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Real-time Outbreak and Disease Surveillance (RODS) System in Ohio: Enhancing Public Health Surveillance

Learn about the Real-time Outbreak and Disease Surveillance (RODS) system in Ohio, its features, and how it is used to monitor patterns suggestive of infectious disease outbreaks. Discover its applications in influenza surveillance, retrospective outbreak studies, animal-based disease surveillance, and specialized investigations.

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Real-time Outbreak and Disease Surveillance (RODS) System in Ohio: Enhancing Public Health Surveillance

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  1. Staffing RODS in OhioFebruary 23rd, 2006Biosurveillance Information Exchange Working GroupRutgers UniversityPiscataway, NJ Loren Shaffer, MPH Loren.Shaffer@odh.ohio.gov Early Event Surveillance Supervisor

  2. Our Current Systems • Real-time Outbreak and Disease Surveillance (RODS) System • BioSense • Influenza-like Illness Sentinel Providers • School Absenteeism • Wildlife Disease Surveillance • Ohio Disease Reporting System • Early Aberration Reporting System (EARS)

  3. RODS • Developed at the University of Pittsburgh • Utilizes a hospital’s existing HL-7 socket to receive real-time data • Interprets free-text chief complaint from emergency department registration database and groups into one of seven prodromes • Collects information from retailers about sales of over-the-counter medications • Provides immediate analysis for trends and anomalies suggestive of disease outbreaks • Secure web access by users

  4. HIPAA • Export of data for public health surveillance is permitted (45 CFR 164.512) • Prior written authorization of individual is not required (45 CFR 164.512)

  5. End Users of RODS in Ohio • Total = 174 • State Health Department = 6 • Local Health Department = 87 • 88 of 135 LHDs represented • Hospital = 77 • Other = 4

  6. RODS Alerts • February 2004 to February 2006 • 310 unique alerts received • Seasonal Elevation – 40% • Outbreaks – 22% • Data Errors – 9% • No Cause Identified – 28% • 53% handled at State level • 47% forwarded to local epidemiologist

  7. What are we doing with RODS? • Monitoring for patterns suggestive of an infectious disease outbreak • Influenza surveillance study & efforts • Retrospective outbreak study (improved specificity) • Adaptation to animal-based sources for emerging infectious disease surveillance • Real-time clinical data analysis • Environmental surveillance • Specialized investigations

  8. Influenza

  9. Influenza

  10. Known Outbreak OTC Sales ED Registrations P(↑Thermometer|Outbreak N)= xt P(↑Cold Relief|Outbreak N)= xcr P(↑Lozenges|Outbreak N)= xl P(↑Chest Rubs|Outbreak N) = xchr P(↑Bronchial Remedies|Outbreak N)= xbr P(↑Antifever|Outbreak N)= xa P(↑Other Categories|Outbreak N)= x P(↑Consitutional|Outbreak N)= xc P(↑Botulinic|Outbreak N)= xb P(↑Respiratory|Outbreak N)= xr P(↑GI|Outbreak N) = xg P(↑Hemorrhagic|Outbreak N)= xh P(↑Neurologic|Outbreak N)= xn P(↑Rash|Outbreak N)= xra P(Combination of Above|Outbreak)=?

  11. Zoonotic Disease Surveillance • Adapt RODS to … • Veterinary Diagnostics Laboratory • Lab orders batched & transmitted via ftp • Parsed into syndrome categories based on previous mapping of tests • Spatial/temporal analysis at the ZIP code-level • Veterinary Clinic • Reason for Visit field included • Near real-time export via ftp • Co-co classifier parses free text into syndrome category • Spatial/temporal analysis at the ZIP code-level

  12. Areas for Attention & Assistance Continuous Daily Emergency Department Categorize Into Syndromes Daily Totals Totals Higher Than Expected? Continuous Alert Chief Complaint and Patient Demographics In HL7 messages Review Trends Historical Models Updated monthly Valid Alert? Initiate Response

  13. Identified Needs • User Training→ 1:1 & Conference Workshops • User Protocols→ Developed Protocol Document • User Support→ 24/7 Coverage Pilot • 24/7 Coverage→ System Enhancement to Permit Alerts to Jurisdictions • Advisory Group(s)→ Expansion of ODRS Advisory Committee • Integration with Other Surveillance Systems→ Ongoing Evaluations and Study Projects • Local Health Department Resources → ?

  14. Questions? Loren Shaffer Loren.Shaffer@odh.ohio.gov 614-728-3343

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