Establishing a nationwide emergency department-based syndromic surveillance system for better public health responses in Taiwan

Wu, Tsung-Shu Joseph; Shih, Fuh‐Yuan; Yen, Muh–Yong; Wu, Jiunn‐Shyan Julian; Lu, Shiou-Wen; Chang, Kevin Chi-Ming; Hsiung, Chao A.; Chou, Jyh–Horng; Chu, Yu-Tseng; Chang, Hang; Chiu, Chan-Hsien; Tsui, Fu-Chiang; Wagner, Michael M.; Su, Ih‐Jen; King, Chwan-Chuen

doi:10.1186/1471-2458-8-18

Cited by 79 publications

(67 citation statements)

References 28 publications

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“…The most frequently used data were chief complaint or ED presentation [9], [10], [11], [12], [13], [14], [15], [16], [17], [18], [19], [20], [21], [22], [23], [24], [25], [26], [27], [28], [29], [30], [31], [32], [33], [34], [35], [36], [37], [38], [39], [40], [41] and preliminary or discharge diagnosis codes [8], [9], [11], [16], [17], [18], [22], [23], [26], [27], [32], [33], [38], [39], [41], [42]. Other creative data used to capture influenza activity included free text analysis of the entire ED medical record, [37] Google flu trends, [25] calls to teletriage and help lines, [16], [25], [38] ambulance dispatch calls, [19], [20], [21], [30], [31], [32] case reports of H1N1 in the media, [8] ED census/”saturation”/length-of-s...…”

Section: Resultsmentioning

confidence: 99%

Syndromic Surveillance for Influenza in the Emergency Department–A Systematic Review

et al. 2013

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The science of surveillance is rapidly evolving due to changes in public health information and preparedness as national security issues, new information technologies and health reform. As the Emergency Department has become a much more utilized venue for acute care, it has also become a more attractive data source for disease surveillance. In recent years, influenza surveillance from the Emergency Department has increased in scope and breadth and has resulted in innovative and increasingly accepted methods of surveillance for influenza and influenza-like-illness (ILI). We undertook a systematic review of published Emergency Department-based influenza and ILI syndromic surveillance systems. A PubMed search using the keywords “syndromic”, “surveillance”, “influenza” and “emergency” was performed. Manuscripts were included in the analysis if they described (1) data from an Emergency Department (2) surveillance of influenza or ILI and (3) syndromic or clinical data. Meeting abstracts were excluded. The references of included manuscripts were examined for additional studies. A total of 38 manuscripts met the inclusion criteria, describing 24 discrete syndromic surveillance systems. Emergency Department-based influenza syndromic surveillance has been described worldwide. A wide variety of clinical data was used for surveillance, including chief complaint/presentation, preliminary or discharge diagnosis, free text analysis of the entire medical record, Google flu trends, calls to teletriage and help lines, ambulance dispatch calls, case reports of H1N1 in the media, markers of ED crowding, admission and Left Without Being Seen rates. Syndromes used to capture influenza rates were nearly always related to ILI (i.e. fever +/− a respiratory or constitutional complaint), however, other syndromes used for surveillance included fever alone, “respiratory complaint” and seizure. Two very large surveillance networks, the North American DiSTRIBuTE network and the European Triple S system have collected large-scale Emergency Department-based influenza and ILI syndromic surveillance data. Syndromic surveillance for influenza and ILI from the Emergency Department is becoming more prevalent as a measure of yearly influenza outbreaks.

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Section: Resultsmentioning

confidence: 99%

Syndromic Surveillance for Influenza in the Emergency Department–A Systematic Review

et al. 2013

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“… 6 , 7 , 8 , 9 , 10 , 11 In addition, many acute conditions can be mitigated by primary prevention; disease surveillance at acute and emergency care facilities has been shown to increase preparedness and disease control capabilities 10 ,. 12 In general, analysis of acute disease patterns and the distribution of mortality across the acute care continuum is a crucial part of identifying the preventive and training initiatives most likely to improve outcomes 13 ,. 14 , 15 , 16 , 17 Facility-based and pre-facility emergency care are essential components of a continuum ranging from prevention, through primary and chronic care, to inpatient critical care and surgery, and with Resolution 60.22 the World Health Assembly has called for all its member states to consider ‘formal, integrated emergency care systems' 18 …”

