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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">MERS PUI Surveillance and Restrospective Identification in
ESSENCE-FL, 2013-2015</title>
<author><name sortKey="Munroe, Julia G" sort="Munroe, Julia G" uniqKey="Munroe J" first="Julia G." last="Munroe">Julia G. Munroe</name>
</author>
<author><name sortKey="Straver, Rachael" sort="Straver, Rachael" uniqKey="Straver R" first="Rachael" last="Straver">Rachael Straver</name>
</author>
<author><name sortKey="Rubino, Heather" sort="Rubino, Heather" uniqKey="Rubino H" first="Heather" last="Rubino">Heather Rubino</name>
</author>
<author><name sortKey="Pritchard, Scott" sort="Pritchard, Scott" uniqKey="Pritchard S" first="Scott" last="Pritchard">Scott Pritchard</name>
</author>
<author><name sortKey="Atrubin, David" sort="Atrubin, David" uniqKey="Atrubin D" first="David" last="Atrubin">David Atrubin</name>
</author>
<author><name sortKey="Hamilton, Janet J" sort="Hamilton, Janet J" uniqKey="Hamilton J" first="Janet J." last="Hamilton">Janet J. Hamilton</name>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">PMC</idno>
<idno type="pmc">5462267</idno>
<idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5462267</idno>
<idno type="RBID">PMC:5462267</idno>
<idno type="doi">10.5210/ojphi.v9i1.7696</idno>
<idno type="pmid">NONE</idno>
<date when="2017">2017</date>
<idno type="wicri:Area/Pmc/Corpus">000626</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000626</idno>
</publicationStmt>
<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">MERS PUI Surveillance and Restrospective Identification in
ESSENCE-FL, 2013-2015</title>
<author><name sortKey="Munroe, Julia G" sort="Munroe, Julia G" uniqKey="Munroe J" first="Julia G." last="Munroe">Julia G. Munroe</name>
</author>
<author><name sortKey="Straver, Rachael" sort="Straver, Rachael" uniqKey="Straver R" first="Rachael" last="Straver">Rachael Straver</name>
</author>
<author><name sortKey="Rubino, Heather" sort="Rubino, Heather" uniqKey="Rubino H" first="Heather" last="Rubino">Heather Rubino</name>
</author>
<author><name sortKey="Pritchard, Scott" sort="Pritchard, Scott" uniqKey="Pritchard S" first="Scott" last="Pritchard">Scott Pritchard</name>
</author>
<author><name sortKey="Atrubin, David" sort="Atrubin, David" uniqKey="Atrubin D" first="David" last="Atrubin">David Atrubin</name>
</author>
<author><name sortKey="Hamilton, Janet J" sort="Hamilton, Janet J" uniqKey="Hamilton J" first="Janet J." last="Hamilton">Janet J. Hamilton</name>
</author>
</analytic>
<series><title level="j">Online Journal of Public Health Informatics</title>
<idno type="eISSN">1947-2579</idno>
<imprint><date when="2017">2017</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass></textClass>
</profileDesc>
</teiHeader>
</TEI>
<pmc article-type="abstract"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Online J Public Health Inform</journal-id>
<journal-id journal-id-type="iso-abbrev">Online J Public Health Inform</journal-id>
<journal-id journal-id-type="publisher-id">OJPHI</journal-id>
<journal-title-group><journal-title>Online Journal of Public Health Informatics</journal-title>
</journal-title-group>
<issn pub-type="epub">1947-2579</issn>
<publisher><publisher-name>University of Illinois at Chicago Library</publisher-name>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmc">5462267</article-id>
<article-id pub-id-type="publisher-id">ojphi-09-e113</article-id>
<article-id pub-id-type="doi">10.5210/ojphi.v9i1.7696</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>ISDS 2016 Conference Abstracts</subject>
</subj-group>
</article-categories>
<title-group><article-title>MERS PUI Surveillance and Restrospective Identification in
ESSENCE-FL, 2013-2015</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Munroe</surname>
<given-names>Julia G.</given-names>
</name>
<xref ref-type="corresp" rid="cor1">*</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Straver</surname>
<given-names>Rachael</given-names>
</name>
</contrib>
<contrib contrib-type="author"><name><surname>Rubino</surname>
<given-names>Heather</given-names>
</name>
</contrib>
<contrib contrib-type="author"><name><surname>Pritchard</surname>
<given-names>Scott</given-names>
</name>
</contrib>
<contrib contrib-type="author"><name><surname>Atrubin</surname>
<given-names>David</given-names>
</name>
</contrib>
<contrib contrib-type="author"><name><surname>Hamilton</surname>
<given-names>Janet J.</given-names>
</name>
</contrib>
<aff id="aff1">Florida Department of Health, Tallahassee, FL,<country>USA</country>
</aff>
</contrib-group>
<author-notes><corresp id="cor1"><label>*</label>
<bold>Julia G. Munroe</bold>
E-mail: <email xlink:href="julia.munroe@flhealth.gov">julia.munroe@flhealth.gov</email>
</corresp>
</author-notes>
<pub-date pub-type="epub"><day>01</day>
<month>5</month>
<year>2017</year>
</pub-date>
<pub-date pub-type="collection"><year>2017</year>
</pub-date>
<volume>9</volume>
<issue>1</issue>
<elocation-id>e113</elocation-id>
<permissions><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by-nc/3.0/"><license-p>ISDS Annual Conference Proceedings 2017. This is an Open Access
article distributed under the terms of the Creative Commons
