Detection of an Influenza Epidemic Using an Electronic Medical Record-Based Bioterrorism Surveillance System During the 2002 Winter Olympics

Details

• Personal Author:
  Alder SC ; Hegmann KB ; Hegmann KT ; Lyon JL ; Magill M ; Wendelboe AM ; White, Gary L.
• Description:
  Surveillance has traditionally, though inefficiently, relied upon paper records and phone calls from physicians. The 2002 Winter Olympics provided an opportunity to implement a bioterrorism surveillance system using an electronic medical record (EMR). This EMR allowed for daily updates of diagnoses. Statistical process control was used to monitor daily ICD-9 coded diagnoses across a clinic system (approximately 100,000) for syndromic patterns of disease consistent with bioterrorism or natural epidemics. An influenza epidemic was identified in January 2002. A significant proportion of cases (rapid test positive) were unexpectedly affected by nausea (16.6%), vomiting (17.9%) and diarrhea (4.9%) that may have resulted in additional cases with significant gastrointestinal symptoms remaining undiagnosed. Subsequent analyses of the prior influenza season found still higher prevalences of nausea (31.1 %) and vomiting (24.4%) in those testing positive. Additionally, antiviral prescriptions were significantly greater in 2002 than 2001 (52.4% vs. 17.8%, p<0.05), likely augmented in part by real-time feedback !O clinicians. However, rapid testing of high probability cases decreased substantially in 2002 (Odds ratio = 0.35, 95% CI = 0.25, 0.50), suggesting greater reliance on clinical diagnosis. Improved outbreak surveillance in the future using such systems appears promising for both major events and routine communicable diseases. [Description provided by NIOSH]
• Subjects:
  Biological Warfare Agents Communicable Diseases Diagnosis Electrical Equipment And Supplies Epidemiology Health Care Facilities Workforce And Services Occupational Health Respiratory System Respiratory Tract Diseases Safety Viral Diseases

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• Keywords:
  Biological-warfare-agents Biological-weapons Clinical-diagnosis Clinical-tests Diagnostic-techniques Diagnostic-tests Electronic-devices Infection-control Infectious-diseases Medical-monitoring Respiratory-infections Surveillance-programs Viral-infections

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• ISSN:
  0002-9262
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Abstract or Summary
• Place as Subject:
  OSHA Region 8 ; Utah
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  157
• Issue:
  11
• NIOSHTIC Number:
  nn:20037576
• Citation:
  Am J Epidemiol 2003 Jun; 157(11)(Suppl):S50
• Federal Fiscal Year:
  2003
• Performing Organization:
  University of Utah
• Peer Reviewed:
  False
• Start Date:
  20050701
• Source Full Name:
  American Journal of Epidemiology
• Supplement:
  Suppl
• End Date:
  20280630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:7e137986a7f7be1998d11b13bc05a4facbe766989bce6cdb657af2af6248954adacd29887fbd457520308483da685059ea6f30acb08df4ff2a7d797536442e84
• Download URL:
  https://stacks.cdc.gov/view/cdc/188648/cdc_188648_DS1.pdf
• File Type:
  [PDF - 178.53 KB ]