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APHA Scientific Session and Event Listing

Recorded presentation

Cara J. Hausler, MPH¹, John Herbold, DVM, MPH, PhD², Roger Sanchez³, Fernando A. Guerra, MD, MPH⁴, and Cherise J. Rohr-Allegrini, PhD, MPH³. (1) Communicable Disease Division, San Antonio Metropolitan Health District, 332 W. Commerce St., Suite 104, San Antonio, TX 78205, 210-207-8838, carajean2007@yahoo.com, (2) University of Texas School of Public Health, San Antonio Regional Campus, University of Texas Health Science Center Houston, 8550 Datapoint, Suite 200, San Antonio, TX 78229, (3) Public Health Preparedness, San Antonio Metro Health District, 8005 Challenger Dr., San Antonio, TX 78235, (4) Health Director, San Antonio Metro Health District, 332 W. Commerce, San Antonio, TX 78205

Background: Beginning August 30, 2005, San Antonio received more than 12,000 evacuees from Hurricane Katrina. All were offered Hepatitis A and tetanus vaccinations upon arrival. Two weeks later, the city received another 12,000 evacuees from Hurricane Rita. By mid-October, 2005, most of the shelter residents moved to more permanent housing; the in-shelter population was approximately 1,000 people. With the onset of flu season there was concern regarding the potential for spread of infectious diseases in the shelter. San Antonio Metro Health District (SAMHD) established a syndromic surveillance system with Comprehensive Health Services (CHS) who provided on-site health care. CHS staff was in daily contact with SAMHD epidemiologists to report symptoms of concern until the shelter closed on December 23, 2005.

Methods: Each visit was recorded by date, demographic information, chief complaint and medical disposition. Logs were obtained daily and subsequently entered into a Microsoft Access database and analyzed in Excel.

Results: Over 4000 visits during a nine week period were recorded and analyzed. Preliminary findings indicate that repeat visits made up to 50% of encounters. Approximately 20% of visits were due to chronic illnesses. Acute care encounters such as headache, pain, allergy and insomnia encompassed approximately 75% of the total. Of the acute care encounters approximately 20% had infectious disease potential as gastrointestinal and respiratory syndromes.

Conclusions: The presence of health care services and syndromic surveillance provided the opportunity to recognize and document any disease outbreak at this long-term shelter. Constant vigilance allowed SAMHD to reassure a concerned community.

Learning Objectives:

• Gain insight into methods used and practical considerations involved in establishing a surveillance system.
• Identify key elements of long-term shelter surveillance design and management.
• Recognize usefulness in response to potential outbreaks of infectious disease.

Keywords: Epidemiology, Surveillance

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation