Tennessee Uses eCR to Detect Candida auris Outbreak

Candida fungi

Electronic case reporting (eCR) is the automated, real-time exchange of case report information between electronic health records and public health agencies for up to 210 conditions. eCR improves the quality of public health data and reduces administrative burden for healthcare providers and public health systems. This allows public health officials to identify and respond to disease outbreaks faster to protect people in their communities from getting sick. Health officials in Tennessee used eCR data to rapidly detect and investigate an outbreak of Candida auris in less than a day.

Candida auris, also known as C. auris, is a type of yeast that can cause severe illness and spreads easily among patients in healthcare facilities. In early 2023, while reviewing eCR data in Tennessee’s disease surveillance system, a state epidemiologist found a cluster of C. auris cases in one Tennessee county. The epidemiologist notified the healthcare-associated infection team, which confirmed they had received several positive laboratory test results for C. auris.

The facilities had not onboarded for electronic laboratory reporting (ELR), which can lead to delays of 48 hours or longer following traditional reporting methods. Importantly, eCR data showed there were additional patients with positive laboratory results that the healthcare associated infection team had not yet received. The eCR data included contact information for each patient, which enabled public health officials to rapidly trace how people got infected, confirm the outbreak, and make data-driven decisions to prevent further spread.

Marisa Hopper, an eCR epidemiologist at the Tennessee Department of Health, emphasized the value of eCR in quickly identifying the outbreak, saying “Though this outbreak was spotted in the test environment of our disease surveillance system, I view this as a success. This scenario demonstrates the promise of eCR data for public health situational awareness, especially coupled with effective state-wide communication strategies and reporting mechanisms.”

Not only did eCR help Tennessee health officials quickly identify which patients were getting sick—including some that may have been missed with manual case reporting—it also provided the information needed to be able to quickly respond to the outbreak. As the number of healthcare facilities and health departments implementing eCR continues to expand nationwide, eCR will become an even more effective tool to protect everyday Americans against disease.