014-02-05

Since 2010 Veneto region (North-Eastern Italy) planned a special integrated surveillance of summer fevers to promptly identify cases of West Nile Fever (WNF), dengue (DENV) and chikungunya (CHIKV). The objectives of this study were (i) To increase the detection rate of imported CHIKV and DENV cases in travellers from endemic areas and promptly identify potential autochthonous cases.(ii) To detect autochthonous cases of WNF, besides those of West Nile Neuroinvasive Disease (WNND) that were already included in a national surveillance. Human surveillance: a traveler who had returned within the previous 15 days from endemic countries, with fever >38°C, absence of leucocytosis (leukocyte count 38°C for Entomologic surveillance: for West Nile (WNV) it was carried out from May through November placing CDC-CO2 traps in five provinces of Veneto Region, while for DENV and CHIKV it was also performed around residences of viremic cases. Human surveillance: between 2010 and 2012, 234 patients with fever after travelling were screened, of which 27 (11,5%) were found infected (24 with DENV and 3 with CHIKV). No autochthonous case of DENV or CHIKV was detected. Autochthonous patients screened for WNF were 408, and 24 (5,9%) were confirmed cases. Entomologic surveillance: the WNV was found in 10, 2 and 11 pools of Culex pipiens from 2010 to 2012 respectively, in sites of Rovigo, Verona, Venezia and Treviso provinces). No infected Aedes albopictus with DENV or CHIKV was found. Veneto is the only Italian region reporting WNV human cases every year since 2008. WNV is likely to cause sporadic cases and unforeseeable outbreaks for decades. Including WNF in surveillance provides additional information and possibly an early alert system. Timely detection of DENV and CHIKV should prompt vector control measures to prevent local outbreaks.

Enhanced Disease Surveillance during the 2012 Republican National Convention, Tampa, FL

Science.gov (United States)

Atrubin, David; Wiese, Michael; Snider, Rebecca; Workman, Kiley; McDougle, Warren

2013-01-01

Objective To describe disease and illness surveillance utilized during the 2012 Republican National Convention (RNC) held August 26–30, 2012 in Tampa, FL. Introduction While the Tampa Bay Area has previously hosted other high profile events that required heightened disease surveillance (e.g., two Super Bowls), the 2012 RNC marked the first national special security event (NSSE) held in Florida. The Hillsborough County Health Department (HCHD), in conjunction with the Pinellas County Health Department (PinCHD) coordinated disease surveillance activities during this time frame. This presentation will focus of the disease surveillance efforts of the Hillsborough County Health Department during the 2012 RNC. In addition to the surveillance systems that are used routinely, the HCHD Epidemiology Program implemented additional systems designed to rapidly detect individual cases and outbreaks of public health importance. The short duration of RNC, coupled with the large number of visitors to our area, provided additional surveillance challenges. Tropical Storm Isaac, which threatened Tampa in the days leading up to RNC, and an overwhelming law enforcement presence likely dissuaded many protestors from coming to Tampa. As a result, a tiny fraction of the number of protestors that were expected actually showed up. Methods Our normal daily analysis of the emergency department (ED) data using the Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE) was expanded to look in detail at ED volumes and chief complaints of those patients who live outside of a 5-county Tampa Bay area. This analysis used patient zip code to determine place of residence. Additionally, ESSENCE queries were utilized to look for heat, tear gas, and RNC related exposures. The ESSENCE system also receives Poison Control data every 15 minutes. Expanded analyses of the Poison Control data were conducted as well. Two Disaster Medical Assistance Teams (DMATs) were

SCORPIO - WWER core surveillance system

International Nuclear Information System (INIS)

Hornaes, Arne; Bodal, Terje; Sunde, Svein; Zalesky, K.; Lehman, M.; Pecka, M.; Svarny, J.; Krysl, V.; Juzova, Z.; Sedlak, A.; Semmler, M.

1998-01-01

The Institut for energiteknikk has developed the core surveillance system SCORPIO, which has two parallel modes of operation: the Core Follow Mode and the Predictive Mode. The main motivation behind the development of SCORPIO is to make a practical tool for reactor operators which can increase the quality and quantity of information presented on core status and dynamic behavior. This can first of all improve plant safety, as undesired core conditions are detected and prevented. Secondly, more flexible and efficient plant operation is made possible. The system has been implemented on western PWRs, but the basic concept is applicable to a wide range of reactors including WWERs. The main differences between WWERs and typical western PWRs with respect to core surveillance requirements are outlined. The development of a WWER version of SCORPIO has been done in co-operation with the Nuclear Research Institute Rez, and industry partners in the Czech Republic. The first system is installed at Dukovany NPP, where the Site Acceptance Test was completed 6. March 1998.(Authors)

SCORPIO - VVER core surveillance system

International Nuclear Information System (INIS)

Hornaes, A.; Bodal, T.; Sunde, S.

1998-01-01

The Institutt for energiteknikk has developed the core surveillance system SCORPIO, which has two parallel modes of operation: the Core Follow Mode and the Predictive Mode. The main motivation behind the development of SCORPIO is to make a practical tool for reactor operators, which can increase the quality and quantity of information presented on core status and dynamic behavior. This can first of all improve plant safety, as undesired core conditions are detected and prevented. Secondly, more flexible and efficient plant operation is made possible. The system has been implemented on western PWRs, but the basic concept is applicable to a wide range of reactors including VVERs. The main differences between VVERs and typical western PWRs with respect to core surveillance requirements are outlined. The development of a VVER version of SCORPIO has been done in co-operation with the Nuclear Research Institute Rez, and industry partners in the Czech Republic. The first system is installed at Dukovany NPP, where the Site Acceptance Test was completed 6. March 1998.(author)

Design and implementation of distributed multimedia surveillance system based on object-oriented middleware

Science.gov (United States)

Cao, Xuesong; Jiang, Ling; Hu, Ruimin

2006-10-01

Currently, the applications of surveillance system have been increasingly widespread. But there are few surveillance platforms that can meet the requirement of large-scale, cross-regional, and flexible surveillance business. In the paper, we present a distributed surveillance system platform to improve safety and security of the society. The system is constructed by an object-oriented middleware called as Internet Communications Engine (ICE). This middleware helps our platform to integrate a lot of surveillance resource of the society and accommodate diverse range of surveillance industry requirements. In the follow sections, we will describe in detail the design concepts of system and introduce traits of ICE.

CDC Behavioral Risk Factor Surveillance System (BRFSS)

Data.gov (United States)

U.S. Department of Health & Human Services — The Behavioral Risk Factor Surveillance System (BRFSS) is a state-based system of health surveys that collects information on health risk behaviors, preventive...

Polio infrastructure strengthened disease outbreak preparedness and response in the WHO African Region.

Science.gov (United States)

Kouadio, Koffi; Okeibunor, Joseph; Nsubuga, Peter; Mihigo, Richard; Mkanda, Pascal

2016-10-10

The continuous deployments of polio resources, infrastructures and systems for responding to other disease outbreaks in many African countries has led to a number of lessons considered as best practice that need to be documented for strengthening preparedness and response activities in future outbreaks. We reviewed and documented the influence of polio best practices in outbreak preparedness and response in Angola, Nigeria and Ethiopia. Data from relevant programmes of the WHO African Region were also analyzed to demonstrate clearly the relative contributions of PEI resources and infrastructure to effective disease outbreak preparedness and response. Polio resources including, human, financial, and logistic, tool and strategies have tremendously contributed to responding to diseases outbreaks across the African region. In Angola, Nigeria and Ethiopia, many disease epidemics including Marburg Hemorrhagic fever, Dengue fever, Ebola Virus Diseases (EVD), Measles, Anthrax and Shigella have been controlled using existing polio Eradication Initiatives resources. Polio staffs are usually deployed in occasions to supports outbreak response activities (coordination, surveillance, contact tracing, case investigation, finance, data management, etc.). Polio logistics such vehicles, laboratories were also used in the response activities to other infectious diseases. Many polio tools including micro planning, dashboard, guidelines, SOPs on preparedness and response have also benefited to other epidemic-prone diseases. The Countries' preparedness and response plan to WPV importation as well as the Polio Emergency Operation Center models were successfully used to develop, strengthen and respond to many other diseases outbreak with the implication of partners and the strong leadership and ownership of governments. This review has important implications for WHO/AFRO initiative to strengthening and improving disease outbreak preparedness and responses in the African Region in respect

Use of a Digital Health Application for Influenza Surveillance in China.

Science.gov (United States)

Hswen, Yulin; Brownstein, John S; Liu, Jeremiah; Hawkins, Jared B

2017-07-01

To examine whether a commercial digital health application could support influenza surveillance in China. We retrieved data from the Thermia online and mobile educational tool, which allows parents to monitor their children's fever and infectious febrile illnesses including influenza. We modeled monthly aggregated influenza-like illness case counts from Thermia users over time and compared them against influenza monthly case counts obtained from the National Health and Family Planning Commission of the People's Republic of China by using time series regression analysis. We retrieved 44 999 observations from January 2014 through July 2016 from Thermia China. Thermia appeared to predict influenza outbreaks 1 month earlier than the National Health and Family Planning Commission influenza surveillance system (P = .046). Being younger, not having up-to-date immunizations, and having an underlying health condition were associated with participant-reported influenza-like illness. Digital health applications could supplement traditional influenza surveillance systems in China by providing access to consumers' symptom reporting. Growing popularity and use of commercial digital health applications in China potentially affords opportunities to support disease detection and monitoring and rapid treatment mobilization.

Outbreak of Bacillus cereus Infections in a Neonatal Intensive Care Unit Traced to Balloons Used in Manual Ventilation

OpenAIRE

Van Der Zwet, Wil C.; Parlevliet, Gerard A.; Savelkoul, Paul H.; Stoof, Jeroen; Kaiser, Annie M.; Van Furth, A. Marceline; Vandenbroucke-Grauls, Christina M.

2000-01-01

In 1998, an outbreak of systemic infections caused by Bacillus cereus occurred in the Neonatal Intensive Care Unit of the University Hospital Vrije Universiteit, Amsterdam, The Netherlands. Three neonates developed sepsis with positive blood cultures. One neonate died, and the other two neonates recovered. An environmental survey, a prospective surveillance study of neonates, and a case control study were performed, in combination with molecular typing, in order to identify potential sources ...

Next Generation Space Surveillance System-of-Systems

Science.gov (United States)

McShane, B.

