McLeod Melissa, Mason Kylie, White Paul, Read Deborah
Regional Public Health, Lower Hutt, New Zealand.
Aust N Z J Public Health. 2009 Jun;33(3):289-94. doi: 10.1111/j.1753-6405.2009.00391.x.
To assess whether the Wellington Emergency Department (ED) Respiratory Syndromic Surveillance System may have provided early warning of the influenza outbreak in Wellington schools during 2005, and as a result might have provided the opportunity for an earlier or more effective public health response.
All events of respiratory syndrome, as defined by selected ICD 10 codes, were extracted from Wellington Hospital ED for the dates 1 January 2004 to 31 December 2006, and analysed using the Centers for Disease Control and Prevention (CDC) surveillance program, Early Aberration Reporting System (EARS). Daily events were analysed for total counts and by lifecycle age group. Seven day moving averages of the numbers of events were also calculated.
This study indicated that the surveillance system may have provided early warning of a potential respiratory outbreak. Regular exceedance flags were generated nine days prior to the initial notification received by Regional Public Health (RPH). The surveillance system also provided information on the type of illness (respiratory), the groups affected (5-14 year olds), and the progression of the outbreak (peak, end).
The surveillance system might have worked by providing early notification of the outbreak. This may have prompted RPH to earlier investigate the potential outbreak and may have led to an earlier response.
Surveillance of Emergency Department activity may be useful for early public health response.
评估惠灵顿急诊科(ED)呼吸道症状监测系统是否能为2005年惠灵顿学校流感爆发提供早期预警,从而是否能为更早或更有效的公共卫生应对提供机会。
从惠灵顿医院急诊科提取2004年1月1日至2006年12月31日期间选定国际疾病分类第十版(ICD 10)编码所定义的所有呼吸道综合征事件,并使用美国疾病控制与预防中心(CDC)的监测程序“早期异常报告系统(EARS)”进行分析。对每日事件按总数和生命周期年龄组进行分析。还计算了事件数量的七天移动平均值。
本研究表明该监测系统可能对潜在的呼吸道爆发提供了早期预警。在地区公共卫生部门(RPH)收到首次通报九天前就产生了定期超标警示。该监测系统还提供了有关疾病类型(呼吸道疾病)、受影响群体(5至14岁)以及疫情发展(高峰、结束)的信息。
该监测系统可能通过提供疫情早期通报发挥了作用。这可能促使RPH更早地调查潜在疫情,并可能导致更早的应对措施。
对急诊科活动进行监测可能有助于早期公共卫生应对。