O'Donnell Francis L, Stahlman Shauna, Fan Michael
MSMR. 2018 Feb;25(2):8-15.
This report summarizes available health record information about the occurrence of vector-borne infectious diseases among members of the U.S. Armed Forces during a recent 7-year surveillance period. Information about confirmed, possible, and suspected cases was obtained from electronic reports of reportable medical events (RMEs) and records of diagnoses documented during hospitalizations and outpatient healthcare encounters. Lyme disease and malaria were the most common diagnoses among confirmed and possible cases. Diagnoses of chikungunya and Zika were elevated in the years following their respective entries into the Western Hemisphere. Large numbers of diagnoses of arboviral diseases were recorded in the category of suspected cases, but the overwhelming majority were associated with coding errors and tentative diagnoses not subsequently confirmed. For many confirmed cases, documentation could not be found in healthcare databases for positive laboratory tests that would be the basis for confirmation. Discussion covers the limitations of the available data and the importance to surveillance of RMEs, confirmatory laboratory tests, and accurate recording of diagnoses and their codes.
本报告总结了近期7年监测期内美国武装部队成员中媒介传播传染病发生情况的现有健康记录信息。关于确诊、可能和疑似病例的信息来自可报告医疗事件（RME）的电子报告以及住院和门诊医疗就诊期间记录的诊断记录。莱姆病和疟疾是确诊和可能病例中最常见的诊断。基孔肯雅热和寨卡病毒病的诊断在它们各自进入西半球后的几年里有所增加。在疑似病例类别中记录了大量虫媒病毒病的诊断，但绝大多数与编码错误和随后未得到证实的初步诊断有关。对于许多确诊病例，在医疗保健数据库中找不到作为确认依据的阳性实验室检测的文件记录。讨论涵盖了现有数据的局限性以及RME监测、确证实验室检测以及诊断及其编码准确记录的重要性。
