193637 Syndromic Surveillance for enhanced detection of waterborne disease outbreaks?

Monday, November 9, 2009: 2:52 PM

Michelle Lee Kirian, MPH , Environmental Health Section, San Francisco Department of Public Health, San Francisco, CA
Syndromic surveillance has received much attention as a method for health departments to accelerate the detection of and the reaction to outbreaks. However, the ability of syndromic surveillance to enhance the detection of waterborne disease outbreaks and under what circumstances has not been demonstrated. In our current study our aims are to investigate whether monitoring of over-the-counter drug sales can be used to detect regional or local diarrhea waterborne outbreaks earlier than traditional surveillance, and if so, to determine appropriate alert levels. For the analysis we are employing time series and control chart techniques on retrospective over-the-counter drug sales data, provided by the National Retail Data Monitor, and reports of diarrhea disease cases and outbreaks to four county health departments. We will present the model development process and sensitivity, specificity and timeliness estimates for a range of models and model parameters. We will also discuss the problems and benefits in using this data or technique, and will develop recommendations on the implementation of syndromic surveillance with over-the-counter drug sales data in the early detection of waterborne disease outbreaks.

Learning Objectives:
Evaluate the benefits and disadvantages to syndromic surveillance in waterborne disease detection. Describe some time series and control chart methods that can be used to monitor syndromic and other time series data. Discuss the difficulties in applying syndromic surveillance.

Keywords: Surveillance, Infectious Diseases

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: In 2005 I earned my MPH from the University of California, Berkeley. Since then I have been working at the San Francisco Department of Public Health on a collaborative effort with the San Francisco Public Utilities Commission. As part of this collaboration I coordinate the San Francisco Bay Area Cryptosporidiosis Surveillance Project which includes disease surveillance activites (case interviews, investigations, analysis), emergency preparedness (plans, exercises) and other activities involving health and water agencies across five California counties. In 2008 this collaboration lead to the publication of "Multi-Jurisdictional investigation of interactive fountain-associated cryptosporidiosis and salmonellosis outbreaks" in the Journal of Epidemiology and Infection for which I was lead author. One of my current projects, described in this submission, is part of a larger, multi-faceted water security initiative supported by funding through the EPA.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.