2014-09-01

International economic and military dependence on space assets is pervasive and ever-growing in an environment that is now congested, contested, and competitive. There are a number of natural and man-made risks that need to be monitored and characterized to protect and preserve the space environment and the assets within it. Unfortunately, today's space surveillance network (SSN) has gaps in coverage, is not resilient, and has a growing number of objects that get lost. Risks can be efficiently and effectively mitigated, gaps closed, resiliency improved, and performance increased within a next generation space surveillance network implemented as a system-of-systems with modern information architectures and analytic techniques. This also includes consideration for the newest SSN sensors (e.g. Space Fence) which are born Net-Centric out-of-the-box and able to seamlessly interface with the JSpOC Mission System, global information grid, and future unanticipated users. Significant opportunity exists to integrate legacy, traditional, and non-traditional sensors into a larger space system-of-systems (including command and control centers) for multiple clients through low cost sustainment, modification, and modernization efforts. Clients include operations centers (e.g. JSpOC, USSTRATCOM, CANSPOC), Intelligence centers (e.g. NASIC), space surveillance sensor sites (e.g. AMOS, GEODSS), international governments (e.g. Germany, UK), space agencies (e.g. NASA), and academic institutions. Each has differing priorities, networks, data needs, timeliness, security, accuracy requirements and formats. Enabling processes and technologies include: Standardized and type accredited methods for secure connections to multiple networks, machine-to-machine interfaces for near real-time data sharing and tip-and-queue activities, common data models for analytical processing across multiple radar and optical sensor types, an efficient way to automatically translate between differing client and

[The EHEC O104:H4 outbreak in Germany 2011 - lessons learned?!].

Science.gov (United States)

Rissland, J; Kielstein, J T; Stark, K; Wichmann-Schauer, H; Stümpel, F; Pulz, M

2013-04-01

The EHEC O104:H4 outbreak 2011 in Germany provided numerous insights into the recognition and control of such epidemic situations. Food-borne outbreaks and their related dynamics may lead to a critical burden of disease and an eventual capacity overload of the medical care system. Possible difficulties in the microbiological diagnostics of new or significantly altered infectious agents may result in a delayed detection of the outbreak as well as the launching of interventional measures. Besides an early notification of the local public health office by the affected institutions, in which a complete electronic procedure and additional sentinel or surveillance instruments (e. g., in emergency departments of hospitals) may be of great help, an interdisciplinary cooperation of the local public health and food safety agencies is the key to an effective outbreak control. Corresponding organizations on the state and federal level should support the investigation process by microbiological diagnostics and advanced epidemiological analysis as well as examination of the food chains. Finally, successful crisis communication relies on "speaking with one voice" (not necessarily one person). Immediate, transparent, appropriate and honest information of the general public concerning the reasons, consequences and (counter-) measures of a crisis are the best means to keep the trust of the population and to counteract the otherwise inevitable speculations. © Georg Thieme Verlag KG Stuttgart · New York.

Drug sales data analysis for outbreak detection of infectious diseases: a systematic literature review.

Science.gov (United States)

Pivette, Mathilde; Mueller, Judith E; Crépey, Pascal; Bar-Hen, Avner

2014-11-18

This systematic literature review aimed to summarize evidence for the added value of drug sales data analysis for the surveillance of infectious diseases. A search for relevant publications was conducted in Pubmed, Embase, Scopus, Cochrane Library, African Index Medicus and Lilacs databases. Retrieved studies were evaluated in terms of objectives, diseases studied, data sources, methodologies and performance for real-time surveillance. Most studies compared drug sales data to reference surveillance data using correlation measurements or indicators of outbreak detection performance (sensitivity, specificity, timeliness of the detection). We screened 3266 articles and included 27 in the review. Most studies focused on acute respiratory and gastroenteritis infections. Nineteen studies retrospectively compared drug sales data to reference clinical data, and significant correlations were observed in 17 of them. Four studies found that over-the-counter drug sales preceded clinical data in terms of incidence increase. Five studies developed and evaluated statistical algorithms for selecting drug groups to monitor specific diseases. Another three studies developed models to predict incidence increase from drug sales. Drug sales data analyses appear to be a useful tool for surveillance of gastrointestinal and respiratory disease, and OTC drugs have the potential for early outbreak detection. Their utility remains to be investigated for other diseases, in particular those poorly surveyed.

Measles & rubella outbreaks in Maharashtra State, India

Science.gov (United States)

Vaidya, Sunil R.; Kamble, Madhukar B.; Chowdhury, Deepika T.; Kumbhar, Neelakshi S.

2016-01-01

Background & objectives: Under the outbreak-based measles surveillance in Maharashtra State the National Institute of Virology at Pune receives 3-5 serum samples from each outbreak and samples from the local hospitals in Pune for laboratory diagnosis. This report describes one year data on the measles and rubella serology, virus isolation and genotyping. Methods: Maharashtra State Health Agencies investigated 98 suspected outbreaks between January-December 2013 in the 20 districts. Altogether, 491 serum samples were received from 20 districts and 126 suspected cases from local hospitals. Samples were tested for the measles and rubella IgM antibodies by commercial enzyme immunoassay (EIA). To understand the diagnostic utility, a subset of serum samples (n=53) was tested by measles focus reduction neutralization test (FRNT). Further, 37 throat swabs and 32 urine specimens were tested by measles reverse transcription (RT)-PCR and positive products were sequenced. Virus isolation was performed in Vero hSLAM cells. Results: Of the 98 suspected measles outbreaks, 61 were confirmed as measles, 12 as rubella and 21 confirmed as the mixed outbreaks. Four outbreaks remained unconfirmed. Of the 126 cases from the local hospitals, 91 were confirmed for measles and three for rubella. Overall, 93.6 per cent (383/409) confirmed measles cases were in the age group of 0-15 yr. Measles virus was detected in 18 of 38 specimens obtained from the suspected cases. Sequencing of PCR products revealed circulation of D4 (n=9) and D8 (n=9) strains. Four measles viruses (three D4 & one D8) were isolated. Interpretation & conclusions: Altogether, 94 measles and rubella outbreaks were confirmed in 2013 in the State of Maharasthra indicating the necessity to increase measles vaccine coverage in the State. PMID:27121521

Yellow Fever Outbreak - Kongo Central Province, Democratic Republic of the Congo, August 2016.

Science.gov (United States)

Otshudiema, John O; Ndakala, Nestor G; Mawanda, Elande-Taty K; Tshapenda, Gaston P; Kimfuta, Jacques M; Nsibu, Loupy-Régence N; Gueye, Abdou S; Dee, Jacob; Philen, Rossanne M; Giese, Coralie; Murrill, Christopher S; Arthur, Ray R; Kebela, Benoit I

2017-03-31

On April 23, 2016, the Democratic Republic of the Congo's (DRC's) Ministry of Health declared a yellow fever outbreak. As of May 24, 2016, approximately 90% of suspected yellow fever cases (n = 459) and deaths (45) were reported in a single province, Kongo Central Province, that borders Angola, where a large yellow fever outbreak had begun in December 2015. Two yellow fever mass vaccination campaigns were conducted in Kongo Central Province during May 25-June 7, 2016 and August 17-28, 2016. In June 2016, the DRC Ministry of Health requested assistance from CDC to control the outbreak. As of August 18, 2016, a total of 410 suspected yellow fever cases and 42 deaths were reported in Kongo Central Province. Thirty seven of the 393 specimens tested in the laboratory were confirmed as positive for yellow fever virus (local outbreak threshold is one laboratory-confirmed case of yellow fever). Although not well-documented for this outbreak, malaria, viral hepatitis, and typhoid fever are common differential diagnoses among suspected yellow fever cases in this region. Other possible diagnoses include Zika, West Nile, or dengue viruses; however, no laboratory-confirmed cases of these viruses were reported. Thirty five of the 37 cases of yellow fever were imported from Angola. Two-thirds of confirmed cases occurred in persons who crossed the DRC-Angola border at one market city on the DRC side, where ≤40,000 travelers cross the border each week on market day. Strategies to improve coordination between health surveillance and cross-border trade activities at land borders and to enhance laboratory and case-based surveillance and health border screening capacity are needed to prevent and control future yellow fever outbreaks.

Implementing systems thinking for infection prevention: The cessation of repeated scabies outbreaks in a respiratory care ward.

Science.gov (United States)

Chuang, Sheuwen; Howley, Peter P; Lin, Shih-Hua

2015-05-01

Root cause analysis (RCA) is often adopted to complement epidemiologic investigation for outbreaks and infection-related adverse events in hospitals; however, RCA has been argued to have limited effectiveness in preventing such events. We describe how an innovative systems analysis approach halted repeated scabies outbreaks, and highlight the importance of systems thinking for outbreaks analysis and sustaining effective infection prevention and control. Following RCA for a third successive outbreak of scabies over a 17-month period in a 60-bed respiratory care ward of a Taiwan hospital, a systems-oriented event analysis (SOEA) model was used to reanalyze the outbreak. Both approaches and the recommendations were compared. No nosocomial scabies have been reported for more than 1975 days since implementation of the SOEA. Previous intervals between seeming eradication and repeat outbreaks following RCA were 270 days and 180 days. Achieving a sustainable positive resolution relied on applying systems thinking and the holistic analysis of the system, not merely looking for root causes of events. To improve the effectiveness of outbreaks analysis and infection control, an emphasis on systems thinking is critical, along with a practical approach to ensure its effective implementation. The SOEA model provides the necessary framework and is a viable complementary approach, or alternative, to RCA. Copyright © 2015 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Youth Risk Behavior Surveillance System (YRBSS)

Data.gov (United States)

U.S. Department of Health & Human Services — The Youth Risk Behavior Surveillance System (YRBSS) monitors 6 types of health-risk behaviors that contribute to the leading causes of death and disability among...

Ebola virus disease outbreak; the role of field epidemiology training programme in the fight against the epidemic, Liberia, 2014.

Science.gov (United States)

Lubogo, Mutaawe; Donewell, Bangure; Godbless, Lucas; Shabani, Sasita; Maeda, Justin; Temba, Herilinda; Malibiche, Theophil C; Berhanu, Naod

2015-01-01

The African Field Epidemiology Network (AFENET) is a public health network established in 2005 as a non-profit networking alliance of Field Epidemiology and Laboratory Training Programs (FELTPs) and Field Epidemiology Training Programs (FETPs) in Africa. AFENET is dedicated to supporting Ministries of Health in Africa build strong, effective and sustainable programs and capacity to improve public health systems by partnering with global public health experts. The Network's goal is to strengthen field epidemiology and public health laboratory capacity to contribute effectively to addressing epidemics and other major public health problems in Africa. The goal for the establishment of FETP and FELTP was and still is to produce highly competent multi-disciplinary public health professionals who would assume influential posts in the public health structures and tackle emerging and re-emerging communicable and non-communicable diseases. AFENET currently networks 12 FELTPs and FETPs in sub-Saharan Africa with operations in 20 countries. During the Ebola Virus Disease (EVD) outbreak in West Africa, African Union Support for the Ebola Outbreak in West Africa (ASEOWA) supported FETP graduates from Uganda, Zimbabwe, Ethiopia and Tanzania for the investigation and control of the EVD outbreak in Liberia. The graduates were posted in different counties in Liberia where they lead teams of other experts conduct EVD outbreak investigations, Infection Control and Prevention trainings among health workers and communities, Strengthening integrated disease surveillance, developing Standard Operating Procedures for infection control and case notification in the Liberian setting as well as building capacity of local surveillance officers' conduct outbreak investigation and contact tracing. The team was also responsible for EVD data management at the different Counties in Liberia. The FETP graduates have been instrumental in the earlier successes registered in various counties in Liberia

Designing and evaluating risk-based surveillance systems

DEFF Research Database (Denmark)

Willeberg, Preben; Nielsen, Liza Rosenbaum; Salman, Mo

2012-01-01

Risk-based surveillance systems reveal occurrence of disease or infection in a sample of population units, which are selected on the basis of risk factors for the condition under study. The purpose of such systems for supporting practical animal disease policy formulations and management decisions...... with prudent use of resources while maintaining acceptable system performance. High-risk category units are selected for testing by identification of the presence of specific high-risk factor(s), while disregarding other factors that might also influence the risk. On this basis we argue that the most...... applicable risk estimate for use in designing and evaluating a risk-based surveillance system would be a crude (unadjusted) relative risk, odds ratio or apparent prevalence. Risk estimates found in the published literature, however, are often the results of multivariable analyses implicitly adjusting...

