Community of Practice Updates

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Policy for Federal Access to NSSP Data

During the November 2022 CoP Monthly meeting, Acting Program Lead Karl Soetebier informed the community of efforts to make NSSP data more accessible and improve collaboration toward common goals.

In December 2022, Soetebier updated site administrators of NSSP’s ongoing work related to data use. He explained how expanded access to NSSP data during the COVID-19 public health emergency enabled innovation in areas such as trend indicators and classification, anomaly detection, and text mining by age and geography. The ability to work this way routinely, outside the context of a public health emergency, is not permitted by the current data use agreement.

To keep community members informed throughout this process, a new Policy for Federal Access to NSSP Data web page will be available in spring 2023. It will contain information on the development and long-term benefits we hope to achieve with the new agreement, so please stay tuned.

Eight New Year’s Resolutions That’ll Improve Your State’s Surveillance

The experts in syndromic surveillance learn from the best—each other. During the 2022 Syndromic Surveillance Symposium, hosted by the Council for State and Territorial Epidemiologists (CSTE), presenter Michael Coletta (InductiveHealth Informatics) showcased public health successes that can be applied across communities. What better time than now to consolidate these practices into resolutions you can take in 2023 to creatively integrate syndromic data into your surveillance program?

Best Practices for Syndromic Surveillance in 2023
  1. Stay alert and astute; don’t become complacent or negative about data limitations.
  2. Set up alerting capabilities for known or possible situations.
  3. Set up response protocol and follow through when alerted.
  4. Characterize event and spread; use all available data, demographics, etc.
  5. Identify and inform probable risk factors, causes, and exposures. Can merge syndromic surveillance with traditional methods like interviews.
  6. Perform active case finding.
  7. Communicate with partners and the public, especially about the actions they can take.
  8. Be decisive with the information you have; act appropriately by initiating change in the environment or by implementing interventions.

Coletta acknowledged numerous instances when health departments have followed these practices and collaborated with partners to successfully change policy, develop interventions, and educate others. Combined, these efforts are improving daily life for many people. Some examples can be found on the NSSP website: Syndromic Surveillance in Action. Coletta cited several examples:

  • Washington Department of Health-Rapid Health Information Network detected potential opioid cluster in Yakima County among a mix of race/ethnicities age 20–50 years and issued a press release to inform community and pharmacies to dispense Narcan.
  • The New York City Department of Health and Mental Hygiene issued an advisory to communicate with the public and health organizations about emergency department visits related to a cluster of synthetic cannabinoids (K2).
  • Clinicians reported an unusual cluster of lung injuries to state health departments. Syndromic surveillance was used to characterize the event, understand its spread, and determine cause and risk factors. Information was disseminated and some products were removed from the market. The New England Journal of Medicine issued a special report highlighting the work of syndromic surveillance for e-cigarette, or vaping, product use-associated lung injury.
  • In Boston, Massachusetts, an extreme increase in bicycle-related pedestrian injuries prompted public health to collaborate with emergency medical services and community partners to prevent further injuries and save lives. Syndromic data identified those populations at greatest risk, and combined data sets characterized risk factors. Data helped officials not only target education efforts to the most affected populations—college towns—but also identified intersections on which to focus redesign efforts. This smart use of syndromic data reduced injuries.
  • Syndromic surveillance by a state health department detected a dangerous exposure to chlorine gas after several children visited local emergency departments with symptoms of coughing and difficulty breathing. Environmental health workers found violations at the pool, resulting in a temporary closure and an opportunity to educate the pool company on proper and safe pool management.
Adapted from a presentation by Michael Coletta, “Successes, Solutions, and Similarities: Ways to Maximize Use of Timely Data,” at the 2022 Syndromic Surveillance Symposium. Michael Coletta is a Senior Manager at InductiveHealth Informatics and leads the firm’s syndromic surveillance practice. The annual symposium is hosted by the Council for State and Territorial Epidemiologists (CSTE).
Perfection paralyze quote

—December 7, 2022, presentation at the 2022 Syndromic Surveillance Symposium

NSSP CoP Monthly Meeting

The National Syndromic Surveillance Program (NSSP) Community of Practice (CoP) cancelled its December meeting in lieu of the 2022 Syndromic Surveillance Symposium held December 6–8, 2022. Recordings for previous monthly CoP calls are posted in the Knowledge Repository. We encourage you to join the January call scheduled for the 25th of the month.