Section: Introductionmentioning

confidence: 99%

Emergency care capacity in Africa: A clinical and educational initiative in Tanzania

Reynolds

Mfinanga

Sawe

et al. 2012

J Public Health Pol

103

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Even though sub-Saharan Africa faces a disproportionate burden of acute injury and illness, few clinical facilities are configured to take an integrated approach to resuscitation and stabilization. Emergency care is a high-impact and cost-effective form of secondary prevention; disease surveillance at facilities delivering acute and emergency care is essential to guide primary prevention. Barriers to emergency care implementation in the region include limited documentation of the acute disease burden, a lack of consensus on regionally appropriate metrics to facilitate impact evaluation, and the lack of coordinated advocacy for acute disease prevention and emergency care. Despite these challenges, interest in creating dedicated acute care facilities and emergency training programs is rapidly expanding in Africa. We describe one such initiative at Muhimbili National Hospital in Dar es Salaam, with a focus on the development of the emergency medicine residency program.

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“…Systems in France, Australia and Taiwan use data from emergency departments [10][11][12], a Canadian system uses over-the-counter pharmacy sales [13,14], and in the Netherlands data from both syndromic and surrogate data sources, such as employee absence records and prescription medications dispensed by pharmacies, are included in surveillance systems [15,16]. Currently systems based on Internet searches via search engines or on queries submitted to medical websites are being developed [17,18].…”

Section: Introductionmentioning

confidence: 99%

Value of syndromic surveillance in monitoring a focal waterborne outbreak due to an unusual Cryptosporidium genotype in Northamptonshire, United Kingdom, June – July 2008

Elliot¹,

Mallaghan

Modha

et al. 2010

Eurosurveillance

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The United Kingdom (UK) has several national syndromic surveillance systems. The Health Protection Agency (HPA)/NHS Direct syndromic surveillance system uses pre-diagnostic syndromic data from a national telephone helpline, while the HPA/QSurveillance national surveillance system uses clinical diagnosis data extracted from general practitioner (GP)-based clinical information systems. Data from both of these systems were used to monitor a local outbreak of cryptosporidiosis that occurred following Cryptosporidium oocyst contamination of drinking water supplied from the Pitsford Reservoir in Northamptonshire, United Kingdom, in June 2008. There was a peak in the number of calls to NHS Direct concerning diarrhoea that coincided with the incident. QSurveillance data for the local areas affected by the outbreak showed a significant increase in GP consultations for diarrhoea and gastroenteritis in the week of the incident but there was no increase in consultations for vomiting. A total of 33 clinical cases of cryptosporidiosis were identified in the outbreak investigation, of which 23 were confirmed as infected with the outbreak strain. However, QSurveillance data suggest that there were an estimated 422 excess diarrhoea cases during the outbreak, an increase of about 25% over baseline weekly levels. To our knowledge, this is the first time that data from a syndromic surveillance system, the HPA/QSurveillance national surveillance system, have been able to show the extent of such a small outbreak at a local level. QSurveillance, which covers about 38% of the UK population, is currently the only GP database that is able to provide data at local health district (primary care trust) level. The Cryptosporidium contamination incident described demonstrates the potential usefulness of this information, as it is unusual for syndromic surveillance systems to be able to help monitor such a small-scale outbreak.

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Establishing a nationwide emergency department-based syndromic surveillance system for better public health responses in Taiwan

Cited by 79 publications

References 28 publications

Syndromic Surveillance for Influenza in the Emergency Department–A Systematic Review

Syndromic Surveillance for Influenza in the Emergency Department–A Systematic Review

Emergency care capacity in Africa: A clinical and educational initiative in Tanzania

Value of syndromic surveillance in monitoring a focal waterborne outbreak due to an unusual Cryptosporidium genotype in Northamptonshire, United Kingdom, June – July 2008

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