Innovative Communicable Disease Reporting

BackgroundDuring the COVID-19 pandemic, contact tracing program as part of a larger epidemiological case investigation was effectively implemented by the local department of health in Paterson, NJ. The Paterson Communicable Disease Strike Team (PCDST) was established by leveraging skills and using existing public health staff of the health department team which led to a timely and robust public health intervention.MethodsPCDST comprised of 25 communicable disease investigators/contact tracers established in preparation for public health response in the event of large-scale communicable disease outbreaks pre-COVID. In March 2020 with initial COVID-19 cases in Paterson, PCDST was activated utilizing NJ DOH’s Communicable Disease Reporting and Surveillance System (CDRSS). Additional staff members were cross-trained to augment team as new cases surged. A triage coordinator would identify and assign new cases to disease investigators at a 24/7 schedule. Disease Investigators would provide test results, perform epidemiological case interviews, elicit close contacts, and provide isolation/quarantine recommendations. Case-contact monitors followed up daily basis until completion of isolation/quarantine period.ResultsAs of June 15, 2020, 6537 cases tested COVID-19 (+) in Paterson, NJ. 91% of cases and their contacts were interviewed. Peak occurred in mid-April with 263 cases on a single day. By mid-June, daily number of cases declined to 7/day. Reported COVID-19 mortality rate in Paterson (4.65%), compared to surrounding towns in the same county of Passaic (6%), other large cities in New Jersey (Newark 8%, Jersey City 7.4%) and New Jersey state (7.59%).ConclusionDespite limited resources, we were able to cross train and engage our frontline public health team (PCDST) to investigate and effectively contact trace new COVID-19 cases to help contain spread of infection. Although its unclear if our intervention impacted mortality rates, it is certain that contact tracing using a trained public health workforce is a model that has proven successful in Paterson. A local public health workforce vested in their communities can develop rapport needed to build trust and confidence in an intervention that elicits confidential medical information to limit viral transmission.DisclosuresAll Authors: No reported disclosures

Communicable Disease Report Get access Journal of Public Health, Volume 8, Issue 3, August 1986, Pages 245–251, https://doi.org/10.1093/oxfordjournals.pubmed.a043861 Published: 01 August 1986

Communicable Disease Report Get access Journal of Public Health, Volume 8, Issue 4, November 1986, Pages 356–360, https://doi.org/10.1093/oxfordjournals.pubmed.a043891 Published: 01 November 1986

In January 2003, the Westchester County Department of Health (WCDH) began conducting electronic syndromic surveillance of hospital emergency department (ED) chief complaints. Although methods for data collection and analysis used in syndromic surveillance have been described previously, minimal information exists regarding the responses to and investigations of signals detected by such systems. This paper describes WCDH's experience in responding to syndromic surveillance signals during the first 9 months after the system was implemented.The objectives of this analysis were to examine WCDH's responses to signals detected by the county's syndromic surveillance system. Specific goals were to 1) review the actual complaints reported by hospital EDs to determine whether complaint data were accurately identified and classified into syndrome categories, and provide feedback from this review to data collection and analysis staff to refine text terms or filters used to identify and classify chief complaints; 2) develop procedures and response algorithms for investigating signals; 3) determine whether signals correlated with reportable communicable diseases or other incidents of public health significance requiring investigation and intervention; and 4) quantify the staffing resources and time required to investigate signals.During January 27-October 31, 2003, electronic files containing chief-complaint data from seven of the county's 13 EDs were collected daily. Complaints were classified into syndrome categories and analyzed for statistically significant increases. A line listing of each complaint comprising each signal detected was reviewed for exact complaint, number, location, patient demographics, and requirement for hospital admission.A total of 59 signals were detected in eight syndrome categories: fever/influenza (11), respiratory (6), vomiting (11), gastrointestinal illness/diarrhea (8), sepsis (7), rash (7), hemorrhagic events (3), and neurologic (6). Line-listing review indicated that complaints routinely were incorrectly identified and included in syndrome categories and that as few as three complaints could produce a signal. On the basis of hospital, geographic, age, or sex clustering of complaints, whether the complaint indicated a reportable condition (e.g., meningitis) or potentially represented an unusual medical event, and whether rates of hospital admission were consistent with medical conditions, 34 of 59 signals were determined to require further investigation (i.e., obtaining additional information from ED staff or medical providers). Investigation did not identify any reportable communicable disease or other incidents of public health significance that would have been missed by existing traditional surveillance systems. Nine staff members spent 3 hours/week collectively investigating signals detected by syndromic surveillance.Standardized sets of text terms used to identify and classify hospital ED chief complaints into syndrome categories might require modification on the basis of hospital idiosyncrasies in recording chief complaints. Signal investigations could be reasonably conducted by using local health department resources. Although no communicable disease events were identified, the system provided baseline and timely objective data for hospital visits and improved communication among county health department and hospital ED staff.

