overview of public health surveillance
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Overview of Public Health Surveillance. Denise Koo , MD, MPH Epidemiology Program Office Centers for Disease Control and Prevention. Risk Factor Identification: What is the cause?. Surveillance: What is the problem?. Public Health Approach. Implementation: How do you do it?. - PowerPoint PPT PresentationTRANSCRIPT
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Overview of Public Health Surveillance
Denise Koo, MD, MPHEpidemiology Program Office
Centers for Disease Control and Prevention
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Public Health Approach
Problem Response
Surveillance:What is the
problem?
Risk FactorIdentification:What is the
cause?
InterventionEvaluation:
Whatworks?
Implementation:How do you
do it?
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Public Health Surveillance
Ongoing, systematic collection, analysis, and interpretation of health-related data essential to the planning, implementation, and evaluation of public health practice, closely integrated with the timely dissemination of these data to those responsible for prevention and control.
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Public Health Surveillance
Systematic, ongoing Collection Analysis Interpretation Dissemination Link to public health
practice
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Purposes of Public Health Surveillance
Assess public health status Define public health
priorities Evaluate programs Stimulate research
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Surveillance
Information for Action
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Uses of Public Health Surveillance
Estimate magnitude of the problem Determine geographic distribution of illness Portray the natural history of a disease Detect epidemics/define a problem Generate hypotheses, stimulate research Evaluate control measures Monitor changes in infectious agents Detect changes in health practices Facilitate planning
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Uses of Public Health Surveillance
Estimate magnitude of the problem Determine geographic distribution of illness Portray the natural history of a disease Detect epidemics/define a problem Generate hypotheses, stimulate research Evaluate control measures Monitor changes in infectious agents Detect changes in health practices Facilitate planning
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ShigellosisUnited States, 1968-1998
00
55
1010
1515
YearYear
1968
1968
1973
1973
1978
1978
1983
1983
1988
1988
1993
1993
1998
1998
Rep
ort
ed
Cases p
er
100,0
00
Pop
ula
tion
Rep
ort
ed
Cases p
er
100,0
00
Pop
ula
tion
Source: CDC. Summary of notifiable diseases. 1998.
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Uses of Public Health Surveillance
Estimate magnitude of the problem Determine geographic distribution of illness Portray the natural history of a disease Detect epidemics/define a problem Generate hypotheses, stimulate research Evaluate control measures Monitor changes in infectious agents Detect changes in health practices Facilitate planning
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Rate of Hepatitis A United States, 1998
< 5.0< 5.0 5.0–9.95.0–9.910.0–19.910.0–19.9 >20.0>20.0
NA
NA
NA
NYCNYC
DCDC
PRPRVIVIGUAMGUAM
AM SAMOAAM SAMOA
CNMICNMI
Source: CDC. Summary of notifiable diseases. 1998.
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Uses of Public Health Surveillance
Estimate magnitude of the problem Determine geographic distribution of illness Portray the natural history of a disease Detect epidemics/define a problem Generate hypotheses, stimulate research Evaluate control measures Monitor changes in infectious agents Detect changes in health practices Facilitate planning
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TOXIC SHOCK SYNDROME (TSS)United States, 1983-1998
TOXIC SHOCK SYNDROME (TSS)United States, 1983-1998
1983
1984
1985
1986
1987
1988 198
9
1990 199
1
1992 199
31994
19951996 199
71998
National Center for Infectious Diseases (NCID) data*
National Electronic Telecommunications System for Surveillance (NETSS) data
0
20
40
60
80
100
120
140
160
Year (Quarter)
Rep
ort
ed
Cases
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Uses of Public Health Surveillance
Estimate magnitude of the problem Determine geographic distribution of illness Portray the natural history of a disease Detect epidemics/define a problem Generate hypotheses, stimulate research Evaluate control measures Monitor changes in infectious agents Detect changes in health practices Facilitate planning
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Botulism (Foodborne) United States, 1978-1998Outbreak
caused by potato salad, NM
Outbreak caused by potato salad, NM
Outbreak caused by sautéed onions, IL
Outbreak caused by sautéed onions, ILOutbreak caused by fermented fish/sea products, AK
Outbreak caused by fermented fish/sea products, AK
Outbreak caused bybaked potatoes, TXOutbreak caused bybaked potatoes, TX
Laboratory-confirmed cases*Laboratory-confirmed cases*NETSS dataNETSS data
00
1010
2020
3030
4040
5050
6060
7070
8080
9090
100100
110110
YearYear19781978 19831983 19881988 19931993 19981998
Rep
ort
ed
Cases
Rep
ort
ed
Cases
Source: CDC. Summary of notifiable diseases. 1998.
