[show abstract][hide abstract] ABSTRACT: This paper presents a pilot project of a real time syndromic surveillance system in French armed forces for early warning of biological attack by mass destruction weapons. For simulating the situation of a theatre of operations and its organisation, an electronic syndromic surveillance system covering all branches of service in French Guiana (about 3,000 persons) has been deployed and connected to a surveillance centre in France. This system has been design taking in account a collaborative view of epidemiological surveillance and the mobility of forces in extreme conditions. Several kinds of hardware, from rugged personal digital assistant to desktop computer, and several telecommunication links, from PSTN to satellite data links, are used. This system allows a quick report of cases, which are georeferenced. In the first results, some problems associated with the human and the technical aspects have been reported, in association with some immediate advantages.
Studies in health technology and informatics 02/2005; 116:983-8.
[show abstract][hide abstract] ABSTRACT: Since 2001, increased attention has been focused on improving acute infectious disease surveillance systems. This article describes options for their design and operation. Systems designed primarily to detect individual cases of reportable diseases may differ from those designed to detect outbreaks or support design or evaluation of control programs. Timeliness, sensitivity, and predictive value of surveillance systems cannot all be maximized at the same time. Core activities of surveillance systems include collection, analysis, and dissemination of information about health events under surveillance. Doing these well requires attention to the mechanics of surveillance, such as making the health department accessible at all times to receive reports and provide consultation, and maintaining current directories of persons for dissemination of surveillance data, alerts, and recommendations. Rapid access to electronic representations of health events (eg, laboratory reports, patient records, or health care claims) provides great opportunities for more timely and complete surveillance. Some important information (eg, exposures, contacts) will still need to be collected directly from affected persons. One productive strategy is to collect core demographic and onset data on all cases and detailed clinical, exposure, and outcome data on a subset.
Journal of public health management and practice: JPHMP 11(3):184-90. · 0.96 Impact Factor
[show abstract][hide abstract] ABSTRACT: A key public health question is whether syndromic surveillance data provide early warning of infectious outbreaks. One cause for skepticism is that biological correlates of the administrative and clinical data used in these systems have not been rigorously assessed. This study measures the value of respiratory data currently used in syndromic surveillance systems to detect respiratory infections by comparing it against criterion standard viral testing within a pediatric population.
We conducted a longitudinal study with prospective validation in the emergency department (ED) of a tertiary care children's hospital. Children aged 7 years or younger who presented with a respiratory syndrome or who were tested for respiratory syncytial virus (RSV), influenza virus, parainfluenza virus, adenovirus, or enterovirus between January 1993 and June 2004 were included. We assessed the predictive ability of the viral tests by fitting generalized linear models to respiratory syndrome counts.
Of 582,635 patient visits, 89,432 (15.4%) were for respiratory syndromes, and of these, 7,206 (8.1%) patients were tested for the viruses of interest. RSV was significantly related to respiratory syndrome counts (adjusted rate ratio [RR] 1.33; 95% confidence interval [CI] 1.04 to 1.71). In multivariate models including all viruses tested, influenza virus was also a significant predictor of respiratory syndrome counts (RR 1.47; 95% CI 1.03 to 2.10). This model accounted for 81.6% of the observed variability in respiratory syndrome counts.
Respiratory syndromic surveillance data strongly correlate with virologic test results in a pediatric population, providing evidence of the biologic validity of such surveillance systems. Real-time outbreak detection systems relying on syndromic data may be an important adjunct to the current set of public health systems for the detection and surveillance of respiratory infections.
Annals of emergency medicine 04/2006; 47(3):265.e1. · 4.23 Impact Factor
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