The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #62267

Kraig E. Humbaugh, MD, MPH¹, Carl E. Hall, PhD¹, Michael J. Silvers, DO, MPH¹, Linda K. Goss, RN, BS², and Ruth M. Carrico, PhD, RN, CIC². (1) Louisville Metro Health Department, 400 E. Gray Street, Louisville, KY 40202, 502-574-6677, kraig.humbaugh@loukymetro.org, (2) Infection Control, University of Louisville Hospital, 530 S. Jackson St., Louisville, KY 40202

Introduction The Kentucky Derby Festival, which attracts hundreds of thousands of persons to outdoor venues in Louisville each May, is a potential target for a biological or chemical weapons attack. Daily syndromic surveillance was conducted during the 4 weeks surrounding the Kentucky Derby, to determine if unusual patterns of illness were noted in patients presenting to local emergency departments (EDs).

Methods Data were collected at the EDs of 12 of 13 local hospitals, using either: 1) personal digital assistants (PDAs) loaded with locally developed collection and database software or 2) pre-existing hospital-specific computerized record systems. Hospital personnel were instructed to categorize the reason for each patient’s visit into one of 7 pre-determined syndromes. Data were transmitted daily to the local health department via electronic mail for compilation and analysis.

Results Baseline data concerning ED use by syndrome were recorded for area hospitals, and no large increase for a particular syndrome was noted during the study period. Hospitals that used computerized record systems were more compliant with their data submission; however, those using PDAs provided data that might not otherwise have been collected.

Conclusions Local health departments and hospitals can cooperate to accomplish continuous, active syndromic surveillance in a large U.S. city during a period of increased risk of terrorist activity. Obtaining commitments from pre-identified key stakeholders in the community and appropriately training and educating hospital staff contribute to success. The use of PDAs in hospital EDs should not be overlooked as an inexpensive, viable method of surveillance for disasters.

Learning Objectives:

• 1) Discuss key components of planning and implementing community-wide syndromic surveillance at hospitals
• 2) List some of the benefits and drawbacks of using pre-existing computerized record systems versus personal digital assistants (PDAs) for collecting data
• 3) Understand the importance of establishing baseline data and analyzing emergency department data daily, in order to detect deviations from the baseline distribution of illness in the community

Keywords: Bioterrorism, Surveillance

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.