Feasibility of using pedometers in a state-based surveillance system: 2014 Arizona Behavioral Risk Factor Surveillance System

Directory of Open Access Journals (Sweden)

Alberto Flórez-Pregonero

2018-01-01

Conclusion: The feasibility of using pedometers in a state-based surveillance system is modest at best. Feasibility may potentially be improved with easy-to-use pedometers where data can be electronically downloaded.

[Current situation and surveillance on dengue fever in China, 2005 - 2007].

Science.gov (United States)

Wang, Qin; Xu, Zhen; Dou, Feng-Man; Zhou, Hang; Wang, Xiao-Fang; Yin, Wen-Wu; Li, Qun

2009-08-01

To provide scientific evidence for prevention and control program on dengue fever through analyzing the situation of dengue fever in China, from 2005 to 2007. Data was collected from Internet-based National Notifiable Infectious Disease Reporting System, National Enhanced Dengue Fever Surveillance System and field investigation on dengue outbreaks, described and analyzed with descriptively and by SPSS statistical software. There was a total number of 1623 dengue cases (including 1356 laboratory confirmed cases and 267 probable cases) and 1 death case reported in China from 2005 to 2007. Among the identified cases, 151 were imported from foreign countries as the Southeast Asian countries, accounting for 9.3%, while the rest 1472 cases were reported from local infections, identified only in 9 cities from Guangdong and Fujian provinces. Data from the monitoring program on Aedes Mosquitoes indicated that: The indicators of BI from 84.6% of the sentinels were over 5, and BI from 72.2% of the sentinels were over 10. This index was especially at a higher level during summer in the southern areas of China. Aedes albopictus was found in all the sentinel sites while Aedes aegypti was only found in Hainan and in limited counties of Guangdong. No dengue virus was isolated from mosquito vectors collected from national sentinel sites, whereas positive results had been detected by PCR test in Guangdong province. It was assumed that a sustainable local circulation of dengue virus had not yet been established successfully in Mainland China according to the surveillance data. However, more local outbreaks reported in Guangdong and Fujian with the wide distribution and high-level density of aedes mosquito, low antibody level in healthy population and the increasing number of imported dengue cases, there is a potential of Dengue outbreaks in southern China. An integrated mosquito vector monitoring and management system is needed in high risk area to reduce the transmission of dengue

An outbreak of Burkholderia cepacia complex in the paediatric unit of a tertiary care hospital

Directory of Open Access Journals (Sweden)

Swapna Mali

2017-01-01

Full Text Available Introduction: Burkholderia cepacia complex (Bcc has emerged as a serious nosocomial pathogen worldwide especially in patients with indwelling catheters and cystic fibrosis. Bcc is a common contaminant of pharmaceutical products. We describe an outbreak of Bcc bacteraemia amongst children admitted in Paediatric Intensive Care Unit (PICU and paediatric ward at a tertiary care hospital, Mumbai, in Western India. Materials and Methods: Blood culture samples from paediatric patients yielded growth of non-fermenting, oxidase positive, motile, Gram negative bacilli (NFGNB (76/909 over a period of 8 months. Based on conventional biochemical tests and antimicrobial susceptibility testing, these isolates were provisionally identified as Bcc. The increased, repeated and continued isolation of Bcc alerted the possibility of an outbreak confined to PICU and paediatric ward. Active surveillance was undertaken to trace the source and contain the outbreak. Isolates were subjected to recA polymerase chain reaction (PCR and Expanded multilocus sequence typing (EMLST. Results: Surveillance revealed the presence of Bcc on the upper surface of rubber stopper of sealed multidose amikacin vials. Isolates from blood culture and rubber stoppers were confirmed as Bcc by recA PCR. EMLST revealed that these isolates shared an identical novel sequence type 824 proving clonality. Timely interventions instituted led to control of the outbreak. Conclusion: This study highlights the importance of identification and molecular characterization of Bcc to establish its role in infection and outbreak.

A lost world disease: Copra itch outbreak caused by Tyrophagus longior mite

Directory of Open Access Journals (Sweden)

Prakit Sarathep

Full Text Available An outbreak investigation of copra itch revealed a cluster of six suspected cases with skin dermatitis, with 11–32 years of age, belonging to a single family, between June and July 2016 in Phang Nga province, Southern Thailand. Epidemiologic investigation of these suspected cases revealed five probable cases developing multiple discrete erythematous papules with intense pruritus on the body rather than the extremities and one confirmed case whose skin was infested with domestic mite, Tyrophagus longior (Gervais (Ascari: Ascaridae. This mite was also found in unused coir mattresses outside their bedrooms. Household infestation with T. longior mites rendered these family members to become more susceptible to expose indoor biting of T. longior adult mites that were adapted well to the domestic environments with poor hygienic conditions. Human exposure to mite bites was more likely to be a direct contact than an indirect contact. Findings from this copra itch outbreak investigation provided understanding of natural disease of copra itch and factors that favored the outbreak, and could guide diagnosis for physicians, surveillance and response for surveillance and rapid response teams (SRRTs, and prevention and control for entomologists and public health personnel. Keywords: Copra itch, Tyrophagus longior, Erythematous papules, Domestic environments

Surveillance and early warning systems of infectious disease in China: From 2012 to 2014.

Science.gov (United States)

Zhang, Honglong; Wang, Liping; Lai, Shengjie; Li, Zhongjie; Sun, Qiao; Zhang, Peng

2017-07-01

Appropriate surveillance and early warning of infectious diseases have very useful roles in disease control and prevention. In 2004, China established the National Notifiable Infectious Disease Surveillance System and the Public Health Emergency Event Surveillance System to report disease surveillance and events on the basis of data sources from the National Notifiable Infectious Disease Surveillance System, China Infectious Disease Automated-alert and Response System in this country. This study provided a descriptive summary and a data analysis, from 2012 to 2014, of these 3 key surveillance and early warning systems of infectious disease in China with the intent to provide suggestions for system improvement and perfection. Copyright © 2017 John Wiley & Sons, Ltd.

Health Care Providers' Knowledge and Practice Gap towards Joint Zoonotic Disease Surveillance System: Challenges and Opportunities, Gomma District, Southwest Ethiopia.

Science.gov (United States)

Gemeda, Desta Hiko; Sime, Abiot Girma; Hajito, Kifle Woldemichael; Gelalacha, Benti Deresa; Tafese, Wubit; Gebrehiwot, Tsegaye Tewelde

2016-01-01

Background. Health care providers play a crucial role for realization of joint zoonotic diseases surveillance by human and animal health sectors, yet there is limited evidence. Hence, this study aimed to determine knowledge and practice gap of health care providers towards the approach for Rabies and Anthrax in Southwest Ethiopia. Methods. A cross-sectional survey was conducted from December 16, 2014, to January 14, 2015. Eligible health care providers were considered for the study. Data were entered in to Epi-data version 3.1 and analyzed using SPSS version 20. Results. A total of 323 (92.02%) health care providers participated in the study. Three hundred sixteen (97.8%) of participants reported that both human and animal health sectors can work together for zoonotic diseases while 96.9% of them replied that both sectors can jointly conduct surveillance. One hundred seventeen (36.2%) of them reported that their respective sectors had conducted joint surveillance for zoonotic diseases. Their involvement was, however, limited to joint outbreak response. Conclusion. There is good opportunity in health care providers' knowledge even though the practice was unacceptably low and did not address all surveillance components. Therefore, formal joint surveillance structure should be in place for optimal implementation of surveillance.

Health Care Providers’ Knowledge and Practice Gap towards Joint Zoonotic Disease Surveillance System: Challenges and Opportunities, Gomma District, Southwest Ethiopia

Directory of Open Access Journals (Sweden)

Desta Hiko Gemeda

2016-01-01

Full Text Available Background. Health care providers play a crucial role for realization of joint zoonotic diseases surveillance by human and animal health sectors, yet there is limited evidence. Hence, this study aimed to determine knowledge and practice gap of health care providers towards the approach for Rabies and Anthrax in Southwest Ethiopia. Methods. A cross-sectional survey was conducted from December 16, 2014, to January 14, 2015. Eligible health care providers were considered for the study. Data were entered in to Epi-data version 3.1 and analyzed using SPSS version 20. Results. A total of 323 (92.02% health care providers participated in the study. Three hundred sixteen (97.8% of participants reported that both human and animal health sectors can work together for zoonotic diseases while 96.9% of them replied that both sectors can jointly conduct surveillance. One hundred seventeen (36.2% of them reported that their respective sectors had conducted joint surveillance for zoonotic diseases. Their involvement was, however, limited to joint outbreak response. Conclusion. There is good opportunity in health care providers’ knowledge even though the practice was unacceptably low and did not address all surveillance components. Therefore, formal joint surveillance structure should be in place for optimal implementation of surveillance.

Smart sensing surveillance system

Science.gov (United States)

Hsu, Charles; Chu, Kai-Dee; O'Looney, James; Blake, Michael; Rutar, Colleen

2010-04-01

An effective public safety sensor system for heavily-populated applications requires sophisticated and geographically-distributed infrastructures, centralized supervision, and deployment of large-scale security and surveillance networks. Artificial intelligence in sensor systems is a critical design to raise awareness levels, improve the performance of the system and adapt to a changing scenario and environment. In this paper, a highly-distributed, fault-tolerant, and energy-efficient Smart Sensing Surveillance System (S4) is presented to efficiently provide a 24/7 and all weather security operation in crowded environments or restricted areas. Technically, the S4 consists of a number of distributed sensor nodes integrated with specific passive sensors to rapidly collect, process, and disseminate heterogeneous sensor data from near omni-directions. These distributed sensor nodes can cooperatively work to send immediate security information when new objects appear. When the new objects are detected, the S4 will smartly select the available node with a Pan- Tilt- Zoom- (PTZ) Electro-Optics EO/IR camera to track the objects and capture associated imagery. The S4 provides applicable advanced on-board digital image processing capabilities to detect and track the specific objects. The imaging detection operations include unattended object detection, human feature and behavior detection, and configurable alert triggers, etc. Other imaging processes can be updated to meet specific requirements and operations. In the S4, all the sensor nodes are connected with a robust, reconfigurable, LPI/LPD (Low Probability of Intercept/ Low Probability of Detect) wireless mesh network using Ultra-wide band (UWB) RF technology. This UWB RF technology can provide an ad-hoc, secure mesh network and capability to relay network information, communicate and pass situational awareness and messages. The Service Oriented Architecture of S4 enables remote applications to interact with the S4

Developing a surveillance system for HIV/AIDS in Pakistan

International Nuclear Information System (INIS)

Emmanuel, F.; Bokhari, A.

