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Rizzo, Sara L (2006) SYNDROMIC SURVEILLANCE FOR THE EARLY DETECTION OF INFLUENZA OUTBREAKS. Master's Thesis, University of Pittsburgh. (Unpublished)

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Syndromic surveillance is a new mechanism utilized to detect naturally occurring and bioterroristic outbreaks. The public health significance is its potential to alert public health to outbreaks earlier and allow a timelier public health response. It involves monitoring data that can be collected in near real-time to find anomalous data. Syndromic surveillance includes school and work absenteeism, over-the-counter drug sales, and hospital admissions data to name a few. This study is an assessment of an extension of the use of syndromic surveillance as an improvement to the traditional method to detect more routine public health problems, specifically, the detection of influenza outbreaks. The assessment involves the prediction of outbreaks in four areas during the period October 15, 2003 to March 31, 2004. The four areas studied included Allegheny County, Pennsylvania, Jefferson County, Kentucky, Los Angeles County, California, and Salt Lake County, Utah. Two aspects of community activity were used as the method for syndromic surveillance, over-the-counter pharmaceutical sales and hospital chief complaints. The over-the-counter sales encompassed a panel of six items including anti-diarrheal medication, anti-fever adult medication, anti-fever pediatric medication, cough and cold products, electrolytes, and thermometers. Additionally, two of the seven hospital chief complaints used in the RODS open source paradigm were monitored. These were constitutional and respiratory chief complaints. Application of standard statistical algorithms showed that the system was able to identify unusual activity several weeks prior to the time when the local health departments were able to identify an outbreak using the standard methods. The largest improvement in detection using syndromic surveillance occurred in Los Angeles where the outbreak was detected 52 days before the Centers for Disease Control had declared widespread activity for the state. In each county over-the-counter sales detected the outbreak sooner then hospital chief complaints, but the hospital chief complaints detect the outbreaks consistently across the various algorithms. More conclusive evidence regarding the possible improvement in outbreak detection with syndromic surveillance can be obtained once a longer time frame has passed to allow more historical data to accumulate. Conducting additional studies on influenza outbreaks in other jurisdictions would also be useful assessments.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Rizzo, Sara
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairCostantino, Joseph Pcostan@nsabp.pitt.eduCOSTAN
Committee MemberTalbott, Evelyn Oeot1@pitt.eduEOT1
Committee MemberArena, Vincent Carena@pitt.eduARENA
Date: 2 February 2006
Date Type: Completion
Defense Date: 29 September 2005
Approval Date: 2 February 2006
Submission Date: 1 December 2005
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Biostatistics
Degree: MS - Master of Science
Thesis Type: Master's Thesis
Refereed: Yes
Uncontrolled Keywords: Disease Surveillance; Influenza; Syndromic Surveillance
Other ID:, etd-12012005-131519
Date Deposited: 10 Nov 2011 20:07
Last Modified: 15 Nov 2016 13:52


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