Community of Practice Updates

Community Highlights

Sujata Joshi Honored with CSTE Presidential Priorities Award at 2021 Annual Conference

Each year, the president of the Council of State and Territorial Epidemiologists (CSTE) develops a list of presidential priorities that focus the efforts of CSTE members and its executive board throughout the year. These priorities reflect key areas affecting the field of applied epidemiology. In 2018, the CSTE President Riptide Award was established to recognize an individual whose professional work had advanced the year’s presidential priorities. This year’s winner—Sujata Joshi (Northwest Portland Area Indian Health Board)—was announced at the 2021 CSTE Virtual Conference, held June 13–17.

Sujata Joshi received the 2021 Presidential Priorities Award for her abstract “Assessing Misclassification of American Indian/Alaska Native People in Washington’s Syndromic Surveillance Data.” Members of CSTE and the National Syndromic Surveillance Program (NSSP) Community of Practice (CoP) are proud of Sujata’s hard work and grateful that she has served as a co-lead for the NSSP CoP Race and Ethnicity Data Quality Improvement Workgroup. Thank you, Sujata, for leading the way with this vital work!

2021 Syndromic Surveillance Symposium

CSTE, in collaboration with NSSP, will convene the 2nd Annual Syndromic Surveillance Symposium in November 2021. Abstracts are being accepted here through August 20, 2021. If you have questions, please email Be on the lookout for more details from CSTE about the symposium and registration!

Have you checked out the NSSP CoP website?

The Council of State and Territorial Epidemiologists (CSTE) has a new online home for the National Syndromic Surveillance Program (NSSP) Community of Practice (CoP)! There, you can find information and resources about the community, ways to get involved, monthly call schedules, and much more. Check out the website and bookmark nsspcommunityofpractice.orgexternal icon for future visits.

Participate in Active NSSP CoP Slack Discussions

As a reminder, CSTE supports and moderates the NSSP Community of Practice Slack Workspace,external icon which acts as a communication and collaboration platform for advancing syndromic surveillance practice. Users can easily share information with peers, plan projects, and accelerate data analyses. Reap the benefits of collectively working with other NSSP BioSense Platform users at CDC; other federal agencies; and state, territorial, local, and tribal (STLT) public health departments through engagements facilitated by the channel.

If you want to speak with other syndromic surveillance experts across the country and are affiliated with a federal agency (as an employee or contractor) or STLT health department, this space is designed for YOU! Submit your request to join here.external icon

Note: The NSSP Community of Practice Slack Workspace will not be used to communicate to or with members of the public. As a public federal record, content on the channel is subject to disclosure under the terms of the Freedom of Information Act.

Encourage Others to Join!

We encourage members to share the opportunity to join the NSSP CoP with other syndromic surveillance practitioners. By completing this form,external icon any individual or organization interested in advancing syndromic surveillance can become a member. As a reminder, membership is voluntary, free of charge, and independent of CSTE membership.

Ways to Engage!

Are you looking for ways to participate and engage in NSSP CoP or related syndromic surveillance (SyS) activities? If so, check out these opportunities to participate:

  • Submit a SyS Success Story: We want to hear from you! Do you have a story to share with the Community but don’t have the time to write? CSTE can help! Just email your idea to, and they can take it from there.
  • Become a Data Quality Subcommittee Co-Chair: The DQ Subcommittee is currently looking for two co-chairs. If you’re interested or want to learn more, please email

To learn more or get involved, please email

If you have questions about the NSSP CoP, its highly collaborative user groups, the NSSP CoP Slack Workspace (a collaboration platform), or syndromic surveillance, please email

NSSP Community of Practice Monthly Call

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Loren Rogers (NSSP) kicked off this month’s NSSP CoP call by sharing program updates:

  • Leadership from U.S. Health and Human Services (HHS) asked NSSP for national numbers on heat-related illness and associated emergency department visits. The NSSP team provided data, which HHS used during a National Climate Taskforce meeting at the White House on June 24, 2021. The meeting included cabinet members and senior leadership from 17 federal agencies. NSSP is drafting a success story about the impact of using syndromic data to show heat-related illness and will post it on the NSSP website with other successes when finalized.
  • As previously shared with the community, NSSP data are being used for heat-related illness tracking. CDC’s Heat & Health Tracker is a public-facing dashboard that shows how extreme heat is affecting counties, populations at risk, and response resources.
  • NSSP is identifying and developing strategies for using the operational access and surveillance accounts to determine which sites (or facilities) have high-quality data. The goal is to identify data that could be used to conduct analyses that are not at the national or HHS regional levels. For example, NSSP recently published a paper describing 13 sites that have high-quality race and ethnicity data. The key takeaway is that operational access accounts, which are established to help assess data quality, can also help surveillance account users identify sites that are candidates for potential analysis. Sites would not be identified, since the data would be in aggregate form, and a site could have the option to opt-in or out. More details will be shared when available.

Rogers concluded by soliciting feedback on a draft of the data request flowchart being developed by the NSSP CoP Data Sharing workgroup. The flowchart proposes ways in which NSSP and sites could respond to data requests. If you want to be part of the Data Sharing Workgroup, please join or update your member preferences here.

Krystal Collier (AZ) introduced this month’s trending topic: The Real Water Public Health Investigation. She remarked on the importance of collaborating with various users within a system when trying to identify a specific outbreak and tailor the syndrome. Colleagues from state and local health departments shared their collaboration experiences and products developed from the Real Water investigations.