2006-01-01

Apart from other interventions, surveillance remains a major focus of the national response to HIV/AIDS. However, with a shift in the epidemic pattern, the existing surveillance strategies are barely insufficient and long-term structural changes are desirable. This article provides a conceptual framework for developing a scientific system for HIV surveillance in Pakistan. Second generation surveillance system including repeated cross-sectional surveys in high risk population groups are suggested to collect behavioral and serological data at regular intervals on an annual basis to monitor the epidemic trend as well as the associated behaviors. In addition, multiple data resources have been highlighted, which could be coordinated to describe the epidemic pattern in the country. This information should form the basis for national prevention planning and ought to be used for making sensible choices through which prevention efforts are most likely to reduce new infections. (author)

A Study of Failure Events in Drinking Water Systems As a Basis for Comparison and Evaluation of the Efficacy of Potable Reuse Schemes.

Science.gov (United States)

Onyango, Laura A; Quinn, Chloe; Tng, Keng H; Wood, James G; Leslie, Greg

2015-01-01

Potable reuse is implemented in several countries around the world to augment strained water supplies. This article presents a public health perspective on potable reuse by comparing the critical infrastructure and institutional capacity characteristics of two well-established potable reuse schemes with conventional drinking water schemes in developed nations that have experienced waterborne outbreaks. Analysis of failure events in conventional water systems between 2003 and 2013 showed that despite advances in water treatment technologies, drinking water outbreaks caused by microbial contamination were still frequent in developed countries and can be attributed to failures in infrastructure or institutional practices. Numerous institutional failures linked to ineffective treatment protocols, poor operational practices, and negligence were detected. In contrast, potable reuse schemes that use multiple barriers, online instrumentation, and operational measures were found to address the events that have resulted in waterborne outbreaks in conventional systems in the past decade. Syndromic surveillance has emerged as a tool in outbreak detection and was useful in detecting some outbreaks; increases in emergency department visits and GP consultations being the most common data source, suggesting potential for an increasing role in public health surveillance of waterborne outbreaks. These results highlight desirable characteristics of potable reuse schemes from a public health perspective with potential for guiding policy on surveillance activities.

Cost analysis of an outbreak of Clostridium difficile infection ribotype 027 in a Dutch tertiary care centre.

Science.gov (United States)

van Beurden, Y H; Bomers, M K; van der Werff, S D; Pompe, E A P M; Spiering, S; Vandenbroucke-Grauls, C M J E; Mulder, C J J

2017-04-01

The economic impact of Clostridium difficile infection (CDI) on the healthcare system is significant. From May 2013 to May 2014, an outbreak of C. difficile ribotype 027 occurred in a Dutch tertiary care hospital, involving 72 patients. The primary aim of this study was to provide insight into the financial burden that this CDI outbreak brought upon this hospital. A retrospective analysis was performed to estimate the costs of a one-year-long C. difficile ribotype 027 outbreak. Medical charts were reviewed for patient data. In addition, all costs associated with the outbreak control measures were collected. The attributable costs of the whole outbreak were estimated to be €1,222,376. The main contributing factor was missed revenue due to increased length of stay of CDI patients and closure of beds to enable contact isolation of CDI patients (36%). A second important cost component was extra surveillance and activities of the Department of Medical Microbiology and Infection Control (25%). To the authors' knowledge, this is the first study to provide insight into the attributable costs of CDI in an outbreak setting, and to delineate the major cost items. It is clear that the economic consequences of CDI are significant. The high costs associated with a CDI outbreak should help to justify the use of additional resources for CDI prevention and control. Copyright © 2016 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Outbreak of H3N2 influenza at a US military base in Djibouti during the H1N1 pandemic of 2009.

Directory of Open Access Journals (Sweden)

Michael T Cosby

Full Text Available BACKGROUND: Influenza pandemics have significant operational impact on deployed military personnel working in areas throughout the world. The US Department of Defense global influenza-like illness (ILI surveillance network serves an important role in establishing baseline trends and can be leveraged to respond to outbreaks of respiratory illness. OBJECTIVE: We identified and characterized an operationally unique outbreak of H3N2 influenza at Camp Lemonnier, Djibouti occurring simultaneously with the H1N1 pandemic of 2009 [A(H1N1pdm09]. METHODS: Enhanced surveillance for ILI was conducted at Camp Lemonnier in response to local reports of a possible outbreak during the A(H1N1pdm09 pandemic. Samples were collected from consenting patients presenting with ILI (utilizing a modified case definition and who completed a case report form. Samples were cultured and analyzed using standard real-time reverse transcriptase PCR (rt-RT-PCR methodology and sequenced genetic material was phylogenetically compared to other published strains. RESULTS: rt-RT-PCR and DNA sequencing revealed that 25 (78% of the 32 clinical samples collected were seasonal H3N2 and only 2 (6% were A(H1N1pdm09 influenza. The highest incidence of H3N2 occurred during the month of May and 80% of these were active duty military personnel. Phylogenetic analysis revealed that sequenced H3N2 strains were genetically similar to 2009 strains from the United States of America, Australia, and South east Asia. CONCLUSIONS: This outbreak highlights challenges in the investigation of influenza among deployed military populations and corroborates the public health importance of maintaining surveillance systems for ILI that can be enhanced locally when needed.

Science and engineering intelligent surveillance systems

CERN Document Server

Huihuan, Qian; Xu, Yangsheng

2011-01-01

As shortcomings such as high labor costs make intelligent surveillance systems more desirable, this practical book focuses on detecting abnormal behavior based on learning and the analysis of dangerous crowd behavior based on texture and optical flow.

Surveyor mobile surveillance system for hazardous environments

International Nuclear Information System (INIS)

Silverman, E.B.; Simmons, R.K.; Kniazewycz, B.G.; Darvish, A.R.; Irving, T.L.

1987-01-01

A successful program was recently conducted to test and evaluate a commercial-ready, wireless, remotely operated surveillance system for use in nuclear power plants. This evaluation of the Surveyor mobile surveillance system took place at Niagara Mohawk Power Corporation's Nine Mile Point Nuclear Power Station. The remotely operated vehicle measures radiation, temperature and relative humidity and provides optical inspection capability. The vehicle is readily maneuvered in 36-inch wide passageways and labyrinth entries and can climb stairs, negotiating 180-degree turns on stair landings. The system consists of a supervisory control station and a rugged, remotely-operated, battery-powered vehicle. The surveyor system is specifically designed to decrease personnel radiation exposure by supplementing the functions of an auxiliary operator or wealth physics technician to perform periodic component inspections inside particular areas within a nuclear power plant

Strengthening Injury Surveillance System in Iran

Directory of Open Access Journals (Sweden)

Motevalian Seyed Abbas

2012-02-01

Full Text Available 【Abstract】Objective: To strengthen the current Injury Surveillance System (IS System in order to better monitor injury conditions, improve protection ways and promote safety. Methods: At first we carried out a study to evaluate the frameworks of IS System in the developed countries. Then all the available documents from World Health Organization, Eastern Mediterranean Regional Organization, as well as Minister of Health and Medical Education concerning Iran were reviewed. Later a national stakeholder抯 consultation was held to collect opinions and views. A national workshop was also intended for provincial representatives from 41 universities to identify the barriers and limitations of the existing program and further to strengthen injury surveillance. Results: The evaluation of the current IS System revealed many problems, mainly presented as lack of accurate pre- and post-hospital death registry, need of precise injury data registry in outpatient medical centers, incomplete injury data registry in hospitals and lack of accuracy in definition of variables in injury registry. The five main characteristics of current IS System including flexibility, acceptability, simplicity, usefulness and timeliness were evaluated as moderate by experts. Conclusions: Major revisions must be considered in the current IS System in Iran. The following elements should be added to the questionnaire: identifier, manner of arrival to the hospital, situation of the injured patient, consumption of alcohol and opioids, other involved participants in the accident, intention, severity and site of injury, side effects of surgery and medication, as well as one month follow-up results. Data should be collected from 10% of all hospitals in Iran and analyzed every 3 months. Simultaneously data should be online to be retrieved by researches. Key words: Wounds and injuries; Population surveillance; Registries; Iran

Outbreak of Salmonella Oslo Infections Linked to Persian Cucumbers - United States, 2016.

Science.gov (United States)

Bottichio, Lyndsay; Medus, Carlota; Sorenson, Alida; Donovan, Danielle; Sharma, Reeti; Dowell, Natasha; Williams, Ian; Wellman, Allison; Jackson, Alikeh; Tolar, Beth; Griswold, Taylor; Basler, Colin

2016-12-30

In April 2016, PulseNet, the national molecular subtyping network for foodborne disease surveillance, detected a multistate cluster of Salmonella enterica serotype Oslo infections with an indistinguishable pulsed-field gel electrophoresis (PFGE) pattern (XbaI PFGE pattern OSLX01.0090).* This PFGE pattern was new in the database; no previous infections or outbreaks have been identified. CDC, state and local health and agriculture departments and laboratories, and the Food and Drug Administration (FDA) conducted epidemiologic, traceback, and laboratory investigations to identify the source of this outbreak. A total of 14 patients in eight states were identified, with illness onsets occurring during March 21-April 9, 2016. Whole genome sequencing, a highly discriminating subtyping method, was used to further characterize PFGE pattern OSLX01.0090 isolates. Epidemiologic evidence indicates Persian cucumbers as the source of Salmonella Oslo infections in this outbreak. This is the fourth identified multistate outbreak of salmonellosis associated with cucumbers since 2013. Further research is needed to understand the mechanism and factors that contribute to contamination of cucumbers during growth, harvesting, and processing to prevent future outbreaks.

