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PH510fa14 class one part two 9_5_14 surveillance

PH510fa14 class one part two 9_5_14 surveillance -...

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Unformatted text preview: Enumeration Origins of the modern system The number and health of the population were measures of the monarchy’s strength. • Social mathematics • ‘Numbering the people’ • Vital statistics Bills of Mortality • 1603 listed deaths by parish as a way to track plague deaths. • 1629 cause of death listed • 1836 replaced by Registrar General’s Office Diseases and Casualties Dec. 1725- Dec. 1726. Abortive Aged Ague Apoplexy Asthma Bedridden Bleeding Bloody-flux [1] Bursten [2] Cancer Canker Childbed Chrisoms [3] Cholick Consumption Convulsion Cough Cramp Diabetes Dropsy Evil [4] Falling Sickness [5] Fever Fistula Flux French Pox [6] Gout Gravel [7] Grief Grip, in the Guts Headmouldshot [8] 73 2667 6 93 144 3 5 23 2 56 15 245 3 116 3764 8708 15 1 1 1072 43 1 4666 15 11 82 32 2 18 Loosness [12] Lunatick Malignant-Fever Measles Miscarriage Mortification Pain in the Head Palsy Planet Struck [13] Plurisy Purples [14] Quinsy [15] Rash Rheumatism Rickets Rising o'th' Lights [16] Rupture St. Anthony's Fire Scald Head Scurvy Small Pox Sores and Ulcers Spleen Spotted Fever Stilborn Stone [17] Stop, in the Stom[ach] Strangury [18] Suddenly 58 55 1 256 1 216 2 34 1 53 12 4 5 40 187 72 18 5 1 2 1559 17 7 84 609 51 183 2 111 General Registrar’s Office was established to record compulsory registration of births, deaths, and marriages in England and Wales. 1837 Dr. William Farr was appointed Chief Statistician; Farr was trained in statistics in Paris at the Royal Academy of Medicine. 1830: Villerme notes that mortality varies among districts in Paris. He tried to correlate mortality with the distance of the arrondissement from the Seine River, the relationship of the streets to the prevailing winds, the arrondissement's source of water and local climatological factors such as soil type, exposure to the sun, elevation and inclination of the arrondissement. Villerme found that mortality correlated nearly perfectly with the degree of poverty in the arrondissement (estimated as the % of people exempted from tax). The findings did not spark action. Lemuel Shattuck MA legislator who introduced registration of births, marriages & deaths (after a long campaign). Shattuck • Proposed standard nomenclature for disease • Collected data by age, sex, occupation, socioeconomic level, location • Applied data to programs in immunization, school health, smoking, alcohol abuse • 1874 MA State Board of Health instituted a voluntary plan for weekly reporting of disease by physicians • 1878 Congress authorized formation of the forerunner of the Public Health Service • 1925 All states begin participating in national reporting of disease Surveillance Defined Surveillance is the cornerstone of public health practice. (Thacker, 2004) The systematic collection, consolidation, analysis and dissemination of data in public health practice. (Langmuir, 1963) The ongoing systematic collection, analysis, and interpretation of outcome-specific data for use in the planning, implementation, and evaluation of public health practice. (Thacker, 2000) Some Reportable Diseases in 2013 (over 50 total): • Polio, Smallpox, Plague • HIV+, AIDS, Gonorrhea, Hepatitis, Syphilis, Chlamydia • Diphteria, Measles, Mumps, Rubella, Pertussis • Malaria, Cholera, Yellow Fever, Typhoid Fever • Anthrax, Botulism, Legionellosis, Tularemia • Cryptosporidiosis, E. coli, Giardiasis, Trichinosis • Lyme Disease, Rabies, Tetanus, Hansen’s Disease • SARS, VRSA, novel influenza A H1N1 Does it matter? Collection Analysis / Interpretation Announcement Resources Politics Needs Investment: success and challenges Source Iraqi casualties March 2003 to... Iraq Family Health Survey 151,000 deaths. June 2006 Lancet survey June 2006 601,027 deaths out of 654,965 excess deaths. Opinion Research Business survey 1,033,000 deaths as August 2007 a result of the conflict. April 2009 Associated Press 110,600 deaths Iraq Body Count April 2010 95,888 – 104,595 civilian deaths as a result of the conflict. http://www.iraqbodycount Iraq Civilian dead • • • • • • • • • • • • Influenza surveillance ­ seven U.S. systems HIV/AIDS surveillance ­ state and federal Occupational health, injury surveillance Water­ and foodborne disease surveillance Cancer registries, ATSDR Adverse event reporting (AERS) Vaccine surveillance BRFSS, NHANES, NHIS YRBS Mental health surveillance Post­marketing drug surveillance Syndromic surveillance/biosurveillance Breadth of Surveillance Limitations • Completeness • Timeliness • Quality • Changing case definitions • Changing demographics questions • How you count • When you count • What you count (case definitions) Examples: ­ YRBS and glbt questions ­ chlamydia screening • Completeness • Timeliness • Quality • Changing case definitions • Changing demographics An epidemic of autism or changing case definitions...? • Provider-initiated • Notifiable diseases, lab-based reporting • Strengths: • Low cost • Continuous • Weaknesses: • Coverage limited to those who have access/seek care • Relies on clinical diagnoses, compliance Passive Surveillance For reportable diseases List maintained by CDC/CSTE Provider reporting mandated by state law Electronic data transmission from state to CDC Strengths: Coverage: all who seek care Well established lines of communication Regular reporting via MMWR Weaknesses: Extent of under­reporting Tip of the illness pyramid NNDSS Illness Pyramid 5 were reported nationally to the CDC 7 had positive culture results 9 submitted stool cultures 28 consulted a physician 76 became symptomatic 100 persons infected with Shigella Shigella Prep for Next week 1. Schneider, Chapters 4 & 5 On blackboard: 2. LaMorte’s modules: you do NOT need to know all of this! Just a resource! 3. Review assignment 1 ! ...
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