Talan D A, Moran G J, Mower W R, Newdow M, Ong S, Slutsker L, Jarvis W R, Conn L A, Pinner R W
Olive View-UCLA Medical Center, Sylmar, CA, USA.
Ann Emerg Med. 1998 Dec;32(6):703-11. doi: 10.1016/s0196-0644(98)70071-x.
Acute infectious disease presentations among many at-risk patient groups (eg, uninsured, homeless, and recent immigrants) are frequently seen in emergency departments. Therefore EDs may be useful sentinel sites for infectious disease surveillance. This article describes the background, development, and implementation of EMERGE ncy ID NET, an interdisciplinary, multicenter, ED-based network for research of emerging infectious diseases. EMERGE ncy ID NET was established in cooperation with the National Center for Infectious Diseases, Centers for Disease Control and Prevention (CDC) as part of the CDC's strategy to expand and complement existing disease detection and control activities. The network is based at 11 university-affiliated, urban hospital EDs with a combined annual patient visit census of more than 900,000. Data are collected during ED evaluation of patients with specific clinical syndromes, and are electronically stored, transferred, and analyzed at a central receiving site. Current projects include investigation of bloody diarrhea and the prevalence of Shiga toxin-producing Escherichia coli, animal exposures and rabies postexposure prophylaxis practices, seizures and prevalence of neurocysticercosis, nosocomial ED Mycobacterium tuberculosis transmission, and hospital isolation bed use for adults admitted for pneumonia or suspected tuberculosis. EMERGE ncy ID NET also was developed to be a mechanism for rapidly responding to new diseases or epidemics. Future plans include study of antimicrobial use, meningitis, and encephalitis, and consideration of other public health concerns such as injury and national and international network expansion.
在许多高危患者群体(如未参保者、无家可归者和新移民)中,急性传染病的症状在急诊科屡见不鲜。因此,急诊科可能是传染病监测的有用哨点。本文介绍了“急诊传染病网络(EMERGE ncy ID NET)”的背景、发展和实施情况,这是一个跨学科、多中心、基于急诊科的新兴传染病研究网络。“急诊传染病网络”是与美国疾病控制与预防中心(CDC)的国家传染病中心合作建立的,作为CDC扩大和补充现有疾病检测与控制活动战略的一部分。该网络以11家大学附属医院的城市急诊科为基地,这些急诊科的年患者就诊总数超过90万。数据在对患有特定临床综合征的患者进行急诊科评估时收集,并在一个中央接收点进行电子存储、传输和分析。当前的项目包括对血性腹泻和产志贺毒素大肠杆菌的患病率的调查、动物接触情况和狂犬病暴露后预防措施、癫痫发作和神经囊尾蚴病的患病率、急诊科医院内结核分枝杆菌传播,以及因肺炎或疑似结核病入院的成人使用医院隔离病床的情况。“急诊传染病网络”也是为快速应对新疾病或疫情而设立的机制。未来计划包括对抗菌药物使用、脑膜炎和脑炎的研究,以及对其他公共卫生问题(如伤害)的考虑,还有国家和国际网络扩展方面的考虑。