Evaluation of Strategies to Control a Potential Outbreak of Foot-and-Mouth Disease in Sweden

Directory of Open Access Journals (Sweden)

Fernanda C. Dórea

2017-07-01

Full Text Available To minimize the potential consequences of an introduction of foot-and-mouth disease (FMD in Europe, European Union (EU member states are required to present a contingency plan. This study used a simulation model to study potential outbreak scenarios in Sweden and evaluate the best control strategies. The model was informed by the Swedish livestock structure using herd information from cattle, pig, and small ruminant holdings in the country. The contact structure was based on animal movement data and studies investigating the movements between farms of veterinarians, service trucks, and other farm visitors. All scenarios of outbreak control included depopulation of detected herds, 3 km protection and 10 km surveillance zones, movement tracing, and 3 days national standstill. The effect of availability of surveillance resources, i.e., number of field veterinarians per day, and timeliness of enforcement of interventions, was assessed. With the estimated currently available resources, an FMD outbreak in Sweden is expected to be controlled (i.e., last infected herd detected within 3 weeks of detection in any evaluated scenario. The density of farms in the area where the epidemic started would have little impact on the time to control the outbreak, but spread in high density areas would require more surveillance resources, compared to areas of lower farm density. The use of vaccination did not result in a reduction in the expected number of infected herds. Preemptive depopulation was able to reduce the number of infected herds in extreme scenarios designed to test a combination of worst-case conditions of virus introduction and spread, but at the cost of doubling the number of herds culled. This likely resulted from a combination of the small outbreaks predicted by the spread model, and the high efficacy of the basic control measures evaluated, under the conditions of the Swedish livestock industry, and considering the assumed control

Internet and free press are associated with reduced lags in global outbreak reporting.

Science.gov (United States)

McAlarnen, Lindsey; Smith, Katherine; Brownstein, John S; Jerde, Christopher

2014-10-30

Global outbreak detection and reporting have generally improved for a variety of infectious diseases and geographic regions in recent decades. Nevertheless, lags in outbreak reporting remain a threat to the global human health and economy. In the time between first occurrence of a novel disease incident and public notification of an outbreak, infected individuals have a greater possibility of traveling and spreading the pathogen to other nations. Shortening outbreak reporting lags has the potential to improve global health by preventing local outbreaks from escalating into global epidemics. Reporting lags between the first record and the first public report of an event were calculated for 318 outbreaks occurring 1996-2009. The influence of freedom of the press, Internet usage, per capita health expenditure, and cell phone subscriptions, on the timeliness of outbreak reporting was evaluated. Freer presses and increasing Internet usage correlate with reduced time between the first record of an outbreak and the public report. Increasing Internet usage reduced the expected reporting lag from more than one month in nations without Internet users to one day in those where 75 of 100 people use the Internet. Advances in technology and the emergence of more open and free governments are associated with to improved global infectious disease surveillance.

Next generation surveillance system (NGSS)

International Nuclear Information System (INIS)

Aparo, Massimo

2006-01-01

Development of 'functional requirements' for transparency systems may offer a near-term mode of regional cooperation. New requirements under development at the IAEA may provide a foundation for this potential activity. The Next Generation Surveillance System (NGSS) will become the new IAEA remote monitoring system Under new requirements the NGSS would attempt to use more commercial components to reduce cost, increase radiation survivability and further increase reliability. The NGSS must be available in two years due to rapidly approaching obsolescence in the existing DCM family. (author)

Surveillance for avian influenza viruses in wild birds in Denmark and Greenland

DEFF Research Database (Denmark)

Hjulsager, Charlotte Kristiane; Breum, Solvej Østergaard; Trebbien, Ramona

Avian influenza (AI) is a disease of major threat to poultry production. Surveillance of AI in wild birds contributes to the control of AI. In Denmark (DK) and Greenland (GL), extensive surveillance of AI viruses in the wild bird population has been conducted. The surveillance aimed at detecting......7 subtypes were detected throughout the period together with several other LPAI subtypes. In GL, HPAI was not detected, but few samples were PCR positive for AI. The occurrence of AI subtypes in the wild bird population correlates with concurrent outbreaks of LPAI in Danish poultry, which may...

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

Science.gov (United States)

Harcourt, S E; Fletcher, J; Loveridge, P; Bains, A; Morbey, R; Yeates, A; McCloskey, B; Smyth, B; Ibbotson, S; Smith, G E; Elliot, A J

2012-12-01

Syndromic 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.

Considerations on a VXI based digital image surveillance system

International Nuclear Information System (INIS)

Gaertner, K.J.; Neumann, G.; Richter, B.

1995-01-01

In 1992 the International Atomic Energy Agency established the IAEA Integrated Safeguards Instrumentation Programme (I 2 SIP) which provides a conceptual framework to guide new equipment development activities. One of the main goals of I 2 SIP is to define the optimum structure of future safeguards equipment inventory that would enable the integration of containment, surveillance and unattended radiation monitoring modules for application in facilities with complex safeguards systems. This approach implies a modular equipment structure in both hardware and software. In December 1993, a Consultants Meeting concluded that the VXI instrument bus (VXIbus) standard does not appear to have any technical limitations that will inhibit the use of I 2 SIP and should be considered the first choice for future safeguards equipment. The Agency's development plan for Digital Image Surveillance (DIS) is part of the I 2 SIP and has defined the need for 'distributed systems', i.e. for multichannel surveillance systems, which should accommodate the integration aspect and meet requirements for both mail-in of recorded information to the Agency and remote surveillance. The paper describes the basic considerations that have led to the selection of the VXI bus to be used for such a system including the different modules emphasizing the integration issue

Can internet search queries be used for dengue fever surveillance in China?

Science.gov (United States)

Guo, Pi; Wang, Li; Zhang, Yanhong; Luo, Ganfeng; Zhang, Yanting; Deng, Changyu; Zhang, Qin; Zhang, Qingying

2017-10-01

China experienced an unprecedented outbreak of dengue fever in 2014, and the number of cases reached the highest level over the past 25 years. Traditional sentinel surveillance systems of dengue fever in China have an obvious drawback that the average delay from receipt to dissemination of dengue case data is roughly 1-2 weeks. In order to exploit internet search queries to timely monitor dengue fever, we analyzed data of dengue incidence and Baidu search query from 31 provinces in mainland China during the period of January 2011 to December 2014. We found that there was a strong correlation between changes in people's online health-seeking behavior and dengue fever incidence. Our study represents the first attempt demonstrating a strong temporal and spatial correlation between internet search trends and dengue epidemics nationwide in China. The findings will help the government to strengthen the capacity of traditional surveillance systems for dengue fever. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Molecular surveillance of measles and rubella in the WHO European Region: new challenges in the elimination phase.

Science.gov (United States)

Santibanez, S; Hübschen, J M; Ben Mamou, M C; Muscat, M; Brown, K E; Myers, R; Donoso Mantke, O; Zeichhardt, H; Brockmann, D; Shulga, S V; Muller, C P; O'Connor, P M; Mulders, M N; Mankertz, A

2017-08-01

The WHO European Region (EUR) has adopted the goal of eliminating measles and rubella but individual countries perform differently in achieving this goal. Measles virus spread across the EUR by mobile groups has recently led to large outbreaks in the insufficiently vaccinated resident population. As an instrument for monitoring the elimination process and verifying the interruption of endemic virus transmission, molecular surveillance has to provide valid and representative data. Irrespective of the country's specific situation, it is required to ensure the functionality of the laboratory surveillance that is supported by the WHO Global Measles and Rubella Laboratory Network. To investigate whether the molecular surveillance in the EUR is adequate for the challenges in the elimination phase, we addressed the quality assurance of molecular data, the continuity and intensity of molecular monitoring, and the analysis of transmission chains. Published articles, the molecular External Quality Assessment Programme of the WHO, the Centralized Information System for Infectious Diseases of the WHO EUR and the WHO Measles and Rubella Nucleotide Surveillance databases served as information sources. Molecular proficiency testing conducted by the WHO in 2016 has shown that the expertise for measles and rubella virus genotyping exists in all parts of the EUR. The analysis of surveillance data reported nationally to the WHO in 2013-2016 has revealed some countries with outbreaks but not sufficiently representative molecular data. Long-lasting supranational MV transmission chains were identified. A more systematic molecular monitoring and recording of the transmission pattern for the whole EUR could help to create a meaningful picture of the elimination process. Copyright © 2017 European Society of Clinical Microbiology and Infectious Diseases. All rights reserved.

Remote-Reading Safety and Safeguards Surveillance System for 3013 Containers

International Nuclear Information System (INIS)

Lechelt, W. M.; Skorpik, J. R.; Silvers, K. L.; Szempruch, R. W.; Douglas, D. G.; Fein, K. O.

2002-01-01

At Hanford's Plutonium Finishing Plant (PFP), plutonium oxide is being loaded into stainless steel containers for long-term storage on the Hanford Site. These containers consist of two weld-sealed stainless steel cylinders nested one within the other. A third container holds the plutonium within the inner cylinder. This design meets the U.S. Department of Energy (DOE) storage standard, DOE-STD- 3013-2000, which anticipates a 50-year storage lifetime. The 3013 standard also requires a container surveillance program to continuously monitor pressure and to assure safeguards are adequate. However, the configuration of the container system makes using conventional measurement and monitoring methods difficult. To better meet the 3013 monitoring requirements, a team from Fluor Hanford (who manages the PFP), Pacific Northwest National Laboratory (PNNL), and Vista Engineering Technologies, LLC, developed a safer, cost-efficient, remote PFP 3013 container surveillance system. This new surveillance system is a combination of two successfully deployed technologies: (1) a magnetically coupled pressure gauge developed by Vista Engineering and (2) a radio frequency (RF) tagging device developed by PNNL. This system provides continuous, 100% monitoring of critical parameters with the containers in place, as well as inventory controls. The 3013 container surveillance system consists of three main elements: (1) an internal magnetic pressure sensor package, (2) an instrument pod (external electronics package), and (3) a data acquisition storage and display computer. The surveillance system described in this paper has many benefits for PFP and DOE in terms of cost savings and reduced personnel exposure. In addition, continuous safety monitoring (i.e., internal container pressure and temperature) of every container is responsible nuclear material stewardship and fully meets and exceeds DOE's Integrated Surveillance Program requirements

Will smart surveillance systems listen, understand and speak Slovene?

Directory of Open Access Journals (Sweden)

Simon Dobrišek

2013-12-01

Full Text Available The paper deals with the spoken language technologies that could enable the so-called smart (intelligent surveillance systems to listen, understand and speak Slovenian in the near future. Advanced computational methods of artificial perception and pattern recognition enable such systems to be at least to some extent aware of the environment, the presence of people and other phenomena that could be subject to surveillance. Speech is one such phenomenon that has the potential to be a key source of information in certain security situations. Technologies that enable automatic speech and speaker recognition as well as their psychophysical state by computer analysis of acoustic speech signals provide an entirely new dimension to the development of smart surveillance systems. Automatic recognition of spoken threats, screaming and crying for help, as well as a suspicious psycho-physical state of a speaker provide such systems to some extent with intelligent behaviour. The paper investigates the current state of development of these technologies and the requirements and possibilities of these systems to be used for the Slovenian spoken language, as well as different possible security application scenarios. It also addresses the broader legal and ethical issues raised by the development and use of such technologies, especially as audio surveillance is one of the most sensitive issues of privacy protection.

