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Uses and Cases

Monitoring community health is a core function provided by health departments across the country. Traditionally, health departments have used surveillance systems to assist with identifying and monitoring disease outbreaks.  Advances in these systems, though, are helping address the ever-increasing demands placed on public health.

We are often asked to share examples of how public health can use a surveillance system. Whether it is executing an emergency preparedness drill or monitoring the falls of elders, a surveillance system captures data that can be a valuable resource for many public health programs.

Below are some ways public health departments use the Epicenter system.

EpiCenter Detects Outbreak During Preparedness Drill

In 2008, the Hudson Regional Health Commission conducted a preparedness drill at one of the hospitals in its jurisdiction.  The simulation was a hypothetical E. coli outbreak at a local restaurant.  As the test patients came into the hospital, EpiCenter detected a spike in complaints of nausea and diarrhea and notified the health commission of a possible event.  The health commission was able to use this information to efficiently manage the situation, quickly notifying the appropriate public health agencies and hospital personnel of the event.

Emergency preparedness drills are a regular activity nationwide; they provide an excellent opportunity to demonstrate the role that EpiCenter can play both in event detection and in situational awareness.

Read the whole article here.

Utah Cryptosporidium Outbreak:  EpiCenter Increases Specificity of Event Detection

In the summer of 2007, the Utah Department of Health reported an epidemic of cryptosporidiosis that involved 711 laboratory-confirmed cases.  The syndromic surveillance system in use at the time failed to detect this event.  One reason for this is that the gastrointestinal syndrome category was so broad that the signal created by the epidemic was lost among the noise.

Retrospective analysis showed that EpiCenter’s more specific symptom categories, in particular the diarrhea category, would have detected this event when it was starting.  By classifying chief complaints into distinct and easily definable symptom categories that more closely reflect how patients talk about their symptoms, EpiCenter increases the specificity of its event detection capabilities.

Emergency department visits classified as diarrhea for all ages and genders.  Graph shows how EpiCenter would have detected this particular event in its early stages toward the beginning of August.

After Widespread Flooding, EpiCenter Monitors Disease Vector Populations

Insects and arachnids are vectors for a variety of diseases of public health importance.  In areas where these diseases are endemic, some health departments routinely monitor these populations and apply control measures as necessary.  In other areas, monitoring is infeasible or unnecessary under normal conditions, but could be of value under extraordinary circumstances such as widespread flooding.  The Ohio Department of Health demonstrated that monitoring of emergency department complaints related to mosquito and insect bites was useful for tracking increases in mosquito populations after an area experienced a major flood.  Thus, EpiCenter could be used to monitor disease vector populations during extraordinary circumstances in areas where the capacity for traditional trapping methods is not maintained.

Poster: “Monitoring Hospital Emergency Department Visits for Chief Complaints of Insect Bites after a Major Flood”, ISDS Conference 2008

Monitoring of Infectious Disease Symptoms Leads to Early Identification of Food-borne Outbreak

On April 19th, 2008, EpiCenter detected an increase in complaints of vomiting in Portage County, Ohio.  A public health investigation revealed that a number of the affected individuals had eaten at the same restaurant in Kent, Ohio over a period of 5 days from April 14th to April 18th.  All of them tested positive for the same strain of norovirus.

Running surveillance against a traditional, broad gastrointestinal syndrome would not have detected this event.  However, because EpiCenter affords users the increased specificity of symptom categories, the system detected the event (displayed below) and alerted the health department of it.

Emergency department visits classified as vomitting for all ages and genders.