Buehler James W, Whitney Ellen A, Smith Donna, Prietula Michael J, Stanton Sarah H, Isakov Alexander P
Emory Preparedness and Emergency Response Research Center, Department of Epidemiology, Emory University, Atlanta, Georgia 30322, USA.
Biosecur Bioterror. 2009 Jun;7(2):165-77. doi: 10.1089/bsp.2009.0013.
Since 2001, many state and local health departments have implemented automated systems to monitor healthcare use and to promptly identify and track epidemics and other public health threats. In 2007-08, we conducted case studies of selected events with actual or potential public health impacts to determine whether and how health departments and hospitals used these new systems. We interviewed public health and hospital representatives and applied qualitative analysis methods to identify response themes. So-called "syndromic" surveillance methods were most useful in situations with widespread health effects, such as respiratory illness associated with seasonal influenza or exposures to smoke from wildfires. In other instances, such as a tornado or hazardous material exposures, these systems were useful for detecting or monitoring health impacts that affected relatively few people, or they were used to affirm the absence of outbreaks following natural disasters or the detection of a potential pathogen in air samples. Typically, these data supplemented information from traditional sources to provide a timelier or fuller mosaic of community health status, and use was shaped by long-standing contacts between health department and hospital staffs. State or local epidemiologists generally preferred syndromic systems they had developed over the CDC BioSense system, citing lesser familiarity with BioSense and less engagement in its development. Instances when BioSense data were most useful to state officials occurred when analyses and reports were provided by CDC staff. Understanding the uses of surveillance information during such events can inform further investments in surveillance capacity in public health emergency preparedness programs.
自2001年以来，许多州和地方卫生部门已实施自动化系统，以监测医疗保健使用情况，并及时识别和跟踪疫情及其他公共卫生威胁。在2007 - 2008年期间，我们对选定的具有实际或潜在公共卫生影响的事件进行了案例研究，以确定卫生部门和医院是否以及如何使用这些新系统。我们采访了公共卫生和医院代表，并应用定性分析方法来确定应对主题。所谓的“症状”监测方法在具有广泛健康影响的情况下最为有用，例如与季节性流感相关的呼吸道疾病或接触野火烟雾。在其他情况下，如龙卷风或有害物质暴露，这些系统对于检测或监测影响相对较少人群的健康影响很有用，或者它们被用于确认自然灾害后没有疫情爆发，或检测空气样本中潜在病原体。通常，这些数据补充了来自传统来源的信息，以提供更及时或更全面的社区健康状况全貌，其使用受到卫生部门和医院工作人员之间长期联系的影响。州或地方流行病学家通常更喜欢他们自己开发的症状监测系统，而不是疾病预防控制中心的BioSense系统，理由是对BioSense不太熟悉，且较少参与其开发。当疾病预防控制中心工作人员提供分析和报告时，BioSense数据对州官员最有用。了解此类事件期间监测信息的用途可为公共卫生应急准备计划中监测能力的进一步投资提供参考。