Wireless sensor network for mobile surveillance systems; 2005BU1-TRSP

NARCIS (Netherlands)

Maris, M.G.; Dijk, G.J.A. van

2005-01-01

Guarding safety and security within industrial, commercial and military areas is an important issue nowadays. A specific challenge lies in the design of portable surveillance systems that can be rapidly deployed, installed and easily operated. Conventional surveillance systems typically employ

Is the HIV sentinel surveillance system adequate in China? Findings from an evaluation of the national HIV sentinel surveillance system

Directory of Open Access Journals (Sweden)

Marc Bulterys

2012-11-01

Full Text Available Background: An external evaluation was conducted to assess the performance of the national HIV sentinel surveillance system (HSS, identify operational challenges at national and local levels and provide recommendations for improvement.Methods: The United States Centers for Disease Control and Prevention’s (CDC Updated Guidelines for Evaluating Public Health Surveillance Systems were followed to assess the key attributes of HSS. Comprehensive assessment activities were conducted, including: using a detailed checklist to review surveillance guidelines, protocols and relevant documents; conducting self-administered, anonymous surveys with 286 local China CDC staff; and carrying out field observations in 32 sentinel sites in four provinces.Results: China has built an extensive HSS with 1888 sentinel sites to monitor HIV epidemic trends by population groups over time. The strengths of HSS lie in its flexibility, simplicity, usefulness and increase in coverage in locations and populations. With its rapid expansion in 2010, HSS faces challenges in maintaining acceptability, timeliness, data quality, representativeness and sustainability.Recommendations: Implementation of the national guidelines should be standardized by strengthening training, monitoring and supervision of all staff involved, including community-based organizations. National surveillance guidelines need to be revised to strengthen data quality and representativeness, particularly to include specific instructions on HIV testing result provision, collection of identifying information, sample size and sampling methods particularly for men who have sex with men (MSM, collection of refusal information, and data interpretation. Sustainability of China’s HSS could be strengthened by applying locally tailored surveillance strategies, strengthening coordination and cooperation among government agencies and ensuring financial and human resources.

R and D study on on-line criticality surveillance system (V)

International Nuclear Information System (INIS)

Yamada, Sumasu

2001-02-01

In view of necessity and importance of criticality surveillance systems for ensuring the safety of nuclear fuel manufacturing and reprocessing plants, 5-year basic studies and 4 year R and D studies on an on-line criticality surveillance system were carried out since 1991. This report is a summary of these series of studies. Noticing that the signal from a neutron detector is random in principle, these series of studies aimed to accumulate knowledge for developing an inexpensive criticality surveillance system with quick response based on the Auto-Regressive Moving Average (ARMA) model identification algorithm. During five-year basic studies on criticality surveillance system since 1991, we obtained knowledge required for developing a criticality surveillance system based on the ARMA model identification algorithm through 1) studies on recursive ARMA model identification algorithms most appropriate for estimating subcriticality form time series data under a steady state condition, 2) studies on pre-processing of signal from neutron detectors, 3) developing a new recursive ARMA model identification algorithm with small time delay to estimate time-dependent subcriticality, 4) proposing a basic concept for the elements required for an on-line criticality surveillance system, and 5) numerical analysis of data from the DCA experiments. During next four-year R and D studies on a criticality surveillance system since 1996, we 1) proposed modules required for a no-line criticality surveillance system, 2) revealed effectiveness of a adaptive digital filter (ADF) algorithm, as an important redundancy to the recursive ARMA model identification algorithm to be used in the signal processing module through numerical analysis of real data, 3) proposed a module of the Feynman-α method over γ ray signal and a fast signal processing module for γ ray signal, 4) developed a line-noise removal filter(Notch filter) and revealed its effectiveness for the DCA data corrupted with power

A Systematic Review of Waterborne Disease Outbreaks Associated with Small Non-Community Drinking Water Systems in Canada and the United States.

Science.gov (United States)

Pons, Wendy; Young, Ian; Truong, Jenifer; Jones-Bitton, Andria; McEwen, Scott; Pintar, Katarina; Papadopoulos, Andrew

2015-01-01

Reports of outbreaks in Canada and the United States (U.S.) indicate that approximately 50% of all waterborne diseases occur in small non-community drinking water systems (SDWSs). Summarizing these investigations to identify the factors and conditions contributing to outbreaks is needed in order to help prevent future outbreaks. The objectives of this study were to: 1) identify published reports of waterborne disease outbreaks involving SDWSs in Canada and the U.S. since 1970; 2) summarize reported factors contributing to outbreaks, including water system characteristics and events surrounding the outbreaks; and 3) identify terminology used to describe SDWSs in outbreak reports. Three electronic databases and grey literature sources were searched for outbreak reports involving SDWSs throughout Canada and the U.S. from 1970 to 2014. Two reviewers independently screened and extracted data related to water system characteristics and outbreak events. The data were analyzed descriptively with 'outbreak' as the unit of analysis. From a total of 1,995 citations, we identified 50 relevant articles reporting 293 unique outbreaks. Failure of an existing water treatment system (22.7%) and lack of water treatment (20.2%) were the leading causes of waterborne outbreaks in SDWSs. A seasonal trend was observed with 51% of outbreaks occurring in summer months (pwater source and whether water treatment was used (missing in 31% and 66% of reports, respectively). More consistent reporting and descriptions of SDWSs in future outbreak reports are needed to understand the epidemiology of these outbreaks and to inform the development of targeted interventions for SDWSs. Additional monitoring of water systems that are used on a seasonal or infrequent basis would be worthwhile to inform future protection efforts.

Usefulness of data from primary care for real-time surveillance of diseases.

NARCIS (Netherlands)

Nielen, M.M.J.; Schellevis, F.G.; Verheij, R.A.

2006-01-01

Background: The increased threat of bioterrorism and the outbreaks of new infectious diseases require rapid identification of clusters of illness. The increased availability of electronic data in health care makes real-time surveillance of diseases possible. Therefore, we investigated the

Surveillance system for nuclear power plants

International Nuclear Information System (INIS)

Mizeracki, M.T.

1981-01-01

This paper describes an integrated surveillance system for nuclear power plant application. The author explores an expanded role for closed circuit television, with remotely located cameras and infrared scanners as the basic elements. The video system, integrated with voice communication, can enhance the safe and efficient operation of the plant, by improving the operator's knowledge of plant conditions. 7 refs

Vaccine-derived poliovirus surveillance in China during 2001-2013: the potential challenge for maintaining polio free status.

Science.gov (United States)

Wang, Hai-Bo; Luo, Hui-Ming; Li, Li; Fan, Chun-Xiang; Hao, Li-Xin; Ma, Chao; Su, Qi-Ru; Yang, Hong; Reilly, Kathleen H; Wang, Hua-Qing; Wen, Ning

2017-12-02

The goal of polio eradication is to complete elimination and containment of all wild, vaccine-related and Sabin polioviruses. Vaccine-derived poliovirus (VDPV) surveillance in China from 2001-2013 is summarized in this report, which has important implications for the global polio eradication initiative. Acute flaccid paralysis (AFP) cases and their contacts with VDPVs isolated from fecal specimens were identified in our AFP surveillance system or by field investigation. Epidemiological and laboratory information for these children were analyzed and the reasons for the VDPV outbreak was explored. VDPVs were isolated from a total of 49 children in more than two-thirds of Chinese provinces from 2001-2013, including 15 VDPV cases, 15 non-polio AFP cases and 19 contacts of AFP cases or healthy subjects. A total of 3 circulating VDPVs (cVDPVs) outbreaks were reported in China, resulting in 6 cVDPVs cases who had not been vaccinated with oral attenuated poliomyelitis vaccine. Among the 4 immunodeficiency-associated VDPVs (iVDPVs) cases, the longest duration of virus excretion was about 20 months. In addition, one imported VDPV case from Myanmar was detected in Yunnan Province. Until all wild, vaccine-related and Sabin polioviruses are eradicated in the world, high quality routine immunization and sensitive AFP surveillance should be maintained, focusing efforts on underserved populations in high risk areas.

Surveillance and laboratory detection for non-polio enteroviruses in the European Union/European Economic Area, 2016

Science.gov (United States)

Harvala, Heli; Jasir, Aftab; Penttinen, Pasi; Pastore Celentano, Lucia; Greco, Donato; Broberg, Eeva

2017-01-01

Enteroviruses (EVs) cause severe outbreaks of respiratory and neurological disease as illustrated by EV-D68 and EV-A71 outbreaks, respectively. We have mapped European laboratory capacity for identification and characterisation of non-polio EVs to improve preparedness to respond to (re)-emerging EVs linked to severe disease. An online questionnaire on non-polio EV surveillance and laboratory detection was submitted to all 30 European Union (EU)/European Economic Area (EEA) countries. Twenty-nine countries responded; 26 conducted laboratory-based non-polio EV surveillance, and 24 included neurological infections in their surveillance. Eleven countries have established specific surveillance for EV-D68 via sentinel influenza surveillance (n = 7), typing EV-positive respiratory samples (n = 10) and/or acute flaccid paralysis surveillance (n = 5). Of 26 countries performing non-polio EV characterisation/typing, 10 further characterised culture-positive EV isolates, whereas the remainder typed PCR-positive but culture-negative samples. Although 19 countries have introduced sequence-based EV typing, seven still rely entirely on virus isolation. Based on 2015 data, six countries typed over 300 specimens mostly by sequencing, whereas 11 countries characterised under 50 EV-positive samples. EV surveillance activity varied between EU/EEA countries, and did not always specifically target patients with neurological and/or respiratory infections. Introduction of sequence-based typing methods is needed throughout the EU/EEA to enhance laboratory capacity for the detection of EVs. PMID:29162204

A Systematic Review of Waterborne Disease Outbreaks Associated with Small Non-Community Drinking Water Systems in Canada and the United States.

Directory of Open Access Journals (Sweden)

Wendy Pons

Full Text Available Reports of outbreaks in Canada and the United States (U.S. indicate that approximately 50% of all waterborne diseases occur in small non-community drinking water systems (SDWSs. Summarizing these investigations to identify the factors and conditions contributing to outbreaks is needed in order to help prevent future outbreaks.The objectives of this study were to: 1 identify published reports of waterborne disease outbreaks involving SDWSs in Canada and the U.S. since 1970; 2 summarize reported factors contributing to outbreaks, including water system characteristics and events surrounding the outbreaks; and 3 identify terminology used to describe SDWSs in outbreak reports.Three electronic databases and grey literature sources were searched for outbreak reports involving SDWSs throughout Canada and the U.S. from 1970 to 2014. Two reviewers independently screened and extracted data related to water system characteristics and outbreak events. The data were analyzed descriptively with 'outbreak' as the unit of analysis.From a total of 1,995 citations, we identified 50 relevant articles reporting 293 unique outbreaks. Failure of an existing water treatment system (22.7% and lack of water treatment (20.2% were the leading causes of waterborne outbreaks in SDWSs. A seasonal trend was observed with 51% of outbreaks occurring in summer months (p<0.001. There was large variation in terminology used to describe SDWSs, and a large number of variables were not reported, including water source and whether water treatment was used (missing in 31% and 66% of reports, respectively.More consistent reporting and descriptions of SDWSs in future outbreak reports are needed to understand the epidemiology of these outbreaks and to inform the development of targeted interventions for SDWSs. Additional monitoring of water systems that are used on a seasonal or infrequent basis would be worthwhile to inform future protection efforts.