This DOI is not currently attached to any metadata records. DOIs can’t actually ever be deleted (they’re persistent), but sometimes our members create DOIs in error. We do have a process to approximate deletion which we follow only in rare cases where the DOI has been genuinely created in error, and most crucially, if the DOI has never been published anywhere online or in print and never otherwise distributed to or communicated with anyone (authors, readers, reviewers, etc.

This DOI is not currently attached to any metadata records. DOIs can’t actually ever be deleted (they’re persistent), but sometimes our members create DOIs in error. We do have a process to approximate deletion which we follow only in rare cases where the DOI has been genuinely created in error, and most crucially, if the DOI has never been published anywhere online or in print and never otherwise distributed to or communicated with anyone (authors, readers, reviewers, etc.

Journal Article Communicable Disease Report: October to December 1984 Get access Journal of Public Health, Volume 7, Issue 2, May 1985, Pages 136–144, https://doi.org/10.1093/oxfordjournals.pubmed.a043772 Published: 01 May 1985

Rhizopus microsporus in wooden tongue depressors: a major threat or minor inconvenience?

This paper describes the management of public relations following an outbreak of multidrug resistant TB at a London hospital. Eight patients were involved, all of the secondary cases occurred in HIV seropositive patients, and three cases died. The paper describes how the the Incident Committee undertook to recall contacts of the cases for screening, inform the general practitioners of all of the contacts about their patients' exposure, warn other organizations and professionals interested or involved in the management of HIV in the London area as to the nature of the incident, and establish a helpline, before informing a wider audience through the EPINET, Communicable Disease Report and national press.

Residential address errors in public health surveillance data: A description and analysis of the impact on geocoding

Objective To analyze and evaluate the monitoring data of China Infectious Diseases Automated-alert and Response System (CIDARS) in Zhejiang Province from 2014 to 2016, and to provide the evidences for further promoting the application and improvement of this system. Methods The data which were collected from the monitoring program during 2014 to 2016 were analyzed descriptively and compared with the incidence data from national notifiable communicable disease report system in the same period. Results A total of 37 870 signals were generated on 30 kinds of infectious diseases in the system in Zhejiang province. The response rate was 100% and the median time to response was 0.67 hour. There were 611 signals (1.61%) preliminarily verified as suspected outbreaks and 215 outbreaks were finally confirmed by further field investigation, with a positive ratio of 0.57%. In all the signals, 9 175 signals were generated by the fixed-value detection method, and 93.96% (8 621/9 175) of signals were responded in 2 hours. A total of 3 868 cases of 5 kinds of diseases were finally confirmed, accounting for 42.16% of the generated signals. There were 28 695 signals generated by the temporal model method, and 99.12% (28 443/28 695) of signals were responded in 24 hours. The signal number of time warning model was positively correlated with reported case numbers (r=0.96, P<0.01) . A total of 193 outbreaks of 6 kinds of diseases were confirmed. Conclusions CIDARS performs well in Zhejiang province which can be used to achieve automatic early alter for outbreak of infectious diseases. Signal response rate and time maintain a rather high level which can assist CDC to find potential outbreak of infectious disease in early stage. However, suspected rate and positive rate of the early warning signals should be improved. Key words: Communicable diseases; Automatic alert; Monitoring data; Evaluation

