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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Robert James Rydman, PhD, Department of Emergency Medicine, Cook County Hospital/Rush University, 1900 W. Polk St. 10th floor, Chicago, IL 60612, 312-996-8010, rjrydman@uic.edu, Rebecca Roberts, MD, Department of Emergency Medicine, Cook County Hospital, 1900 West Polk, 10th Floor, Chicago, IL 60612, Pamela Diaz, MD, Chicago Department of Health - CDC, Ogden and Taylor, Chicago, IL 60612, and Brandon Zagorski, MPH, Dept Emerg Med, Cook County Hospital, 1900 W. Taylor Street, 10th Floor, Chicago, IL 60612.
Background: Hospital Emergency Departments (ED) have over 100 million patient visits per year making them an ideal place for surveillance of events resulting from possible bioterrorism. As part of a CDC-funded B2 Bioterrorism project, an urban ED with an annual census of 120,000 visits studied the rates of Influenza-Like-Illness (ILI) in the ED over a 4.5 person year cycle of events. Methods: Longitudinal cross sectional analysis of ED database consisting of 4.5 years, 1/1/97-7/1/01, 596,306 visits. Case definition of ILI followed the Centers for Disease Control (CDC) definition of: fever GT 100 degrees, with cough or sore throat. Unduplicated case enumerations were stratified by adult (GE 16 years) and pediatric (LT 16 years) age groups. A time-series ARIMA analysis was performed by month-year to detect statistical outliers. Results: 596,306 visits were analysed. Number of unduplicated patients was 281,358 (49.8%). Pediatric cases ranged from 36/1000 to 150/1000, and adult cases from 6/1000 to 20/1000 per month. Rises in pediatric cases tended to occur earlier than adult cases. The year from 9/98 through 3/99 resulted in statistically significant elevations in adult cases compared to all other years. Conclusion: Syndromic surveillance defined as case detection by clinical signs, symptoms, chief complaint, or diagnosis is the mainstay of ED bioterrorism research. Such surveillance systems must be able to detect unusual clustering or increases in patient volume; unusual age distributions for common illnesses; unusual temporal of geographic clustering of illnesses; diseases not endemic to area; and sudden increases in non-specific syndromes. Determining sensitivity, specificity, and predictive value of such systems requiring a public health response remain issues for future research.
Learning Objectives:
Keywords: Bioterrorism, Emergency Department/Room
Related Web page: www.ccbh.org
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.