[Surveillance of infection events in neonatal intensive care].

Science.gov (United States)

Decembrino, L; Perrini, S; Stronati, M

2010-06-01

Nosocomial infections are one of the major causes of morbidity and mortality in the newborn intensive care unit (NICU). They result in prolonged hospital stays and increased hospital costs. Neonates are susceptible hosts because of prematurity of organ systems, immaturity of immune system, low birth weight and the use of invasive devices. Most infections are endemic others can occur during outbreaks. As advances in medical technology improve mortality in the tiniest of infants, it is imperative that health care providers identify effective interventions to minimize the risks of nosocomial infections in the NICU. Recommended infection control and prevention strategies are: hand washing promotion, decreased use of invasive procedures, limited antitibiotic exposure, environmental hygiene. In this context infection surveillance is the first step to recognize and analyze problems, to effectively target infection control measures and feedback. Any suspicion of an outbreak should lead to a review of general infection control procedures to prevent the spread of the pathogens as quickly as possible. A multidisciplinary approach can be an effective means of developing a plan of action to apply prolonged and strict adherence to isolation precautions', to detect potential reservoirs or source of infections, to educate every member of the patient care team and to review NICU protocols.

Response to a Large Polio Outbreak in a Setting of Conflict - Middle East, 2013-2015.

Science.gov (United States)

Mbaeyi, Chukwuma; Ryan, Michael J; Smith, Philip; Mahamud, Abdirahman; Farag, Noha; Haithami, Salah; Sharaf, Magdi; Jorba, Jaume C; Ehrhardt, Derek

2017-03-03

As the world advances toward the eradication of polio, outbreaks of wild poliovirus (WPV) in polio-free regions pose a substantial risk to the timeline for global eradication. Countries and regions experiencing active conflict, chronic insecurity, and large-scale displacement of persons are particularly vulnerable to outbreaks because of the disruption of health care and immunization services (1). A polio outbreak occurred in the Middle East, beginning in Syria in 2013 with subsequent spread to Iraq (2). The outbreak occurred 2 years after the onset of the Syrian civil war, resulted in 38 cases, and was the first time WPV was detected in Syria in approximately a decade (3,4). The national governments of eight countries designated the outbreak a public health emergency and collaborated with partners in the Global Polio Eradication Initiative (GPEI) to develop a multiphase outbreak response plan focused on improving the quality of acute flaccid paralysis (AFP) surveillance* and administering polio vaccines to >27 million children during multiple rounds of supplementary immunization activities (SIAs). † Successful implementation of the response plan led to containment and interruption of the outbreak within 6 months of its identification. The concerted approach adopted in response to this outbreak could serve as a model for responding to polio outbreaks in settings of conflict and political instability.

Epidemiological investigation of an outbreak of typhoid fever in Jorhat town of Assam, India.

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Roy, Jashbeer Singh; Saikia, Lahari; Medhi, Mithu; Tassa, Dipak

2016-10-01

Typhoid fever is a global health problem and is also endemic in India. An outbreak of fever occurred in January 2014 in Jorhat Town in Assam, India. Here we report the results of an investigation done to find out the aetiology and source of the outbreak. The affected areas were visited on January 23, 2014 by a team of Jorhat district Integrated Disease Surveillance Project personnel. A total of 13 blood samples from patients with fever as first symptom and six water samples were collected from the affected areas. The blood samples were cultured and isolates were identified using standard biochemical tests. Isolates were also tested for antimicrobial sensitivity. Widal test was performed on 10 of the 13 blood samples collected. Sanitary survey was carried out to find any leakage in the water supply and also the sewage system of the Jorhat town. Blood culture yielded Salmonella enterica serovar Typhi in six (46.15%) patients whereas Widal test was positive in 10 (76.9%) of 13 patients. Water culture showed presumptive coliform count of >180/100 ml in two out of the six samples tested. Salmonella Typhi was also isolated from water culture of these two samples. Sanitary survey carried out in the affected places showed that the water supply pipes of urban water supply were in close proximity to the sewage drainage system and there were few leakages. The outbreak occurred due to S. Typhi contaminating the water supply. Sanitation and immunization are the two most important components to be stressed to prevent such outbreaks.

Large multistate outbreak of norovirus gastroenteritis associated with frozen strawberries, Germany, 2012.

Science.gov (United States)

Bernard, H; Faber, M; Wilking, H; Haller, S; Höhle, M; Schielke, A; Ducomble, T; Siffczyk, C; Merbecks, S S; Fricke, G; Hamouda, O; Stark, K; Werber, D

2014-02-27

From 20 September through 5 October 2012, the largest recorded food-borne outbreak in Germany occurred. Norovirus was identified as the causative agent. We conducted four analytical epidemiological studies, two case–control studies and two surveys (in total 150 cases) in secondary schools in three different federal states. Overall, 390 institutions in five federal states reported nearly 11,000 cases of gastroenteritis. They were predominantly schools and childcare facilities and were supplied almost exclusively by one large catering company. The analytical epidemiological studies consistently identified dishes containing strawberries as the most likely vehicle, with estimated odds ratios ranging from 2.6 to 45.4. The dishes had been prepared in different regional kitchens of the catering company and were served in the schools two days before the peaks of the respective outbreaks. All affected institutions had received strawberries of one lot, imported frozen from China. The outbreak vehicle was identified within a week, which led to a timely recall and prevented more than half of the lot from reaching the consumer. This outbreak exemplifies the risk of large outbreaks in the era of global food trade. It underlines the importance of timely surveillance and epidemiological outbreak investigations for food safety.

[Clustering analysis of Mycobacterium tuberculosis using the JATA(12)-VNTR system for molecular epidemiological surveillance in broad areas of Japan].

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Wada, Takayuki; Tamaru, Aki; Iwamoto, Tomotada; Arikawa, Kentaro; Nakanishi, Noriko; Komukai, Jun; Matsumoto, Kenji; Hase, Atsushi

2013-04-01

Japan Anti-Tuberculosis Association (JATA) (12)-variable numbers of tandem repeats (VNTR) is a standard method for genotyping of clinical isolates of Mycobacterium tuberculosis in Japan. As a model study for nationwide surveillance, this study aimed to describe the tendency and frequency of genotypes of M. tuberculosis in a large number of clinical samples. Clinical isolates of M. tuberculosis (n = 1,778) were obtained from patients with tuberculosis in 3 areas, i.e., Osaka City, Osaka Prefecture, and Kobe City, during 2007 and 2008. The samples were analyzed using JATA (12)-VNTR. All genotypes were subjected to clustering analysis. In total, 1,086 (61.1%) isolates showed clustering. The most common clusters were composed of 3 members. Such clusters were considered to reflect either actual transmission or low discriminatory power of JATA (12)-VNTR. Several prevalent JATA(12)-VNTR genotypes formed large clusters and were discussed in relation with epidemiological findings of other studies. The findings of this study will aid in the construction of an effective genotyping-based surveillance system of M. tuberculosis, through improvement of interpretation of VNTR types, observation of certain particular strains in an area, and efficient detection of unidentified outbreaks.

Hepatitis A outbreak in Ba subdivision, Fiji, October–December 2013

Directory of Open Access Journals (Sweden)

Aneley Getahun

2015-06-01

Full Text Available Objective: A cluster of suspected hepatitis A cases was notified to the Fiji Ministry of Health on 22 October 2013. An outbreak investigation team was mobilized to confirm the existence of an outbreak of hepatitis A and advise appropriate public health interventions. Methods: A case definition for the outbreak investigation was established, and standardized data collection tools were used to collect information on clinical presentation and risk factors. An environmental assessment was also conducted. Results: There were 160 clinical cases of hepatitis A of which 15 were laboratory-confirmed. The attack rate was 349 per 10 000 population in the Nukuloa nursing zone; there were no reported deaths. Residents of the Nukuloa settlement were 6.6 times more likely to present with symptomatic hepatitis A infection (95% confidence interval: 3.8–12.6 compared with residents of another village with a different water supply. Discussion: This is the first significant hepatitis A outbreak documented in Ba subdivision and possibly in Fiji. Enhanced surveillance of hepatitis A may reveal other clusters in the country. Improving the primary water source dramatically reduced the occurance of disease in the affected community and adjacent areas.

Hepatitis A outbreak in Ba subdivision, Fiji, October-December 2013.

Science.gov (United States)

Getahun, Aneley; Rafai, Eric; Tolosa, Maria Ximena; Dawainavesi, Akanisi; Tabua, Anaseini Maisema; Tabua, Josefa

2015-01-01

A cluster of suspected hepatitis A cases was notified to the Fiji Ministry of Health on 22 October 2013. An outbreak investigation team was mobilized to confirm the existence of an outbreak of hepatitis A and advise appropriate public health interventions. A case definition for the outbreak investigation was established, and standardized data collection tools were used to collect information on clinical presentation and risk factors. An environmental assessment was also conducted. There were 160 clinical cases of hepatitis A of which 15 were laboratory-confirmed. The attack rate was 349 per 10,000 population in the Nukuloa nursing zone; there were no reported deaths. Residents of the Nukuloa settlement were 6.6 times more likely to present with symptomatic hepatitis A infection (95% confidence interval: 3.8-12.6) compared with residents of another village with a different water supply. This is the first significant hepatitis A outbreak documented in Ba subdivision and possibly in Fiji. Enhanced surveillance of hepatitis A may reveal other clusters in the country. Improving the primary water source dramatically reduced the occurance of disease in the affected community and adjacent areas.

Inexpensive remote video surveillance system with microcomputer and solar cells

International Nuclear Information System (INIS)

Guevara Betancourt, Edder

2013-01-01

A low-cost prototype is developed with a RPI plate for remote video surveillance. Additionally, the theoretical basis to provide energy independence have developed through solar cells and a battery bank. Some existing commercial monitoring systems are studied and analyzed, components such as: cameras, communication devices (WiFi and 3G), free software packages for video surveillance, control mechanisms and theory remote photovoltaic systems. A number of steps are developed to implement the module and install, configure and test each of the elements of hardware and software that make up the module, exploring the feasibility of providing intelligence to the system using the software chosen. Events that have been generated by motion detection have been simple, intuitive way to view, archive and extract. The implementation of the module by a microcomputer video surveillance and motion detection software (Zoneminder) has been an option for a lot of potential; as the platform for monitoring and recording data has provided all the tools to make a robust and secure surveillance. (author) [es

Success Factors of European Syndromic Surveillance Systems: A Worked Example of Applying Qualitative Comparative Analysis.

