Public Health Chapter 22

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Ohio State University *

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2010

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Health Science

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Oct 30, 2023

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Public Health Chapter 22: Public Health Surveillance and Outbreak Investigation Disease Surveillance  Definitions and importance  Use of public health surveillance  Purposes of surveillance  Collaboration among partners  Nurse competencies  Data sources for surveillance Definitions  Disease surveillance  Event  Process data  Outcome data  Biological terrorism  Chemical terrorism  2 different types of data Uses of Public Health Surveillance  Estimate the magnitude of a problem  Determine geographical distribution  Portray the natural history of a disease  Detect epidemics; define a problem  Generate hypotheses; stimulate research  Evaluate control measures  Monitor changes in infectious agents  Detect changes in health practices  Facilitate planning Collaboration Partners  Federal agencies  State and local public health agencies  Hospitals  Health care providers

 Medical examiners  Veterinarians  Agriculture  Pharmaceutical agencies  Emergency management  Law enforcement agencies  911 systems  Ambulance services  Urgent care and emergency departments  Poison control centers  Nurse hotlines  School industry Collaboration – Shared Ideas  How to use algorithms to identify events to investigate?  How to investigate?  Whom to contact?  How and to whom information is to be disseminated?  Who is responsible for appropriate action? Nurse Competencies  Analytic assessment skills  Communication  Community dimensions of practice  Basic public health science skills  Leadership and systems thinking Dada Sources for Surveillance  Mortality data o Viral statistics reports  Morbidity data o Notifiable disease reports o Laboratory reports o Hospital discharge reports

o Billing data o Outpatient health care data o Specialized disease registries o Injury surveillance systems o Environmental surveys o Sentinel surveillance systems Notifiable Diseases  National notifiable diseases o Data published weekly in Morbidity and Mortality Weekly Report (NNWR)  State notifiable disease o Each state differs, but the usefulness of data depends on uniformity, simplicity, and timeliness Case Definitions  Essential for the following: o Establishing a uniform, standardized method of reporting and monitoring diseases o Understanding of the data being collected o Reducing the chance that different criteria will be used for reporting similar cases of a disease  Classification of cases o Suspected o Probable o Confirmed Types of Surveillance Systems  Passive system  Active system  Sentinel system  Special systems Passive System  Case reports or laboratory reports are sent to local health department

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o Case reports are summarized and forwarded to state health department, national government, or organizations responsible for monitoring the problem  National Notifiable Disease Surveillance System (NNDSS) o Voluntary system monitored by the Centers for Disease Control and Prevention (CDC) includes 68 infectious diseases/conditions with case definition considered important to the public’s health Active System  Public health nursing begins a search for cases through the following: o Local health providers o Health care agencies  Names the disease/event  Gathers data  Determines magnitude Special Systems  Collecting particular types of data  May be a combination of active, passive, or sentinel systems  Examples: o PulseNet system o BioNet o Laboratory Response Network (LRN) o Syndromic surveillance systems (bioterrorism) o Enhanced surveillance project (ESP) Steps in an Investigation  Confirm the existence of an outbreak  Verify the diagnosis/define a case  Estimate the number of cases  Orient data collected to person, place, and time  Develop and evaluate a hypothesis  Institute control measures and share findings Displaying of Data  Graphic illustration of what’s happening