D URING the autumn of 1955 and the early winter of 1955-56, diphtheria occurred in the Nation with a frequency not witnessed for a number of years. Fear of a definite resurgence was aroused when outbreaks occurred in areas which had been almost entirely free of the disease for extended periods. The particularly high incidence of the disease in the southeastern States has been described in a previous report (1) prepared at the close of 1955. It is the purpose of this paper briefly to summarize the United States diphtheria experience in 1956. Data on the occurrence of diphtheria cases and deaths were obtained primarily from publications of the Public Health Service's National Office of Vital Statistics, Morbidity and Mortality Weekly Reports and their annual supplements and Vital Statistics of the United States. More detailed information was obtained from current communicable disease reports prepared by States for internal use and from the annual communicable disease statistics published by most States. Additional details were collected by personnel of the Communicable Disease Center in connection with field assignments which dealt directly or indirectly with diphtheria. The assembling and review of such data are continuing functions of the Surveillance Section of the Center. The occurrence of diphtheria in 1955 and 1956, by weeks, is given in figure 1, and the States contributing heavily to the weekly peaks are also indicated. During the first half of 1956 diphtheria incidence continued to be relatively high and was above that of the preceding year in about two-thirds of all weeks. Following the seasonal low, however, the expected pattern of early increase of diphtheria cases in the southern States did not develop to the usual extent. Incidence remained well below that of 1955 throughout the fall and winter, and at the close of the year 1,581 cases had been tentatively reported, compared with 2,039 cases in 1955. Data for 1956 in figures 2 and 3 and table 1 are also preliminary. Although final figures for 1956 are now available, they do not alter the pattern or change the conclusions since they change the total by less than 1 percent. This 22 percent decrease in the incidence of diphtheria restores somewhat the trend of the last decade. After the last increase in reported diphtheria in 1945 there was a fairly steady decline at about 25 percent per year until 1953. In this year the decrease was only 20 percent. In 1954 it was 13 percent and in 1955 only 3 percent. The small drop in cases for the calendar year does not give as clear a picture as the statistics for the disease years. For the disease season of 1955-56, there was actually a 12 percent increase over the disease year 1954-55. The decline in cases in the calendar year of 1956 was due almost entirely to decreases in the last half of the year and in the southeastern States. In figure 2 and table 1, diphtheria morbidity rates are shown by standard geographic divisions and by States for 1949-56. The areas showing the greatest decline in 1956 were the South Atlantic and East South Central States. Small decreases, or essentially no change, occurred in all other divisions except the East North Central and the Mountain States, which showed increases of 0.6 cases per 100,000 population. The increased rate in the East North Central division is almost entirely due to increases in Dr. Moore is chief of the Diphtheria Unit, Surveillance Section, Communicable Disease Center, Public Health Service, Atlanta, Ga.

Scientific progress around the development, use and best practices for communicating the benefits of vaccines is rapid, and keeping up-to-date with the substantial body of evidence on these topics is challenging. However, the increase in the number of vaccines and decline in vaccine-preventable illnesses has often focused public attention more on the risks of vaccines rather than the risks of the diseases. In Canada and elsewhere, an increasing number of parents are choosing to delay and/or refuse some or all vaccines for their children, leading to declining community protection against vaccine-preventable diseases and an increase in the number of outbreaks of vaccine-preventable diseases. Evidence suggests that the concept of vaccine hesitancy contributes to a deeper understanding of vaccination decisions by moving beyond the traditional binary of pro- or anti-vaccine attitudes to recognize a spectrum of beliefs and associated behaviours that occupies the space between the two poles. At a time of growing antimicrobial resistance to infections, protection conferred by vaccination is more important than ever. The Canadian Vaccination Evidence Resource and Exchange Centre (CANVax) is an online curated database of resources to support immunization and promotional activities aimed at improving vaccine acceptance and uptake in Canada. It includes both the identification of accurate and reliable resources and the creation of new resources by a group of multidisciplinary professionals. This issue of the Canada Communicable Disease Report (CCDR) includes the first of a series of "CANVax Briefs" that have been developed by experts after conducting scoping reviews and environmental scans and assessing the most rigorous evidence. The aim of the CANVax Briefs is to bring attention to current and emerging issues by providing short summaries of the recent best available evidence to assist frontline public health and clinical care professionals in optimizing the immunization rate in Canada. CANVax Briefs will be published in CCDR throughout 2020.

To analyze the epidemic situation and epidemiological characteristics of malaria in Lishui City from 2013 to 2018, so as to provide the evidence for formulating the malaria control strategy. The data pertaining malaria cases in Lishui City from 2013 to 2018 were captured from National Notifiable Communicable Disease Reporting System and the Information System for Parasitic Diseases Control and Prevention, and the epidemiological features of malaria cases were analyzed. A total of 119 malaria cases were reported in Lishui City from 2013 to 2018, including 101 cases with falciparum malaria (84.87%), 6 cases with vivax malaria (5.04%), 8 cases with ovale malaria (6.72%), and 4 cases with mixed infection (3.36%). Among the 119 cases, there were one local case with blood transfusion-induced malaria and 118 cases with over- seas imported malaria. There were 98.32% of the imported malaria cases acquiring infection in African countries, and most cases were reported in Qingtian County (60.50%) and Liandu District (22.69%). In addition, 86.55% of the malaria cases were detected in individuals at ages of 20 to 50 years, and most cases were found in oversea workers (52.94%) and businessmen (38.65%). Most of the malaria cases in Lishui City are imported from Africa, and the monitoring and health education pertaining to malaria control knowledge requires to be intensified among high-risk populations.

This DOI is not currently attached to any metadata records. DOIs can’t actually ever be deleted (they’re persistent), but sometimes our members create DOIs in error. We do have a process to approximate deletion which we follow only in rare cases where the DOI has been genuinely created in error, and most crucially, if the DOI has never been published anywhere online or in print and never otherwise distributed to or communicated with anyone (authors, readers, reviewers, etc.