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Ziemann, Alexandra; Fouillet, Anne; Brand, Helmut; Krafft, Thomas

2016-01-01

Syndromic surveillance aims at augmenting traditional public health surveillance with timely information. To gain a head start, it mainly analyses existing data such as from web searches or patient records. Despite the setup of many syndromic surveillance systems, there is still much doubt about the benefit of the approach. There are diverse interactions between performance indicators such as timeliness and various system characteristics. This makes the performance assessment of syndromic surveillance systems a complex endeavour. We assessed if the comparison of several syndromic surveillance systems through Qualitative Comparative Analysis helps to evaluate performance and identify key success factors. We compiled case-based, mixed data on performance and characteristics of 19 syndromic surveillance systems in Europe from scientific and grey literature and from site visits. We identified success factors by applying crisp-set Qualitative Comparative Analysis. We focused on two main areas of syndromic surveillance application: seasonal influenza surveillance and situational awareness during different types of potentially health threatening events. We found that syndromic surveillance systems might detect the onset or peak of seasonal influenza earlier if they analyse non-clinical data sources. Timely situational awareness during different types of events is supported by an automated syndromic surveillance system capable of analysing multiple syndromes. To our surprise, the analysis of multiple data sources was no key success factor for situational awareness. We suggest to consider these key success factors when designing or further developing syndromic surveillance systems. Qualitative Comparative Analysis helped interpreting complex, mixed data on small-N cases and resulted in concrete and practically relevant findings.

Comparing national infectious disease surveillance systems: China and the Netherlands.

NARCIS (Netherlands)

Vlieg, Willemijn L; Fanoy, Ewout B; van Asten, Liselotte; Liu, Xiaobo; Yang, Jun; Pilot, Eva; Bijkerk, Paul; van der Hoek, Wim; Krafft, Thomas; van der Sande, Marianne A; Liu, Qi-Yong

2017-01-01

Risk assessment and early warning (RAEW) are essential components of any infectious disease surveillance system. In light of the International Health Regulations (IHR)(2005), this study compares the organisation of RAEW in China and the Netherlands. The respective approaches towards surveillance of

The Need for European Surveillance of CDI.

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Wiuff, Camilla; Banks, A-Lan; Fitzpatrick, Fidelma; Cottom, Laura

2018-01-01

Since the turn of the millennium, the epidemiology of Clostridium difficile infection (CDI) has continued to challenge. Over the last decade there has been a growing awareness that improvements to surveillance are needed. The increasing rate of CDI and emergence of ribotype 027 precipitated the implementation of mandatory national surveillance of CDI in the UK. Changes in clinical presentation, severity of disease, descriptions of new risk factors and the occurrence of outbreaks all emphasised the importance of early diagnosis and surveillance.However a lack of consensus on case definitions, clinical guidelines and optimal laboratory diagnostics across Europe has lead to the underestimation of CDI and impeded comparison between countries. These inconsistencies have prevented the true burden of disease from being appreciated.Acceptance that a multi-country surveillance programme and optimised diagnostic strategies are required not only to detect and control CDI in Europe, but for a better understanding of the epidemiology, has built the foundations for a more robust, unified surveillance. The concerted efforts of the European Centre for Disease Prevention and Control (ECDC) CDI networks, has lead to the development of an over-arching long-term CDI surveillance strategy for 2014-2020. Fulfilment of the ECDC priorities and targets will no doubt be challenging and will require significant investment however the hope is that both a national and Europe-wide picture of CDI will finally be realised.

Imported Genotype 2B Rubella Virus Caused the 2012 Outbreak in Anqing City, China.

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Zhen Zhu

Full Text Available A rubella outbreak occurred in Anqing city of Anhui province, China, from February to July of 2012, and a total of 241 clinically diagnosed or lab-confirmed patients were reported. The highest number of rubella cases during this outbreak was recorded in teenagers between 10 and 19 years of age who had not previously received the rubella vaccine. Genotyping results indicated that the genotype 2B rubella virus (RV was responsible for the outbreak. However, a phylogenetic analysis showed that the genotype 2B RVs isolated in Anqing City were not related to 2B RVs found in other cities of Anhui province and in other provinces of China, thus providing evidence for importation. After importation, the transmission of Anqing RVs was interrupted owing to an effective immunization campaign against rubella, suggesting the timeliness and effectiveness of contingency vaccination. Strengthening rubella surveillance, including the integration of epidemiologic information and laboratory data, is a vital strategy for rubella control and elimination. In addition, except for routine immunization, targeted supplementary immunization activities aimed at susceptible groups according to sero-epidemiological surveillance data also play a key role in stopping the continuous transmission of rubella viruses and in preventing further congenital rubella syndrome cases.

An outbreak of multidrug-resistant, quinolone-resistant Salmonella enterica serotype typhimurium DT104

DEFF Research Database (Denmark)

Molbak, K.; Baggesen, Dorte Lau; Aarestrup, Frank Møller

1999-01-01

Background Food-borne salmonella infections have become a major problem in industrialized countries. The strain of Salmonella enterica serotype typhimurium known as definitive phage type 104 (DT104) is usually resistant to five drugs: ampicillin, chloramphenicol, streptomycin, sulfonamides......, and tetracycline. An increasing proportion of DT104 isolates also have reduced susceptibility to fluoroquinolones. Methods The Danish salmonella surveillance program determines the phage types of all typhimurium strains from the food chain, and in the case of suspected outbreaks, five-drug-resistant strains...... are characterized by molecular methods. All patients infected with five-drug-resistant typhimurium are interviewed to obtain clinical and epidemiologic data. In 1998, an outbreak of salmonella occurred, in which the strain of typhimurium DT104 was new to Denmark. We investigated this outbreak and report our...

Information and communication technology in disease surveillance, India: a case study

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Krishnan Sampath K

2010-12-01

Full Text Available Abstract India has made appreciable progress and continues to demonstrate a strong commitment for establishing and operating a disease surveillance programme responsive to the requirements of the International Health Regulations (IHR[2005]. Within five years of its launch, India has effectively used modern information and communication technology for collection, storage, transmission and management of data related to disease surveillance and effective response. Terrestrial and/or satellite based linkages are being established within all states, districts, state-run medical colleges, infectious disease hospitals, and public health laboratories. This network enables speedy data transfer, video conferencing, training and e-learning for outbreaks and programme monitoring. A 24x7 call centre is in operation to receive disease alerts. To complement these efforts, a media scanning and verification cell functions to receive reports of early warning signals. During the 2009 H1N1 outbreak, the usefulness of the information and communication technology (ICT network was well appreciated. India is using ICT as part of its Integrated Disease Surveillance Project (IDSP to help overcome the challenges in further expansion in hard-to-reach populations, to increase the involvement of the private sector, and to increase the use of other modes of communication like e-mail and voicemail.

Information and communication technology in disease surveillance, India: a case study.

Science.gov (United States)

Kant, Lalit; Krishnan, Sampath K

2010-12-03

India has made appreciable progress and continues to demonstrate a strong commitment for establishing and operating a disease surveillance programme responsive to the requirements of the International Health Regulations (IHR[2005]). Within five years of its launch, India has effectively used modern information and communication technology for collection, storage, transmission and management of data related to disease surveillance and effective response. Terrestrial and/or satellite based linkages are being established within all states, districts, state-run medical colleges, infectious disease hospitals, and public health laboratories. This network enables speedy data transfer, video conferencing, training and e-learning for outbreaks and programme monitoring. A 24x7 call centre is in operation to receive disease alerts. To complement these efforts, a media scanning and verification cell functions to receive reports of early warning signals. During the 2009 H1N1 outbreak, the usefulness of the information and communication technology (ICT) network was well appreciated. India is using ICT as part of its Integrated Disease Surveillance Project (IDSP) to help overcome the challenges in further expansion in hard-to-reach populations, to increase the involvement of the private sector, and to increase the use of other modes of communication like e-mail and voicemail.

Evaluation of the influenza sentinel surveillance system in Madagascar, 2009-2014.

Science.gov (United States)

Rakotoarisoa, Alain; Randrianasolo, Laurence; Tempia, Stefano; Guillebaud, Julia; Razanajatovo, Norosoa; Randriamampionona, Lea; Piola, Patrice; Halm, Ariane; Heraud, Jean-Michel

2017-05-01

Evaluation of influenza surveillance systems is poor, especially in Africa. In 2007, the Institut Pasteur de Madagascar and the Malagasy Ministry of Public Health implemented a countrywide system for the prospective syndromic and virological surveillance of influenza-like illnesses. In assessing this system's performance, we identified gaps and ways to promote the best use of resources. We investigated acceptability, data quality, flexibility, representativeness, simplicity, stability, timeliness and usefulness and developed qualitative and/or quantitative indicators for each of these attributes. Until 2007, the influenza surveillance system in Madagascar was only operational in Antananarivo and the observations made could not be extrapolated to the entire country. By 2014, the system covered 34 sentinel sites across the country. At 12 sites, nasopharyngeal and/or oropharyngeal samples were collected and tested for influenza virus. Between 2009 and 2014, 177 718 fever cases were detected, 25 809 (14.5%) of these fever cases were classified as cases of influenza-like illness. Of the 9192 samples from patients with influenza-like illness that were tested for influenza viruses, 3573 (38.9%) tested positive. Data quality for all evaluated indicators was categorized as above 90% and the system also appeared to be strong in terms of its acceptability, simplicity and stability. However, sample collection needed improvement. The influenza surveillance system in Madagascar performed well and provided reliable and timely data for public health interventions. Given its flexibility and overall moderate cost, this system may become a useful platform for syndromic and laboratory-based surveillance in other low-resource settings.

Applied learning-based color tone mapping for face recognition in video surveillance system

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Yew, Chuu Tian; Suandi, Shahrel Azmin

2012-04-01

In this paper, we present an applied learning-based color tone mapping technique for video surveillance system. This technique can be applied onto both color and grayscale surveillance images. The basic idea is to learn the color or intensity statistics from a training dataset of photorealistic images of the candidates appeared in the surveillance images, and remap the color or intensity of the input image so that the color or intensity statistics match those in the training dataset. It is well known that the difference in commercial surveillance cameras models, and signal processing chipsets used by different manufacturers will cause the color and intensity of the images to differ from one another, thus creating additional challenges for face recognition in video surveillance system. Using Multi-Class Support Vector Machines as the classifier on a publicly available video surveillance camera database, namely SCface database, this approach is validated and compared to the results of using holistic approach on grayscale images. The results show that this technique is suitable to improve the color or intensity quality of video surveillance system for face recognition.