Reminders and Announcements

  • Session recordings and slides from the 2022 Syndromic Surveillance Symposium, held December 6–8, 2022, are available in the NSSP CoP Knowledge Repository.
  • CSTE Annual Conference 2023: Meet, build relationships, and network with colleagues and experts in areas including informatics, infectious diseases, substance use, chronic disease, and injury control. Join more than 2,500 public health epidemiologists from across the nation in workshops, plenary sessions, oral breakout sessions, roundtable discussions, and poster The plan is to hold conference sessions in person; however, CSTE will monitor circumstances and public health recommendations of group gatherings.

Worthwhile Reads on SyS

Between day-to-day surveillance and emergency response activities, 2022 has been quite the year for applying syndromic surveillance (SyS), integrating syndromic data with other sources, and doing so FAST. Thanks to the monthly NSSP Community of Practice meetings—and, of course, symposiums, conferences, and trainings—some of the best applications of SyS are readily available from expert practitioners in our own community. Still, there’s a lot to learn and read for inspiration. A quick web scan found some articles from 2022 that are worthwhile to check out:

Addictive Behaviors Reports: Analysis of trends and usage of ICD-10-CM discharge diagnosis codes for poisonings by fentanyl, tramadol, and other synthetic narcotics” [Editorial note: NSSP data are used to detect overdose spikes and clusters. Article notes a significant increase in ED visits for synthetic opioid overdoses.]

American Journal of Public Health: “Timing and Trends for Municipal Wastewater, Lab-Confirmed Case, and Syndromic Case Surveillance of COVID-19 in Raleigh, North Carolina “Brief report: Using syndromic surveillance to monitor MIS-C associated with COVID-19 in Military Health System beneficiaries” [Editorial note: Multisystem inflammatory syndrome in children, MIS-C, is a rare but serious condition associated with COVID-19 in which different body parts become inflamed. This brief describes the use of ESSENCE to detect potential cases of MIS-C within a military health system.]

International Journal of Environmental Research and Public Health: Spatial Syndromic Surveillance and COVID-19 in the U.S.: Local Cluster Mapping for Pandemic Preparedness

International Journal of Infectious Diseases: Syndromic surveillance of respiratory infections during protracted conflict: experiences from northern Syria 2016–2021 [Editorial note: During conflict (vaccine interruption, displacement, etc.), Syria used two syndromic surveillance systems to detect outbreaks. One system, set up by the World Health Organization and Syrian Ministry of Health, serves government-controlled areas; the other system serves areas outside government control.]

Journal of Public Health Management and Practice: “An Evaluation of Syndromic Surveillance-Related Practices Among Selected State and Local Health Agencies

Preventive Veterinary Medicine: Veterinary syndromic surveillance using swine production data for farm health management and early disease detection

Public Health Practices: Protocol to implement a syndromic surveillance survey of COVID-19 in Malawi

World Health Organization: “Syndromic screening for COVID-19 of travellers crossing land borders: scientific brief, 21 December 2022” [Editorial note: Borders add complexity to intervention design.]

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Slack Channels

It’s easy to join. And the community is always exchanging ideas, exploring possibilities, and discussing topics relevant to today’s surveillance challenges.

So what are your colleagues discussing?

  • #covid19
  • #data-quality
  • #data-sharing
  • #drug-overdose-use
  • #environmental-health-and-severe-weather
  • #essence-user
  • #general
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  • #lab-data
  • #mortality-data
  • #national-data-requests-sop
  • #nssp-cop
  • #planned-analyses-and-publications
  • #race-and-ethnicity
  • #random
  • #r-user
  • #sas-user
  • #spherr
  • #syndrome-definitions
  • #technical
  • #training
  • #violence-surveillance

Find and Join Channels

  1. Hover cursor over “Channels” on left side of Slack space.
  2. Click the three dots icon that appears next to “Channels” titled “Section Options.”
  3. Select “Browse Channels.”
  4. Find and join any channel that looks interesting!