Community of Practice Updates

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Policy for Federal Access to NSSP Data

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

In early 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.

In early 2023, to build on public health response innovations and to continue to enhance data use, CDC began designing a new NSSP agreement to incorporate lessons learned from the COVID-19 response, enable close collaboration between sites and CDC, enable new innovations and services for sites, and maximize responsible use of data and provide timelier synthesis of findings and recommendations. Further, this agreement would help respond to the top concerns raised by public health departments in the Review of Federal Access to National Syndromic Surveillance Program Data: Findings and Implementation Strategies, posted by the Council of State and Territorial Epidemiologists (CSTE) in February 2023.

CDC has made a thoughtful choice to change from a data use agreement (DUA) to a memorandum of understanding (MOU) to better reflect the collaborative nature of the agreement. By refocusing the DUA as an MOU, the collaborative and participatory goals of the partnership across federal, state, and local public health authorities become more transparent. Details of the DUA/MOU are being worked through.

NSSP CoP Monthly Meeting

The National Syndromic Surveillance Program (NSSP) Community of Practice (CoP) met on May 24, 2023. On average, 100 to 120 people participate in these monthly meetings. Recordings for CoP monthly calls are posted in the Knowledge Repository. The June NSSP CoP monthly call is cancelled because the 2023 CSTE Annual Conference is being held June 25–29, 2023.

Syndromic Surveillance for Mass Gathering Events

William Smith with the Maricopa County, Arizona Department of Public Health (MCDPH), presented on mass gathering event surveillance using syndromic surveillance. Maricopa County is one of the largest counties in the United States and hosts large events such as the Waste Management Open PGA tournament and, earlier this year, the Super Bowl.

Syndromic surveillance for these events relies specifically on pre-diagnostic symptoms and chief complaints that are assessed via a 50-question survey administered to those seeking care at a first aid tent. The survey is broken down into four main categories including visit classification, illness, injury, and general information. The visit classification determines if the patient is being seen for an injury, illness, or other reason. When patients are seen for an illness, they are asked about their symptoms including what types of symptoms they’re experiencing, when symptoms began, and what caused those symptoms. When patients are being seen for injuries, they are asked about when and where the injury occurred, whether it was intentional or unintentional, and information about the type of injury. Patient surveys are anonymous and voluntary. The results of this type of syndromic surveillance have led to prevention of injury due to uneven floors and early detection of disease clusters and helped to address reports of lack of water and sunscreen for future events.

Additionally, MCDPH partners with the Arizona Department of Health Services (ADHS) to use ESSENCE dashboards to inform surveillance efforts for mass gathering events. In addition to common syndromes found in ESSENCE, MCDPH has developed event-specific queries that search free-text fields for the event name, team or performer names, hazmat queries, chemical exposure discharge diagnosis (DD) queries, burn and corrosion DD queries, radiological rule-out queries, and radiological isotope queries. MCDPH and ADHS also collaborate to check data quality, completeness, and timeliness of data during these events.

The presentation is available on the NSSP CoP Knowledge Repository here.

Wildfire Surveillance

Introduction to Syndromic Surveillance (SyS) Methodology