Attribution-Noncommercial 3.0 Unported License, permitting all
non-commercial use, distribution, and reproduction in any medium, provided the
original work is properly cited.</license-p>
</license>
</permissions>
<kwd-group kwd-group-type="author"><title>Keywords </title>
<kwd>Surveillance</kwd>
<kwd>Syndromic</kwd>
<kwd>MERS</kwd>
<kwd>Investigation</kwd>
<kwd>ESSENCE</kwd>
</kwd-group>
</article-meta>
</front>
<body><sec><title>Objective</title>
<p>To retrospectively identify initial emergency department (ED) and urgent care center
(UCC) visits for Florida’s Middle East respiratory syndrome coronavirus
disease (MERS-CoV) patients under investigation (PUIs) in the Florida Department of
Health’s (DOH) syndromic surveillance system, the Electronic Surveillance
System for the Early Notification of Community-based Epidemics (ESSENCE-FL), using
information gathered from PUI case report forms and corresponding medical records
for the purpose of improving syndromic surveillance for MERS-CoV. The results of
this study may be further utilized in an effort to evaluate the current MERS-CoV
surveillance query.</p>
</sec>
<sec sec-type="intro"><title>Introduction</title>
<p>Human MERS-CoV was first reported in September 2012. Globally, all reported cases
have been linked through travel to or residence in the Arabian Peninsula with the
exception of cases associated with an outbreak involving multiple health care
facilities in the Republic of Korea ending in July 2015. While the majority of
MERS-CoV cases have been reported in the Arabian Peninsula, several cases have been
reported outside of the region. Most cases are believed to have been acquired in the
Middle East and then exported elsewhere, with no or rare instances of secondary
transmission. Two cases of MERS-CoV were exported to the United States and
identified in May 2014. One of these cases traveled from Saudi Arabia to
Florida.</p>
<p>DOH conducts regular surveillance for MERS-CoV through the investigation of persons
with known risk factors. PUIs have most often been identified by physicians
reporting directly to local health departments and by DOH staff regularly querying
ED and UCC chief complaint data in ESSENCE-FL. ESSENCE-FL currently captures data
from 265 EDs and UCCs statewide and has been useful in identifying cases associated
with reportable disease and emerging pathogens.</p>
</sec>
<sec sec-type="methods"><title>Methods</title>
<p>From 2013-2015 DOH identified and investigated 62 suspected cases of MERS-CoV,
including one confirmed case in May 2014. Specimens were collected from all 62
patients under investigation (PUIs) and 61 were ruled out. Of the 61 PUIs who were
ruled out, ten were part of the contact investigation initiated following the
identification of MERS-CoV in May 2014 and were not included in this analysis. DOH
utilizes a MERS-CoV PUI case report form to collect data regarding demographics,
clinical presentation, and risk factors. Retrospectively, additional documents
including medical records and discharge summaries were gathered and utilized to
evaluate PUIs identified in ESSENCE-FL.</p>
<p>Name of the facility where PUIs presented, date and time of visit, age at event, and
sex were identified using PUI case report forms and corresponding medical records
and discharge summaries. Visit details for each of the identified facilities were
queried in ESSENCE-FL and pulled for all visits with corresponding age at event and
sex for the patient’s visit date. Additional PUI information including chief
complaint, discharge diagnosis, ZIP code, race, and ethnicity were gathered for the
purpose of matching corresponding ESSENCE-FL data fields. ESSENCE-FL visit details
were narrowed by ZIP code (or lack of ZIP code for residents of other countries) and
match details were recorded and evaluated. The fields examined were not always
complete in ESSENCE-FL. Visits were considered matches when all available data in
the fields examined were consistent with information obtained in the PUI case report
form and available medical records and discharge summaries.</p>
</sec>
<sec sec-type="results"><title>Results</title>
<p>Of the 52 PUIs included in this analysis, 39 sought treatment at facilities
participating in ESSENCE-FL at their time of visit. Comparing information obtained
from PUI documents with data provided in ESSENCE-FL, 30 ED visits were successfully
matched to PUIs, including an initial ED visit for the patient with a confirmed case
of MERS-CoV.</p>
</sec>
<sec sec-type="conclusions"><title>Conclusions</title>
<p>Following preliminary identification, all matches are to be confirmed with the
appropriate hospitals. Future work to examine the chief complaints associated with
patients’ initial ED visits identified in ESSENCE-FL will serve as a way to
validate and improve upon the query currently being used as a surveillance tool for
MERS-CoV. Detailing these methods also has value in the replication of this study
for other diseases and in the development and validation of other disease-specific
queries. Summarizing the reasons why PUIs were unable to be matched to ESSENCE-FL
visits is also useful in improving system robustness.</p>
</sec>
</body>
</pmc>
</record>
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