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Uses of Public Health Surveillance
Estimate magnitude of the problem Determine geographic distribution of illness Portray the natural history of a disease Detect epidemics/define a problem Generate hypotheses, stimulate research Evaluate control measures Monitor changes in infectious agents Detect changes in health practices Facilitate planning
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YearYear
Rep
ort
ed
Cases
(Th
ou
san
ds)
Rep
ort
ed
Cases
(Th
ou
san
ds)
Vaccine licensedVaccine licensed
00
5050
100
100
150
150
200
200
250
250
300
300
350350
400
400
450
450
500
500
1963
1963
1968
1968
1973
1973
1978
1978
1983
1983
1988
1988
1993
1993
1998
1998
MEASLES — by year, United States, 1983–1998MEASLES — by year, United States, 1983–1998
00
55
1010
1515
2020
2525
3030
YearYear
19831983 19881988 19931993 19981998Rep
ort
ed
Cases
(Th
ou
san
ds)
Rep
ort
ed
Cases
(Th
ou
san
ds)
MEASLES (Rubeola)United States, 1963-1998
20
10
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Pertussis (Whooping Cough)United States, 1998
0
0
300
300
600
600
900
900
1,200
1,200
1,500
1,500
1,800
1,800
2,100
2,100
2,400
2,400
Age Group (Years)
Age Group (Years)
<1<1 1–41–4 5–95–9 10–1410–1415–1915–1920–2920–2930–3930–3940–4940–4950–5950–59>60>60
Rep
ort
ed
C
ases
Rep
ort
ed
C
ases
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Uses of Public Health Surveillance
Estimate magnitude of the problem Determine geographic distribution of illness Portray the natural history of a disease Detect epidemics/define a problem Generate hypotheses, stimulate research Evaluate control measures Monitor changes in infectious agents Detect changes in health practices Facilitate planning
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Poliomyelitis (Paralytic)
YearYear
00
55
1010
1515
2020
2525
3030
3535
4040
4545
5050
5555
6060
19681968 19731973 19781978 19831983 19881988 19931993 19981998
Rep
ort
ed
Cases
Source: CDC. Summary of notifiable diseases. 1998.
Rate
/100,0
00 P
op
ula
tion
Year
Inactivated Vaccine
Oral Vaccine
0.001
0.01
0.11
10
1001000
19511956 19611966 1971197619811986 19911996
United States, 1968-1998
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Uses of Public Health Surveillance
Estimate magnitude of the problem Determine geographic distribution of illness Portray the natural history of a disease Detect epidemics/define a problem Generate hypotheses, stimulate research Evaluate control measures Monitor changes in infectious agents Detect changes in health practices Facilitate planning
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Trends in Plasmid-Mediated Resistance to Penicillin and
TetracyclineUnited States, 1988-1997
Source: Gonococcal
Isolate Surveillance
Project (GISP)
Percent
0
2
4
6
8
10
12
1988198919901991199219931994199519961997
PPNGTRNG
PPNG & TRNG
Year
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Uses of Public Health Surveillance
Estimate magnitude of the problem Determine geographic distribution of illness Portray the natural history of a disease Detect epidemics/define a problem Generate hypotheses, stimulate research Evaluate control measures Monitor changes in infectious agents Detect changes in health practices Facilitate planning
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Breast Cancer Screening
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Uses of Public Health Surveillance
Estimate magnitude of the problem Determine geographic distribution of illness Portray the natural history of a disease Detect epidemics/define a problem Generate hypotheses, stimulate research Evaluate control measures Monitor changes in infectious agents Detect changes in health practices Facilitate planning
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Foreign-born
Year
U.S.-born
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
0
4,000
8,000
12,000
16,000
20,000
Rep
ort
ed
C
ases
Tuberculosis United States, 1986-1998
(U.S.- and foreign-born persons)
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Obesity
United States, 1987-1998
Not available
< 10 %
………….…….
10%-15%
>15%
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Source: BRFSS 1998
Physical ActivityGeorgia 1998
Less than15,000$
15,000-24,999$
Responses
25,000-34,999$
35,000-49,999$
$50,000>
NOYES
PE
R C
EN
T