  • Jeanne Ruff (CDC) and Ying Zhang (Southern NV) described their investigation and emphasized the need to collaborate across different jurisdictions, partners, and agencies. Zhang shared an overview of the ICD-10 hospital discharge data query and the inclusion and exclusion criteria. A key takeaway from this investigation is the lack of ICD-10 code related to hepatitis of unknown causes. Consequently, the collaboration with NSSP staff and other community members was crucial to developing an appropriate query and conducting the investigation.
  • Zach Stein (ICF) shared the codes used to determine Real Water exposure with NSSP data. This collaborative effort established codes and key terms that could serve as a starting point that sites could use to customize essential queries so that these queries would align with what they saw in their public health jurisdiction.
  • Attendees heard from Krystal Collier (AZ), Ariella Dale (Maricopa County, AZ), Randon Gruninger (UT), and Mary Derby (Pima County, AZ) as they each gave an overview of their experiences with collaboration, use of newly developed queries, and notifying and coordinating across stakeholders during their investigations.
  • Kelly Carrey (CDC) explained how the R text mining tool evaluated themes and trends by using codes that matched emergency department visits. This report is available in RStudio and the GitHub for community members to review.

NSSP CoP Core Committee

  • Krystal Collier (AZ)—Core Committee Chair
  • Yushiuan Chen (Tri-County, CO)—Core Committee Deputy Chair
  • Data Quality Subcommittee Co-Chairs: If you’re interested in working with others and co-chairing this subcommittee, we are looking for two co-chairs. Please email
  • Diksha Ramnani (WI)—Data Quality Subcommittee Co-Chair
  • Teresa Hamby (NJ)—Knowledge Repository Curation Subcommittee Chair
  • Bill Smith (Maricopa Co., AZ)—Syndromic Surveillance and Public Health Emergency Preparedness, Response, and Recovery Co-Chair
  • Fatema Mamou (MI)—Syndromic Surveillance and Public Health Emergency Preparedness, Response, and Recovery Co-Chair
  • Rasneet Kumar (Tarrant Co., TX)—Syndrome Definition Subcommittee Co-Chair
  • Rosa Ergas (MA)— Syndrome Definition Subcommittee Co-Chair
  • Natasha Close (WA)—Technical Subcommittee Co-Chair
  • Caleb Wiedeman (TN)—Technical Subcommittee Co-Chair

Data Quality (DQ) Subcommittee

  • The Data Quality subcommittee is seeking two co-chairs. Please email for details.
  • In April 2021, CSTE solicited input from NSSP CoP Data Quality Subcommittee members to understand members’ current knowledge and expertise and inform future activities and call topics. Key topics included data quality tools and practices, data visualization, onboarding, standardization, common issues and obstacles, and questions related to new data quality teams and practitioners. During the June 2021 call, attendees broke out into three groups to discuss these topics and identify ways in which the DQ subcommittee can respond. If you are interested in presenting on any of these topics or want to make suggestions, please email
  • Link to previous call recordings and other resources from the DQ Subcommittee here.

Knowledge Repository (KR) Curation Subcommittee

Syndrome Definition (SD) Subcommittee

  • During the June 2021 Syndrome Definition call, Zach Stein (ICF) shared the recently added Chief Complaint and Discharge Diagnosis categories related to the mental health suite developed within the SD Subcommittee. Additionally, CSTE Consultant Meredith Jagger presented two novel wildfire-related syndromes:
    • wildfire and smoke visits
    • respiratory visits of interest
  • These syndromes were developed by members of the NSSP CoP; CSTE’s Climate, Health, and Equity Subcommittee; and CDC colleagues. Before the June call, subcommittee members were asked to validate the queries, share their findings, and be prepared to give feedback during the call. CSTE plans to release the Wildfire Guidance Document later this summer.
  • Check out previous call recordings and other resources from the SD Subcommittee here.

Syndromic Surveillance and Public Health Emergency Preparedness, Response, and Recovery (SPHERR) Subcommittee

  • During the June 2021 SPHERR call, Rita Seith (MI) presented on Michigan’s Overdose Outbreak Response. Seith explained how lessons learned from e-cigarette, or vaping, product use-associated lung injury (EVALI) informed the development of an anomaly response protocol and how a syndromic alert and its criteria were incorporated in the response plan. Several critical components should be considered when adding a syndromic alert, including:
    • automate wherever possible
    • set response levels
    • identify questions for alert assessments
    • conduct tabletop exercises beforehand
    • identify additional data sources
    • develop draft documents
  • Check out previous call recordings and other resources from the SPHERR Subcommittee here.

Technical Subcommittee

  • Check out previous call recordings and other resources from the Technical Subcommittee here.
CDC's Date Modernization Initiative to Advance Syndromic Surveillance

“Modernization” of our public health data and surveillance systems is one way in which CDC invests in the future of public health.

The CDC Public Health Data Modernization Initiative lays out a path to move us toward integrated systems that provide data more efficiently for public health action. This framework guides decisions for allocating resources to create interoperable systems (federal, state, local, and healthcare), coordinate investments across CDC (and with partners), develop next-generation tools (e.g., modeling, visualization, machine learning), and strengthen predictive analytics and forecasting. One objective of DMI is for syndromic surveillance to give a faster understanding of emerging health threats through electronic reporting of emergency department visits.

“This is a moment in time when our national leaders will seek to identify or build platforms to detect and monitor future health threats,” NSSP Lead Loren Rodgers said during a 2021 NSSP Community of Practice call. “I’d like to challenge the NSSP community to consider our place in a new public health infrastructure. I don’t know of another program that is so purpose-built for this task with the ability to scale to include new data sources and analytics and to share these data with allied [public health] jurisdictions and trusted partners. Our syndromic community exemplifies innovative approaches that other surveillance systems aim to implement.”

CDC’s earlier modernization efforts laid the groundwork that supports NSSP’s current approach to surveillance and—bolstered by CDC’s Data Modernization Initiative—positions the program to better protect our country from all types of public health threats.